Nebraska State Funded Services

The transition from educational services to adult services requires a great deal of joint planning and discussion for each individual. Referrals for state Developmental Disabilities services should be made as early as possible (often as soon as 10 years of age depending upon the needs of the individual), so that eligibility may be determined and a service coordinator may join the school team in planning for transition to adult services. Please note that per DHHS, anyone who may need services is encouraged to apply and enter the waitlist so the individual has a greater understanding of future needs.

In regards to state Developmental Disability services, individuals are considered to be “children” until the age of 21. Currently in Nebraska, individuals are entitled to receive day services once they have reached age 21 and have left the Nebraska school system. Due to limited funding, other services may not be available, such as residential or respite services, and the individual may be placed on a waiting list for services.

Day/Vocational Services are designed to assist individuals in learning or maintaining skills as well as efforts to become employed with the acknowledgement that some people may need special assistance long term. Services may range from supporting the person in recreational activities in the community to teaching job skills in a specialized setting. To utilize services funded through the Division of Developmental Disabilities (DDD) providers must be contracted and certified with the State. If a program is not certified by the State, this does not mean that the program is not reputable or a good choice. It only means that they can receive State funds to provide services to individuals. It is up to the consumer to thoroughly investigate any provider before accepting services. These providers are overseen by the state. State funded providers are located across the state and offer a variety of services to meet the needs of individuals.

What is the Service Coordinator’s role in transiting to new waiver services?

The Service Coordinator must engage in person center planning. This mean that the Service Coordinator will meet and discuss with the individual and their legal representative, if applicable, the opportunities available to access services and supports designed to assist the individual in achieving their vision for a meaningful life. This interaction should occur during private conversations with the individual and their legal representative (if applicable) known as the individual/family meeting. From that discussion, the Service Coordinator will document on the Individual Plan the individual’s hopes, dreams and desires. This plan will identify the outcomes the individual has prioritized for themselves. Individuals will also identify who they choose to attend their Individual Planning meeting to determine what strategies support their needs. The Individual Plan meeting should be a cooperative effort between both formal and informal supports which include family, friends, neighbors, and other community members. The IPP team will develop SMART goals that are Specific, Measurable, Action oriented, Realistic, and timely based on the preferences, interests, and needs of the individual.

What are the steps Service Coordination will take?

1. Meet with the individual in private and ask them to identify their hopes and dreams for their future.

2. Identify and share possible resources including both formal and informal supports as well as the annual funding amount available to the individual based on the OAP.

3. Have the individual identify who they want to participate in their team meeting.

4. Invite desired individuals

5. Set the ground rules for the meetings and have the individual identify their outcomes and needs.

6. Facilitate discussions about possible strategies.

7. The individual determines which strategies they would like to utilize.

8. Document the individual’s options and choice on their IPP.

a. Identify the individual’s strengths.

b. Match the strengths with appropriate interventions and activities whenever possible.

c. Make a plan that includes a coordinated set of activities and long range goals that will lead to success.

9. Implement and monitor IPP.

What should individuals look for in a quality transition planning?

• Age appropriateness

• Activities that are community referenced

• Functional skills: displaying good work habits, communicating needs, making decisions, etc.

• Skills that can be generalized

• Activities that are based on the individual’s preferences and interests, desired goals, and present abilities as they relate to transition goals.

The options provided by the State are meant to offer a variety of service delivery options that meet the specific needs of the individual. An individual and/or their guardian can choose from one or many of the options available to build the best program for their needs.

The information below is adapted from the Specialized Service Provider Guidance as provided by the State of Nebraska Department of Developmental Disabilities as well as other State resources:

Individualized Support Options

Support Options means that services can include both continuous and intermittent supports. There must be flexibility of services that change, as the person’s needs change, without the individual having to move elsewhere for services. These services must:

1. Be person centered;

2. Demonstrate that the individual is in charge of his/her services and supports;

3. Promote the freedom for an individual to live a meaningful life and participate as a member of the community as any other citizen;

4. Promote the individual’s rights and autonomy;

5. Promote the use of generic services, natural supports, and options;

6. Assist the individual in acquiring, retaining, and improving the skills and competence necessary to live successfully in his/her residence and as a member of the larger community; and

7. Promote well planned and proactive opportunities for the individual and his/her family to determine the type and amount of support desired with meaningful direction from the individual, the individual’s family or guardian (where appropriate) and the proposed or current provider (as appropriate and desired).

