reglab/statecodes huggingface dataset:
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 3 - ELIGIBILITY AND AUTHORIZATION › Section 404-3-004 - HEARINGS FOR ISSUES RELATED TO DEVELOPMENTAL DISABILITIES SERVICES FUNDED BY STATE GENERAL FUNDS

Current through June 17, 2024
An individual has the right to appeal decisions made by the
				  Department with respect to State General Fund services as follows:
(A) The denial, change, or termination of
				eligibility of the individual for specialized services;
(B) The evaluation of the
				individual;
(C) The provision of
				specialized services to the individual;
(D) The amount of the individual's authorized
				funding; or
(E) The records
				relating to the individual.
004.01
				An individual is not entitled to appeal when state or federal law requires
				automatic changes adversely affecting some or all classes of persons applying
				for or receiving services under the Developmental Disabilities Services
				Act.
004.02
TIMELINESS
				OF APPEAL.
In order to exercise the right to appeal, an individual
				must file a formal appeal, within 90 days of the mailing date of the decision
				being contested. If the individual does not file an appeal, the decision
				becomes final on the 90th day after the mailing date of the decision.
004.03
REQUESTING A
				HEARING.
In order to exercise the right to a hearing, the
				individual must file an appeal with the Department. The appeal may be made on a
				form provided by the Department for such purpose or in another writing that
				contains at least the following information:
(1) The name, address, and phone number of
				the appellant; the name, address, and phone number of the legal representative,
				if applicable; and the signature of the appellant or legal
				representative;
(2) The specific
				decision contested;
(3) The date of
				the decision contested; and
(4) Any
				other information that the individual wants to be included at the
				hearing.
004.03(A) If the appeal
				fails to include any of the above information, it will be ineffective to
				initiate the hearing process and the Department may either reject the appeal or
				request additional information from the individual.
004.03(B) In order to be effective, the
				appeal must be either mailed, sent via electronic mail, submitted by telephone
				or online portal, or hand delivered to the Department.
004.03(C) If mailed, the appeal will be
				deemed to be received by the Department on the date of the postmark. If hand
				delivered, emailed, or submitted via online portal or telephone, the appeal
				will be deemed to be received by the Department on the actual date of
				receipt.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 4 - CERTIFICATION REQUIREMENTS FOR CERTIFIED PROVIDERS OF SERVICES › Section 404-4-002 - ADMINISTRATION STANDARDS

Current through June 17, 2024
All agency providers of services under the Developmental
				  Disabilities Services Act must meet the administration standards and
				  requirements in this section.
002.01
MEDICAID PROVIDERS.
All providers must be an enrolled
				Medicaid provider pursuant to applicable laws and regulations relating to the
				Nebraska Medical Assistance Program.
002.02
DIRECTOR.
Each provider must have a director who is responsible for overall management
				and compliance of the requirements in this Title, establish policies and
				procedures as specified in this chapter, and ensure compliance with applicable
				laws and regulations.
002.03
PROVIDER POLICIES AND PROCEDURES.
The provider must
				establish and implement written policies and procedures that:
(1) Describe the provider's operation and how
				systems are set up to meet participants' needs;
(2) Comply with all applicable regulations
				and laws governing providers;
(3)
				Are available to staff; and
(4) Are
				reviewed at least annually and revised if needed.
002.03(A)
PROCEDURAL REQUIREMENTS
				REGARDING RIGHTS.
The provider must establish procedures that:
(i) Specify participant rights and
				responsibilities and this specification does not conflict with Title 404
				NAC;
(ii) Inform each participant
				served, and if applicable, the participant's parent if a minor, or the
				participant's legal representative, of the participant's rights and
				responsibilities;
(1) The information must be
				given at the time of entry to services, at the participant's annual individual
				support plan (ISP) review, and when significant changes occur; and
(2) The information must be provided in a
				manner that is easily understood, given verbally and in writing, in the native
				language of the participant, or through other modes of communication necessary
				for understanding;
(iii)
				Require the provision of supports to participants receiving services in
				exercising their rights;
(iv) Do
				not treat participants' rights as privileges; and
(v) Prohibit retaliation against
				participants' services and supports due to the participant, family members, or
				legal representatives advocating on behalf of the participant served. This
				includes initiating a complaint with outside agencies.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 4 - CERTIFICATION REQUIREMENTS FOR CERTIFIED PROVIDERS OF SERVICES › Section 404-4-004 - QUALITY ASSURANCE AND QUALITY IMPROVEMENT (QA/QI)

