Where your future begins
Where your future begins
Contact: Carla Lasley
Created: 11/06/2019
Date Emailed to Staff: 11/06/2019
Effective Date: 11/06/2019
Summary of Changes
* The Releases for benefits providers (signified by BP before the form) to obtain information from various entities have been revised as follows: Goodwill's address has changed. All referrals and information released will go through the Columbus address, rather than North Platte.
* The Benefits Referral form has been changed to include the updated GW address/contact info.
* The HHS 160 form --DHHS Authorization for Disclosure of Protected Health Information (English and Spanish versions) have been updated to include a radio button so that the benefits provider name and address information can be automatically populated; the change in Goodwill address is included with this change.
Forms - New or Revised
https://webforms.nebraska.gov/assets/vr_forms/20/original/BP_SSAinfoRelEarn.pdf?1571336515
https://webforms.nebraska.gov/assets/vr_forms/166/original/BP_SSAinfoRelGen.pdf?1571336562
https://webforms.nebraska.gov/assets/vr_forms/164/original/Benefits_Referral.pdf?1571340097
QE2 Update
No changes
To Do
Destroy any paper copies of these forms (now outdated) and remove any saved to desktops.
Team Communication
As above in To-Do section.
VRIS Posting
Benefits Orientation
Monitoring Requirements
None.
Training Dates
None.