Neb. Admin. Code tit. 470 — Refugee Resettlement Program and the Refugee Medical Assistance Program

Chapter 1 General Background

Neb. Admin. Code tit. 470, ch. 1 General Background {#sec-470-nac-1 omnilex-key=us-ne-regs-official--title-470--470 NAC 1}

001. SCOPE AND AUTHORITY . The Refugee Act (Public Law 96-212), Refugee Assistance Amendments of 1982 (Public Law 97-363), and the Federal Deficit Reduction Act of 2005 (Public Law 109-171) authorize the financial and medical assistance to refugees in the United States. The program is governed by federal regulations found at 45 CFR § 400. The program is funded completely with federal money. The Department operates the program in accordance with its federally approved state plan.

002. PURPOSE . The purpose of the Refugee Resettlement Program is to provide assistance to refugees who are not eligible for another categorical assistance program so they may achieve economic self-sufficiency as quickly as possible and to assist with refugees’ financial and medical assistance during their initial resettlement in the United States.

003. ADMINISTRATION . The Refugee Resettlement Program is administered by the Department in accordance with federal and state laws and regulations established by the Department.

004. DEFINITIONS . The following definitions apply:

004.01 ADEQUATE NOTICE. Notice of case action which includes 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.

004.02 APPLICATION. The action by which the individual indicates in writing on a Department approved form the desire to receive Program assistance.

004.03 CATEGORICAL ASSISTANCE. Assistance administered by the Department. For the purposes of this definition, it includes Aid to Dependent Children (ADC), Child Welfare Payment and Medical Services Program, Assistance to the Aged, Blind, or Disabled (AABD), State Disability Program (SDP), and the Refugee Resettlement Program (RRP).

004.04 DEPARTMENT. The Nebraska Department of Health and Human Services.

004.05 GRANT CASE. A case receiving a Refugee Resettlement payment or eligible to receive payment but not receiving it because of the minimum payment requirement.

004.06 HOUSEHOLD. Individuals living together. There may be more than one public assistance unit within a household.

004.07 MATCH GRANT. An agreement with a voluntary resettlement agency that enables the agency to issue the assistance grant for the first time four months of a refugee’s eligibility.

004.08 OFFICE OF REFUGEE RESETTLEMENT. A federal office created by The Refugee Act of 1980. The office is housed within the United States Department of Health and Human Services and is primarily responsible for federal oversight of federal refugee resettlement services and program administration.

004.09 REFUGEE. A refugee is defined by the Immigration and Nationality Act at 8 (United States Code) U.S.C. § 1101.

004.10 REFUGEE RESETTLEMENT CASH AND MEDICAL. A categorical program consisting of financial and medical assistance to eligible refugees.

004.11 REFUGEE MEDICAL ASSISTANCE PROGRAM. A program providing medical assistance, but no cash assistance, to eligible refugees.

004.12 SHARE OF COST. An individual’s monthly financial out-of-pocket obligation for medical services when the individual’s income exceeds the program limits.

004.13 TIMELY NOTICE. A notice of case action dated and mailed at least 10 calendar days before the date the action becomes effective.

004.14 UNIT. Eligible individuals considered in determining the grant and medical assistance.

004.15 WITHDRAWAL. A voluntary written retraction of an application.

005. CONFIDENTIALITY . The records of those applying for or receiving assistance under this Program are safeguarded in accordance with 45 CFR § 400.27 and Nebraska Revised Statute (Neb. Rev. Stat.) § 68-313.

006. INDIVIDUAL RESPONSIBILITIES . Individuals applying for or receiving Refugee Resettlement benefits are required to:

(A) Provide complete and accurate information. State and federal law provides penalties of a fine, imprisonment, or both for persons found guilty of obtaining assistance or services for which they are not eligible by making false statements or failing to report promptly any in their circumstances;

(B) Report a change in circumstances no later than 10 days following the change, unless good cause is shown. The recipient is responsible for establishing the existence of a good cause circumstance. Unverified statements do not constitute good cause. Changes required to be reported include:

(i) Change or receipt of a resource;

(ii) Changes in who lives in the home of the refugee resettlement unit;

(iii) New employment must be reported within ten days of receipt of the first paycheck;

(iv) When employment has ended;

(v) Changes in the amount of monthly income, including:

(1) All changes in unearned income; and

(2) Changes in the source of employment, in the wage rate and in employment status, such as part-time to full-time or full-time to part-time. For reporting purposes for the Refugee Resettlement Program, 30 hours per week is considered full- time; and

(vi) Changes in residence.

