a. The actual cost of
travel, or an amount equal to $0.30 multiplied by the number of miles traveled,
which shall not exceed 520 miles per month or $160 per month as authorized by
an NHEP representative; and
b. The
actual cost of approved automobile repairs up to $500 per state fiscal year per
NHEP participant and subject to the following:
1. An automobile for which an NHEP
participant is requesting automobile repairs reimbursement shall be:
(i) Determined by an NHEP representative as
necessary for the NHEP participant to participate in an approved NHEP activity
or employment, according to
He-W
655.06(c) ; and
(ii) Registered to:
i. The NHEP participant;
ii. To either parent in a 2-parent family, as
long as the parent indicates in writing that the parent will consistently
transport the NHEP participant to the participant's NHEP activity; or
iii. The NHEP participant's dependent child
who resides in the same household, as long as the NHEP participant is the
dependent child's parent and the dependent child indicates in writing that the
dependent child will consistently transport the NHEP participant to the
participant's NHEP activity;
2. The NHEP participant requesting the
automobile repair reimbursement shall:
(i)
Have a valid operator and/or commercial license in effect at the time the
request for automobile repair reimbursement is made or, if the NHEP participant
lacks a valid license, the other parent in the 2-parent family, or the
dependent child who resides in the same household, has a valid license and the
other parent in the 2-parent family or the dependent child indicates in writing
that the other parent in the 2-parent family or the dependent child will
consistently transport the NHEP participant to the participant's NHEP activity;
and
(ii) Obtain one written
estimate of the cost of automobile repairs from a provider who operates an
automobile repair business, which contains:
i. The name, address, and telephone number of
the provider;
ii. A description of
the types of repairs in the form of an itemized list of parts, labor, and
associated costs which are auto-body and/or mechanical repairs necessary to
make the automobile functional;
iii. A statement from the provider indicating
that in the provider's professional judgment the automobile repair is
reasonable based on the roadworthiness and reliability of the car;
and
iv. The signature of the
provider and date of the provider's signature;
3. The written estimate as described in
2.(ii) above shall be submitted to an NHEP representative for prior approval
for the automobile repair reimbursement from DHHS;
4. The NHEP representative shall review the
written estimate for completeness and ensure that it meets the requirements of
2.(i) and (ii) above, prior to approving the repair;
5. Automobile repair reimbursement shall be
approved by an NHEP representative in advance of the actual service(s) to be
provided, except in an emergency in which the vehicle required towing and
repairs needed to make it functional;
6. Repairs shall be performed by any
individual of the participant's choice or by the participant;
7. An NHEP participant or provider shall
complete a reimbursement invoice, subsequent to approved repairs being
completed, which includes the following:
(i)
The participant's name, address, and recipient identification number;
(ii) The provider's name, address, and
telephone number;
(iii) An itemized
receipt or bill indicating the total amount charged for automobile repairs, or
if the repairs are performed by the participant, the unreimbursed total cost of
the parts and supplies necessary to make the repairs, excluding any labor
costs;
(iv) The date the service
was provided;
(v) The provider's or
participant's social security number or federal identification number used for
IRS purposes;
(vi) The signature of
the provider or participant who performed the repairs and signature date;
and
(vii) To whom payment shall be
made payable by DHHS;
8.
A legible, complete and correct reimbursement invoice, as described in 7.
above, shall be submitted to DHHS, data management unit, no later than 90 days
from the date services were provided;
9. DHHS shall not pay for any balance due on
automobile repairs after payment is made to or on behalf of an NHEP
participant;