Current through June 17, 2024
The provider must have a quality assurance and quality
				  improvement (QA/QI) process. This process must include:
(1) Ongoing proactive internal review of the
				quality and individualization of services;
(2) Continuous quality review of the services
				provided; and
(3) The provider must
				provide evidence that participants served and their families are involved in
				the quality assurance and quality improvement (QA/QI) process.
004.01
QUALITY ASSURANCE AND
				QUALITY IMPROVEMENT (QA/QI) STRUCTURAL COMPONENTS.
The provider
				must create the structural components of the quality assurance and quality
				improvement (QA/QI) process. The process must be applied on a provider-wide
				basis and include:
(A) Areas of services to be
				monitored and evaluated to determine the quality of these services through
				identification of patterns and trends of the provider services; and
(B) Provisions for reviewing quality
				assurance and quality improvement (QA/QI) policies and procedures at least
				annually and revising as needed.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES › Section 404-5-001 - PROVIDER SERVICE STANDARDS

Current through June 17, 2024
All certified agency providers and independent providers of
				  services under Medicaid Home and Community Based Services waivers must meet
				  requirements established by the Department of Health and Human Services in
				  this.
001.01 Provider services are
				based on goals and needs identified in the participant's individual support
				plan (ISP). The provider must:
(A) Participate
				in the individual support planning team;
(B) Provide services in accordance with the
				participant's individual support plan (ISP);
(C) Prioritize the needs of the participant,
				such that:
(i) The participant is challenged
				to overcome barriers that result in the need for specialized services;
				and
(ii) The highest level of
				independence in all areas of community living is achieved;
(D) Develop strategies and supports that are:
(i) Based on prioritized needs;
(ii) Relevant to the individual support plan
				(ISP);
(iii) Functional;
(iv) Tailored to individual needs, and
				respectful of participant choice; and
(v) Documented in the individual support plan
				(ISP);
(E) Implement
				training and supports consistently in all settings, as the need arises and as
				opportunities occur;
(F) Encourage
				and reinforce incidental learning and appropriate behaviors;
(G) Provide activities and environments that
				facilitate acquisition of skills, appropriate behavior, greater independence,
				and personal choice;
(H) Accurately
				measure performance and modify training, supports, or both based on data and
				changes in the participant's circumstances; and
(I) Monitor service delivery and address
				needs as they occur. Participants with conditions that make further growth or
				development unlikely must receive training and supports designed to maintain
				skills and functioning and to prevent regression to the fullest extent
				possible.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES › Section 404-5-002 - TRANSPORTATION

Current through June 17, 2024
If the provider transports participants, the provider must
				  ensure that all participants are transported in a safe and comfortable manner
				  that meets the needs of each participant. The provider must:
(A) Use vehicles adapted to meet the needs of
				the participants;
(B) Take adequate
				measures to provide a sufficient number of staff in the vehicle to ensure
				safety and to meet the needs of each participant being transported;
				and
(C) Only have people
				transporting participants served that:
(i)
				Have a valid driver's license with the appropriate class code;
(ii) Assist participants into and out of
				vehicles and to and from parking places, as appropriate; and
(iii) Have received training in first aid,
				cardiopulmonary resuscitation (CPR), and in meeting the needs of the specific
				participants for whom transportation is provided.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES › Section 404-5-003 - COMPLAINTS AND GRIEVANCES

Current through June 17, 2024
The provider must promptly address complaints and grievances
				  filed with the provider on behalf of participants served. The provider's
				  process to address complaints and grievances must:
(A) Be made available to participants, legal
				representatives, staff, and other representatives. Utilization of the
				provider's process is voluntary and is not meant to deny or delay a
				participant's right to file a complaint elsewhere or to access the legal
				system;
(B) Be convenient to the
				participant;
(C) Include time
				frames and procedures for review of complaints and grievances and the provision
				of a response;
(D) Be reviewed by
				the provider with the participant and his or her legal representative, where
				applicable; and
(E) Include the
				right to access the court system.
The provider must maintain documentation of the receipt of
				  all complaints and grievances, the resolution, and the response to the
				  complainant.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES › Section 404-5-004 - ABUSE AND NEGLECT

