Legal Aid of Nebraska's 2026 Disability-Assessment Lawsuit: What Families Should Know

The Lawsuit That Could Change Nebraska Home Care

In May 2026, Legal Aid of Nebraska — alongside national disability advocacy organizations — filed a lawsuit challenging changes to Nebraska's Medicaid services for people with developmental disabilities (DD). The core allegation is that a new assessment system reduced authorized funding without adequately accounting for individual needs, putting some people at risk of losing necessary supports or being pushed toward institutional placement.

If you have a parent on the AD Waiver whose care hours were recently reduced, do not assume this lawsuit covers their situation. The case concerns the developmental-disability services system; ask Legal Aid whether it applies to your parent's program and notice.

What Happened

Nebraska uses the interRAI assessment tool to evaluate Nursing Facility Level of Care (NFLOC) eligibility — the clinical gateway to the AD Waiver. The interRAI records standardized information about ADL limitations, cognitive function, behavioral challenges, and medical complexity. Do not treat an interRAI score alone as a complete explanation of the services authorized; ask DHHS or the service coordinator how the assessment was used in your parent's case.

The lawsuit alleges that a new assessment methodology reduced authorized funding for at least some people in the developmental-disability services system. Legal Aid's account described one plaintiff whose funding was reduced by 35%, leaving the person at risk of losing services; the filing does not establish that all AD Waiver participants see the same reduction.

The Spending Cap Connection

This lawsuit intersects with another controversial DHHS policy: the proposed AD Waiver spending cap that restricts total annual service costs to 150% of the average nursing home per capita cost — roughly $138,657 annually. The cap's exception criteria specifically exclude individuals who receive support from live-in, unpaid family caregivers.

Critics argue this creates a perverse incentive: the state reduces paid care hours through algorithmic assessment, families fill the gap with unpaid labor, and the spending cap's exception criteria then exclude those families from seeking higher service levels — because they have an unpaid caregiver at home.

What This Means for Your Parent

If your parent's care hours were recently reduced: You have the right to appeal. Nebraska Medicaid provides an administrative hearing process for any reduction in authorized services. Request a hearing within 10 days of receiving the notice of reduction to maintain the current service level during the appeal process (known as "aid paid pending").

If your parent is applying for the AD Waiver for the first time: The interRAI assessment is still the clinical eligibility tool. Prepare thoroughly — document your parent's ADL limitations in detail, because standardized assessments may not capture every need. Our recommendation: keep a written log of your parent's daily care needs for at least two weeks before the assessment, noting every instance of assistance with bathing, dressing, transferring, toileting, eating, and mobility.

If your parent is transitioning from hospital to home: The lawsuit doesn't change the discharge process or Medicaid eligibility rules, and it does not automatically change AD Waiver service levels. If the authorized hours don't match the clinical need documented in the discharge plan, document the discrepancy and request an administrative hearing using the instructions in the reduction notice; Legal Aid can help assess whether the lawsuit applies.

Free Legal Help

Legal Aid of Nebraska provides free legal assistance to low-income Nebraskans, including representation in Medicaid and disability benefit disputes. If your parent's AD Waiver services were reduced and you believe the reduction puts their health or safety at risk:

• Legal Aid of Nebraska: 1-877-250-2016 (toll-free intake line)
• Nebraska Aging and Disability Resource Center (ADRC): 1-844-843-6364
• Nebraska Long-Term Care Ombudsman: 1-800-942-7830

The Ombudsman can't provide legal representation but can advocate on your parent's behalf within the DHHS system and help you understand the appeal process.

Building a Stronger Discharge Plan

When a hospital is discharging your parent and the AD Waiver is part of the care plan, the gap between what's prescribed and what's authorized is a real risk. Our Nebraska Hospital Discharge Guide includes the ADL observation log worksheet — a structured tool for documenting daily care needs in the format the interRAI assessment uses, so the assessment record reflects actual needs rather than relying on incomplete information.

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