As a participant in Medicaid Home and Community-Based Services (HCBS) Waiver services, there are many community-based services you may choose. The services available to you are based on which waiver you have. HCBS Waivers Available for Eligible People looks at the waivers and includes a chart of services by waiver.
The Medicaid Home and Community-Based Services (HCBS) Developmental Disabilities (DD) Waivers offer an array of services to support people in their homes. This page focuses on those services, coordination of services, and providers of services.
Eligibility
To be eligible, you must have a developmental disability, as defined in Neb. Rev. Stat. §83-1205, meet Level of Care for an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), and have a need for waiver services.
Service Coordination
When you are on a waiver, a Service Coordinator provides case management to coordinate and oversee your services.
Your Service Coordinator:
- Works with you to develop your service plan based on your needs
- Completes referrals for developmental disabilities providers and assists with visits
- Helps a person enroll as an independent provider
- Helps you access resources such as Medicaid, SSI, and SNAP
- Helps you identify and access community resources
- Holds meetings at least every six months to help you work toward life goals
- Monitors your plan to ensure it is being implemented and adequately addresses your needs
- Follows up with you to ensure your needs are being met
- Follows up with your guardian and, as requested, your family
- Adjusts your service plan when changes are needed for success
- Helps advocate for what you need from your service provider(s), family, and community
- Makes sure services promote independence, productivity, and inclusion
When you have the CDD or DDAD Waiver, your Service Coordinator is an employee of DDD. There are offices across the state, so you can work with a local office.
Developmental Disabilities Waivers
When you are on a DD waiver, the services available to you are based on which waiver you receive.
CDD Waiver services help people of all ages who have developmental disabilities. Services maximizes independence as participants live, work and socialize in their communities.
In general terms, CDD Waiver services include:
- Day services focus on finding a job and increasing skills needed to work in the community. Services include prevocational, supported employment, habilitative workshop, and habilitative community inclusion.
- There is a focus on integrated, competitive employment.
- Residential services occur in your own home or apartment, your family home, or a provider-operated location. All services help you learn independent living skills and do things in your community.
- Provider-operated locations include
- Shared Living with a family.
- Group Home with three or fewer people with disabilities.
- Centers for Developmentally Disabled (CDDs) home with four or more people with disabilities. These are licensed by Public Health.
- Respite provides relief for your usual non-paid caregiver who lives with you.
- Assistive devices and modifications.
The DD Policy Manual Chapter 8 gives CDD Waiver service definitions.
DDAD Waiver services help people ages 21 and over who have developmental disabilities. Services maximize participants' independence to work in their communities. There is a focus on competitive, integrated employment.
In general terms, DDAD Waiver services include:
- Day services focus on finding a job and increasing skills needed to work in the community. Services include prevocational, supported employment, habilitative workshop, and habilitative community inclusion.
- There is a focus on integrated, competitive employment.
- Residential services occur in your own home or apartment, your family home, or in your community. This waiver does not focus on residential services, but some options may be available to you.
- Respite provides relief for your usual non-paid caregiver who lives with you.
- Assistive devices and modifications.
The DD Policy Manual Chapter 8 gives DDAD Waiver services definitions.
The Family Support Waiver (FSW) Offers services to people under the age of 21 years old, who are eligible with a developmental disability, and live with their family. Services support the child and their family. There is a $10,000 budget per annual budget year.
The following publications provide more information:
- FSW Info Sheet – A one-page flyer listing services and eligibility requirements.
- FSW Eligibility and Priority Brochure – A trifold brochure including eligibility requirements, DD Registry information, FSW funding priorities, and a flow-chart on the funding offer process.
- FSW Services Quick Guide – Paragraph descriptions of each service available on this waiver, as well as a chart comparing to the services available on other DD Waivers.
In general terms, FSW services include:
- Residential services in your family home and community.
- Respite provides relief for your usual non-paid caregiver who lives with you.
- Assistive devices and modifications.
Services Available on the DD Waivers
The following services may be available to DD Waiver participants, depending on which waiver you receive.
Work with your Service Coordinator to see which services you qualify to receive.
Adult Day provides meaningful day activities in a safe, supervised place away from your home. You can use this service to do things in your community. You cannot use this service for a job or volunteering. Your provider helps you become more independent with health and social needs. Your provider helps you with activities of daily living, health maintenance, and supervision.
Assistive Technology includes devices, equipment, and appliances to help you do things on your own so you need less help from other people.
Behavioral In-Home Habilitation is a short-term service for when you are having a severe mental health event or behavior that keeps you from your normal day activity. This service is provided in your home. Your provider helps you with activities of daily living, health maintenance, and supervision. This is a habilitative service.
Child Day Habilitation takes place in a community provider setting. It provides teaching and staff support to meet the age-appropriate needs your child, due to a disability or special health condition. The focus is teaching and providing support to promote independence and personal growth, while encouraging community integration. This is a habilitative service.
Community Inclusion teaches self-help, appropriate behaviors, socialization, and adaptive skills. This service mostly takes place in the community. You decide where and how often you want to go places. This service increases your independence and personal choice, and interactions with people in your community. Your provider helps you with activities of daily living, health maintenance, and supervision. This is a habilitative service.
Consultative Assessment helps you stay in your current services while keeping you, and others, safe. The provider observes you in your home and where you receive day services, does a behavioral assessment, and gives your team recommendations. Behavioral interventions are developed, used, evaluated, and revised as needed. This is a habilitative service.
