If you’re the parent of a child or adult with intellectual or developmental disabilities in Nebraska, you’ve probably heard about “waivers” — specifically the CDD waiver and the FSW waiver. Maybe your case manager mentioned them. Maybe another parent brought them up at an IEP meeting. Maybe you’ve been researching online and keep seeing these acronyms without a clear explanation of what they actually mean or which one your family needs.
Here’s the truth: Nebraska’s waiver system is confusing. The names don’t help. The eligibility criteria overlap in some places and diverge in others. And the stakes feel high because choosing the wrong path could mean your loved one doesn’t get the support they need.
This guide breaks down the differences between Nebraska’s Comprehensive Developmental Disability (CDD) Waiver and Family Support Waiver (FSW) in plain language — what each one covers, who qualifies, and how to know which one makes sense for your family.
What Are Medicaid Waivers and Why Do They Matter?
Before we compare the two waivers, let’s start with the basics.
Medicaid waivers are programs that allow states to “waive” certain Medicaid rules so they can provide home and community-based services to people who would otherwise need institutional care. Instead of requiring someone to live in a facility to access services, waivers allow individuals with disabilities to receive support in their own homes and communities.
In Nebraska, these waivers are managed through the Department of Health and Human Services (DHHS) and provide funding for services like personal care, residential support, skill-building, therapies, and more.
For families, waivers can be life-changing. They open doors to services that wouldn’t otherwise be affordable. They make it possible for adults with IDD to live independently or in family-style settings rather than institutions. They provide respite for exhausted caregivers. They fund the therapies and supports that help individuals reach their potential.
But not all waivers are the same.
CDD Waiver: Comprehensive Support for Complex Needs
The Comprehensive Developmental Disability (CDD) Waiver is Nebraska’s most robust waiver program for individuals with intellectual and developmental disabilities. It’s designed for people who need significant, ongoing support across multiple areas of life.
Who Qualifies for the CDD Waiver?
To be eligible for the CDD waiver, an individual must:
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Have a developmental disability (diagnosed before age 22)
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Require the level of care typically provided in an ICF/DD (Intermediate Care Facility for Individuals with Developmental Disabilities)
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Meet financial eligibility requirements (based on the individual’s income, not family income for adults)
The “level of care” requirement is key. This means the individual needs substantial assistance with activities of daily living, health and safety supervision, or behavioral support. It’s the waiver for people with more intensive or complex needs.
What Services Does the CDD Waiver Cover?
The CDD waiver offers the widest range of services, including:
Residential Services:
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Residential Habilitation (24/7 support in a group home or shared living setting)
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Supported Living (support for individuals living independently)
Day Services:
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Day Habilitation (skill-building and community activities during the day)
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Prevocational Services (preparation for employment)
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Supported Employment (job coaching and support)
Personal Care:
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LRI Personal Care (family members can provide personal care for individuals meeting Extraordinary Care criteria — up to 70 hours per week in some cases)
In-Home and Community Support:
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Supported Family Living (in-home support that can be provided by family members)
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Independent Living Services (skill-building toward greater independence)
Therapies and Specialized Services:
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Occupational Therapy
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Physical Therapy
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Speech-Language Pathology
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Behavioral Consultation
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Nursing services
Other Supports:
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Respite Care (temporary relief for family caregivers)
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Personal Emergency Response System
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Home Modifications
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Assistive Technology
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Transportation
The CDD waiver also allows for significantly higher service hours. For example, LRI Personal Care can be authorized up to 70 hours per week for individuals with high support needs.