Current through June 17, 2024
The provider must develop and implement a system to detect
				  and prevent abuse or neglect and to handle allegations or suspicions of abuse,
				  neglect, or exploitation. The provider must:
(A) Establish a definition of abuse or
				neglect that is consistent with these regulations;
(B) Establish a process and timelines for
				prompt and accurate reporting of allegations or suspicions of abuse or neglect
				to appropriate outside authorities that is in accordance with applicable
				law;
(C) Have measures and
				timelines for reporting of allegations or suspicions of abuse or neglect to
				appropriate provider administrative staff; the legal representative, if
				appropriate; and the service coordinator;
(D) Conduct a timely, thorough, and objective
				investigation of all allegations or suspicions of abuse or neglect, including
				protection of participants during the investigation;
(E) Establish a process for disciplinary
				action taken when staff are found to have engaged in abusive or neglectful
				behavior; and
(F) Take appropriate
				corrective or disciplinary action in response to the investigation. As part of
				this action, the provider must:
(i) Complete a
				review, by the director of the entity or designee, of all allegations or
				suspicions, and investigations and make decisions on the action to be
				taken;
(ii) Identify the means to
				lessen the likelihood of further incidents if the allegation or suspicion is
				substantiated; and
(iii) Document
				the allegation or suspicion, investigation, conclusion, action taken, and means
				to prevent further incidents.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES › Section 404-5-005 - CONFIDENTIALITY

Current through June 17, 2024
The provider must protect the confidentiality of each
				  participant's information, including verbal, electronic, and written forms.
				  Participant information must be protected regardless of the form or storage
				  method of the records. Participant information may not be released without
				  valid legal consent except as otherwise provided by law.
005.01 The provider must specify the method
				and frequency for obtaining authorizations for medical treatment and
				consents.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES › Section 404-5-006 - RECORD KEEPING

Current through June 17, 2024
The provider must maintain accurate, current, and complete
				  administrative records and records specific to participants in services.
006.01
PARTICIPANT
				RECORDS.
The participant's records must contain information that
				includes, but is not limited to:
(A) Date of
				entry into services with the provider;
(B) Name, gender, and birth date of the
				participant;
(C) Current physical
				description or current photo of the participant;
(D) The language or means of communication
				utilized by the participant;
(E)
				Legal status of participant, and name, telephone number, and address of
				guardian, if applicable;
(F) Name,
				phone number, and address of persons to contact in an emergency;
(G) Name, phone number, and address of the
				participant's current personal physician and other health care professionals,
				if applicable;
(H) Relevant medical
				information including but not limited to: history of seizures, illness,
				physician orders, treatments, medications, medication history, known allergies,
				immunizations, physician contacts, emergency room visits, dental visits,
				counseling visits, and hospitalizations;
(I) Records of incidents and
				accidents;
(J) Consents as
				appropriate;
(K) Records of
				emergency safety intervention usage and the rationale for use;
(L) Individual support plan (ISP);
(M) Documentation of delivery of services and
				supports;
(N) The participant's
				rights notification;
(O) Notice of
				charges;
(P) Name of service
				coordinator and phone number;
(Q)
				Accounting of the participant's funds, if managed by provider;
(R) Notification of termination of services
				with the provider, if applicable; and
(S) Social history information.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 6 - PROVIDER DATA COLLECTION AND REPORTING › Section 404-6-001 - DATA COLLECTION AND REPORTING

Current through June 17, 2024
Each provider must maintain data, statistics, schedules,
				  reports, and other information as required by the Department.
001.01
PROVISION OF
				INFORMATION.
The provider must, upon request, submit data,
				statistics, schedules, reports, and any other requested information to the
				Department.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 6 - PROVIDER DATA COLLECTION AND REPORTING › Section 404-6-002 - DEPARTMENT ACCESS

Current through June 17, 2024
Each provider must allow access to records, must provide
				  copies of documents upon request, and must allow access to the provider's
				  operations for on-site review by the Department.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 6 - PROVIDER DATA COLLECTION AND REPORTING › Section 404-6-003 - FISCAL ACCOUNTABILITY

Current through June 17, 2024
Each provider must have fiscal and budgetary financial
				  systems that provide accounting for funds received from the Department. Fiscal
				  accountability must be consistent with generally accepted accounting principles
				  and standards acceptable to the Department.
003.01
ACCOUNTING
				RECORDS.
The provider must maintain accounting records that allow
				the provider to:
(A) Produce a complete
				annual financial report in a format specified by the Department;
(B) Provide copies of source documents and
				work papers;
(C) Maintain records
				for each employee that:
(i) Are prepared at
				the end of each pay period;
(ii)
				Show the employee's:
(1) Name;
(2) Position title or description;
(3) Gross salary;
(4) Taxes; and
(5) All other deductions or
				contributions;
(iii) Are
				the final, approved copies;
(iv)
				Document when personnel are compensated in whole or in part with room and
				board; and
(v) Show charges for
				employee benefits;
(D)
				Maintain itemized records of:
(i) Expenditures
				for technical assistance;
(ii) Cost
				of the operation of programs;
(iii)
				Rent;
(iv) Equipment leasing
				expenses; and
(v) Maintenance costs
				for facilities and services; and
(E) Maintain accounting records in sufficient
				detail to allow for the calculation of the cost of each service
				provided;
(F) Identify costs that
				are not allowed for consideration by Center for Medicaid and Childrens Health
				Insurance Program (CHIP) Services for rate setting purposes, including costs
				associated with the provision of room and board for participants; and
(G) Identify transactions between the
				provider and a related party.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 6 - PROVIDER DATA COLLECTION AND REPORTING › Section 404-6-004 - ANNUAL AUDIT OF CERTIFIED PROVIDERS

