Nebraska families will be able to apply for spending cap exceptions under new DHHS rule

More changes are in store for Nebraska’s Aged and Disabled waiver, a program for people with developmental disabilities. The state’s Department of Health and Human Services said a previous draft of the rules capped spending at just shy of $140,000 per person each year. That’s a 150% calculation of the average cost of living in a nursing home.

Now, families will be able to apply for an exception to that rule. People using in-home and out-of-home care will qualify.

“These changes reflect the state’s commitment to balancing access to supports and the ability to offer a sustainable waiver program,” Tony Green, director of the division of developmental disabilities, said in a news release Wednesday.

This marks one of the many changes to the state’s developmental disability services in the past couple of years. Gov. Jim Pillen has taken up the issue as one of his main initiatives, due to a previously long, eight-year waiting list for services. Those proposals have drawn mixed reviews with some thankful to receive anything, while some advocates and families sounded the alarm that people aren’t getting what they applied for.

Craig Casados with the Nebraska Association of Service Providers said he hopes the changes will become more clear as the program rolls out. As with many state programs for people with intellectual or developmental disabilities, it can be hard to get clear information on how the program works, he said.

“I would hope that with the cap and with [the] exception, there is going to be a negotiating point to what someone is asking for,” Casados said, “if they need some more money, if they need some more of this or that.”

Under the updated waiver, participants using both in-home and out-of-home caregivers are eligible to request a threshold exemption, DHHS said.

Some people have seen cuts to their benefits recently, he said, adding that his organization wants to eliminate waste, fraud and abuse to the same level as DHHS.

“[Families are] asking for something that will help keep their son, their daughter, their child, whoever, their brother, sister alive and being able to be in the community,” Casados said.

DHHS said its developmental disabilities clinical team will review all requests for exceptions to the spending cap.

This is the final draft of the application that gets sent to the federal government’s Centers for Medicare and Medicaid Services. DHHS said it’s unclear how long that process will take.

The department of health won’t hear public comment on this particular change. A spokesperson said the new rule isn’t significant enough to warrant that. DHHS held two public comment periods on different rounds of AD waiver changes.

In total, the department will hire more than 80 service coordinators and 10 supervisors to cover additional caseloads and will monitor caseloads to ensure care needs are met. Hiring is ongoing, the department said.