Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 202 - OPERATIONS WITHIN FACILITIES AND COMMUNITY-BASED SERVICES FOR PERSONS WITH MENTAL ILLNESS OR DEVELOPMENTAL DISABILITIES
Chapter 1 - DETERMINING ABILITY TO PAY FOR SUPPORTS AND SERVICES FUNDED BY THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES
Section 202-1-004 - CLIENT'S ABILITY TO PAY
Universal Citation: 202 NE Admin Rules and Regs ch 1 ยง 004
Current through March 20, 2024
The following documents must be completed and submitted to the Department by the client, or the client's legal guardian, spouse, or parent, if applicable:
(A) Financial questionnaire detailing income, assets, and liabilities;
(B) Statement of insurance coverage;
(C) Signed bank release form for all accounts;
(D) Signed US citizenship attestation form; and
(E) Signed authorization to request a copy of the Nebraska tax return.
004.01
NET ASSETS. The Department deducts liabilities from
income and assets to determine available net assets eligible to pay for care.
The available net assets eligible to pay for care is multiplied by a percentage
to determine the amount the client has to pay. The percentages are:
004.01(A)
CLIENT WITH NO
DEPENDANTS. For a client with no dependents and who is receiving
services, 1.5% of the available net assets eligible to pay for care is owed for
care.
004.01(B)
CLIENT
WITH DEPENDANTS. For a client with dependents and who is receiving
services, 1.0% of the available net assets eligible to pay for care is owed for
care.
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