Can Family Members Get Paid to Care for a Loved One with IDD in Nebraska?
If you're caring for a family member with intellectual or developmental disabilities
If you're caring for a family member with intellectual or developmental disabilities in Nebraska, you've probably wondered: Can I actually get paid for this?
The short answer is yes — under certain circumstances, Nebraska's Medicaid waiver programs allow family members to serve as paid caregivers for their loved ones with IDD. But the specifics matter, and understanding which waiver services allow family caregivers, who qualifies, and what the requirements are can make all the difference.
Here's what Nebraska families need to know.
Which Nebraska Waiver Programs Allow Family Caregivers?
Nebraska offers several Medicaid waiver programs for individuals with intellectual and developmental disabilities. Not all of them allow family members to serve as paid caregivers, but a few critical services do.
LRI Personal Care (CDD and DDAD Waivers)
LRI stands for "Legally Responsible Individual." This service specifically allows parents of minors (under age 19) or spouses of individuals with IDD to be compensated for providing hands-on personal care.
What it covers:
Bathing, dressing, grooming
Eating and feeding assistance
Mobility support and transfers
Toileting and personal hygiene
Medication reminders (as authorized)
Who can provide care:
Parents of minors
Spouses
Hour limits:
CDD Waiver: Up to 70 hours per week
FSW Waiver: Limited based on need and fit within the capped waiver (typically between 5-10 hours per week)
DDAD Waiver: Up to 25 hours per week
To qualify for LRI Personal Care, the individual receiving services must meet Nebraska's criteria for Extraordinary Care — meaning they require significant support due to complex needs.
Supported Family Living (CDD and FSW Waivers)
Supported Family Living offers more flexibility than LRI Personal Care. It provides in-home and community-based support to help individuals build everyday skills and live as independently as possible.
What makes it different:
Services can be provided by a wider range of family members (not just parents or spouses)
Includes skill-building and community integration, not just personal care
Available through both CDD and FSW (Family Support Waiver)
Who can provide care:
Parents (when Participant is an adult)Other family members and relatives
Qualified staff
This service is particularly valuable for families navigating transitions — like when a young adult is aging out of school-based services or working toward greater independence.
Independent Living Services (CDD and FSW Waivers)
Independent Living services focus on developing the skills needed for greater independence. These services are also provided in the individual's home and can be delivered by family members.
What it covers:
Daily living skills training
Community navigation
Money management
Self-advocacy skills
Like Supported Family Living, Independent Living services can be provided by family members or qualified staff, depending on the situation.
What Are the Requirements for Family Caregivers?
Being a family member doesn't automatically qualify you to serve as a paid caregiver. Nebraska has specific requirements to ensure quality and safety.
Training and Certification
Family caregivers must complete training in areas like:
Medication administration
Universal precautions and infection control
Emergency procedures
Person-centered planning
Documentation and reporting
CPR and First Aid
Most approved provider agencies — like Alora — provide this training and help family caregivers maintain current certifications.
Provider Agency Oversight
You can't simply bill Medicaid directly as a family caregiver. You must work through an approved provider agency that handles:
Waiver paperwork and billing
Quality assurance and oversight
Payroll processing
Coordination with Nebraska DHHS
Ongoing support and coaching
Working with a provider agency ensures you're meeting all state requirements while focusing on what matters most: caring for your loved one.
Documentation
Family caregivers are required to document the services they provide, including:
Hours worked
Tasks completed
Any incidents or changes in condition
Progress toward goals
This documentation is essential for Medicaid billing and ensuring the individual is receiving appropriate services.
How Much Do Family Caregivers Get Paid?
Compensation varies based on the service type, waiver program, and approved hourly rate set by Nebraska DHHS. While exact rates can change, family caregivers typically receive:
Hourly wages comparable to other direct support professionals
Payroll processing through the provider agency
Tax withholding and W-2 forms
It's worth noting that this isn't "getting paid to do what you'd do anyway." The requirements, documentation, and oversight ensure that family caregivers are providing services that meet professional standards.
What If My Loved One Isn't on a Waiver Yet?
If your family member with IDD isn't currently enrolled in a Nebraska Medicaid waiver, the first step is connecting with a case manager or service coordinator. They'll help you:
Determine which waiver program best fits your loved one's needs
Navigate the application process
Understand what services are available
Get on the waiting list (if applicable)
Some waivers have waiting lists, while others may have more immediate availability. The CDD waiver, for example, tends to have longer wait times but offers more comprehensive services and higher hour caps. The FSW waiver is often more accessible and focuses on family-centered support.
Why This Matters for Nebraska Families
For many families, the ability to serve as a paid caregiver changes everything. It means:
You don't have to choose between providing care and earning income
Your loved one receives consistent care from someone who knows them best
You gain access to training, support, and resources you might not have otherwise
Your expertise and dedication are recognized and valued
Family members often already possess the deep knowledge and relationship that make them excellent caregivers. Nebraska's waiver programs allow that care to be formalized, compensated, and supported.
Important Limitations to Know
While family caregivers can provide many services, there are some restrictions:
Geographic limitations: For CDD waiver services specifically, some restrictions apply in Lancaster, Douglas, and Sarpy counties due to current service structures. DDAD and FSW waiver services are available statewide without these restrictions.
Service-specific eligibility: Not every waiver service allows family caregivers. It's essential to work with your case manager and provider agency to understand which services your family member is eligible for and which roles you can fill.
Conflict of interest considerations: In some cases, there may be situations where a family member serving as both guardian and paid caregiver creates conflicts. Your provider agency can help navigate these situations.
Getting Started
If you're interested in exploring whether you can serve as a paid caregiver for your family member with IDD in Nebraska, here's what to do:
Talk to your case manager or service coordinator — They can explain which services your loved one qualifies for and whether family caregivers are allowed.
Connect with an approved provider agency — Agencies like Alora can walk you through the requirements, provide training, and handle the administrative side.
Ask specific questions — Don't hesitate to ask about hourly limits, compensation rates, training requirements, and what's expected of you.
Understand the commitment — Serving as a paid caregiver comes with real responsibilities. Make sure you're prepared for the documentation, training, and oversight that's required.
The Bottom Line
Yes, family members can get paid to care for loved ones with IDD in Nebraska — but it's not automatic, and it's not without requirements. Programs like LRI Personal Care, Supported Family Living, and Independent Living Services create pathways for families to formalize the care they're already providing while receiving compensation, training, and support.
If you're caring for someone with IDD and wondering whether this could work for your family, the best next step is reaching out. Whether you're already navigating the waiver system or just starting to explore options, connecting with an approved provider agency can help you understand what's possible.
Ready to learn more about family caregiver options in Nebraska? Visit Alora Supports to explore your options and connect with a team that understands Nebraska's IDD services.
