When caregiving becomes a job
For many Nebraska families, caregiving isn't something that starts when someone clocks in for a shift.
It starts when a parent helps a child with daily tasks that other children their age can do independently. It's a spouse helping with dressing, bathing or mobility. It's arranging appointments, managing daily routines and making sure someone you love can remain safe at home.
For some families, that care goes far beyond what would ordinarily be expected of a parent or spouse.
And in Nebraska, there may be a way for that work to become paid employment.
What is LRI Personal Care in Nebraska?
Nebraska's Medicaid Home and Community-Based Services programs include a service called LRI Personal Care.
LRI stands for Legally Responsible Individual. Nebraska defines an LRI specifically as the natural or adoptive parent of a minor child or the spouse of a waiver participant.
Through LRI Personal Care, a qualifying parent or spouse may be able to become a paid caregiver for the person they are already caring for at home.
There are important eligibility requirements. This is not a program that automatically pays someone simply because they are caring for a family member.
Nebraska requires the person receiving care to have what the state defines as extraordinary care needs. These are needs that go beyond the care a parent or spouse would normally provide for a person without a disability or chronic illness of the same age.
A Service Coordinator works with the family to complete Nebraska's Extraordinary Care Tool, known as the DD-26, to determine whether the individual qualifies and how much LRI Personal Care may be authorized. Approved LRI Personal Care cannot exceed 40 hours per week.
More than a paycheck
For families providing significant amounts of care, employment can make a meaningful difference.
Many caregivers reduce their hours at another job, change careers or leave the workforce altogether because someone they love needs them at home.
Becoming an LRI caregiver doesn't change the fact that you're a parent or spouse first. It recognizes that some of the care you're providing is also work.
When an LRI becomes an employee of an agency such as Safe at Home, that can mean more than receiving a paycheck for authorized caregiving hours.
Eligible Safe at Home employees may also have access to benefits including health, dental and vision insurance, life insurance, short-term disability, a 401(k) and paid sick leave.
For a family that has had to balance providing care with maintaining employment, those benefits can matter.
Why does the agency matter?
Not every home care agency provides LRI Personal Care.
LRI Personal Care is a regulated Medicaid service, and agencies that provide it have responsibilities that extend well beyond processing a paycheck.
To participate, an agency must meet Nebraska's Medicaid provider requirements and maintain the policies and processes required for LRI Personal Care. Once an LRI caregiver is employed, the agency is responsible for required screening, training, supervision, documentation and other ongoing program requirements.
LRI caregivers themselves have requirements to meet as well. They are employees of the agency and must complete required screening and training and provide care according to the participant's approved service plan.
Safe at Home has made LRI Personal Care part of the services we provide because we see the value it can bring to Nebraska families. We handle the employment side of the relationship, including onboarding, training, payroll and ongoing support.
The state determines eligibility for waiver services and how much LRI Personal Care may be authorized, but families don't have to navigate the employment side of the process alone.
Could your family qualify?
Every family's circumstances are different.
If you are the parent of a minor child with a disability or chronic illness, or the spouse of someone who requires significant assistance with daily living, it may be worth asking whether LRI Personal Care is an option.
A good place to begin is with your Nebraska DHHS Service Coordinator or by learning more about Nebraska's Home and Community-Based Services waiver programs.
You can also talk with Safe at Home about what becoming an LRI employee through our agency looks like, what the employment process involves and what benefits may be available to eligible employees.
Sometimes the person best suited to provide care isn't a stranger coming through the door.
Sometimes they're already home.
Not sure where to start?
If you think LRI Personal Care may be an option for your family, you don't have to figure out the process on your own.
Applications for Nebraska's Aged and Disabled Waiver can be started online through Nebraska iServe. Safe at Home staff can also help you understand where to begin and what steps may come next.
Call our Client Relations team at (308) 249-0718 to talk with someone directly.
Learn more
For official information about LRI Personal Care, waiver eligibility and Nebraska's Home and Community-Based Services programs, visit the Nebraska Department of Health and Human Services:
Details about LRI Personal Care, extraordinary care and the DD-26 assessment.
Information about services and eligibility through Nebraska's Aged and Disabled Waiver.
Information about Nebraska's Developmental Disabilities waiver services.
Information about waiver eligibility and how to apply.
