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Home care programs · Nebraska

Nebraska home care programs

Nebraska pays for care at home through 9 programs. Consumer-directed care is available through Personal Assistance Services (PAS). Family members can be paid caregivers in 6 of them.

Verified Oct 9, 2026Sources: official state and federal agencies

Every state
Programs
9
Consumer-directed
Yes
Family can be paid
Yes
Structured family caregiving
No
On this page
Programs

Every way Nebraska pays for care at home

Nebraska pays for care at home through 9 programs. Consumer-directed care is available through Personal Assistance Services (PAS). Family members can be paid caregivers in 6 of them.

ProgramTypeCan family be paidHow it differs
Home Health Agency and Skilled Nursing ServicesState Plan home health (471 NAC 9; 42 CFR 440.70)Home healthNot statedSkilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.
Personal Assistance Services (PAS)State Plan personal care (42 CFR 440.167; 471 NAC 15)Consumer-directedYesConsumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a Medicaid State Plan benefit, paid fee-for-service.
Comprehensive Developmental Disabilities Services Waiver1915(c) waiver NE.4154Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Developmental Disabilities Day Services Waiver for Adults (DDAD)1915(c) waiver NE.0394Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Family Support Waiver (FSW)1915(c) waiver NE.2366Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
HCBS Waiver for Aged and Adults and Children with Disabilities1915(c) waiver NE.0187Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Traumatic Brain Injury Waiver1915(c) waiver NE.40199Waiver in-homeYesWaiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.
Program of All-Inclusive Care for the Elderly (PACE)PACE (42 CFR Part 460; 471 NAC 37)PACENot statedPACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit.
Community Aging Services (State Unit on Aging funding) (CASA)state-funded (Nebraska Community Aging Services Act) with Older Americans Act fundsState-fundedNot statedState-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.
Guide

Home health vs home care vs consumer-directed care in Nebraska

What each kind of program is, who employs the caregiver and when a family member can be paid.

Home health: the medical benefit

In Nebraska, skilled home health is Home Health Agency and Skilled Nursing Services. It is a medical benefit: a doctor or other practitioner orders nursing, therapy or home health aide visits under a written plan of care, and the visits stop when the skilled need ends.

Only a licensed home health agency enrolled with Nebraska Medicaid can bill it, and the agency's own nurses, therapists and aides make the visits.

Home care: non-medical personal care through an agency

Help with bathing, dressing, eating and household tasks is "home care" or personal care. In Nebraska it is paid through the programs below rather than a separate agency personal care benefit.

Consumer-directed care: the person hires their own aide

Nebraska's consumer-directed option is Personal Assistance Services (PAS). The person receiving care, or a representative, recruits, hires, trains, schedules and supervises the aide, and can let go of one. A fiscal intermediary runs payroll, taxes and background checks, so the person never handles wages directly.

This is the route most families use to be paid: Personal Assistance Services (PAS) allows a relative to be hired as the paid aide. Which relatives qualify (adult children, parents of adults, spouses, legal guardians) and how a live-in caregiver is treated are set program by program.

Structured family caregiving: a paid live-in family caregiver

Nebraska has no structured family caregiving program. A family caregiver is paid instead through consumer-directed care (Personal Assistance Services (PAS)), by the hour, as the participant's chosen aide.

Other ways Nebraska pays for care at home

Waiver in-home services: Comprehensive Developmental Disabilities Services Waiver, Developmental Disabilities Day Services Waiver for Adults (DDAD), Family Support Waiver (FSW), HCBS Waiver for Aged and Adults and Children with Disabilities, and Traumatic Brain Injury Waiver. These pay for in-home supports for people who meet a nursing-home or similar level of care, often with more services than state plan personal care and, in some programs, a waiting list or enrollment cap.

PACE: Program of All-Inclusive Care for the Elderly (PACE). One PACE organization covers medical care, a day center and home care for people 55 and over who need nursing-home level care.

