Nebraska Disability Services: Waivers, Jobs, and Advocacy

Nebraska disability services run through several state agencies and cover Medicaid home and community-based waivers, cash assistance for people who don’t qualify for Medicaid, vocational rehabilitation for job seekers, independent living support, legal advocacy, and residential care. Which door you walk through depends on your age, your diagnosis, your income, and what you need help doing.

Medicaid Waivers for Developmental Disabilities

The Division of Developmental Disabilities at the Department of Health and Human Services runs three Medicaid waivers that pay for support in your home and community instead of in an institution.¹

The Family Support Waiver covers people under 21 who live with their families, with an annual budget of $10,000.
The Developmental Disabilities Adult Day Waiver covers adults 21 and older and focuses on independence and competitive integrated employment.
The Comprehensive Developmental Disabilities Waiver covers all ages and funds a wider range of residential, employment, and community supports, with funding levels set through an objective assessment.

Who Qualifies

To get a DD waiver, you need a developmental disability as defined by Nebraska Revised Statutes §83-1205. That means a diagnosis made before age 22 by a licensed psychologist or physician, with substantial limitations in conceptual, social, and practical skills. You must also have Nebraska Medicaid, meet the level of care typically provided in an Intermediate Care Facility for Individuals with Intellectual Disabilities, and show you need waiver services.²

How to Apply

You can apply online through the iServe Nebraska portal, or mail or email a DD-10 form. Once DHHS has your complete application and documents, you’ll usually get a decision within 90 days. If you look eligible, the state sets up an in-person assessment using the interRAI tool to figure out your funding level. Eligibility is reviewed again at ages 10 and 18.²

What the Waivers Pay For

Services vary by waiver and personal need. Residential supports include host homes, shared living, and independent living. Employment services include benefits counseling, employment exploration, and supported employment. Other covered supports include assistive technology, respite care, home and vehicle modifications, personal care, remote supports, and transportation.¹

Once you’re enrolled, a DHHS service coordinator builds a person-centered plan with you, helps find providers, and monitors services. You can choose agency providers certified by DHHS or hire independent providers directly.¹

One real-world barrier: there aren’t always providers available. In 2024, 37% of provider agencies reported turning away new referrals because they didn’t have staff, down from 55% the year before.³ Being approved and being served aren’t the same thing.

Aged and Disabled Waiver and Traumatic Brain Injury Waiver

If your situation doesn’t fit the DD definition, Nebraska also runs an Aged and Disabled (AD) Waiver and a Traumatic Brain Injury (TBI) Waiver. The AD Waiver covers adult day health, chore services, companion services, home-delivered meals, personal care, home modifications, and respite care for older Nebraskans and people with non-developmental disabilities. The TBI Waiver adds community connections, caregiver training, and supported employment on top of several shared services.⁴

The AD Waiver is in transition. DHHS proposed changes before the waiver’s July 31, 2026, expiration, and after public opposition, Governor Jim Pillen directed DHHS to drop proposed caps on caregiver hours. The revised plan keeps the existing 112-hour weekly limit but adds a cost review: cases exceeding 150% of the average annual nursing home cost (about $138,657) trigger an administrative review, with reimbursement capped at 175% (about $161,767) subject to clinical review.⁵ The final draft went to the federal Centers for Medicare and Medicaid Services for approval; as of April 2026, DHHS said it was unclear how long the federal review would take.⁶

Legislative Bill 958, signed into law April 16, 2026, now requires DHHS to work with the Legislature before requesting Medicaid waivers that introduce individual cost limits, cut service hours, or narrow eligibility.⁷

If You Were on the DD Waitlist

For years, Nebraska maintained a waitlist for DD services that at one point held about 4,500 names, with projected waits of up to eight years.⁸ In June 2025, the governor announced the waitlist had been eliminated after more than 3,000 families received offer letters over 15 months.⁹

The system replacing it is a continuum of care rather than a single waiver pathway. Many people are now offered targeted services right away: respite care, the $10,000 Family Support Waiver, employment services, and case management. The Comprehensive DD Waiver, which pays for residential and broader supports, is largely reserved for adults with the highest needs.⁸ Edison McDonald of The Arc of Nebraska said the shift reduces guaranteed access to comprehensive residential services for many families.¹⁰

Of about 3,100 families offered waivers as of early 2025, roughly 45% had accepted, 27% had declined, and the rest were still deciding.¹⁰

Help If You Don’t Qualify for Medicaid

The Disabled Persons and Family Support (DPFS) program is Nebraska’s safety net for people who have a severe, chronic disability diagnosed by a licensed medical professional but who are not Medicaid-eligible. It covers all ages.¹¹¹²

Funding is capped at $400 per month, or $4,800 per year, and can go toward architectural home modifications, personal care assistance, adaptive equipment, vehicle modifications, housekeeping, medication management, medical mileage, and disability-related counseling.¹¹ You apply with a self-assessment application and a disability report form, both available in English and Spanish. Reach the program at (402) 471-9188 or DHHS.DPFS@nebraska.gov.

Help Getting or Keeping a Job

Nebraska Vocational Rehabilitation

Nebraska Vocational Rehabilitation, part of the Nebraska Department of Education, helps people with physical, mental, emotional, or learning impairments prepare for, find, and keep work. You qualify if you have a diagnosed impairment that significantly impedes employment and VR services would help you reach a successful job outcome. Nebraska VR serves every disability group except people who are blind or visually impaired, who go through a separate agency.¹³

As of July 2024, Nebraska VR ended its “Order of Selection,” so it is no longer prioritizing cases by disability severity and is accepting all eligible applicants.¹⁴ Offices operate in Columbus, Fremont, Grand Island, Hastings, Kearney, Lincoln, Norfolk, North Platte, Omaha, and Scottsbluff. The general number is (877) 637-3422.

