Montana Administrative Code

37.49.704 IV-E FOSTER CARE ELIGIBILITY: OPPORTUNITY FOR HEARING The placing worker who does not agree with an adverse action of the department related to IV-E eligibility shall have the right to a hearing as provided in ARM 37.5.304, 37.5.307, 37.5.313, 37.5.316, 37.5.318, 37.5.3…

37.5.101 APPLICABLE HEARING PROCEDURES This chapter specifies the fair hearing procedures applicable to department actions in the various programs administered by the department. This chapter does not grant any right to a hearing, but specifies the hearing rules that apply where …

37.5.103 PUBLIC ASSISTANCE, DAYCARE, MEDICAL, LICENSURE, AND REFUGEE ASSISTANCE PROGRAMS: APPLICABLE HEARING PROCEDURES Hearings contesting adverse department actions under the programs specified in (1)(a) through (1)(k) are available to the extent granted in and according to the…

37.5.105 NURSING FACILITY RELATED CASES: APPLICABLE HEARING PROCEDURES Hearings contesting a transfer or discharge of a nursing facility resident by a nursing facility are available to the extent granted in 42 CFR part 431, subpart E and shall be conducted in accordance with ARM …

37.5.107 STATE INSTITUTIONS, ADMISSION, DISCHARGE, AND ABILITY TO PAY FOR CARE: APPLICABLE HEARING PROCEDURES Hearings relating to determinations of ability to pay for cost of care in a state institution are available to the extent granted in 53-1-407 , MCA and shall be conducted…

37.5.109 CHEMICAL DEPENDENCY PROGRAM CERTIFICATION: APPLICABLE HEARING PROCEDURES Hearings contesting adverse department actions regarding denial, suspension, revocation, limitation or restriction of approval of chemical dependency treatment programs, and chemical dependency educ…

37.5.113 MENTAL HEALTH SERVICES PLAN: APPLICABLE HEARING PROCEDURES Hearings relating to the Mental Health Services Plan (MHSP), are available to the extent provided in ARM 37.89.131. The procedures specified in ARM 37.5.304, 37.5.307, 37.5.310, 37.5.311, 37.5.313, 37.5.316, 37.5…

37.5.114 CHILDREN'S MENTAL HEALTH BUREAU (CMHB) MEDICAID SERVICES: APPLICABLE HEARING PROCEDURES Except as otherwise provided in department rule, hearings contesting adverse department actions relating to CMHB Medicaid services are available to the extent provided and according t…

37.5.115 DEVELOPMENTAL DISABILITIES PROGRAMS: APPLICABLE HEARING PROCEDURES Hearings relating to the Developmental Disability Services program are available as follows: except as otherwise provided by department rule, hearings contesting adverse department actions in the Developm…

37.5.116 INTERMEDIATE CARE FACILITY FOR THE DEVELOPMENTALLY DISABLED (ICF/DD): APPLICABLE HEARING PROCEDURES Hearings relating to involuntary transfers and discharge from an intermediate care facility for the developmentally disabled are available, subject to the following extent…

37.5.117 CERTAIN TITLE 50 PROGRAMS AND OTHER PROGRAMS FOR WHICH NO PROCEDURE IS OTHERWISE SPECIFIED: APPLICABLE HEARING PROCEDURES Hearings under the programs specified in this rule are available to the extent specifically provided by law, including the Montana Code Annotated and…

37.5.118 DETERMINATIONS OF REPORTS OF CHILD ABUSE, NEGLECT, AND EXPLOITATION: APPLICABLE HEARING PROCEDURES Hearings contesting substantiated reports of child abuse, neglect or exploitation are available to the extent provided in ARM 37.47.610. The procedures specified in ARM 37.…

37.5.119 LONG-TERM CARE FACILITY CERTIFICATE OF NEED: APPLICABLE HEARING PROCEDURES Hearings relating to along-term care facility certificate of need are available to the extent granted and as provided in 50-5-306, MCA, ARM 37.106.115, and 37.106.120. The provisions of ARM 37.5.3…

37.5.121 WOMEN, INFANTS, CHILDREN (WIC) PROGRAM: APPLICABLE HEARING PROCEDURES Hearings relating to the Women, Infants, Children (WIC) program are available to the extent provided in and according to the procedures specified in ARM Title 37, chapter 59. The provisions of ARM 37.5…

37.5.123 CHILD AND ADULT CARE FOOD PROGRAM (CACFP): APPLICABLE ADMINISTRATIVE REVIEW (APPEAL) PROCEDURES FOR INSTITUTIONS, RESPONSIBLE PRINCIPALS, AND RESPONSIBLE INDIVIDUALS Administrative reviews (appeals) are available to the extent granted in 7 CFR 226.6. The provisions of AR…