Current through June 17, 2024
The certified provider must contract with a certified public
				  accountant licensed to practice in the State of Nebraska for an annual
				  independent audit of its financial operations. This audit must be conducted
				  using generally accepted auditing standards acceptable to the Department. A
				  certified provider is exempt from the annual audit requirement described in
				  this paragraph if the certified provider's gross receipts from Medicaid Home
				  and Community Based Services developmental disabilities waiver program payments
				  for its fiscal year are less than $1,500, 000.00. A certified provider must
				  comply with the annual audit requirement for any fiscal year in which its gross
				  receipts from Medicaid Home and Community Based Services Developmental
				  Disabilities Waiver program payments equal or exceed $1,500, 000.00.
004.01
AUDIT REPORT.
The certified provider must submit the required audit report, if any, to the
				Department within 180 calendar days after the end of the provider's first full
				fiscal year, and for every fiscal year thereafter unless otherwise exempt. At a
				minimum, the audit report must include:
(A) A
				review of receipts and disbursements;
(B) A review of cash control
				procedures;
(C) An audit of the
				provider's income statement, balance sheet, source, and use of funds
				statement;
(D) An accounting of all
				lease agreements and mortgages and, if requested by the Department, a copy of
				any such documents;
(E) A review of
				the cash balance on hand at the beginning and at the end of the fiscal
				year;
(F) A disclosure of all
				related party transactions, or a statement attesting that no such transactions
				were found;
(G) A disclosure of
				all deficiencies in internal control over financial reporting identified during
				the audit; and
(H) An accounting of
				all business lines of credit for which the provider is approved at the end of
				its fiscal year.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 404 - DEVELOPMENTAL DISABILITIES SERVICES › Chapter 6 - PROVIDER DATA COLLECTION AND REPORTING › Section 404-6-005 - COMPLIANCE AUDITS

Current through June 17, 2024
All providers must permit the Department, the U.S. Department
				  of Health and Human Services, and any other duly authorized agent or
				  governmental agency to perform audits or inspections, or both, of its
				  records.
005.01 The provider must
				retain all financial records, supporting documents, statistical records, and
				all other records as directed by the Department. The provider must retain such
				records in a format acceptable to the Department.
005.02 The provider may be required to
				prepare and submit a plan to the Department to address audit
				findings.
005.03 The certified
				provider may establish a fiscal year for accounting purposes, but if the
				provider does not establish a fiscal year the Department will presume the
				provider's fiscal year is July 1 through June 30 for purposes of enforcing the
				requirements of this chapter
005.04
				Failure to comply with the requirements imposed upon certified providers in
				this chapter may result in reduction in or reimbursement of funds, or
				disciplinary action or termination of certification as provided for in 404 NAC
				4, or other applicable law or regulation.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 1 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT › Section 405-1-001 - SCOPE AND AUTHORITY

Current through June 17, 2024
These regulations govern taxes levied against an Intermediate
				  Care Facility for Individuals with Developmental Disabilities (ICF/DD). The
				  regulations implement provisions of the Intermediate Care Facility for
				  Individuals with Developmental Disabilities (ICF/DD) Reimbursement Protection
				  Act, Nebraska Revised Statute (Neb. Rev. Stat.) §§
									68-1801
				  to
				  68-1809.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 1 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT › Section 405-1-002 - REMITTANCE OF TAX

Current through June 17, 2024
The Intermediate Care Facility for Individuals with
				  Developmental Disabilities (ICF/DD) provider must remit one-twelfth of the tax
				  obligation to the Department for credit to the Intermediate Care Facility for
				  Individuals with Developmental Disabilities (ICF/DD) protection fund by the end
				  of each month.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 1 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT › Section 405-1-003 - REFUND OF OVERPAYMENT OF TAX

