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JUNE 17, 2002
NEBRASKA HEALTH AND CCS PROGRAM MANUAL LETTER # 37-2002 HUMAN SERVICES MANUAL 392 NAC 4-002.03
These notices must include a statement of what action(s) the worker intends to take, the reason(s) for the intended action, and the corresponding manual reference(s).
A Notice of Action must also be sent when an applicant is determined eligible or a client redetermined eligible for Child Care Subsidy. 4-002.03A Advance Notice: When a provided service is to be reduced or terminated, the worker must provide formal written notice. This notice must be dated and mailed or given to the client at least ten calendar days before the adverse action is effective. 4-002.03B Adequate Notice: If the worker has verified possible client fraud, the worker must send a notice of termination or reduction to the client no later than the action's effective date. 4-002.03C Notice Not Required: No notice need be sent to the client in the following situations: 1. The client reports that service is no longer required and requests that his/her case be closed; 2. The worker learns of a client's death; 3. The client is committed to an institution or admitted to a nursing home on a long-term basis; 4. The client's whereabouts are unknown; 5. The worker has verified that service is being received through another local office; or 6. An authorization period is ending and the client has not acted upon a request for redetermination information. 4-002.03D Service Continuation During Appeal: In cases where advance notice has been given, the client may appeal. If an appeal is requested in writing within ten days following the date the Notice of Action was mailed, the worker must not carry out the adverse action until a fair hearing decision is made. In situations where only an adequate notice was required, service is not continued pending a hearing decision.
4-003 Maximum Rate and Unit Authorization: 4-003.01 Provider Rates: A provider must establish a private pay rate before contracting with the Department. The rate charged to the Department must not exceed the rate charged to private pay clients. The rate for each established unit of care must be limited to the rate established as the Department's maximum for the type of care, unit of care, and the age of the child involved. If the provider has a discounted rate for the care of second and succeeding children, the Department will pay the discounted rate.