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State Autism Profiles: Nebraska

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DEMOGRAPHICS

In 2000, 374 or 0.87% of children ages 3-21 who received special education services in Nebraska have autism. In 2014-2015, 3,068 or 6.48 % of children with disabilities ages 3-21 who received special education services have autism.

Table 1-1: IDEA Part B - Children with Autism in Nebraska for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

 37

263

Age 6-21

 337

2,805

Age 3-21

 374

3,068

Source: Reported by the State of Nebraska in accordance with Section 618 of IDEA to U.S. Department of Education, Office of Special Education Programs

Table 1-2: IDEA Part B - Children with Disabilities in Nebraska for 1999-2000 and 2014-2015
(Child Count by Age Group)

  1999-20002014-2015
Age 3-5

 3,724

5,465

Age 6-11

 19,420

21,686

Age 12-17

17,594 

18,368

Age 18-21

 2,055

1,822

Age 6-21

 39,069

41,876

Age 3-21

 42,793

47,341

Source: Reported by the State of Nebraska in accordance with Section 618 of IDEA to U.S. Department of Education, Office of Special Education Programs

STATE TASK FORCE

The State of Nebraska does not have an active task force on autism at this time. 

STATE INSURANCE COVERAGE

On April 21, 2014, Governor Dave Heineman signed into law L.B. 254 a requirement to provide insurance coverage for the screening, diagnosis, and treatment of autism spectrum disorder in an individual less than twenty-one years of age. The new law requires coverage for speech, occupational and physical therapy, as well as pharmaceutical care for the treatment of autism. No visit or dollars are imposed on those services.  The law also includes coverage of behavioral health treatment, and pharmacy, psychiatric, psychological, and therapeutic care. Coverage for behavioral health treatment, including applied behavior analysis, is limited to twenty-five hours a week until the insured reaches twenty-one years of age, and the insurer is able to review treatment once every sixth months. Certain insurance plans are exempt from providing the autism requirement, including health plans sold in the individual or small group federally facilitated market place under the Affordable Care Act, as well as other limited hospital insurance policies. Also, Nebraska is preempted from mandating coverage on plans governed by the federal Employee Retirement Income Security Act of 1974 (ERISA).
Neb.Rev.Stat. 44-7, 106
Additional coverage may be available under Nebraska’s mental health parity law, which states that mental health conditions must be covered, as with other medical conditions, if the plan offers mental health coverage. The law covers mental health conditions, including autism spectrum disorders, as defined in the International Classification of Diseases. NE Rev Stat §44-792 (2007)

ESSENTIAL HEALTH BENEFITS

Nebraska’s benchmark plan does not include autism services or applied behavior analysis (ABA) as part of the Essential Health Benefits package. Its exchange is being run by the federal government.
(Blue Cross and Blue Shield of Nebraska; Blue Pride)

MEDICAID

On March 30, 2016, the Centers for Medicare & Medicaid Services (CMS) approved Nebraska’s Medicaid state plan amendment to cover applied behavioral analysis (ABA) and behavior modification services under traditional Medicaid retroactive to October 1, 2015. Services include day treatment, community treatment aides and outpatient therapy. Previously the state had refused to cover these services, but a court decision in a class action lawsuit (see below) precipitated the change. 

Nebraska Home and Community-Based Services Waiver: NE Autism
This waiver, implemented on April 8, 2014, provides early intensive behavioral intervention to children ages 0-17 with autism. This waiver expires on April 7, 2017.

Nebraska Home and Community-Based Services Waiver: NE Day Services Waiver for Adults w/DD 
This waiver, implemented on January 1, 2011, provides integrated community employment, prevocational workshop habilitation, respite, assistive technology and supports, behavioral risk services, community inclusion day habilitation, community living and day supports, home modifications, medical risk services, PERS, retirement services, team behavioral consultation, vehicle modifications, vocational-planning habilitation, and workstation habilitation for individuals ages 21 and older with autism, intellectual disability, and developmental disabilities. This waiver was scheduled to expire on December 31, 2015, however the CMS site continues to show it as active. 

Nebraska Home and Community-Based Services Waiver NE Comprehensive DD Waiver for AdultsThis waiver, implemented on January 1, 2011, provides group home residential habilitation, integrated community employment, prevocational workshop habilitation, respite, assistive technology and supports, behavioral risk services, community-inclusion day habilitation, community living and day supports, companion home residential habilitation, extended family home residential habilitation, home modifications, in-home residential habilitation, medical risk services, PERS, retirement services, team behavioral consultation, vehicle modifications, vocational planning habilitation, and workstation habilitation for individuals ages 21 and older with autism, intellectual disability, and developmental disabilities. This wavier was scheduled to expire on December 31, 2015, however the CMS site continues to show it as active.
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/Waiver-Descript-Factsheet/NE-Waiver-Factsheet.html#NE0187
https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/waivers_faceted.html

LEGAL ACTION AND THE COURTS

In July 2015, a federal district court judge in Lancaster County Nebraska found that the state Department of Health and Human Services policy excluding Medicaid coverage for applied behavior analysis violated federal law. Since the case was certified as a class action. The order applied to all children in similar situations in Nebraska. The state decided not to appeal the decision. The judge’s opinion rested on the fact that the services were medically necessary and therefore must be covered under Medicaid for its Medicaid eligible children. The state’s decision not to appeal was also based on a CMS 2014 guidance that autism services cannot be categorically denied and must be covered under the federal Medicaid program’s Early Periodic Screening Diagnosis and Treatment rules (EPSDT).
http://www.livewellnebraska.com/health/judge-nebraska-medicaid-must-cover-treatments-for-kids-with-autism/article_49d17858-2030-11e5-82d8-238cec9f7d33.html
http://www.kearneyhub.com/news/regional/nebraska-won-t-appeal-ruling-expanding-autism-coverage-under-medicaid/article_139326ec-36b5-11e5-aa3e-6f6ee96036d0.html

EDUCATION

Nebraska Autism Spectrum Disorder (ASD) Network
The Nebraska ASD Network was established in 2002 and is funded by the Nebraska Department of Education. The ASD Network offers training to schools and families through workshops and trainings, and supports children with autism spectrum disorders through the regional autism centers or the Nebraska Autism Spectrum Disorders Regions.
http://www.unl.edu/asdnetwork/

EDUCATION PROGRAMS AND ACTIVITIES

Autism Conference
The Nebraska ASD Network hosts an annual conference on autism spectrum disorders. The conference is an opportunity for parents, educators, and students to learn more about autism and best practices for educational services.
http://www.unl.edu/asdnetwork/

STATE LEGISLATIVE CALENDAR

The Nebraska State Legislature meets annually on the first Wednesday in January for approximately 90 days in odd-numbered years or for 60 days in even-numbered years. The 2016 session convened on January 6, 2016 and adjourned on April 20, 2016. The 2017 session is expected to convene January 4, 2017 and adjourn in May 2of 2017.
http://nebraskalegislature.gov/

Sponsors of Autism Legislation

  • Sen. Colby Coash (Lincoln) District 27

Prepared by Easterseals, Inc.; November 2016.

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