State-funded: Community Aging Services (State Unit on Aging funding) (CASA). Paid from state funds outside Medicaid, for people who do not qualify for Medicaid or are waiting for it.

Which one fits

  • Needs nursing, wound care, injections or therapy at home: home health (Home Health Agency and Skilled Nursing Services).
  • Wants to choose the aide, including a relative where allowed: Personal Assistance Services (PAS).
  • Meets nursing-home level of care and needs more than personal care: Comprehensive Developmental Disabilities Services Waiver, Developmental Disabilities Day Services Waiver for Adults (DDAD), Family Support Waiver (FSW), HCBS Waiver for Aged and Adults and Children with Disabilities, and Traumatic Brain Injury Waiver.
In the workspace

Nebraska program rules, side by side

Eligibility, the family caregiver rules (spouses, parents, live-in caregivers), employer of record, fiscal intermediary, caregiver training, provider requirements, how to enroll, published pay, EVV and waiting lists: 108 details across 9 programs.

ProgramFamily rulesEmployerEligibilityPay
See Nebraska's program rules — start free

Who can be paid, who employs the caregiver, what each program requires of agencies and caregivers, how to become a provider and what it pays, for all 9 programs.

  • Family caregiver rules
  • Provider requirements
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Program by program

Nebraska's programs

What each program is and how it differs from the others. Locked details open in the workspace.

Home Health Agency and Skilled Nursing Services

Home health

State Plan home health (471 NAC 9; 42 CFR 440.70) · Nebraska DHHS, Division of Medicaid and Long-Term Care

Skilled home health: nursing, therapy and aide visits under a plan of care from a licensed home health agency; run as a Medicaid State Plan benefit, available through fee-for-service and managed care.

Can family be paid?Not stated
How to get set up
Provider track · 8 steps
  1. Form the business and get an NPI
  2. 7 more steps: forms, fees, timelines and links
Family / participant track · 6 steps
  1. Get Nebraska Medicaid
  2. 5 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Personal Assistance Services (PAS)

Consumer-directed

State Plan personal care (42 CFR 440.167; 471 NAC 15) · Nebraska DHHS, Division of Medicaid and Long-Term Care

Consumer-directed care: the participant hires and directs their own aide, with payroll handled for them; run as a Medicaid State Plan benefit, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 9 steps
  1. Be chosen by (or line up) a PAS client
  2. 8 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Apply for Medicaid and ask for PAS
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerPay rateEVVRecent changesHow it differs, in detailSetup checklistUnlock the details →

Comprehensive Developmental Disabilities Services Waiver

Waiver in-home

1915(c) waiver NE.4154 · Nebraska DHHS, Division of Developmental Disabilities (operates); Division of Medicaid and Long-Term Care (Medicaid agency)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 12 steps
  1. Agency track: attend Prospective Provider Orientation
  2. 11 more steps: forms, fees, timelines and links
Family / participant track · 10 steps
  1. Have (or apply for) Nebraska Medicaid
  2. 9 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

Developmental Disabilities Day Services Waiver for Adults (DDAD)

Waiver in-home

1915(c) waiver NE.0394 · Nebraska DHHS, Division of Developmental Disabilities (operates); Division of Medicaid and Long-Term Care (Medicaid agency)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 12 steps
  1. Agency track: attend Prospective Provider Orientation
  2. 11 more steps: forms, fees, timelines and links
Family / participant track · 10 steps
  1. Have (or apply for) Nebraska Medicaid
  2. 9 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansHow it differs, in detailSetup checklistUnlock the details →

Family Support Waiver (FSW)

Waiver in-home

1915(c) waiver NE.2366 · Nebraska DHHS, Division of Developmental Disabilities (operates); Division of Medicaid and Long-Term Care (Medicaid agency)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 12 steps
  1. Agency track: attend Prospective Provider Orientation
  2. 11 more steps: forms, fees, timelines and links
Family / participant track · 10 steps
  1. Have (or apply for) Nebraska Medicaid
  2. 9 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordFiscal intermediaryCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