Current through June 17, 2024
An Intermediate Care Facility for Individuals with
				  Developmental Disabilities (ICF/DD) provider who has paid an amount in excess
				  of the required tax may request a refund. The Intermediate Care Facility for
				  Individuals with Developmental Disabilities (ICF/DD) provider must request the
				  refund in writing to the Department and must identify the reason why the
				  provider believes an overpayment has occurred and the estimated amount of the
				  overpayment.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 2 - NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Section 405-2-001 - SCOPE AND AUTHORITY

Current through June 17, 2024
These regulations govern assessments levied against nursing
				  facilities and skilled nursing facilities. The regulations implement provisions
				  of the Nursing Facility Quality Assurance Assessment Act as set forth in
				  Nebraska Revised Statute (Neb. Rev. Stat.) §§
									68-1901
				  to
				  68-1930.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 2 - NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Section 405-2-002 - REDUCTION OF ASSESSMENT

Current through June 17, 2024
As permitted by Neb. Rev. Stat. §
									68-1919,
				  the two facilities with the highest volume of Medicaid residents shall pay a
				  reduced quality assurance assessment of $ 1.98 per day.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 2 - NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Section 405-2-003 - REFUND OF OVERPAYMENT OF ASSESSMENT

Current through June 17, 2024
A nursing facility or skilled nursing facility provider who
				  has paid an amount in excess of the required assessment may request a refund.
				  The nursing facility or skilled nursing facility provider must request the
				  refund in writing to the Department and must identify the reason why the
				  provider believes an overpayment has occurred and the estimated amount of the
				  overpayment.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 405 - INTERMEDIATE CARE FACILITY FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES (ICF/DD) REIMBURSEMENT PROTECTION ACT AND NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Chapter 2 - NURSING FACILITY QUALITY ASSURANCE ASSESSMENT ACT › Section 405-2-004 - APPEAL PROCESS

Current through June 17, 2024
Hearings shall be conducted per Nebraska Administrative Code
				  (NAC) Title 465 Chapter 6.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 462 - NEBRASKA HOMELESS ASSISTANCE PROGRAM › Chapter 1 - FUNDING › Section 462-1-001 - GENERAL PROVISIONS

Current through June 17, 2024
These regulations govern funds made available to the Nebraska
				  Homeless Assistance Program through the Homeless Shelter Assistance Trust Fund
				  and the Emergency Solution Grant Fund.
001.01
LEGAL
				AUTHORITY.
The Homeless Shelter Assistance Trust Fund is
				authorized by Nebraska Revised Statue Sections
				68-1601
				through
				68-1608.
				The Emergency Solutions Grant is authorized by Title IV of the McKinney-Vento
				Homeless Assistance Act, 42 U.S.C. §§ 11371-11378 and the Federal
				Code of Regulations 24 CFR § 576. The Nebraska Homeless Assistance Program
				is administered by the Nebraska Department of Health and Human Services, in
				compliance with the Nebraska statutes governing the Homeless Shelter Assistance
				Trust Fund, the federal statutes and regulations governing the Emergency
				Solutions Grant and the Consolidated State Plan prepared by the Nebraska
				Department of Economic Development and the Department.
001.02
FUND
				DISTRIBUTION.
The funds for the program are distributed across the
				state to eligible agencies through a competitive application process. The
				Nebraska Homeless Assistance Program posts the notice of funding opportunity
				publicly on the Nebraska Department of Health and Human Service's
				website.
001.03
SET
				ASIDE OF EMERGENCY DISCRETIONARY FUNDS.
The Nebraska Department of
				Health and Human Services will set aside up to $75,000 of the Homeless
				Assistance Trust Fund to be used for emergency or for discretionary situations
				that occur outside of the annual Homeless Shelter Assistance Trust Fund program
				cycle, related to the support of homeless and near homeless
				populations.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 463 - ADULT PROTECTIVE SERVICES › Chapter 1 - ADULT PROTECTIVE SERVICES › Section 463-1-001 - DEFINITIONS

Current through June 17, 2024
The definitions found in Neb. Rev. Stat. §§
									28-348
				  to
				  28-387,
				  the Adult Protective Services¤ Act, and the following definitions
				  apply:
001.01
CENTRAL
				REGISTRY CHECK.
A Central Registry check is a review of the child
				abuse and neglect Central Registry, a review of the adult abuse and neglect
				Central Registry, or a review of both registries. The individual authorizing
				the Central Registry check, must identify which review is being
				authorized.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 463 - ADULT PROTECTIVE SERVICES › Chapter 1 - ADULT PROTECTIVE SERVICES › Section 463-1-002 - DISCLOSURE OF INFORMATION

