SUPPORTING INDEPENDENT LIVING THROUGH HOUSEHOLD ASSISTANCE AND PERSONAL CARE

Homemaker Services in Nebraska provide essential household support for individuals with disabilities, chronic illnesses, or age-related conditions. These services help individuals maintain a clean, safe, and comfortable living environment, promoting independence and well-being. Homemaker Services are authorized under Nebraska Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Nebraska Department of Health and Human Services (DHHS)
Role: Administers Medicaid waiver funding for Homemaker Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Nebraska Medicaid and Long-Term Care (MLTC) Division
Role: Oversees quality standards, service delivery, and compliance for Homemaker Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Medicaid-funded Homemaker Services meet HCBS quality, person-centered planning, and participant protection standards.

2. HOMEMAKER SERVICES OVERVIEW

Homemaker Services provide essential household support and personal care assistance to help individuals maintain a clean, safe, and manageable home environment.

Approved providers may deliver:

• Household Cleaning: Dusting, vacuuming, sweeping, mopping, and sanitizing surfaces
• Laundry and Linen Care: Washing, drying, folding, and organizing clothing and bed linens
• Meal Preparation: Preparing meals according to dietary needs and preferences
• Grocery Shopping: Assisting with shopping for food and household supplies
• Personal Care Assistance: Light personal hygiene tasks and grooming support
• Safety and Home Maintenance: Checking for hazards, replacing light bulbs, and maintaining a safe environment
• Social and Emotional Support: Providing companionship and reducing isolation

All services are provided based on the Individualized Service Plan (ISP) to meet the specific needs of the participant.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Nebraska Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid Waiver Homemaker Services provider via the Nebraska Medicaid Provider Enrollment Portal
• Obtain licensure as a Homemaker Agency through Nebraska DHHS if applicable
• Maintain general liability and professional liability insurance
• Develop policies for household assistance, safety management, and emergency response
• Ensure staff meet background checks, health screenings, and relevant training requirements

4. NEBRASKA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Nebraska Medicaid Provider Enrollment Portal for Homemaker Services under HCBS waivers

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff qualifications, and policy manuals

Program Readiness Review:

• DHHS evaluates provider readiness, including staff qualifications, service delivery protocols, and client safety procedures

Approval & Medicaid Enrollment:

• Upon successful review, providers receive authorization to bill Medicaid for Homemaker Services using designated billing codes

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Nebraska Secretary of State)
• IRS EIN confirmation
• NPI confirmation
• Homemaker Agency License (if applicable)
• Proof of general and professional liability insurance

Homemaker Services Policy & Procedure Manual including:

• Client intake, assessment, and service planning procedures
• Safety and hygiene protocols for household tasks
• Personal care assistance guidelines
• Staff credentialing, background checks, and training requirements
• HIPAA compliance, client rights, and grievance handling
• Billing, documentation, and audit readiness procedures
• Emergency response and safety management policies

6. STAFFING REQUIREMENTS

Role: Homemaker Program Director
Requirements: Bachelor’s degree in human services, healthcare, or related field, supervisory experience preferred.

Role: Homemaker/Personal Care Aides
Requirements: High school diploma or GED, basic training in household management and personal care assistance, background clearance.

Role: Support Staff
Requirements: Experience in home maintenance and light personal care tasks, basic safety and hygiene training.

All staff must complete:

• Training in infection control, safety, and basic caregiving skills
• HIPAA compliance and client rights education
• Annual competency evaluations and ongoing professional development
• Ongoing training in household management and emergency response

7. MEDICAID WAIVER PROGRAMS

Homemaker Services are available under the following Nebraska Medicaid Waivers:

• Aged and Disabled (AD) Waiver
• Traumatic Brain Injury (TBI) Waiver
• Developmental Disabilities (DD) Waiver
• Children with Disabilities Waiver
• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Light housekeeping and cleaning
• Meal preparation and grocery shopping assistance
• Laundry and linen care
• Light personal care and grooming support
• Social interaction and companionship
• Maintaining a safe and hazard-free living environment

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation
Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 2–3 months

Phase: Nebraska Medicaid Provider Enrollment and Readiness Review
Timeline: 60–90 days

Phase: Medicaid Billing Setup and Homemaker Service Launch
Timeline: 30–45 days

9. CONTACT INFORMATION

Nebraska Department of Health and Human Services (DHHS)
Website: https://dhhs.ne.gov/

Nebraska Medicaid and Long-Term Care (MLTC) Division
Website: https://dhhs.ne.gov/Pages/Medicaid.aspx

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/

10. SCOPE OF WORK

• Business registration, Medicaid enrollment, and licensing assistance
• Policy manual development tailored to homemaker and personal care services
• Staff credentialing, training program templates, and documentation guidance
• Medicaid billing setup and audit-prepared financial management
• Branding, website development, and client engagement strategies
• Quality assurance systems for safety monitoring and compliance

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEBRASKA HOMEMAKER SERVICES PROVIDER

We support agencies in launching Medicaid-compliant Homemaker Services in Nebraska.

To get started, click the link to request portal access