03/01/2026
Sharing from a concerned family member—
PLEASE, HELP OUR SPECIAL NEEDS ADULTS AND CALL OR SEND AN E-MAIL BY MARCH 4
To control the budget deficit, our Governor decided to cover 30% of the loss by taking it from the care of our special needs adults, A new assessment was designed by DHHS for the Governor to reclassify our special needs adults and take away support. They have changed adults that for decades are severe cognitively with medical assessments, psych evals, behaviorists, trained educationalists documentation with an assessment given in less than an hour and refusing to include decades of medical professional evaluations and abilities of the client. The stories coming from parents are heart-wrenching. What a surprise it was for us to see they marked answers that Seth could prepare himself a meal, take his own meds, take care of all personal needs, safety, and not see any of the answers we gave recorded. Appeals are done in house and not one appeal, regardless of documentation has been overturned. Please take time to call the committee members in the Unicameral. It is inhumane and unethical.
Our guiding light has always been that "All God's Children Got a Place in the Choir." Nebraska elected leaders are making sure that does not happen.
The Arc of Nebraska
LEGISLATIVE UPDATES
IDD Evaluation Process: InterRAI Assessment
LB 958 and the pending amendment 1992 is important in helping to improve the evaluation process used to determine level of service for individuals with IDD.
"LB 958 - Provide a requirement for the Department of Health and Human Services relating to 1915(c) waivers and define nursing facility level of care under the Medical Assistance Act"
Nebraska Legislature - Legislative Document
Amendments would be a significant improvement in the appeal process & the public hearing for LB958 is happening NOW. Public comment for record had to be in by 8am, but ongoing comments can still be submitted.
Call senators on the HHS Committee in support of this bill and the amendment or send in a quick written notice simply supporting the bill and the amendment.
Nebraska Legislature
Read more about the specific amendments below...
MENDMENT TO LB 958
Strike the original sections and insert the following new sections:
Section 1.
(1) For purposes of this section and sections 2 through 4 of this act:
(a) Department means the Department of Health and Human Services;
(b) Clinical interviewing means a type of directed conversation applied in a variety of contexts, including assessment and treatment planning for persons applying for or receiving services under the medical assistance program or a home and community-based services waiver authorized under section 1915(c) of the federal Social Security Act, as amended. Clinical interviewing may include the use of standard assessment materials but allows the interviewer, based on training and patient responses, to determine which questions to ask, clarify ambiguities, and adapt questions to the patient's comprehension in order to enhance understanding;
(c) Assessment tool means any standardized instrument, including the InteRAI assessment system or successor tools, used by the department to evaluate functional eligibility, service needs, or service tier assignments for medical assistance or home and community-based services waiver participants; and
(d) Waiver participant means any individual applying for or receiving services under a home and community-based services waiver authorized under section 1915(c) of the federal Social Security Act, as amended.
Sec. 2.
(1) The department shall ensure that all employees and contractors who administer or utilize assessment tools for waiver participants receive training in clinical interviewing techniques.
(2) Such training shall include, but not be limited to:
(a) Proper administration of assessment tools;
(b) Techniques for adapting questions to the comprehension and communication needs of the individual being assessed;
(c) Methods for clarifying ambiguous or incomplete responses; and
(d) Procedures to ensure accurate and complete assessment results.
Sec. 3.
(1) The department shall communicate eligibility determinations, service tier assignments, and service hour determinations to the waiver participant, parent, guardian, or caregiver, as applicable, in a timely, clear, and specific manner.
(2) Such communication shall include:
(a) A complete explanation of the assigned service tier or eligibility determination;
(b) A clear and precise explanation of the assessment tool results;
(c) A description of the scoring methodology and metrics used in the assessment tool; and
(d) Information regarding the right to appeal the determination.
(3) If a determination results in a reduction of a waiver participant's service tier, authorized service hours, or service provision, the department shall require an immediate supervisory review of the assessment and determination prior to final implementation of the reduction.
(4) If an appeal is requested, the waiver participant, parent, or guardian shall have the right to obtain an independent evaluation of the assessment and determination. The cost of such independent evaluation shall be paid by the state and the evaluation shall be included as evidence in the appeal hearing.
Sec. 4.
(1) On or before August 1, 2026, and on or before August 1, 2027, the department shall submit a report to the Legislative Oversight Committee of the Nebraska Legislature, the Health and Human Services Committee of the Nebraska Legislature, and the Office of Public Counsel regarding the implementation and use of assessment tools for waiver participants.
(2) The report shall include, but not be limited to:
(a) The metrics used in the assessment tools;
(b) An explanation of any algorithms, case-mix methodologies, or scoring matrices used to determine eligibility or service tiers;
(c) The number and percentage of waiver participants whose service tiers remained the same, increased, or decreased, and the reasons for such changes;
(d) Aggregate assessment results compared to previous years' assessments and service tier determinations;
(e) Any identified disparities, trends, or implementation challenges; and
(f) Any other information necessary to evaluate the effectiveness, accuracy, and fairness of the assessment tools.
(3) The report shall also include information on the department's compliance with federal home and community-based services access regulations adopted in 2024 and effective in 2025, including requirements related to grievance procedures, critical incident reporting, and appeal processes for waiver participants.
(4) The report shall include information regarding how medicaid managed care contractors are implementing grievance, critical incident, and appeal procedures for waiver participants.
Sec. 5.
Since an emergency exists, this act takes effect when passed and approved according to law.
Specifically:
(4) If an appeal is requested, the waiver participant, parent, or guardian shall have the right to obtain an independent evaluation of the assessment and determination. The cost of such independent evaluation shall be paid by the state and the evaluation shall be included as evidence in the appeal hearing.
Public Comment Reminder:
The DHHS extension for public comment period runs until March 4th for the A&D and TBI Waiver amendments.
To learn more about the modified service cap and how to submit comments, click the link below to be redirected to the DHHS website.
Public Comment
Second Public Comment Period - AD and TBI Waivers
"Pursuant to 42 C.F.R. §441.304(f), the Nebraska Department of Health and Human Services (DHHS) is required to give public notice related to the state's plan to renew the 1915(c) Medicaid Home and Community Based Services (HCBS) Aged and Adult and Children with Disabilities (NE.0187) waiver and amend the Traumatic Brain Injury Waiver (NE.40199).
The 30-day public comment period is from February 2 through March 4, 2026.
Upon approval by the Centers for Medicare and Medicaid Services (CMS), these waiver amendments would go into effect July 1, 2026."