HCBS Waiver for Aged and Adults and Children with Disabilities

Waiver in-home

1915(c) waiver NE.0187 · Nebraska DHHS, Division of Developmental Disabilities (operates); Division of Medicaid and Long-Term Care (Medicaid agency)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 12 steps
  1. Get a referral from DHHS or the Area Agency on Aging
  2. 11 more steps: forms, fees, timelines and links
Family / participant track · 9 steps
  1. Have (or apply for) Nebraska Medicaid
  2. 8 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

Traumatic Brain Injury Waiver

Waiver in-home

1915(c) waiver NE.40199 · Nebraska DHHS, Division of Developmental Disabilities (operates); Division of Medicaid and Long-Term Care (Medicaid agency)

Waiver in-home services: supports at home for people who meet a nursing-home or similar level of care; run as a 1915(c) home and community-based services waiver, paid fee-for-service.

Can family be paid?Yes
How to get set up
Provider track · 13 steps
  1. Get a referral from DHHS or the Area Agency on Aging
  2. 12 more steps: forms, fees, timelines and links
Family / participant track · 8 steps
  1. Have (or apply for) Nebraska Medicaid
  2. 7 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredHours or budgetFamily caregiver rulesEmployer of recordCaregiver requirementsProvider requirementsHow to become a providerEVVWaiting list or capManaged-care plansRecent changesHow it differs, in detailSetup checklistUnlock the details →

Program of All-Inclusive Care for the Elderly (PACE)

PACE

PACE (42 CFR Part 460; 471 NAC 37) · Nebraska DHHS, Division of Medicaid and Long-Term Care

PACE: one organization covers medical care, a day center and home care for people 55 and over; run as the PACE benefit.

Can family be paid?Not stated
How to get set up
Provider track · 4 steps
  1. Send DHHS a letter of interest
  2. 3 more steps: forms, fees, timelines and links
Family / participant track · 3 steps
  1. Check you qualify
  2. 2 more steps: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredEmployer of recordProvider requirementsHow to become a providerHow it differs, in detailSetup checklistUnlock the details →

Community Aging Services (State Unit on Aging funding) (CASA)

State-funded

state-funded (Nebraska Community Aging Services Act) with Older Americans Act funds · Nebraska DHHS State Unit on Aging through Area Agencies on Aging

State-funded home care: paid outside Medicaid, usually for people who do not qualify for it; run as state funds outside Medicaid, paid fee-for-service.

Can family be paid?Not stated
How to get set up
Provider track · 2 steps
  1. Contact the regional Area Agency on Aging
  2. 1 more step: forms, fees, timelines and links
Family / participant track · 2 steps
  1. Call your Area Agency on Aging or ADRC
  2. 1 more step: forms, fees, timelines and links
Open the full checklist →
EligibilityServices coveredProvider requirementsHow to become a providerHow it differs, in detailSetup checklistUnlock the details →
FAQ

Frequently asked questions

Can family members get paid to be caregivers in Nebraska?

Yes. Personal Assistance Services (PAS), Comprehensive Developmental Disabilities Services Waiver, Developmental Disabilities Day Services Waiver for Adults (DDAD), Family Support Waiver (FSW), HCBS Waiver for Aged and Adults and Children with Disabilities, and Traumatic Brain Injury Waiver let a family member be the paid caregiver. Which relatives qualify, including spouses and parents of minor children, is set program by program.

Does Nebraska have consumer-directed care?

Yes: Personal Assistance Services (PAS). The person receiving care hires and directs their own aide, and a fiscal intermediary handles payroll.

Does Nebraska have structured family caregiving?

No. Nebraska does not run a structured family caregiving program. Family caregivers are paid through consumer-directed care instead.

What is the difference between home health and home care in Nebraska?

Home health (Home Health Agency and Skilled Nursing Services) is medical: nursing, therapy and aide visits ordered by a practitioner and delivered by a licensed home health agency. Home care is non-medical help with daily activities, based on functional need.

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