Individualized Support Options includes the provision of the following:

1. Habilitation, staff support, professional services, and any related support services necessary to ensure the health, safety, and welfare of the individual(s) receiving services;

2. A combination of lifelong or extended duration support, training, and other services essential to daily living; and

3. Protective oversight to do, to whatever degree necessary, what is required to ensure that basic health and safety are always provided and readily available.

Service Options in Nebraska

The ways in which the State of Nebraska funds vocational services are as follows:

Day Habilitation Services

Intermittent:

• Integrated Community Employment – Adult and Child (child, summer only)

• Vocational Planning – Adult and child (child, summer only)

Continuous:

• Adult Day Habilitation

• Child Day Habilitation (summer only)

• Workstation Habilitation Services – Adult and child (child, summer only)

Residential Habilitation Services

Intermittent:

• Companion Home – Adult and Child

• In Home – Adult and Child

Continuous:

• Companion Home – Adult and Child –

• Extended Family Home – Adult and Child

• Group Home – Adult and Child

Community Living and Daily Supports

Respite Services

Vocational Rehabilitation

Day Habilitation Services: Day Habilitation Services are options that can be considered by the individual receiving support and offered by providers as an option in their menu of services. These services can be provided at a provider’s facility or integrated within the community. Day services can be vocational, recreational, or educational in nature, but having the common goal of increasing or maintaining skills that allow an individual to live a fulfilling life within the community.

To find out additional information about vocational services, click here to visit our vocational page.

• Integrated Community Employment – ICE – Intermittent Services: Integrated community employment (ICE) service is intermittent formalized training and staff supports – needed by an individual to acquire and maintain a job/position in the general workforce at or above the state’s minimum wage. The outcome of this service is sustained paid employment in an integrated setting in the general workforce that meets personal and career goals, as documented in the individual service plan. ICE services include habilitation that is outcome based and focused to sustain paid work by individuals and is designed to obtain, maintain or advance employment. Intensive direct habilitation will be designed to provide the individual with face to face instruction necessary to learn explicit work-related responsibilities and skills, as well as appropriate work behavior.

• Vocational Planning – Intermittent Services: Vocational planning habilitation services focus on enabling the individual to attain work experience through career planning, job searching, and paid and unpaid work experience with the goal or outcome of vocational planning being integrated community employment. Services are furnished as specified in the service plan. Vocational planning services focus on the acquisition of work skills, appropriate work behavior, and the behavioral and adaptive skills necessary to enable the individual to attain or maintain his or her maximum inclusion and personal accomplishment in the working community. Habilitation may include teaching such concepts as compliance, attendance, task completion, problem solving, and safety as well as accessing transportation independently and explicit employment objectives. Vocational planning habilitation services also include personal care and protective oversight and supervision when applicable to the individual. The habilitative services, supports, and strategies are documented in the service plan and delivered based on the service plan.

• Adult Day Habilitation – Continuous Services: Day habilitation services are formalized training and staff supports that take place in a non-residential setting. Day Habilitation services are scheduled activities, formalized training, and staff supports for the acquisition, retention, or improvement in self-help, behavioral, and adaptive skills that enhance social development and develop skills in performing activities of daily living, community living and employment. Day habilitation services may be prevocational in nature or may be provided to individuals not currently seeking to join the general workforce. Activities and environments are designed to foster the acquisition of skills, building positive social behavior and interpersonal competence, greater independence, and personal choice necessary to participate successfully in community living. Day Habilitation may be delivered in integrated community settings or in provider owned and operated settings. Staff support is continuous, that is staff are present at all times the individual is present. The provider may operate a location where individuals come to check-in prior to participating in integrated activities and/or to participate from a variety of daily activities, some which may be prevocational in nature or related to greater community living. Provider owned and controlled settings may also allow for individuals who are experiencing short-term medical or behavioral crisis a location to participate in activities that are outside the residence. The activities, services, supports, and strategies are documented in the service plan, and the frequency and duration for which the services are delivered will be based on the IPP.

