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Division of Developmental Disabilities
Developmental Disability Services in Nebraska – Now & In the Future
For adults and children with intellectual and related
developmental disabilities
Eligibility for DD Services
DD Services are voluntary – they are not an entitlement like educational services
Anyone can request eligibility determination through their local DD office
Follows statutory definition of developmental disability in accordance with the Developmental Disabilities Services Act (DDSA) § 83-1201 to § 83-1226
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Eligibility (continued)
§ 83-1205. Developmental disability, defined.Developmental disability shall mean:
1. Mental retardation; or2. A severe, chronic disability other than mental
retardation or mental illness which:a. Is attributable to a mental or physical
impairment other than a mental or physical impairment caused solely by mental illness;
b. Is manifested before the age of twenty-two years;
c. Is likely to continue indefinitely; and
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Eligibility (continued)
d. Results in:i. In the case of a person under three years
of age, at least one developmental delay; or
ii. In the case of a person three years of age or older, a substantial limitation in three or more of the following areas of major life activity, as appropriate for the person's age:
(A) Self-care; (B) Receptive and expressive language development and use; (C) Learning; (D) Mobility; (E) Self-direction; (F) Capacity for independent living; and (G) Economic self-sufficiency. 4
Eligibility (continued)
Once eligibility is determined, a date of need is requested
Individuals are put on the registry (aka the waiting list) until funding is available or they meet the criteria to become a ‘priority’ for emergency funding
If the individual is over age of 21 and has graduated from a Nebraska high school on or before September 6, 1993, ‘day’ services are automatically funded according to § 83-1216
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Home and Community Based Services (HCBS) Waivers
1915 (c) Waivers are DDD’s policy documents, they define the services which allow Nebraska to collect federal matching dollars
A HCBS Waiver is a waiver from institutional care. To be eligible to be on a Waiver, an individual has to meet ICF/MR level of care requirements
ICF/MR level of care and DD eligibility are NOT the same, so some individuals may have state only funded services
Regardless of funding source, all DD services are the same
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DDD Currently Manages Five Waivers
Adult Day (DDAD) Assisted Day – prevocational workshops and some
workstations Supported Day Supported Employment
Adult Residential (DDAR) Assisted residential Supported residential
Adult Comprehensive (DDAC) Community Supports Program (CSP) For Children and their Families
Assisted = All the timeSupported = Some of the time
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Adult Day, Residential & Comprehensive
Offers a combination of specialized services Residential habilitation services
Traditional group homes or extended family homes (continuous support), intermittent in-home support.
Day habilitation services Vocational planning, integrated community
employment, workstations, prevocational workshops.
Respite for families Team behavioral consultation
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Community Supports Program
Offers non-specialized supports provided by independent providers, people hired by the individual and their family – job coaches, companions, and housekeepers that are your neighbors, college students, friends, etc. Community living and day supports PERS Respite for families Assistive technology and supports Home modifications Vehicle modifications
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Community Living and Day Supports Supports to access the community Supports to maintain or obtain employment—not in
specialized provider-operated settings Supports to access services and opportunities in community Supports to assist the individual to develop self-advocacy
skills Supports to assist the individual in identifying and sustaining
a personal support network of family, friends, and associates Household activities necessary to maintain person’s home
living environment on a day to day basis Home maintenance activities (personal living space) Assistance with hygiene, bathing, eating, dressing, grooming,
toileting, menstrual care, transferring, or basic first aid
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DDD’s Focus on Employment
In April 2010, DDD got approval from CMS to amend current adult waivers to redefine supported day and supported employment services.
New services included: Vocational Planning Integrated Community Employment (ICE)
DDD’s Focus on Employment (continued)
Focus on community integration, activities and job experiences in the community
Provides graduates with more options to live and work in their community
Funds more job training activities Allows for in home job searching activities Allows for home-based businesses
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A Sneak Peak…
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The adult day, residential and comprehensive waivers expire on 12/31/2010
Renewals were submitted to CMS in September 2010
Our current five waivers will become three waivers upon approval of the renewals
Individual Budgets with a menu of services Individuals will have more flexibility and options Will be implemented January 1, 2011
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Individualized Budget Amounts
Separately authorized monthly allocated amounts for day and residential services will be converted into one annual amount for participants to choose the services that meet their goals and preferences
Individuals can budget their year and flex the amount they spend from month to month
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A Menu of Services
The 4 adult waivers will become two by: Adding community support (non-specialized)
services to all adult waivers, eliminating annual cap on CSP services as well as the cap on rate for services
Transitioning CSP participants to the comprehensive waiver and residential waiver participants to the comprehensive waiver
Terminating CSP and DDAR waivers
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A Menu of Services (continued)
Adding more specialized services to the two adult waivers Retirement services Medical risk services Behavioral risk services
Going from four service definitions to nineteen – most already exist but were grouped together in either assisted or supported services
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Questions?
Tricia Mason, AdministratorCommunity-Based Services
Division of Developmental DisabilitiesDepartment of Health and Human Services
