Best Practices in Medicaid - Nebraska

The Center for Health Transformation is inviting leaders from all 50 states to share their transforming solutions for the Medicaid program. In order that key decision-makers and industry leaders from around the country may learn from others’ successes, it is our intention to provide this interactive resource for showcasing the most innovative practices in the country. Please note that the following contributions have not been edited by CHT staff and will remain open indefinitely to future updates.

Consumer-directed care demonstrations(include number of beneficiaries served now and in any expansion plans)

Personal Assistance Services:

Nebraska's Personal Assistance Services (PAS) is a consumer-directed program where consumers manage their own care through agency and individual providers whom they hire to provide them assistance with their activities of daily living, such as bathing or dressing. Individuals of any age can qualify for PAS if they are Medicaid eligible; living in a home, not an institution; have a chronic medical condition or a disability; and have an assessed need for the service in order to live in the community. More information is available at www.dhhs.ne.gov/HCS/Services/PAS.htm.

Developmental Disabilities Community Supports Waiver:

Nebraska is one of 31 states selected by the Centers for Medicare and Medicaid Services to host a new five-year demonstration project called Money Follows the Person. The project will be operated by the Nebraska Department of Health and Human Services, with the goal of helping to rebalance Medicaid’s long-term care spending, decreasing the percentage that would normally be spent on facility-based care and increasing the percentage spent on home and community-based services. Eligible participants who currently reside in nursing homes or intermediate care facilities and who wish to relocate will be assisted with their transition from the facility back to their own home or to other suitable community residences, such as houses, apartments, or small group living arrangements. The least restrictive living arrangements are often the ones that individuals find to be the most desirable, so Medicaid's goal is to offer them an array of services that promote choice and independence.

Expanded Transportation Option:

The Nebraska Department of Health and Human Services expanded transportation options for agency clients by allowing reimbursement to non-commercial transportation providers at the same mileage reimbursement available to state employees. Consumers refer individuals (e.g. neighbor, church volunteer) who have their own vehicles to the Department for completion of background checks, review of driving records, and determination of proofs of insurance. Approved providers bill the Department on a per mile basis for authorized trips.

Expanding coverage through private sector initiatives

Own Your Future Long-Term Care Planning Campaign:

Launched in November 2006 by Governor Heineman and the Nebraska Health and Human Services System, Nebraska's "Own Your Future" Long-Term Care Planning Campaign encourages consumers to plan for their future long-term care needs, including initiating family conversations, living healthier, exploring community resources, considering home modification and assistive technology and considering legal and financial options. Research indicates that planning ahead allows individuals more control over their future choices. More information is available at www.dhhs.ne.gov/ags/ltcPlanning.htm.

Nebraska's Long-Term Care Savings Plan:

  The Nebraska Long-Term Care Savings Plan (LTCSP) is the first of its kind throughout the entire nation. Created by LB 965 in 2006, the plan offers a tax deduction for Nebraska residents who open a LTCSP account at participating financial institutions. To learn more, visit www.treasurer.state.ne.us/ltcsp.

Nebraska's Long-Term Care Partnership Program:

Home Again initiative, as part of the Medicaid Aged and Disabled Waiver program, assists Medicaid-eligible nursing home residents in moving to more independent living situations. This initiative provides $1,500 to community organizations or individuals who serve as Sponsors for Home Again participants and who purchase the items or services necessary for participants to transition from facility- to community-based settings. These items or services can include furniture, household supplies, security deposits, utility installation fees or deposits and moving expenses. Home Again not only supports successful transitions, but helps to strengthen the connection between the participant and their community. Created by LB 965 in 2006, Nebraska's Long-Term Care Partnership establishes a special public/private program that joins private long-term care insurance with Medicaid. A Partnership Policy is a tax qualified long-term care insurance policy that allows Nebraskans to retain a greater share of their assets should they need to apply for Medicaid after using their long-term care insurance benefits. To learn more, visit www.doi.ne.gov/ltcare/index.htm.

The most comprehensive information on Nebraska’s Medicaid covered services is available in the Nebraska regulations located at www.dhhs.ne.gov/reg/regs.htm. The state plan is not available through the state webpage.

What changes would you make to the federal Title XIX so that you could provide better services to individuals and families on Medicaid in your state?

We would increase federal funding and ensure more flexibility in the program.

What are your future plans?

Enhanced care coordination for high cost, recipients with multiple medical conditions.Preferred drug list and purchasing pool for prescribed drugs.  Study of rate-setting methodology for Long-Term Care Services.  Study of hospital payment methodology.