Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 471 - NEBRASKA MEDICAL ASSISTANCE PROGRAM SERVICES
Chapter 25 - SCHOOL BASED SERVICES
Section 471-25-004 - DIRECT SERVICE REQUIREMENTS

Universal Citation: 471 NE Admin Rules and Regs ch 25 ยง 004

Current through September 17, 2024

004.01 GENERAL SERVICE REQUIREMENTS. School-based services must be medically necessary to meet the specific and covered needs of a student and the student's family, if applicable, and be required by:

(A) A related service or supplementary aid or service in an Individual Education Program HER; or

(B) An early intervention service in an Individualized Family Service Plan (IFSP).

004.02 SPECIFIC COVERED SERVICES AND REQUIREMENTS. When indicated in a child's Individual Education Plan (IEP) or Individualized Family Service Plan (IFSP), the following are covered services within school-based services.

004.02(A) DIRECT SERVICES.

Direct services that are available in the schools include:

(i) Physical therapy, occupational therapy, and speech pathology audiology services;

(ii) Behavioral modification, psychotherapy services, psychological testing, and assessment needs for specific therapy services and evaluation, when not only medically necessary, but also:
(1) Necessary to diagnose, treat, cure, or prevent regression of significant functional impairments resulting from symptoms of a mental health disorder diagnosis;

(2) Supported by evidence that the treatment improves symptoms and functioning for the individual client's mental health or substance use disorder diagnosis; and

(3) Reasonably expected to improve the individual's condition or prevent further regression so that the services will no longer be necessary;

(iii) Nursing services, when provided through direct intervention in a face-to-face encounter;

(iv) Personal assistance services, which assist with activities of daily living (and other activities listed in 471 NAC Chapter 15) and supplement a child's own personal abilities and resources, when approved by a physician and provided by someone other than a legally responsible relative;

(v) Transportation to an outside medical service, including the assistance of a Transportation Aide and the use of a specially adapted vehicle, subject to the following:
(1) The student must be in attendance at school on the day of the medical service to receive transportation services, and cannot be taken directly from home to the medical service;

(2) Medical services must be provided on the same day as the transportation;

(3) Only one round trip transportation per student is covered each day; and,

(4) The transportation cannot duplicate what would otherwise have been received in the course of attending school; and

(vi) Visual care services to diagnose or treat a specific eye disorder, disease, symptom, complaint, or injury, and vision therapy. One assessment per calendar year is permitted, which must be performed in the school by a licensed optometrist.

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