Pillen, DHHS alter developmental disabilities program proposal following public comment period

A waiver program for people with developmental disabilities will be changing following public outcry earlier this month, according to the Nebraska Department of Health and Human Services and Gov. Jim Pillen.

The department had proposed to cap live-in caregiver services at 40 billable hours per week for those on the Aged and Disabled Waiver. That limit, and an additional 30-hour limit on other caregiver services, will be dropped under a new proposal, DHHS said in a news release Tuesday.

In the announcement, Gov. Pillen said, “I am truly appreciative of the Nebraskans who reached out to my office and participated in the public feedback process,” he said. “Based on my conversations with dedicated family members and AD Waiver recipients, I directed DHHS to take a second look at the proposal and make necessary changes to ensure Nebraska families continue receiving the support they need.”

The process of updating the AD Waiver provisions is a part of a routine five-year examination, Tony Green with DHHS told Nebraska Public Media News in mid-January. The department had been getting concerns from people saying limiting family caregiving could cost the state by directing people to understaffed agencies.

“We have received a significant number of comments that have indicated if we operationalize it as written, it would cost the state additional money,” Green said in mid-January, “and we are absolutely evaluating that and appreciate that feedback.”

Also included in the updated proposal, DHHS is changing the annual cost limit per waiver recipient to 150% of the average spending at nursing facilities. It was previously 175%. The new proposal drops the limit from nearly $162,000 to just under $139,000, but an “exception process will be available when services provided by out-of-home caregivers are necessary to protect the participant’s immediate health and safety,” the department said Tuesday.

Since 2016, the AD Waiver’s cost increased by more than 300%, Green said. In 2024, Pillen directed the department of health to eliminate an eight-year waiting list for developmental disability waiver programs. In June, the governor announced the end of the wait list, but DHHS data showed more than 75% of people accepting a waiver offer at the time were not accessing services.

Green, the director for the Division on Developmental Disabilities, said in Tuesday’s press release, “we believe these revisions will allow us to continue providing high-quality care while responsibly managing costs.”

A second public comment period will run from Feb. 2-March 4.