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Home & Community-Based Services: State-Only Funded Programs in Nebraska

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Respite Subsidy Program Across the lifespan³,⁴

Administrative Agency: Dept of Health & Human Services

Population Served: N/A

Annual Expenditure: $810,000 FY02 Appropriation

Funding Source: General revenue, tobacco settlement funds

Number of People Served: 415 FY02

Eligibility Criteria: income limit $2,304/mth, asset limit $38,000 (individual).

Further Information: Cost control Respite cap of $125/month. Other information Family members may be paid to provide services. There may be at least 3 partly state-funded programs (Disabled Persons & Family Support Program, Disabled Children's Program).

Program Name: Care Management⁴

Administrative Agency: Health & Human Services

Population Served: N/A

Annual Expenditure: $1,716,558 FY02 Appropriation

Funding Source: General revenue, clients contribute

Number of People Served: 8,975 FY02

Eligibility Criteria: No income or asset limit.

Further Information: Cost control Co-pay on sliding scale

Program Name: Disabled Persons & Family Support⁴

Administrative Agency: Health & Human Services

Population Served: Elderly & physically disabled adults

Annual Expenditure: $910,000 FY02 Appropriation

Funding Source: General Revenue

Number of People Served: 550 FY02

Eligibility Criteria: Individuals who do not meet the financial &/or functional eligibility requirements of Medicaid &/or individuals waiting placement on the Medicaid HCBS program or individuals receiving Medicaid HCBS. Income limit FY02 $1,364/mth (185% FPL). No asset limit.

Further Information: Cost control: Cost cap $300/mth. Service limits applied: hours - $100/mth chore. Quality control: client driven, client selects provider. Consumer direction Can be consumer directed.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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