Many Nebraskans age 65 and older with health limitations, as well as younger people living with a disability, want to remain in their own homes.

Medicaid's Home and Community Based Services Waiver programs can make it possible.

Stephanie Hoyt, who supervises the Medicaid Aged and Disabled Waiver program at the Eastern Nebraska Office on Aging, said it waives the fees for in-home support. Medicaid-eligible Nebraskans ages 18 to 64 with a disability, and those over 65 who require nursing home-level care, are eligible based on certain qualifications.

"It's a combination of personal care assistance, cognition, risk factors, and medical," Hoyt outlined. "Those are the four different areas that make up needing nursing facility-level care."

Hoyt pointed out the services used most often include a medical alert system and basic personal care assistance, such as help with bathing, dressing, eating and mobility. Some people can receive cleaning, laundry, shopping and meal prep assistance. Applications are made with the Nebraska Department of Health and Human Services, and the state's Area Agencies on Aging administer the program.

Medicaid waivers are also available for developmental disability and traumatic brain injury. Hoyt explained someone whose spouse or other family member provides support can still qualify for the waiver program.

"If the spouse is there and able to do it, but also wants to be able to go and have lunch with friends one day, or to be able to go to their doctor's appointments, then there's still a need because one person can't do everything for another person," Hoyt observed. "They still have to be able to take care of themselves, or they're no longer support."

She pointed out married couples may have to go through a spousal impoverishment process in order for the spouse needing care to qualify for Medicaid.

Hoyt added some non-spouse family members even qualify to receive pay for their caregiving.

"Sometimes they'll quit their work and get approved as an Aged and Disabled Waiver Provider," Hoyt noted. "Then they get paid to provide a certain amount of hours to supplement some of that income if they've had to leave work."

Medicaid waivers can also help people with the cost of assisted living once they qualify for Medicaid if the facility accepts the waiver. Hoyt said sometimes people improve enough while in a long-term care facility to move back home with Medicaid Waiver services.


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Rural Nevada is facing a housing and transportation crisis. Advocates for those with disabilities say things are getting out of hand.

Dee Dee Foremaster, director of the Rural Center for Independent Living, said there is not enough available low-income housing, and added the units that are available to folks on the Housing Choice Voucher program, formerly called Section Eight, is "substandard."

She added the average Nevadan on Social Security receives almost $1,000 a month. But the average Nevadan can expect to pay around $1,400 a month in rent.

"People are having to double up to be able to make their rent. And it makes it difficult because a lot of times some people with disabilities really would prefer to live by themselves," she said.

Foremaster added she is among those who feel like the calls they are making for housing reform are falling on deaf ears. And while local leaders are eyeing federal lands as part of the solution to address the housing shortage, Foremaster said she has solutions that are more immediate, including creating a program for landlords to receive tax incentives for allocating units to low-income Nevadans.

She stressed that even in rural Nevada, the housing supply isn't able to keep up with demand, and said easing restrictions on accessory dwelling units would help everyone.

"So that people have an array of plans to be able to draw from that are approved, so that they don't have to go through the building commission and hoops that we all have to jump through every time we want to build something on a property," she explained.

Margaret Marcucci, with the Elko support staff of the Rural Center for Independent Living, said a lack of transportation is another issue impacting people's daily lives.

"I won't tell you how many times I get calls from friends, going 'I'm stuck, can you come get me?' or 'Can you take me to an appointment?' said Marcucci. "A lot of our seniors and a lot of disabled do not go to the doctor because they can't get there."

Last year, a free ride-share program launched in rural Nevada to help remove barriers to access medical care. But Marcucci is calling for a more diversified and flexible fleet of services that can get folks to where they need to go.


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Maryland is facing a $3 billion budget deficit, and planned cuts in 2026 would include millions in disability assistance. But one advocate says those cuts would threaten lives.

More than 20,000 Marylanders with disabilities receive state support to help their families afford caregiver services. More than 3,500 families use self-directed services, which give families the ability to set up caregiving separately from traditional programs.

Those services in the proposed budget will face cuts, which advocates say would drive caregivers out of the system to better-paying opportunities.

Montgomery County resident Hamza Khan, a disability rights advocate, has two siblings with special needs. He said funding issues stem from the state overextending itself while getting federal COVID-19 assistance.

"As the pandemic wound down, the state also received one-time federal injections of cash into our budget," Khan said. "And it appears that the governor built those into long-term injections of cash - that he built those structurally into the budget, rather than counting for them to be one time."

Gov. Wes Moore's supplemental budget avoided steep cuts through the rest of 2025, but did not address more than $400 million in cuts for next year.

Khan pointed out these cuts to disability assistance come as the state has added 5,000 employees to its payroll. Khan said these proposed budget reductions would run counter to current laws that require more community input - and give Maryland families the right to choose their care.

"Given the fact that 18,000 people are going to suffer extraordinary pain, and some of them might very well die, he should prioritize funding that prior arrangement first," Khan added. "It's been guaranteed under Maryland law for many years, and it's been expected that costs would rise, but they haven't risen so extraordinarily that the budget can't cover for that."

State salaries, wages and benefits are projected to cost Marylanders $12.2 billion in 2025.


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Tennessee's Disability Day on the Hill is an opportunity for people living with a disability to unite, and engage in the legislative process.

The Centers for Disease Control and Prevention reports nearly 1.6 million Tennesseeans have a disability.

Carrie Carlson, director of community engagement with the Tennessee Disability Coalition, said people are encouraged to meet them for the Disability Day on the Hill in Nashville.

The event focuses on issues and challenge policies that threaten protections under the Americans with Disabilities Act.

"Disability Day on the Hill is a day where hundreds of people with disabilities will come to Nashville, to Cordell Hull, and get involved in the legislative process," said Carlson, "meaning having meetings with their Senate and House of Representatives."

She said Tennesseans with disabilities face unequal access to education, housing, transportation, and health care.

The theme for Wednesday's event is Liberty Not Limits, which means having a disability should not limit your liberty to live the life of your choosing.

Carlson said Tennesseans are encouraged to light up and wear "coalition blue," and post to social media in support of Disability Advocacy Day.

She added that this will be the fifth year recognizing March 11 as Disability Advocacy Day, with an annual proclamation that highlights the strength of advocacy efforts.

"Disability Advocacy Day," said Carlson, "is a day where specific landmarks across the state of Tennessee in each region West, middle and East go blue to show the amazing accomplishments and advocacy efforts of Tennesseans with disabilities."

Carlson said Disability Advocacy Day began with key landmarks in Tennessee lighting up blue to raise awareness, and chosen to address transportation barriers.

Now, it has expanded as communities participate in their own ways - lighting homes, wearing blue, and gathering for photos to show support for local advocacy work.



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