(C) Cooperate with state and federal quality control;

(D) Contact the agency for an interview within 30 days of the date of application if notified that an interview is required;

(E) Provide verification of information when requested to do so by the Department;

(F) Present the individual’s medical card to medical providers;

(G) Inform the medical provider and worker of any health insurance plan, any individual, or any group that may be liable for their medical expenses;

(H) Cooperate in obtaining any third party medical payments as outlined in the Medicaid Program, Title 477 Nebraska Administrative Code (NAC);

(I) Enroll in a health plan and maintain enrollment if:

(i) One is available to the individual;

(ii) The individual is able to enroll on their own behalf; and

(iii) The Department has determined that enrollment in the plan is cost effective;

(J) Pay any unauthorized medical expenses; and

(K) Pay any required medical copayment as outlined in the rules and regulations from the Medicaid Program, Title 477 NAC.

007. INDIVIDUAL RIGHTS . Individuals applying for or receiving assistance have the right to:

(A) An individual who wishes to request and apply for assistance must be given the opportunity to do so. No individual may be denied the right to apply for the Refugee Resettlement cash and medical assistance program;

(B) Reasonably prompt action on their applications for assistance;

(C) Adequate notice of any action affecting their application or assistance cases;

(D) Appeal to the Director for a hearing on any action or inaction with regard to their applications, the amount of the assistance payments, or failure to act with reasonable promptness. The appeal must be filed in writing within 90 days of the action or inaction;

(E) Have their information treated confidentially;

(F) Have their civil rights upheld. No person may be subjected to discrimination on the grounds of their race, color, national origin, sex, age, disability, religion, or political belief;

(G) Have the program requirements and benefits fully explained;

(H) Be assisted in the application process by the person of their choice; and

(I) Referral to other agencies.

008. APPLICATION . An application must be properly signed by an individual for himself or herself, by the applicant’s guardian or conservator, by an individual acting under a duly executed power of attorney, or by a specified relative applying on behalf of or for a child. When adding a program to the application, the application date is the date the request to add the program is made. A properly signed application contains:

(A) Name;

(B) Address; and

(C) Proper signature, as defined by the appropriate program.

008.01 PROMPT ACTION ON APPLICATIONS. The Department has 30 days from the date the application is received to make an eligibility determination.

008.02 WITHDRAWALS. The applicant may voluntarily withdraw an application.

008.03 AUTHORIZATION FOR RELEASING INFORMATION. For some sources the Department asks the individual to sign a Release of Information when it appears that information given is incorrect, when the individual is unable to furnish the necessary information, or for sample quality control verification. A copy of the authorization for information from the application for assistance may be used if the source will accept it.

008.04 NEW APPLICATION. A new application is required after one calendar month of ineligibility or after an application has been denied.

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

009.01 ADEQUATE 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.

009.02 TIMELY 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.

009.03 ADEQUATE 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.

009.04 SITUATIONS 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.

009.05 WAIVER 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.

009.06 IN 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 applicant or recipient; and

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

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

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

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

(C) The individual does not refuse continued assistance.

009.08 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.

009.08(A) 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.

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

010. ELIGIBILITY REVIEW . Eligibility is redetermined at six months. Eligibility may be redetermined in less than six months to coordinate review dates for more than one program. An application is required as part of the eligibility review and to establish a new eligibility period.

011. COMPUTATION OF TIME . In computing time prescribed or allowed by Title 470 NAC or by any applicable statute or regulation in which the method of computing time is not specifically provided, days will be computed by excluding the day of the act or event and including the last day of the period. If the last day of the period falls on a Saturday, Sunday, or state holiday, the period shall include the next working day.

History

• Effective 2022-06-06

Chapter 2 Eligibility Requirements

Neb. Admin. Code tit. 470, ch. 2 Eligibility Requirements {#sec-470-nac-2 omnilex-key=us-ne-regs-official--title-470--470 NAC 2}

001. APPLICATION . An individual wishing to apply for assistance must complete and submit an application. A relative or other person acting for the client may complete the application.

001.01 INTERVIEW. An interview is required at initial application.

(A) Applicants can request a face-to-face interview or the Department can request a face-to-face interview if determined necessary; and

(B) For medical benefits only, an application may be signed by and an interview held with a relative or another individual acting on the applicant’s behalf.

