Section 467-6-007 - INDIVIDUAL SERVICE PLANAn individual service plan is developed for each recipient based upon their needs assessment, service components of the program, and available funds. The plan details the services available to the recipient which are prior approved by the Department.
007.01LOCATION OF SERVICES. Recipients are encouraged to use medical providers and facilities closest to their place of residence. If a medical provider or facility is available closer to the residence and the recipient chooses one further away, the Department is not obligated to pay for supportive services for that care or treatment.007.02SERVICE COMPONENTS. Service components may be covered based on identified needs and available funds. 007.02(A)MEDICAL MILEAGE. Medical mileage reimbursement is a covered service for families who transport recipients to disability-related medical care or treatment. Mileage for routine, general health care is not a covered service. The reimbursement rate for medical mileage follows the annual Internal Revenue Service standard mileage rate per mile driven for medical purposes.007.02(B)LODGING. Lodging is a covered service for families who travel long distances for disability-related care or treatment for the recipient. If lodging is available through another program at no cost or minimal cost, this service may not be available. The reimbursement rate for lodging follows the annual United States General Services Administration Per Diem Rates based on the location of the lodging. Additional lodging for leisure is optional and not covered.007.02(C)RESPITE CARE. Respite care is a covered service to provide caregivers a short break from taking care of the recipient with special health care needs. The Department determines the maximum dollar amount of respite care for each recipient based on the needs of the family and available funds, not to exceed $125 per month, which is then included in the individual service plan. Respite care may not be used as child care when a caregiver is working or going to school. 007.02(C)(i)RESPITE PROVIDERS. Parents and legal guardians of recipients are responsible for locating respite providers to care for the recipients. The following are required of all respite providers: (1) The provider must undergo a child and an adult registry check at least once every twelve (12) months to be enrolled as a provider. The Department may require additional registry checks when the circumstances warrant further investigation. The Department may in its discretion accept a child and an adult registry check completed by another Department program within the previous twelve (12) months. Funds cannot be used to pay providers identified on the Department's child or adult registries as a substantiated perpetrator of abuse or neglect.(2) The provider must be age 19 years or older.(3) The provider must not reside in the household with the recipient.(4) Non-relative providers are encouraged. The Department has the discretion to deny payment for relative providers so long as providers are available in the recipient's residing area.007.02(D)SPECIAL EQUIPMENT AND ACCESSIBILITY MODIFICATIONS. Special equipment and accessibility modifications are covered services based on the needs of each recipient, available funds, and individual service plans. The maximum dollar amount is $3,600 per recipient's family per 12-month period. Medical necessity must be documented by a health care professional.467 Neb. Admin. Code, ch. 6, § 007
Amended effective 5/17/2022