37.5.124 CHILD AND ADULT CARE FOOD PROGRAM (CACFP): APPLICABLE ADMINISTRATIVE REVIEW (APPEAL) PROCEDURES FOR DAY CARE HOMES Administrative reviews (appeals) are available to the extent granted in 7 CFR 226.6(l). The provisions of ARM 37.5.304, 37.5.307, 37.5.310, 37.5.311, 37.5.3…

37.5.125 VOCATIONAL REHABILITATION AND BLIND AND LOW VISION SERVICES PROGRAMS: APPLICABLE HEARING PROCEDURES Hearings relating to the provision of vocational rehabilitation services inclusive of the Blind and Low Vision Services program are available to the extent granted and as …

37.5.127 TELECOMMUNICATIONS ACCESS PROGRAM: APPLICABLE HEARING PROCEDURES Hearings relating to the Telecommunications Access program are available to the extent granted and as provided in ARM 37.36.901 and 37.36.902. The provisions of ARM 37.5.304, 37.5.307, 37.5.310, 37.5.311, 3…

37.5.129 CHILD SUPPORT SERVICES: APPLICABLE HEARING PROCEDURES Hearings relating to child support services matters are available to the extent granted and as provided in ARM Title 37, chapter 62, subchapter 9. Unless specifically referenced in that subchapter, the provisions of a…

37.5.131 DEPARTMENT HEARING PROCEDURES, SCOPE, AND SUBORDINATION TO CERTAIN OTHER LAW There is no right to a hearing in any matter except as specifically provided by law, including department rule. There is no right to a hearing in a contract dispute between the department and an…

37.5.301 APPLICABILITY This rule and ARM 37.5.304, 37.5.307, 37.5.310, 37.5.313, 37.5.316, 37.5.318, 37.5.322, 37.5.325, 37.5.328, 37.5.331, 37.5.334, and 37.5.337 apply only to hearings in the program areas specified in ARM 37.5.101, 37.5.103, 37.5.105, 37.5.107, 37.5.109, 37.5.…

37.5.304 DEFINITIONS For purposes of this subchapter, unless the context requires otherwise, the following definitions apply: "Adverse action" means: a failure of the department to provide a claimant an opportunity to make application or reapplication for benefits; a failure of t…

37.5.305 APPLICABILITY OF NOTICE REQUIREMENTS This rule, ARM 37.5.503 and 37.5.505 apply only to claimants under the following programs: Developmental Disabilities program; Temporary Assistance for Needy Families (TANF); food stamps; Medical Assistance program (Medicaid); Low Inc…

37.5.307 OPPORTUNITY FOR HEARING A claimant who is aggrieved by an adverse action of the department will be afforded the opportunity for a hearing as provided in this chapter. A request for a hearing is any clear written expression by the claimant or an authorized representative …

37.5.310 ADMINISTRATIVE REVIEW AND FAIR HEARING PROCESS FOR MEDICAL ASSISTANCE PROVIDERS The following administrative review and fair hearing process applies to all medical assistance providers that are aggrieved by an adverse action of the department, except medical assistance p…

37.5.311 INFORMAL RECONSIDERATION A provider or other person may request an informal reconsideration of a department action in the following cases: where the hearing is to be held after the effective date of a denial, termination, or nonrenewal of enrollment, certification, or re…

37.5.313 DISMISSAL OF HEARING A hearing may be dismissed when: the request for a hearing is withdrawn by the claimant or provider or his representative: except as provided in (1)(a)(ii), the request for hearing must be withdrawn in writing; a request for hearing contesting an adv…

37.5.316 CONTINUATION OF PUBLIC ASSISTANCE BENEFITS This rule regarding continuation of benefits applies only to benefits under the following programs: TANF cash assistance; food stamps; and Medicaid, subject to (2). For purposes of this rule, benefits include services being rece…

37.5.318 ADMINISTRATIVE REVIEW Upon the request for a hearing by a claimant or a provider, other than a medical assistance provider, the department shall conduct an administrative review with the purpose of resolving the case and avoiding an unnecessary hearing. This review may b…

37.5.322 HEARING OFFICER, POWERS, AND DUTIES A hearing shall be conducted by an impartial individual appointed or hired by the department as hearing officer who has had no direct involvement in the initial determination of the adverse action. The hearing officer may: require the …

37.5.325 HEARING PROCEDURE A claimant's hearing shall be conducted: by telephone conference, unless a party to the hearing requests an in-person hearing; and at a reasonable time and date. Except as otherwise provided by department rule, a claimant's hearing shall be held in the …

37.5.328 PROPOSAL FOR DECISION BY HEARING OFFICER The proposal for decision shall: be based on the facts and evidence admitted in the hearing record as applied to pertinent state and federal law and regulation; consist of proposed findings of fact, proposed conclusions of law, an…

