The Problem:
The Nebraska Department of Health and Human Services (DHHS) proposed major changes to the Aged and Disabled (A&D) Waiver that would reduce reimbursable caregiver hours and set strict cost caps tied to nursing home rates. These changes threatened the ability of people with disabilities and older adults to remain safely in their homes. The proposal also conflicted with person-centered planning by limiting flexibility to meet individual needs. DHHS opened a public comment period from December 5, 2025, to January 5, 2026.
Action:
The Nebraska Council on Developmental Disabilities (NCDD) mobilized advocacy networks and engaged families, self-advocates, and disability partners to respond. NCDD submitted formal public comments, worked closely with DD Network partners, and used its representation on state committees to elevate concerns. The Council also helped raise awareness of the proposed changes and encouraged families and advocates to share their experiences and support person-centered planning.
Results:
Strong advocacy and public feedback led to important changes. On January 27, 2026, DHHS announced it would remove the proposed 40-hour cap on live-in caregivers and the 70-hour combined limit, preserving greater flexibility for person-centered planning. The revised waiver also includes an exception process for cost caps, helping ensure people with higher support needs can remain safely in their homes. The updated A&D waiver is open for a second public review period from February 2 through March 4, 2026, and NCDD plans to submit additional comments.
Unique Role of the Council:
NCDD’s strong relationships with families, advocacy groups, and state committees allowed the Council to quickly mobilize stakeholders and ensure lived experiences directly informed policy decisions.