Getting Appropriate and Cost-effective Solutions to Enable Consumer Independence

Initiative Description

Nebraska ATP has a contract with the Nebraska Department of Health and Human Services-Home and Community Based Waivers to provide assessments and project management for all home modifications, vehicle modifications, and assistive technology services statewide for individuals receiving services through the Nebraska Aged and Disabled Waiver.  Referrals are sent to ATP by Services Coordinators. The referral is then screened for appropriateness by the Program Supervisor and then assigned to a technology specialist (many referrals are not appropriate due to DHHS regulations). The technology specialist then contacts the individual and sets up a date/time to perform an assessment. At the assessment, the technology specialist assesses for the individual’s accessibility/assistive technology needs taking into consideration their functional limitations. An evaluation is written up and recommendations are made using the lowest cost option that will meet the consumer's needs. ATP then obtains permission from the consumer to proceed with the project. The project is then sent out for bid (including blueprints and specifications when necessary) to numerous vendors/contractors. Once the bids are back, the project is sent to the Program Supervisor for a final review. The project is then awarded to the lowest most appropriate bidder using a Service Authorization. On average the contractor/vendor has 60 days to complete the work/provide the equipment. If more time is needed because of shipping issues, weather, or any unforeseen circumstances the vendor/contractor is required to inform the technology specialist overseeing the project. During the project the technology specialist is available to both the consumer and contractor in case there are questions or concerns. Once the project is finished the contractor invoices ATP. The technology specialist then sets up a date/time to inspect the work/product with the consumer to ensure that everything was done to specification and that the project will meet the needs of the consumer, and to provide training if necessary. The consumer and the technology specialist then sign off on the project allowing the accounting department to proceed with paying the invoice. In the past year this program has provided consumers with entrance and bathroom modifications, vertical platform lifts, ceiling track patient lifts, vehicle modifications, and assistive technology. This program is funded through Medicaid dollars and serves between 500 and 800 waiver-eligible consumers across Nebraska yearly.

Lessons Learned/Replication

This program helps ensure that waiver-eligible consumers are getting the most appropriate cost-effective solutions to enable them to remain independent in their homes and communities. This program also helps to save tax dollars by keeping consumers that meet a nursing home level of care out of long-term care facilities. The average cost of these projects is usually less than a 3 month stay in a long-term care facility. Through funding coordination ATP helps to leverage waiver funding for qualified consumers against Vocational Rehabilitation funding, and various private grants. Also, through ATP's loan program temporary solutions are put in place while the project is moved forward. Consumers are also introduced to other programs that ATP offers, including reuse, resource coordination, and AT demonstrations. These programs help consumers learn about and obtain assistive technology and needed equipment that may not qualify under the Waiver program. This partnership between ATP and DHHS will be continuing into the foreseeable future.

Year of Implementation




Initiative contact information

Tobias Orr