Day Support provides activities in a provider-controlled day location. Your provider teaches self-help, appropriate behaviors, socialization, and adaptive skills. This service is available when you do not have an employment goal and are not looking for a job. Your provider helps you with activities of daily living, health maintenance, and supervision. This is a habilitative service.
Environmental Modification Assessment is an evaluation to identify devices you need or changes that should be made to your home or vehicle. The assessment looks at your health and safety needs, how you access your community, and your independence. This service may be required before using Assistive Technology, Home Modifications, or Vehicle Modifications.
Family Caregiver Training provides training and education to your unpaid family members or caregivers who provide informal support.
Family and Peer Mentoring provides mentors who have shared experiences with families or participants to provide support, education, and guidance by sharing strategies and experiences in navigating the system and resources.
Home Modifications are changes to your home to make it easier and safer to get around and do things for yourself. Modifications should help you better access your home and need less help from other people.
Homemaker helps with general household tasks, such as cooking, laundry, errands, and cleaning. This short-term service can be used when the person who usually does household tasks is not able to help. Homemaker does not include care or supervision. This service is available to people under the age of 21, because other DHHS services can meet this need for people age 21 and older.
Independent Living is provided in your own home. Your provider teaches skills for living independently and to do things in your community. Your provider helps you with activities of daily living, health maintenance, and social and leisure skills. This is a habilitative service.
Medical In-Home Habilitation is a short-term service for when you are having a severe medical event that keeps you from your normal day activity. This service is provided in your home. Your provider helps you with activities of daily living, health maintenance, and supervision. This is a habilitative service.
PERS is an electronic device to help you contact someone in an emergency. The system is connected to your telephone and notifies a designated person or call center when you push a button.
Prevocational teaches you general job-related skills needed to get a job in the community. This service can be used for up to 12 months. Your provider helps you with activities of daily living, health maintenance, and supervision. This is a habilitative service.
Continuous Home is provided in a provider-controlled home with shift staff. Your provider teaches you skills for living independently and to do things in your community. Your provider helps you with activities of daily living, health maintenance, social and leisure skills, and supervision. This is a habilitative service.
Host Home is provided in the home of an agency provider employee. You live with the employee and share daily life with the family in the home and community. Your provider teaches you skills for living independently and to do things in your community. Your provider helps you with activities of daily living, health maintenance, social and leisure skills, and supervision. This is a habilitative service.
Shared Living is provided in the home of an agency provider contractor. You live with the contractor and share daily life with the family in the home and community. Your provider teaches you skills for living independently and to do things in your community. Your provider helps you with activities of daily living, health maintenance, social and leisure skills, and supervision. This is a habilitative service.
- Shared Living Fact Sheet - Information on using this residential habilitation service and choosing a person to live with.
- Home Study Survey - When you think you have found a place you want to live, complete this survey to ensure it meets your needs.
Respite is a short-term service you can use when you cannot care for yourself. Respite is temporary relief to the usual caregiver who lives with you. Your provider helps with activities of daily living, health maintenance, and supervision. This service has yearly limits of 240 hours on the DDAD waiver and 360 on the CDD waiver.
You can only receive Respite from one source; if you are NOT on a waiver, you may be able to receive Lifespan Respite.
Small Group Vocational Support is provided at a business or in your community. You work alone or with a team to learn work skills and behavior. The business pays your provider and your provider pays you. You may interact with employees or customers. Your provider helps you with activities of daily living, health maintenance, and supervision. This is a habilitative service.
Supported Employment – Follow-Along helps you keep your competitive job. This service may be provided with you or by communicating with your employer for you. This is a habilitative service.
Supported Employment – Individual provides a job coach for one-on-one teaching to help you keep your competitive job. This service is provided at your job. Your provider helps you with job skills and referrals for other resources. This is a habilitative service.
Supported Family Living is provided in your family home. Your provider teaches you skills for living independently and to do things in your community. Your provider helps you with activities of daily living, health maintenance, social and leisure skills, and community access. This is a habilitative service.
Therapeutic Residential Habilitation is an all-inclusive habilitative service. It is specifically for you when you have co-occurring disorders of developmental disabilities and severe mental illness. This service is provided by shift staff in a provider's residential setting and the community. This is a habilitative service.
Transitional pays the one-time expenses to help you move out of an ICF-IID, nursing home, or regional center. Transitional may include essential furniture, household supplies, security deposits, basic utility fees or deposits, or moving cost.
Transportation provides rides to and from waiver services, separate from transportation during services. Transportation should not replace other options available to you, such as rides from friends or family. Transportation cannot be used for rides to medical appointments because other DHHS services can meet this need.
Vehicle Modifications are changes to your own vehicle to make it easier for you to travel without paid support. This service may be used for maintenance or repair of previous modifications. Changes must be needed so you can travel safely.
Provider Options
You can choose the provider(s) you want to work with. There are different types of providers available for Medicaid HCBS waiver services.
- DD agency provider - a company which is an enrolled Medicaid provider and certified by DHHS to provide developmental disabilities services. The agency provider is responsible for hiring or contracting, and supervising employees and contractors who work with you, and other administrative functions. The DD Agency Providers Directory includes alphabetical and geographical listings, what services each provider offers, and contact information.
- DD independent provider - a person enrolled as a Medicaid provider and employed by you. You are responsible for hiring and supervising your independent provider. Once you choose a person, the state has an approval process to ensure requirements are met. Your Service Coordinator will help with the process.
Developmental Disability Court-Ordered Custody Act (DDCOCA)
Information in this training is aimed at explaining the Nebraska Developmental Disability Court-Ordered Custody Act (DDCOCA) process for participants and families.