001.02 ELIGIBLE INDIVIDUALS. The following categories of individuals are eligible for assistance and services if they meet the other eligibility requirements of the program:

(A) Refugees admitted under Section 207 of the immigration and Nationality Act and Amerasians from Vietnam admitted with a visa with Section 204 indicated;

(B) Asylees under Section 208 of the Immigration and Nationality Act;

(C) Individuals whose alien status has been adjusted. An individual from any country is eligible if their status has been adjusted to a permanent resident alien from one of the previously listed statuses;

(D) Asylees or parolees as refugees;

(E) Cuban and Haitian Entrants or Parolees in accordance with the requirements in 45 CFR 400.43(a)(4) and 401.2;

(F) Individuals admitted as conditional entrants under Section 203(a)(7) of the Immigration and Nationality Act; and

(G) Victims of severe forms of trafficking, as determined by the Office of Refugee Resettlement.

001.03 INDIVIDUALS INCLUDED IN THE UNIT. When an individual in the unit reaches their time limit for assistance, their needs are removed from the grant. Income and resources of a responsible adult who is no longer eligible are counted for the rest of the unit.

002. TIME LIMIT ON CASH AND MEDICAL ASSISTANCE . Effective June 1, 2022, if the refugee’s date of eligibility for Office of Refugee Resettlement benefits is before October 1, 2021, the refugee may receive a maximum of eight months of refugee cash and medical assistance. Refugees whose date of eligibility for Office of Refugee Resettlement benefits is on or after October 1, 2021, may receive a maximum of twelve months of refugee cash and medical assistance. The number of months is determined by the Office of Refugee Resettlement and is subject to change. Eligibility begins with the date of arrival in the United States, if the refugee meets all eligibility requirements. For asylees, victims of severe forms of trafficking, and Cuban and Haitian Parolees eligibility begins with the date of granted status. The time limit is applied to each refugee separately, not to the unit as a whole. If the refugee applies after the date of arrival in the United States, they may receive assistance for the remaining months of their eligibility period. If an asylee applies after the date of arrival in the United States, they may receive assistance for the remaining eligibility period, after they are granted asylum.

003. RESIDENCE . To be eligible for assistance, individuals must be a Nebraska resident. A resident is defined as an individual who is living in the state voluntarily with the intent of making Nebraska their home and who is not receiving Refugee Resettlement Program services from another state. Residence starts with the month the refugee moves into the state, even if the refugee received categorical assistance in another state. An individual cannot be denied assistance if they have not resided in the state for a specified period within their cash and medical assistance time limit.

003.01 ABSENCE FROM THE STATE. An individual cannot be denied assistance due to being temporarily absent from the state.

003.02 LOSS OF STATE RESIDENCE. Eligibility for assistance ends if the individual or family unit leaves Nebraska with the intent of establishing a home in another state.

003.03 DISQUALIFICATION FOR MISREPRESENTING RESIDENCE. Any individual convicted in federal or state court of having fraudulently misrepresented their residence in order to obtain refugee assistance in two or more states is ineligible for refugee assistance.

004. REQUIREMENT OF SOCIAL SECURITY NUMBER . All eligible individuals of the Refugee Resettlement Program unit must apply for a social security number. The social security number, in conjunction with other information, provides evidence of identify of the individual.

004.01 INDIVIDUALS WHO HAVE NOT BEEN ISSUED A SOCIAL SECURITY NUMBER. Individuals who have not been issued a Social Security Number must apply for a Social Security Number within 30 days of being notified of the requirement.

004.02 INDIVIDUALS WHO DO NOT PROVIDE A SOCIAL SECURITY NUMBER. When a financially responsible individual does not provide a Social Security Number, the entire Refugee Resettlement Program case is closed.

005. INELIGIBILITY FOR OTHER CATEGORICAL ASSISTANCE . The Refugee Resettlement Program is available only if the individual or family is ineligible for another categorical assistance program. Exception: An 18-year-old who is not in school may apply as a separate grant case if their time limit for eligibility has not expired and they meet other eligibility requirements.

006. RESOURCES . For purposes of determining resources and resource eligibility for the Cash and Medical Assistance Refugee Resettlement Program under Chapter 3 of this Title, the Department applies the rules and regulations from the Aid to Dependent Children Program, Title 468 Nebraska Administrative Code (NAC).

