Introduction

Welcome and congratulations! You are now a provider of Medicaid Waiver Assisted Living for the Home and Community-Based Services Medicaid Waiver administered by the Nebraska Department of Health and Human Services. Thank you for joining our team!

We've designed this handbook to help you with your job. Remember, however, this is not a substitute for the Service Provider Agreement signed by you and a Nebraska Department of Health & Human Services staff person. You may want to review the Service Provider Agreement/DSS-9 (Appendix A ) paying special attention to the “Terms of Agreement” and “General Provider Standards.”

As a new partner with DHHS, we want to make sure you know and understand some of our often-used terms: “DHHS” refers to the Nebraska Department of Health and Human Services. DHHS's mission is to create and sustain a unified, accessible, caring and competent health and human services system for each Nebraskan. DHHS staff and contractors are charged to work with clients, providers and communities to make sure quality services are delivered to aged persons and adults and children with disabilities.

The Home and Community-Based Services Medicaid Waiver for Aged Persons and Adults with Disabilities, sometimes referred to as the Aged and Disabled (A & D) Medicaid Waiver, offers Medicaid-eligible individuals the chance to receive necessary supportive services in the least restrictive and most homelike setting.

You are an important part of the A & D Medicaid Waiver program. You and other service providers enable residents to maintain independence in their own homes —their units in your facility.

Along with your Waiver clients, you'll work with Services Coordinators, Resource Developers and Local DHHS Office Medicaid Eligibility Workers. Services Coordinators help residents determine their needs and available resources. Resource Developers will work with you, the provider, to ensure that standards are met and to eliminate gaps and barriers to service delivery. Local DHHS Office Medicaid Eligibility Workers determine eligibility and keep everyone informed of changes regarding residents' eligibility and financial matters such as “spenddown” or Paid from Other Sources (POS) amounts.

Services Coordinators (sometimes referred to as Case Managers) and Resource Developers may be employees of the Nebraska Department of Health and Human Services. On the other hand, either or both may be employed by an agency, which contracts with DHHS to provide Services Coordination and/or Resource Development. Therefore, in addition to DHHS clients and staff, you may be working with one or more staff of a contractor such as one of the three Independent Living Centers or the eight Area Agencies on Aging located throughout the State.

Also, in order to improve the readability of this Handbook, we've taken some shortcuts. Client/residents are usually referred to simply as residents but may also be called clients. In any case, there is no real difference. For simplicity sake, we have also abbreviated Medicaid Waiver Assisted Living Services by simply saying Waiver Services.