• Child Day Habilitation – Continuous Services: Day habilitation services are formalized training and staff supports that take place in a non-residential setting and in an integrated community setting. Day Habilitation services only take place during times when a child is not attending school due to school not being in session. These services are scheduled activities, formalized training, and staff supports for the acquisition, retention, or improvement in self-help, behavioral, and adaptive skills that enhance social development and develop skills in performing activities of daily living, community living and employment. Day habilitation services may be prevocational in nature or may be provided to individuals not currently seeking to join the general workforce. Activities and environments are designed to foster the acquisition of skills, building positive social behavior and interpersonal competence, greater independence, and personal choice necessary to participate successfully in community living.

• Workstation Habilitation Services – Continuous Services: Workstation habilitation services are formalized training and staff supports for the acquisition, retention, or improvement in self-help, behavioral, and adaptive skills which takes place during typical working hours, separate from the individual’s residence and typically within a business or a community setting where individuals without disabilities work or meet together. Workstation habilitation services focus on the acquisition of work skills, appropriate work behavior, and the behavioral and adaptive skills necessary to enable the individual to attain or maintain his or her maximum inclusion, inclusion, and personal accomplishment in the working community

Residential Habilitation Services – Supported Living: Residential Services are options that can be considered by the individual receiving support and offered by providers as an option in their menu of services. Residential Services are defined as formalized training and staff supports that include adaptive skill development of daily living activities, such as personal grooming and cleanliness, bed making and household chores, eating and the preparation of food, community inclusion, transportation, and the social and leisure skill development necessary to enable the individual to live in the most integrated setting appropriate to his/her needs. Residential habilitation may also include personal care, protective oversight, and supervision as applicable to the individual when provider staff is present.

The residence must be in a community integrated setting. Supported Living means that the individual(s) have control and choice over where and with whom they live. Providers may suggest potential roommates for individuals, but the recommendation must not be based on diagnosis alone but by the individuals’ preferences and compatibility.

• In Home Residential Habilitation – Intermittent Services: Residential Habilitation services provided to a participant living in his/her family home. Supported services are provided in a home or apartment that is not owned and operated by a certified DD provider. The home is instead controlled by the individual living there or his or her family or guardian. Community based DD provider staff is intermittently available to deliver habilitation to the person receiving services in the family home or in the community. Individuals may choose to live with others with developmental disabilities or with people without disabilities in home where they receive supported services.

• Extended Family Home – Continuous Services: An Extended Family Home (EFH) situation may qualify as a Supported Living option if the requirements of Individual Support Option services described in this chapter are met. To be considered, it must be a residence for no more than two individuals with developmental disabilities, owned or leased by the subcontractor providing supports. The individual, who is his/her own payee or representative payee, pays room and board directly to the subcontractor. Agency owned housing when the EFH provider is engaged as a subcontractor does not qualify as a Supported Living option.

• Companion Home – Intermittent or Continuous Services: A new option is the Companion Home. This is much like an EFH, but in a Companion Home the residence is owned or leased by the individual receiving services. Services in a Companion Home may be provided intermittently or continuously. Individuals may choose to live with others with developmental disabilities or with people without disabilities in home where they receive supported services.

• Group Home – Continuous Services: Group home residential habilitation services are continuous services and are delivered in provider operated or controlled settings, such as a home with three or less individuals with DD, or a licensed Center for persons with Developmental Disabilities (CDD) with four or more individuals with DD. Group homes are commonly referred to as Assisted Services, because these homes are owned and operated by a certified agency provider who “assist” individuals in daily habilitation. Usually a group of individuals live together in a home and share things like staff, household duties, common living spaces like kitchens and living rooms – but they still have their own personal space, such as a bedroom. Rental agreements with and payment for room and board to a DD provider must be treated as landlord-tenant agreements and all applicable state and local laws must be followed. These settings can be more economical because they allow individuals to share living expenses, such as room and board, that are not paid for by the Division. Transportation between the participant’s place of residence and other service sites and places in the community is provided as a component of residential habilitation services and the cost of this transportation is included in the rate paid to providers of residential habilitation services.

Community Living and Day Supports: With the recent revision of our waivers, we have integrated the Community Supports Program into our array of services. Community Supports are provided by independent providers who are hired by the individual and their family. These can be neighbors, local college students, friends, etc. They may assist in maintaining or obtaining employment and accessing services and opportunities in the community. They can also help an individual develop self-advocacy skills, including developing a personal support network of family, friends, and associates. They may also assist with household and home activities and with personal assistance activities that are necessary to help an individual live independently. Community Supports are for people who want more control over their services and supports – who are willing and able (either independently or with the assistance of their family) to choose, train, and direct their services.