Nebraska Commission for the Blind and Visually Impaired

If you are blind or have a significant visual impairment, the Nebraska Commission for the Blind and Visually Impaired is your VR agency. NCBVI covers all 93 counties from offices in Lincoln, Omaha, Norfolk, North Platte, Kearney, and Scottsbluff.¹⁵

Its programs include the Nebraska Center for the Blind, a residential training facility in Lincoln that uses a Structured Discovery approach to teach orientation and mobility, Braille, access technology, and home management. The commission also runs transition programs for youth ages 14 to 24, independent living services for adults, and the Nebraska Business Enterprises program for people managing vending and food service operations.¹⁶

Independent Living Centers and the Client Assistance Program

Four Centers for Independent Living cover the state. Independence Rising runs seven locations across western and central Nebraska. The League of Human Dignity operates the Lincoln Center for Independent Living, serving south-central and southeastern counties; the Norfolk Center for Independent Living, serving northern and northeastern counties; and the Omaha Center for Independent Living, serving Douglas and Sarpy counties.¹⁷

If you run into a problem with Nebraska VR, NCBVI, or a Center for Independent Living, the Nebraska Client Assistance Program (CAP) is a free, confidential option. CAP provides short-term advocacy, mediates disputes, and runs a statewide Hotline for Disability Services with information and referrals. Call (800) 742-7594, Monday through Friday.¹⁸

Legal Advocacy Through Disability Rights Nebraska

Disability Rights Nebraska is the state’s federally designated Protection and Advocacy organization for people with intellectual, developmental, physical, and mental health disabilities. It provides legal representation, information and referrals, and training.¹⁹

DRN has pushed hard on guardianship problems. Its 2025 report, Guarding from the Guardians, documented for-profit guardians charging up to $500 in client funds without accounting, carrying caseloads well above the state limit of 20, and failing to visit clients. One guardian managing more than 30 clients across 16 counties was arrested and charged with stealing more than $20,000 from a vulnerable adult in York County. Over 10,000 Nebraskans are under full guardianship, according to the organization.²⁰ Nebraska has not enacted supported decision-making legislation as a formal alternative to guardianship; a 2024 bill on the subject, L.B. 1168, was indefinitely postponed.²¹

Separately, the U.S. Department of Justice issued a letter of findings in May 2024 concluding that Nebraska unnecessarily segregates people with serious mental illness in violation of the Americans with Disabilities Act. The DOJ found that the state over-relies on assisted living facilities and segregated day programs and severely limits access to community services like permanent supportive housing and supported employment. About 5,000 Nebraskans with serious mental illness live in facilities, with roughly 1,000 in nineteen assisted living facilities that mainly serve this population.²²²³ As of mid-2026, no formal settlement has been publicly reported. The state’s response is its 2025–2032 Olmstead Plan, submitted to the Legislature on July 29, 2025, which sets seven goals across community-based services, housing, employment, education, and transportation.²⁴

Social Security Disability Decisions

Social Security disability claims filed in Nebraska are evaluated medically by Disability Determination Services (DDS), a division of the Nebraska Department of Education funded by the Social Security Administration. You file your claim at a local SSA field office, which verifies your age, work history, and Social Security coverage. The office then forwards the case to DDS, which gathers medical records from your providers and, if needed, arranges a consultative examination. If you’re found disabled, the case goes back to the SSA field office for benefit calculation. Denials can be appealed through DDS or before an administrative law judge.²⁵

Residential Care at Beatrice State Developmental Center

The Beatrice State Developmental Center is Nebraska’s only remaining state-operated residential facility for people with intellectual and developmental disabilities. It sits on 188 acres in Beatrice and houses about 70 adults across 10 cottages. It operates as a federally certified Intermediate Care Facility (ICF-IID).²⁶

Residents can take part in on-campus vocational opportunities, community-based employment, and recreation. Since May 2017, BSDC has also run a crisis stabilization unit providing temporary stays of 30 to 180 days for people transitioning between community services, psychiatric hospitals, or court-ordered care.²⁶

Reporting Abuse or Neglect

If you suspect abuse or neglect of a person with a developmental disability, DHHS runs a statewide hotline at (800) 652-1999.²⁷

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Nebraska DHHS. DD Service Array
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Nebraska DHHS. DD Eligibility
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Nebraska DHHS. State of the Workforce in IDD At-a-Glance
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Nebraska DHHS. DD Resources
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Nebraska Examiner. DHHS Won’t Seek to Cap Medicaid Waiver Caregiver Hours
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Nebraska Public Media. Nebraska Families Will Be Able to Apply for Spending Cap Exceptions Under New DHHS Rule
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Nebraska Examiner. End Is Near, Pillen Says, for Persistent Wait List
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Office of the Governor. Gov. Pillen Celebrates Elimination of Developmental Disabilities Waitlist
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Nebraska Public Media. Developmental Disability Waitlist Ends; Many Families Still Not Accepting Offers
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Nebraska DHHS. Disabled Persons and Family Support
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NCBVI. Nebraska Commission for the Blind and Visually Impaired
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ILRU. CIL Directory – Nebraska
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Nebraska Client Assistance Program. Client Assistance Program
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Disability Rights Nebraska. Disability Rights Nebraska
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Disability Rights Nebraska. Disability Rights Nebraska Calls for Reform Following Another Guardianship Scandal
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Supported Decision-Making. Supported Decision-Making in Nebraska
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U.S. Department of Justice. State of Nebraska
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Nebraska DHHS. DOJ Letter of Finding
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Nebraska DHHS. Olmstead Plan
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Nebraska Department of Education. Disability Determination Services
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Nebraska DHHS. Beatrice State Developmental Center
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Nebraska DHHS. Division of Developmental Disabilities