007. INCOME . For purposes of determining income eligibility for Refugee Resettlement Cash and Medical Assistance benefits of Chapter 3, the Department applies the rules and regulations from the Aid to Dependent Children Program, Title 468 NAC and the following:

007.01 RESETTLEMENT ASSISTANCE. Supportive services may be provided by an individual, a family, or a group of people representing a church or another organization who have agreed to sponsor a refugee family or individual. Assistance may include, but is not limited to clothing, food, and housing. The assistance is disregarded as income.

007.02 RESETTLEMENT CASH ASSISTANCE. Voluntary resettlement agencies may provide cash assistance for the initial resettlement of the refugee family or individual. Resettlement assistance from a voluntary resettlement agency is disregarded as income.

008. MEDICAL ASSISTANCE ONLY CASES . For individuals applying only for Medical Assistance Program benefits under Chapter 4 of this Title, the income and resource guidelines of Title 477 NAC, Medicaid program apply.

009. COMPLIANCE WITH EMPLOYMENT AND TRAINING REQUIREMENTS . Unless determined exempt by the Department, a refugee is required to register for employment services within 30 days from the date of application with one of the state’s Refugee Social Service Employment Providers and accept appropriate employment or training opportunities.

009.01 APPROPRIATE WORK AND TRAINING CRITERIA. The following outlines appropriate work and training:

(A) May be temporary, permanent, full-time, part-time, or seasonal if this work meets the other work standards outlined in this section;

(B) The wage must meet or exceed the minimum wage established by law; and

(C) The daily and weekly hours of work must be those customary to the occupation.

009.02 SITUATIONS WHEN AN INDIVIDUAL CAN NOT BE REQUIRED TO ACCEPT EMPLOYMENT. An individual cannot be required to accept employment in the following circumstances:

(A) The individual would be required to work for an employer contrary to the conditions of their existing membership in the union governing that occupation. However, employment not governed by the rules of a union in which they have membership may be determined appropriate;

(B) The individual is not able to perform the task required by the work or training assignment on a regular basis. Any claim of adverse effect on an individual’s physical or mental health must be substantiated by adequate medical statements; or

(C) The commuting time to and from home to the work or training site should not normally exceed two hours. This does not include the time it takes to transport a child to and from a childcare facility.

009.03 ENGLISH CLASSES. Enrollment in English classes does not qualify as a training program and therefore does not exempt the refugee from the employability requirement. English classes may be part of the employability plan.

009.04 NONCOOPERATION WITH EMPLOYMENT REQUIREMENTS. If an employable individual refuses to comply, accept, or participate in employment services without good cause, the individual is ineligible. The individual is allowed one mediation period of up to seven days. If the employable individual continues to refuse refugee services, the case is closed.

009.04(A) APPLICANT. If an applicant refuses to register with a Refugee Social Service Provider and seek employment, they are ineligible. If the applicant begins to cooperate while the application is still pending, the applicant is eligible to receive services effective with the date of application if all other eligibility factors are met. If the applicant begins to cooperate after the application has been approved, their refugee resettlement program benefits resume effective the first day of the month during which the individual successfully participates.

009.04(B) RECIPIENT. If the individual refuses to actively seek employment:

(i) The refugee is allowed one mediation period of seven days. The individual is not removed from the unit during the mediation period unless the mediation period is terminated because the recipient is uncooperative or refuses the mediation; and

(ii) If the individual refuses to actively seek employment, the case is closed.

009.05 TRAINING REQUIREMENTS FOR EMPLOYED REFUGEE CLIENTS. In the instance of a refugee who is employed and receiving supplementary assistance and working less than 100 hours per month, the individual must participate in part-time training such as English-language or skill training, if available and determined appropriate.

009.06 GOOD CAUSE. An individual may be allowed good cause for refusing employment or training, or not cooperating with the service agency if approved by the Department.

010. ELIGIBILITY FOR MEDICAL ASSISTANCE FOLLOWING INELIGIBILITY FOR A GRANT . The following individuals remain eligible without a Share of Cost after losing cash assistance if the individual is still within their time limit for eligibility:

(A) Individuals sanctioned for not cooperating with employment services; and

(B) Individuals who become ineligible for cash assistance because of increased earnings or increased hours of employment.

011. OTHER RELATED ELIGIBILITY REQUIREMENTS . Other eligibility requirements are described in this section.

011.01 RECEIPT OF OTHER ASSISTANCE. An individual whose needs are included in the refugee resettlement program payment must not at the same time receive a payment of another type of categorical assistance that is administered by the Department. Assistance from a source other than the Department may be used to supplement, but not to duplicate, an assistance payment made for a particular case.

