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And I suspect the determination is made by doctors and other health professionals familiar with the patient. Or the patient in question might request themselves to be hospitalized.

There should be a system in place through which someone can appeal their incarceration, generally a hearing before a judge. I don't know the specifics of how it does or doesn't work in Nebraska, but in general the DOJ is notoriously loathe to bring cases like this. It might be better under President Biden--and I hope it is--but in the past disability rights advocates have castigated the DOJ for being so lax when it comes to enforcing the ADA. So the fact that the DOJ has taken this action means I think that the Nebraska system is definitely a problem.

I'll be curious to see more details, and follow this to see if and how it is resolved.