37.5.331 NOTICE OF APPEAL AND REVIEW OF PROPOSAL FOR DECISION If a party is aggrieved by an adverse proposal for decision, a request for review may be made by filing notice of appeal in accordance with this rule. The notice of appeal must be made to and shall be decided by the Bo…

37.5.334 JUDICIAL REVIEW A party who is aggrieved by a final decision may seek judicial review of that decision by filing a petition in district court within 30 days after service of the final decision as provided in 2-4-702 , MCA. Authorizing statute(s): 53-2-201, 53-2-606, 53-4…

37.5.337 AVAILABILITY OF HEARING RECORDS The proposal for decision, the verbatim transcript, if requested by a party, all exhibits, papers and requests filed in the proceeding, and, if applicable, the decision of the board or the director or the director's designee on review unde…

37.5.503 NOTICE UPON APPLICATION FOR PUBLIC ASSISTANCE At the time of application for benefits administered by the department, including but not limited to Temporary Assistance for Needy Families (TANF), food stamps, Medicaid, LIEAP, LIWAP, refugee assistance, and daycare benefit…

37.5.505 NOTICE UPON ADVERSE PUBLIC ASSISTANCE ACTION Upon an adverse action by the department affecting benefits administered by the department, including but not limited to Temporary Assistance for Needy Families (TANF), food stamps, Medicaid, LIEAP, LIWAP, refugee assistance, …

37.5.601 PURPOSE The purpose of ARM 37.5.601 through 37.5.615 is to supplement those provisions of the Code of Federal Regulations (CFR) which provide the requirements nursing facilities must meet in order to participate in the Medicaid program, and which govern the certification…

37.5.602 DEFINITIONS The following definitions shall apply to nursing facilities participating in the Medicaid program, and to the certification of nursing facilities for participation in the Medicaid program by the state survey agency, as provided for at 42 CFR parts 442, 483 an…

37.5.603 OPPORTUNITY FOR INFORMAL DISPUTE RESOLUTION A facility may request an informal dispute resolution to refute a deficiency citation made by the state survey agency. An informal dispute resolution is a different and separate form of procedure from an administrative review a…

37.5.606 INFORMAL DISPUTE RESOLUTION FACILITY REQUIREMENTS A request for informal dispute resolution must be in writing and either received by the department or postmarked within ten calendar days of the facility's receipt of the state survey agency's written deficiency citations…

37.5.607 INFORMAL DISPUTE RESOLUTION STATE SURVEY AGENCY RESPONSIBILITIES The state survey agency shall not interfere with the right of a facility to request an informal dispute resolution. The state survey agency must give the facility notice of the facility's right to request i…

37.5.610 INFORMAL DISPUTE RESOLUTION PROCESS Upon receipt by the department of a timely written request for informal dispute resolution complying with the requirements of this chapter, the department shall designate an individual who was not directly involved in the certification…

37.5.611 INFORMAL DISPUTE RESOLUTION, CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) RESPONSIBILITIES The presiding official shall make a written recommendation to CMS, the facility and the state survey agency following the informal dispute resolution. CMS shall have the final …

37.5.615 INCORPORATION OF STANDARDS FOR MONITORING AND REFERRAL FOR MEDICATIONS AND TREATMENTS IN THE CERTIFICATION PROCESS In compliance with 53-6-109 , MCA, the following facility monitoring and referral standards for medications and treatments shall be used in the survey and c…

37.50.101 DEFINITIONS The following definitions apply to the rules contained in this subchapter. "Daily rate" means the rate the department will pay to facilities for supervision and treatment services. The daily rate is a percentage of the model rate and is based upon the depart…

37.50.105 GENERAL REQUIREMENTS The department may place a child in substitute care pursuant to: a court order; emergency protective services as authorized by 41-3-301 , MCA; a voluntary placement agreement entered by the department and the parents or guardians of the child; or ot…

37.50.106 VOLUNTARY PLACEMENT Voluntary placement should not exceed 6 months in duration. Voluntary placement agreements will generally not be accepted if: the child requests placement to avoid being held responsible for the child's behavior or because of conflicts with the paren…

37.50.1101 GUARDIANSHIP AND HOME APPROVAL In order to be approved as a guardian pursuant to 41-3-444, MCA, the prospective guardian and the home of the prospective guardian must meet the requirements set forth for youth foster homes contained in ARM 37.51.210, 37.51.216, 37.51.30…

37.50.1102 STATE-SUBSIDIZED GUARDIANSHIP A child is eligible to have state subsidized guardianship payments made on the child's behalf if the child has been adjudicated a youth in need of care pursuant to Title 41, chapter 3, part 4, MCA. Subsidized guardianship payments may be m…