468 Neb. Admin. Code, ch. 1, § 009

Current through September 17, 2024

Section 468-1-009 - NOTICE OF ACTION

A Notice of Action is sent to inform the applicant or recipient of any action affecting his or her eligibility.

009.01ADEQUATE NOTICE. An adequate notice must include a statement of what action the Department intends to take, the reason for the intended action, the specific regulation or guidance document that supports the action, or the change in federal or state law that requires the action.

009.02TIMELY NOTICE. A timely notice must be dated and mailed at least ten calendar days before the date that action would become effective, which is always the first day of the month.

009.03ADEQUATE AND TIMELY NOTICE. In cases of intended adverse action, including action to discontinue, terminate, suspend, or reduce assistance, or to change the manner or form of payment or service to a more restrictive method, such as a protective payee, the applicant or recipient is given adequate and timely notice.

009.04SITUATIONS REQUIRING ADEQUATE NOTICE ONLY. In the following situations, only adequate notice is required:

(A) The Department has factual information confirming the death of an individual in the unit;

(B) The Department receives a written and signed statement from an individual in the unit:

(i) Stating that assistance is no longer required; or

(ii) Giving information which requires termination or reduction of assistance, and indicating, in writing, that the individual understands the consequences of supplying such information;

(C) An individual in the unit has been admitted or committed to an institution, and no longer qualifies for assistance;

(D) An individual in the unit has been placed in skilled nursing care, intermediate care, or long-term hospitalization or the individual is receiving assisted living waiver services;

(E) An individual in the unit's whereabouts are unknown and agency mail directed to the individual has been returned by the post office indicating no known forwarding address;

(F) An individual in the unit has been accepted for assistance in another state and that fact has been established; or

(G) A child in the unit is removed from the home as a result of a judicial determination or is voluntarily placed in foster care.

009.05WAIVER OF NOTICE. An applicant or recipient may agree to waive their right to a timely notice in situations that require timely notice by providing a signed statement indicating their choice to waive the notice.

009.06IN FRAUD CASES. At least five days' advance written notice must be given if:

(A) The Department has facts indicating that action should be taken to discontinue, terminate, or reduce assistance because of probable fraud by the client; and

(B) The facts have been verified where possible through collateral sources.

009.07CONTINUATION OF BENEFITS. Adverse action will not be carried out pending an appeal hearing if:

(1) The action being appealed required adequate and timely notice;

(2) The individual requests an appeal hearing in writing within ten days following the date the Notice of Action is mailed; and

(3) The individual does not refuse continued assistance.

009.07(A)CONTINUATION OF NORMAL CASE ACTIONS. Normal case actions, including implementing changes to the assistance case that are not directly related to the appeal issue, are still completed pending an appeal hearing.

009.07(B)BENEFIT RECOVERY. If the Department's action is sustained by the hearing decision, the benefits received by the unit during the appeal period are subject to recovery.

009.07(C)REFUSAL OF CONTINUED BENEFITS. An individual may refuse continuation of benefits pending an appeal hearing.

468 Neb. Admin. Code, ch. 1, § 009

Amended effective 8/29/2022