Current through June 17, 2024
002.01
SUMMARY OF FINDINGS AND ACTIONS.
Upon request, a
				physician or the person in charge of an institution, facility, or agency making
				a legally mandated report, will receive a written summary of the findings and
				actions taken by the Department in response to such report.
002.01(A) The summary will contain the
				following:
(i) The date of the
				report;
(ii) The name of the
				alleged victim;
(iii) The name of
				the alleged perpetrator;
(iv) The
				allegations; and
(v) The
				findings.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 463 - ADULT PROTECTIVE SERVICES › Chapter 1 - ADULT PROTECTIVE SERVICES › Section 463-1-003 - CENTRAL REGISTRY CLASSIFICATIONS

Current through June 17, 2024
003.01
CENTRAL REGISTRY CLASSIFICATIONS.
Central Registry
				Classifications: The following findings are available to the Department:
003.01(A)
COURT-SUBSTANTIATED.
When a court of competent jurisdiction has entered a judgment of
				guilty against the subject of the report of the abuse, neglect, or
				exploitation. An allegation with this finding will list the perpetrator on the
				Central Registry.
003.01(B)
AGENCY-SUBSTANTIATED
When the Department determines based upon an investigation
				  that a preponderance of evidence supports the allegation of abuse, neglect, or
				  exploitation and the victim is a vulnerable adult. An allegation with this
				  finding will list the perpetrator on the Central Registry.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 463 - ADULT PROTECTIVE SERVICES › Chapter 1 - ADULT PROTECTIVE SERVICES › Section 463-1-004 - NOTIFICATIONS

Current through June 17, 2024
004.01
PERPETRATOR
				NOTIFICATION.
Upon completion of an investigation, the Department
				will provide notification to the person who allegedly abused, neglected, or
				exploited a vulnerable adult as required by Neb. Rev. Stat. §
									28-374.01.
004.02
VULNERABLE ADULT
				NOTIFICATION.
The Department will provide the vulnerable adult or
				his or her guardian or guardian ad litem a written notice of the finding or
				determination and if the person alleged to have abused, neglected, or exploited
				him or her will be listed on the Central Registry.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 463 - ADULT PROTECTIVE SERVICES › Chapter 1 - ADULT PROTECTIVE SERVICES › Section 463-1-005 - EXPUNGEMENTS

Current through June 17, 2024
005.01
REQUESTS FOR AMENDMENT,
				REMOVAL, OR EXPUNGEMENT OF CENTRAL REGISTRY INFORMATION.
Requests
				may be submitted by individuals as set forth in Neb. Rev. Stat. §
									28-380.
				Requests must be written and submitted to the Department.
005.02
PROCESS.
After receiving a written expungement or amendment request, investigation
				information will be reviewed by the Department and a response will be sent to
				the party requesting expungement.
005.02.(A)
DENIAL.
When a decision is made to deny the
				expungement or amendment request, an individual may request an administrative
				hearing to appeal the decision by the Department. The individual must send a
				written request for a hearing to the Department's Hearing Office within 90 days
				of the date the letter denying the request was mailed. Administrative hearings
				will be carried out in accordance with the Administrative Procedure Act and 465
				NAC 6.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 463 - ADULT PROTECTIVE SERVICES › Chapter 1 - ADULT PROTECTIVE SERVICES › Section 463-1-006 - RECORDS ACCESS

Current through June 17, 2024
006.01
COSTS OF RESEARCH OR AUDITING RECORDS.
Estimated costs
				will be provided to the researcher for approval, prior to producing the
				information requested. If the costs associated with the research exceeds $
				50.00, the Department may require
				the researcher to furnish a deposit. Such costs include but are not limited to:
(A) The actual costs of reproduction of
				records at a per page fee in accordance with the rate used to calculate the
				costs for public records requests;
(B) Actual postage costs associated with the
				research;
(C) Staff time calculated
				using the employee's hourly rate of pay. Staff time may include, but is not
				limited to time spent locating records, reviewing records, redacting
				information, copying records, and returning the records to their original
				location;
(D) Any actual costs and
				payment obligations to contractors as a result of the research;
(E) Charge for electronic records, including
				charges for computer run time, programming time, and the time for any analysis
				for the records; and
(F) The actual
				costs of any media provided to the requestor, including DVDs, CDs, and USB
				drives.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-001 - SCOPE AND AUTHORITY

