Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 467 - MEDICALLY HANDICAPPED CHILDREN'S PROGRAM › Chapter 2 - REFERRAL, APPLICATION, AND ELIGIBILITY FOR THE MEDICALLY HANDICAPPED CHILDREN'S PROGRAM AND THE GENETICALLY HANDICAPPED PERSONS PROGRAM › Section 467-2-003 - MEDICAL AND FINANCIAL ELIGIBILITY

Current through June 17, 2024
Eligibility for the Medically Handicapped Children's Program
				  and Genetically Handicapped Persons Program is based on medical eligibility and
				  financial qualifications. Current medical and financial information must be
				  provided.
003.01
MEDICAL
				ELIGIBILITY DETERMINATION.
Medical eligibility is determined by
				either the Department or Department designated medical reviewer. If an
				applicant is seen by a Department designated clinic team, medical eligibility
				can be determined without going through the medical reviewer. Eligibility is
				specific to one or more diagnosis and each diagnosis must meet the
				qualifications in Chapter 3. To determine eligibility, the medical records must
				include the diagnosis and a current individual medical treatment plan developed
				by a physician, physician assistant, or nurse practitioner. Medical records
				submitted must have a date of service less than six months prior to the
				determination request date.
003.02
MEDICAL ELIGIBILITY REVIEWS.
Current medical specialty
				reports must be received for the eligible diagnosis at the time of review
				annually. Department designated clinic team reports may take the place of a
				specialty report. Medical eligibility for reviews are not determined by a
				medical consultant.
003.03
FINANCIAL ELIGIBILITY DETERMINATION.
Financial
				eligibility is determined based on the probable cost of specialized medical
				care and the income and resources available to the applicant, parents, or legal
				guardians. The recipient's income must be at or below 185 percent of the
				federal poverty level for the appropriate family size after countable income is
				figured minus deductions. If the family's income minus deductions exceeds the
				requirement, a financial margin must be calculated. Countable income includes
				all income not listed as exclusions in the Title.
003.03(A)
INCOME
				EXCLUSIONS.
The following are excluded as sources of income:
(i) Withdrawals of bank deposits;
(ii) Money borrowed;
(iii) Tax refunds;
(iv) Cash gifts under $500;
(v) Earnings of all children age 18 years and
				younger;
(vi) Child or spousal
				support;
(vii) Subsidized adoption
				or subsidized guardianship payments from Title IV-E or child welfare
				funds;
(viii) Value of United
				States Department of Agriculture donated foods;
(ix) Any payment received under the Uniform
				Relocation Assistance and Real Property Acquisition Policies Act of
				1970;
(x) Loans, grants, and
				scholarships obtained and used under conditions that prohibit the use for
				current living costs;
(xi) Alaska
				Native Claims Settlement Act payments to the extent the payments are exempt
				from taxation under section 21(a) of the Act;
(xii) Value of Supplemental Nutrition
				Assistance Program and the special food service program for children under the
				National School Lunch Program Child Nutrition Act of 1966, as
				amended;
(xiii) Money awarded by
				the Indian Claims Commission or the Court of Claims;
(xiv) Reimbursement of expenses or payments
				for services from the Senior Companion Program, AmeriCorps, Senior Corps,
				Foster Grandparents, Service Corps of Retired Executives, Experience Works, and
				any other programs under Title II and III of Public Law 93-113;
(xv) Payments to an individual participating
				in training or school attendance subsidized Vocational Rehabilitation within
				the Nebraska Department of Education; and
(xvi) Low Income Energy Assistance
				funds;