Nebraska DD Waitlist Eliminated: What Actually Changed in 2025

In August 2025, Nebraska announced it had eliminated the developmental disabilities waitlist that families had endured for years — sometimes decades. The state invested over $18 million in state and matching federal funds to serve more than 3,000 individuals who had been waiting for services. The headlines made it sound like the problem was solved. The reality was more complicated.

What "Eliminated" Actually Means

Eliminating the waitlist meant that every person on the DD registry received an offer of services. It did not mean everyone received the level of services they needed.

Approximately 97% of offers were for the Family Support Waiver (FSW), which carries a strict $10,000 annual funding cap and is limited to individuals under 21. Only about 3% received offers for the Comprehensive Developmental Disabilities (CDD) Waiver, which has no spending cap and covers 24-hour residential services, full daytime habilitation, and intensive community supports.

For families whose adult child needs 40+ hours per week of supervision, behavioral support, or residential placement, a $10,000-per-year waiver doesn't change the fundamental problem. The waitlist is gone, but the gap between available funding and actual support needs persists.

How the New System Works

Nebraska has transitioned from a waitlist-based model to what it calls offering services "near the time of need." The process now works like this:

1. Apply for DD eligibility through the Division of Developmental Disabilities (DDD) — this establishes that the individual meets Nebraska's developmental disability definition under Neb. Rev. Stat. § 83-1205.
2. Receive a Service Coordinator who helps develop a person-centered service plan.
3. Complete the interRAI needs assessment — implemented July 1, 2025, this standardized tool determines which waiver the individual qualifies for and how much funding they receive.
4. Receive a waiver offer based on the interRAI results and available capacity.

The interRAI assessment replaced the older ICAP tool and has been controversial. Over 800 families reported significant budget reductions after the switch. An independent evaluation by Alvarez & Marsal, hired by the Nebraska Legislature and DHHS for $420,000, is currently reviewing the tool's validity and impact.

What This Means for Transition-Age Families

If your child is approaching 18 and hasn't yet applied for DD eligibility, the waitlist elimination is good news — you won't face a multi-year wait to receive any services. But it doesn't change the need for careful preparation:

Apply for DD eligibility at age 16. Even though there's no longer a years-long wait, establishing eligibility early allows the Family Support Waiver to begin providing services during the high school years.

Prepare for the interRAI assessment. The assessment determines funding, and the documentation you bring directly affects the outcome. Log daily support needs for 30-60 days before the assessment — supervision hours, behavioral incidents, medical interventions, and personal care assistance. Document the worst days, not the averages.

Understand the waiver transition at age 21. The FSW ends at 21. The transition to adult waivers (DD Adult Day or Comprehensive DD) depends on the interRAI assessment conducted around that time. If the assessment underestimates needs, the resulting budget won't cover the services your child was receiving through the school system.

Explore supplemental services. Medicaid state plan services — personal care assistance, home health, medical equipment — operate independently of waiver enrollment. They don't count against the FSW cap and can fill gaps while waiver services are limited.

The CDD Waiver Path

For families whose child genuinely needs the uncapped Comprehensive DD Waiver, the path forward involves demonstrating through the interRAI assessment that the individual has:

• Limited informal (family) supports — either because caregivers are aging, have their own health issues, or because the individual's needs exceed what family support can sustain
• Residential instability — the current living arrangement can't continue long-term
• High supervision requirements — continuous or near-continuous oversight for safety
• High respite needs — primary caregivers need substantial relief to prevent burnout

Building documentation around these four indicators is the most direct route to a CDD Waiver determination. If the interRAI results in an Adult Day Waiver instead, you can appeal the budget determination within 90 days.

The Nebraska SSI at 18 & Adult Disability Benefits Guide includes interRAI preparation templates and a waiver comparison worksheet to help families build the documentation needed for an accurate needs assessment.

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