Current through June 17, 2024
The Lifespan Respite Services Program provides funding for
				  eligible unpaid primary family caregivers, hereinafter "caregivers", to
				  purchase respite services. The Program is authorized by Nebraska Revised
				  Statutes (Neb. Rev. Stat.) §§
									68-1520
				  through
				  68-1528.
				  The Program is administered by the Nebraska Department of Health and Human
				  Services hereinafter, "The Department."
001.01
RESPITE
				SERVICES:
Respite is a service designed to give caregivers a break from
				  the demands of providing ongoing care for recipients with special needs unable
				  to care for themselves without regard to age, type of special needs or other
				  status. The basic intent of respite is to:
(A) Prevent or postpone out-of-home
				placements or care at public expense;
(B) Reduce family and caregiver
				stress;
(C) Enhance the family and
				the caregiver's coping abilities;
(D) Strengthen the family and the caregiver's
				ability to meet the demands of caring for family members; and
(E) Reduce the risk of abuse or neglect of
				children, the elderly and other vulnerable individuals.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-003 - NON-DISCRIMINATION

Current through June 17, 2024
The Department does not discriminate against any person
				  applying for or receiving benefits through the Program on the basis of race,
				  color, national origin, gender, age, disability, religion, or political
				  belief.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-004 - FRAUD

Current through June 17, 2024
Any person who knowingly provides false information or
				  knowingly withholds pertinent information to obtain or attempt to obtain
				  services under this Program may have services denied or ended, be charged an
				  overpayment, and be criminally prosecuted for fraud.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-005 - ELIGIBILITY FOR OTHER RESPITE SERVICES

Current through June 17, 2024
The assistance provided by the Program must not replace or
				  reduce services and support by other government-administered programs for which
				  the applicant or recipient is eligible or may be eligible.
005.01
APPLICATION
				REQUIREMENTS.
The applicant or recipient must apply for and
				provide evidence of current application and eligibility denial or lack of
				available funds from other federal or state-funded programs offering respite
				services before eligibility can be determined;
(A) The applicant or recipient must accept
				respite available through another government-administered program; or
(B) A lack of cooperation with other respite
				support programs are grounds for denial or termination from the
				Program.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-006 - INELIGIBILITY DUE TO OTHER AVAILABLE ASSISTANCE

Current through June 17, 2024
The applicant or recipient is ineligible if:
(A) The applicant or recipient has available
				insurance, financial means or other available support programs to cover the
				cost of requested program services;
(B) The applicant or recipient failed to
				apply for, failed to cooperate with the application process; or
(C) The applicant or recipient failed to
				notify the program of services provided by other funding source and continued
				to bill for the same service on the same dates.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-007 - INDIVIDUAL RESPONSIBILITIES

Current through June 17, 2024
Each applicant or recipient must comply with the
				  responsibilities listed below.
007.01
COMPLETE AND ACCURATE INFORMATION.
Each applicant or
				recipient must provide complete and accurate information. State law provides
				penalties of a fine, imprisonment, or both for persons found guilty of
				obtaining assistance or services for which the individual is not eligible by
				making false statements or failing to report promptly any changes in his or her
				circumstances.
007.02
CHANGE IN CIRCUMSTANCES.
Each applicant or recipient
				must report a change in the following circumstances no later than ten calendar
				days following the change of:
(A) Earned and
				unearned income;
(B)
				Resources;
(C) Living
				arrangement;
(D) Address;
(E) Family composition;
(F) Household composition;
(G) Need for services; or
(H) Recipient's medical condition or
				health.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-008 - APPLICATION PROCESS

Current through June 17, 2024
Anyone may submit an application on a Department approved
				  form. Anyone may submit a completed, dated, and signed program application
				  electronically, by mail, fax, or in person.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-009 - ELIGIBILITY CRITERIA

Current through June 17, 2024
In order to be eligible, applicants must:
(A) Reside in the State of
				Nebraska;
(B) Reside in a
				non-institutional setting;
(C) Have
				a special need requiring ongoing care without regard to age, type of special
				needs or other status;
(D) Meet the
				income and resource criteria for the Program;
(E) The applicant or recipient must be a
				United States citizen or meet the qualified alien status as required by Neb.
				Rev. Stat. §
									4-111;
				and
(F) Inform the Department of
				everyone who lives in household regardless of relative status.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-010 - CAREGIVER REQUIREMENTS

Current through June 17, 2024
To be eligible, caregivers must:
(A) Be providing care or supervision of
				applicant or recipient with special needs without reimbursement or
				payment;
(B) Need respite
				services;
(C) Reside in the same
				home as the person with special needs or be providing care to recipient in the
				recipient's home for a minimum of 4 hours per day Sunday through Saturday;
				and
(D) Caregivers may not use
				respite services while engaging in employment activities.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-012 - MAXIMUM SUPPORT