Respite Services: Respite services are intended to provide temporary, intermittent relief to the family or unpaid caregiver from the continuous support and care of the individual. Respite services allow the caregiver to pursue personal, social, and recreational activities such as personal appointments, shopping, attending support groups, club meetings, or other personal activities. Respite services can be performed by a certified DD provider, or they may be provided by a non-specialized community supports provider of an individual’s choosing. Services can be provided for only a few hours, or even for overnight supports if needed. Respite services are capped at 30 days per year and must be purchased within an individual’s service budget. If you are interested or have questions about respite services, please contact your service coordinator or your local DD office for more information.

Vocational Rehabilitation: If you do not qualify for Developmental Disability services through the Department of Health and Human Resources and need help finding employment, you can contact Vocational Rehabilitation (Voc Rehab). The following types of services are offered by Voc Rehab: Vocational Counseling, Job Matching, Custom Training, Assistive Technology, Independent Living, and Job Placement. Even if you do qualify for Developmental Disability services, you can still apply for assistance from Voc Rehab. For a listing of Voc Rehab offices, click here, or call 1-877-637-3422 (1-877-NE REHAB) to locate a service office near you.

Vocational Rehabilitation services are time limited. Typically, after the acquisition of a paid employment position, they will stay on your care for a few months, then end services. You can always reapply to Voc rehab if you want to change jobs, lose your job, or need further assistance. If you feel that you would need long term support, look for other providers that can either carry on your support after Voc Rehab has ended services, or look for a provider that offers long term support from the start.

Prosper Workforce Services, the Partnership for Autism Career Employment is one provider in the Omaha metropolitan area that offers long term autism specific employment supports. Prosper Workforce Services is a community team player and will work with an individual who is exiting services from Voc Rehab and would like long term supports. Prosper Workforce Services does not require State funding and provides comprehensive job planning and support services to individuals on the spectrum. Click here to find out more about Prosper Workforce Services and how they can help you achieve your employment goals. 

Questions to Ask Service Providers

Before deciding on a service provider or any job for that matter, it is important to make sure that you find the right service provider for you. Keep your goals and needs in mind and tour the facilities you are interested in. Listed below are questions to ask yourself and the service provider as well as things to consider when touring different facilities.

Questions to ask yourself or to discuss with your family or friends:

• How would you like to spend your days?

• What type of atmosphere makes you happy? Laid back? Active? Fun?

• What type of activities would you like to participate in?

• Is finding employment a goal?

• What are you good at?

• Do you need transportation or other supports?

• Do you want part-time or full-time work? Days or evenings? Week or weekends?

• If walking to work, can you call a cab or take a bus in bad weather and pay for it? Who could you call in emergencies?

• Do you need to balance State and Government benefits with an income?

• What makes a “good” work day? What can prevent a “bad” work day for you?

 Questions to ask service providers:

• What is the staff to client ratio?

• Is a nurse on staff?

• How do you determine placement in work/activity areas?

• How often do individuals go out in the community?

• Is transportation provided?

• Can my parents/advocates visit whenever they would like?

• What types of decisions can I make about my day while I am here?

• What type of behavior modification do you utilize?

• Do you utilize behavior restraints at any time?

• How will you support me when other parts of my life change or people leave or pass away?

• How often can I change my activities?

• Are there time clocks, shift schedules, or meal schedules to follow? When are breaks and for how long?

Things to consider when touring:

• How clean is the facility and what is the condition of the building and furniture?

• How cluttered or organized is the facility?

• How engaged are the support staff?

• Is the manager present? Where do supervisors spend their time?

• Do you notice any unsettling smells, spills, or safety issues?

• Is the facility close to public transportation or home?

• Would you feel safe here?

• Are people introducing you by speaking respectfully with you?

• Do you notice any screaming, crying, loud talking, frustration, or impatience?

• Do you value the activities that are provided by the organization?

• Are restrooms and changing facilities safe, well-maintained, and smell fresh?

• Do most of the people working there seem happy?

• As an advocate, would you like to spend your days at this facility?