PREPARED BY: Mikayla Findlay
LB 239 DATE PREPARED: March 3, 2025
PHONE: 402-471-0062
Revision: 00
FISCAL NOTE
LEGISLATIVE FISCAL ANALYST ESTIMATE
ESTIMATE OF FISCAL IMPACT – STATE AGENCIES (See narrative for political subdivision estimates)
FY 2025-26 FY 2026-27
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS $2,880,493 $2,984,392
CASH FUNDS
FEDERAL FUNDS $3,716,307 $3,612,408
OTHER FUNDS
TOTAL FUNDS $6,596,800 $6,596,800
Any Fiscal Notes received from state agencies and political s ubdivisions are attached following the Legislative Fiscal Analyst Estimate.
This bill modifies provisions of the state’s Home and Community Based Services (HCBS) waiver for indi viduals with developmental
disabilities (DD) as administered by the Department of Health and Human Services (DHHS).
The bill amends Neb. Rev. Stat. § 83-1216 to include the following provisions:
• Requires the assessment formula for HCBS to be published on the website
• Requires the Governor’s DD advisory board or other stake holder group as required by the access rule
• Establishes in statute that the assessment tool shall n ot decrease an individual ’s budget to the point where they are removed
from a setting
• Requires for requests for redetermination to be completed within thirty days
o Note that it is unclear at what point the thirty-day limit begins
• Establishes an independent mediation process
• Establishes that individuals or their representatives choose their own providers
The bill also amends provisions in S ubsection 4 of the statute which set funding priorities as follows:
• Expands the first funding priority to include threat to life and safety of family/household members, and the public
• Requires DHHS to create a form and process for expedited request for priority one status.
o DHHS has five calendar days to respond to such a request
• Expands the second funding priority to individuals who have been institutionalized for at least 2 months and those who are at
risk for placement in juvenile detention centers
• Expands the third funding priority to anyone who has been supervised by the Office of Probation Administration
• Expands the fourth funding priority to include those aged 18- 21 or who have departed the education system
Finally, the bill removes the sunset date from Neb. Rev. Stat. § 83-1216.02 which establishes priorities that determine which individuals
receive services if funding is not sufficient to meet total need.
DHHS estimates the fiscal impact based on the changes to the fou rth funding priority citing counts of 199 individuals age 18-20 awaiting
day services and 67 individuals currently on the Family Support Waiver ( FSW) who would move to day services. The annual cost of day
services is assumed to be $24,800 resulting in an added cost of $6,596,800 . The federal fund participation is assumed to be 56.34 % in
FY26 and 54.76% in FY27 based on the state’ s Federal Medical Assistance Percentage. The 67 newly available FSW openings would
be filled by individuals currently awaiting services therefore there is no offsetting reduction accounted for in the estimate.
ADMINISTRATIVE SERVICES STATE BUDGET DIVISION: REVIEW OF AGENCY & POLT. SUB. RESPONSE
LB: 239 AM: AGENCY/POLT. SUB: Nebraska Department of Health & Human Services
REVIEWED BY: Ann Linneman DATE: 2 -28-2025 PHONE: (402) 471-4180
COMMENTS: Concur with the Nebraska Department of Health and Human Services’ assessment of fiscal impact.
LB (1) 239 FISCAL NOTE 2025
ESTIMATE PROVIDED BY STATE AGENCY OR POLITICAL SUBDIVISION
State Agency or Political Subdivision Name:(2) Department of Health and Human Services
Prepared by: (3) John Meals Date Prepared 2-27-25 Phone: (5) 471-6719
FY 2025-2026 FY 2026-2027
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS $2,880,493 $3,551,819
CASH FUNDS
FEDERAL FUNDS $3,716,307 $4,298,373
OTHER FUNDS
TOTAL FUNDS $6,596,800 0 $7,850,192 0
Return by date specified or 72 hours prior to public hearing, whichever is earlier.
Explanation of Estimate:
LB239 updates Nebraska’s Medicaid Home and Community Based Services (HCBS) waivers for individuals
with developmental disabilities. The bill adds requirements to the objective assessment process and changes
the existing tiered priority system for HCBS funding including an expansion of the criteria for the first funding
priority. The bill will require submission of three new waiver amendments to CMS.
LB239 changes the age limit from 21 to 18 for participants under funding priority four. There are currently 199
participants aged 18-20 waiting for day services and 67 participants aged 18- 20 on the Family Support Waiver
(FSW) that would begin receiving day services when the age limit is changed from 21 to 18.
The estimated cost for these individuals would be $6,596,800 ($2,880,493 state general funds and $3,716,307
federal funds) in fiscal year 2026 and $7,850,192 ($3,551,819 state general funds and $4,298,373 federal
funds) in fiscal year 2027.
MAJOR OBJECTS OF EXPENDITURE
PERSONAL SERVICES:
NUMBER OF POSITIONS 2025-2026 2026-2027
POSITION TITLE 26-26 26-27 EXPENDITURES EXPENDITURES
Benefits...............................................................................................................................
Operating............................................................................................................................
Travel..................................................................................................................................
Capital Outlay.....................................................................................................................
Aid......................................................................................................................................
$6,596,800 $7,850,192
Capital Improvements.........................................................................................................
TOTAL............................................................................................................
$6,596,800 $7,850,192