173 Neb. Admin. Code, ch. 2, § 003

Current through September 17, 2024

Section 173-2-003 - ELIGIBILITY

To be eligible for assistance from the Tuberculosis Program, a client must:

(A) Be diagnosed with communicable tuberculosis, be suspected to have communicable tuberculosis, be a contact, or have a Class B tuberculosis designation;

(B) Be residing in Nebraska;

(C) Meet income and resource requirements based on household size; and

(D) Meet all statutory requirements for receiving assistance from the program.

003.01INCOME AND RESOURCE REQUIREMENTS. A client's annual income for the household must be at or below two hundred and fifteen percent of the federal poverty level in order to participate in the program. The income level is adjusted based on household size. A client's available resources may not exceed an estimated total of four thousand dollars. Available resources includes cash or other liquid assets or any type of real or personal property or interest in property that the client owns and may convert into cash to be used for support and maintenance. A resource which appears on record in the name of a client is deemed to belong to the client Jointly owned resources other than in joint tenancy are to be given the proportionate share based on the number of owners of the resource available to each owner. Resources that are owned jointly, are to be given the proportionate share based on the number of owners of the resource available to each owner. Resources that are owned in joint tenancy are considered available in total to the client. If the encumbrances against the property equal or exceed the price for which the property could be sold, the property is not an available resource. The value of the property is determined after any the amount of debt secured by mortqaqes, liens, promissory notes, and judgements are subtracted from the gross value of the encumbered property. The following resources are excluded in making a determination of eligibility:

(A) Real property which is owned by the client or the client's household and which the client occupies as a home. Lots adjacent to a home are considered an available resource if they can be sold separately;

(B) Household goods;

(C) Clothing;

(D) A motor vehicle if used for employment or medical transportation;

(E) A motor vehicle used as the client's home;

(F) The cash value of life insurance policies;

(G) Irrevocable burial trusts;

(H) Burial spaces;

(i) Stocks, inventories, and supplies used in self-employment;

(j) U.S, savings bonds;

(K) Any unavailable employment related retirement account that is held by the employer; and

(L) Earned income from a child 18 years of age and younger.

003.02APPLICATION. Application to the program is made by submission of a complete application to the Department Prior to eligibility being determined, a client must also provide the following as requested by the Department:

(A) Documentation to verify income and resources;

(B) Documentation to verify household size;

(C) Documentation of health insurance or a sworn statement that the client does not have health insurance from any third party payer; and

(D) Documentation of meeting the requirement of 173 Nebraska Administrative Code (NAC) 2-Q03(A).

003.03APPROVAL. An approved application establishes client eligibility for 12 months provided the client continues to meet the eligibility requirements in statue and this chapter. The service start date for a client may be set for when a client is identified as a contact, or a suspect, receives a Class B Tuberculosis designation, or receives a diagnosis of communicable tuberculosis.

003.04DENIAL. When the Department determines a client does not meet the eligibility requirements or is in violation of any provision set out in this chapter the Department will send written notice to the client stating the reason for the denial.

003.05MAINTENANCE OF CLIENT ELIGIBILITY. The client, or the client's representative, is responsible for informing the program in writing, within thirty (30) days of the following changes:

(A) When the client's annual income increases above the two hundred fifteen percent of the federal poverty level;

(B) When the client's resources increases above four thousand dollars;

(C) in the number of individuals living in the household;

(D) in treatment status which includes:

(i) Is no longer receiving treatment for communicable tuberculosis;

(ii) Has died; or

(iii) Has competed treatment; or

(E) Address or primary telephone number changes.

003.06TERMINATION. When the Department determines a client meets the requirements for termination from participation in the program the Department will send written notice to the client stating the reason for the termination. Clients are ineligible for the program and may be terminated from it under the following circumstances:

(A) Misrepresentation by the client;

(B) The client does not meet eligibility requirement or violates a provision set out in this chapter;

(C) Fails to provide documentation upon request; or

(D) Death.

003.07INACTIVITY. if there have been no payments processed on a client's behalf in a state fiscal year the client's participation in the program shall be terminated.

173 Neb. Admin. Code, ch. 2, § 003

Amended effective 7/19/2022