Current through June 17, 2024
The support provided through this Program must not exceed
				  $125 per recipient per month except for recipients the Department has approved
				  for exceptional circumstances funding, including crisis respite. The Department
				  determines the maximum monthly expenditure for each recipient based on need and
				  available funds.
012.01
FLEXIBILITY IN USE OF FUNDS.
A caregiver may request
				Department flexibility in use of authorized funds to meet recipient
				need.
012.02
ADDITIONAL
				SERVICES.
A caregiver may contact the Department to request
				additional services in unusual circumstances, including a crisis
				need.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-013 - NOTICES

Current through June 17, 2024
Applicants and recipients are sent adequate notice in writing
				  of eligibility decisions within 30 calendar days of the Department's receipt of
				  application. Recipients are also sent notices when services are to be reduced,
				  added, or terminated. Applicants will be notified in writing when a review or
				  annual renewal is necessary.
013.01
TIMELY NOTICE.
A notice of case action dated and mailed at least ten
				  calendar days before the date the action becomes effective. A timely notice
				  must be issued if services are to be reduced or terminated before the current
				  authorization period ends.
013.02
SITUATIONS REQUIRING
				ADEQUATE NOTICE.
In some instances, timely notice is not needed,
				but adequate notice is still required. A notice is sent to the recipient no
				later than the action's effective date. Consult the Guidance Document for a
				complete listing of these situations.
013.03
NOTICE NOT
				REQUIRED.
The recipient will not receive a notice of action when:
(A) The Department learns of a recipient's
				death;
(B) The applicant or
				recipient is committed to an institution or admitted to a nursing home on a
				long-term basis;
(C) The applicant
				or recipient's whereabouts are unknown; or
(D) The authorization period is ending and
				the recipient has not acted upon a request for renewal information.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-014 - ELIGIBILITY PERIODS

Current through June 17, 2024
The Department establishes eligibility periods for recipients
				  with ongoing special needs. Eligibility must be renewed at least every twelve
				  months. A renewal will be completed more frequently if the recipient's
				  circumstances change.
014.01
ELIGIBILITY REVIEWS.
Upon receipt of a renewal request
				from the Department, the recipient has 45 calendar days from the date of the
				renewal notification to provide the same documentation that is required for
				initial eligibility.
014.02
ACCEPTABLE VERIFICATION FOR ANNUAL ELIGBILITY REVIEW.
Recipient must provide the same documentation required for initial
				eligibility.
014.03
VERIFICATION REQUESTS.
Applicant or recipient has ten
				calendar days to respond to written requests from the Department for supportive
				documentation or application will be denied or case closed.
014.04
CHANGES WITHIN ELIGIBILITY
				PERIODS.
Caregivers must immediately report any change in income,
				resources, living arrangement, or need to the Department. Failure to do so may
				result in termination of services and an overpayment which must be refunded to
				the Department.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-015 - PRIOR AUTHORIZATIONS

Current through June 17, 2024
The Department does not pay for respite services received
				  prior to Program eligibility determination. The Program only pays for
				  authorized respite services.
Nebraska Administrative Code › Topic - HEALTH AND HUMAN SERVICES SYSTEM › Title 464 - RESPITE SUBSIDY PROGRAM ACROSS THE LIFESPAN › Chapter 1 - PROGRAM REQUIREMENTS › Section 464-1-016 - PAYMENTS

Current through June 17, 2024
The Department determines whether payments are made directly
				  to the recipient or to the provider.
016.01
PAYMENTS TO THE
				RECIPIENT.
Recipients receiving direct payment must complete a
				Department approved billing document. Incomplete or inaccurate billing
				documents will be rejected and not paid.
016.02
PAYMENTS TO THE
				PROVIDER.
Providers receiving direct payment must complete a
				Department approved billing document. Incomplete or inaccurate billing
				documents will be rejected and not paid.
016.03
LIMITATIONS ON
				PAYMENTS.
The recipient is responsible for any amount owed to the
				provider in excess of the authorized amount. The recipient must not bill the
				Department for more than the amount authorized. The Department will not pay
				recipient or the provider for any amount in excess of the authorized
				amount.
016.04
FREQUENCY OF PAYMENTS.
Billing documents for respite
				services must be submitted no more than once a month per respite provider after
				all the respite services have been provided for the month. Billing documents
				must be submitted for any given month within 60 days of the date when the
				service is provided.
016.05
LACK OF BILLING WITHOUT JUSTIFICATION.
The recipient
				may be determined Program ineligible if no claims have been submitted for
				Program authorized services for three consecutive months without providing
				justification to show how the recipient's needs were met during that time and
				why the needs will no longer be met without continued Program
				assistance.