011.02 INELIGIBILITY OF FLEEING FELON. An individual is ineligible for refugee resettlement program cash and medical assistance during any period in which the individual is:

(A) Fleeing to avoid prosecution or custody or confinement after conviction for a crime in the United States or attempt to commit a crime that is a felony under the law of the place from which the individual is fleeing; or

(B) Violating a condition of United States federal or state probation or parole.

011.03 INELIGIBILITY FOR DRUG RELATED FELONIES. An individual who has committed and been convicted under federal or state law after August 22, 1996, of any offense which is classified as a felony and which has an element the possession, use, or distribution of a controlled substance, is permanently ineligible for refugee resettlement cash assistance. Other family members may continue to receive benefits.

History

• Effective 2023-07-14

Chapter 3 Refugee Resettlement Program Cash and Medical Assistance Benefits

Neb. Admin. Code tit. 470, ch. 3 Refugee Resettlement Program Cash and Medical Assistance Benefits {#sec-470-nac-3 omnilex-key=us-ne-regs-official--title-470--470 NAC 3}

001. REFUGEE RESETTLEMENT PROGRAM BENEFITS . If an individual is eligible for a cash assistance payment, they are also eligible for medical assistance. An individual may apply for medical assistance only. Refugee Resettlement benefits consist of:

(A) Cash assistance payments to the refugee payee; and

(B) Payments made directly to the provider for medical care and services as identified in the Medicaid Program, Title 477 Nebraska Administrative Code (NAC).

001.01 THOSE WHO RECEIVE OTHER ASSISTANCE. An individual who receives assistance from the Aid to Dependent Children program or Assistance to the Aged, Blind, or Disabled program is ineligible for the Refugee Resettlement Program.

001.02 DETERMINATION OF CASH ASSISTANCE PAYMENT. For purposes of calculating cash assistance for the Refugee Resettlement Program, the Department applies the rules and regulations from the Aid to Dependent Children Program, Title 468 NAC.

001.02(A) BUDGET COMPUTATION. For purposes of calculating cash payment for the Refugee Resettlement program, the Department applies the rules and regulations from the Aid to Dependent Children program, Title 468 NAC.

001.02(B) MULTIPLE HOUSEHOLDS. When a refugee resettlement program unit lives with an individual who is receiving assistance from another categorical program, the eligibility case is budgeted separately.

001.03 EFFECTIVE DATE OF PAYMENT. When an application for assistance is approved, the first month’s payment begins with the date of application if all eligibility factors are met.

001.04 INDIVIDUALS ELIGIBLE FOR CASH AND MEDICAL ASSISTANCE. Individuals who receive a refugee resettlement cash assistance, including individuals who do not receive a payment because of the $10 minimum payment, are automatically eligible for medical assistance without a separate eligibility determination.

001.05 EFFECTIVE DATE OF MEDICAL ELIGIBILITY. For purposes of determining the effective date of Medical Eligibility for the Refugee Resettlement Program, the Department applies the rules and regulations from the Medicaid Program, Title 477 NAC.

History

• Effective 2022-06-06

Chapter 4 Refugee Medical Assistance Program

Neb. Admin. Code tit. 470, ch. 4 Refugee Medical Assistance Program {#sec-470-nac-4 omnilex-key=us-ne-regs-official--title-470--470 NAC 4}

001. REFUGEE MEDICAL ASSISTANCE PROGRAM . The Refugee Medical Assistance Program provides medical care and services to refugees who:

(A) Are eligible for Refugee cash assistance based on Title 468 Nebraska Administrative Code (NAC);

(B) Do not have sufficient income to meet their medical needs;

(C) Qualify according to the program requirements;

(D) Are within the time limit; and

(E) Are eligible based on the requirements and limitations of the Nebraska Medical Assistance Program (see NAC 471 and 477).

001.01 RESOURCES. For purposes of determining resources and resource levels for the Refugee Resettlement Medical Assistance Program only, the Department applies the rules and regulations from the Medicaid Program, Title 477 NAC.

001.02 TREATMENT OF INCOME. For purposes of determining income and income levels for the Refugee Resettlement Medical Assistance Program only, the Department applies the rules and regulations from the Medicaid Program, Title 477 NAC.

001.03 MEDICALLY NEEDY INCOME LEVEL. For purposes of determining the medically needy income level for the Refugee Resettlement Medical Assistance Program only, the Department applies the rules and regulations from the Medicaid Program, Title 477 NAC.

History

• Effective 2022-06-06