Montana Administrative Code

37.90.401 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: FEDERAL AUTHORIZATION AND STATE ADMINISTRATION The department has established the Severe and Disabling Mental Illness, Home and Community Based Services waiver program for members who…

37.90.402 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SERVICES The services available through the waiver program are: adult day health, as described in ARM 37.90.430; behavioral intervention assistant, as described in ARM 37.90.433; case…

37.90.403 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: DEFINITIONS "Activities of daily living" (ADL) means basic personal everyday activities. "Applicant" means an individual requesting services but not enrolled in the SDMI program. "Com…

37.90.406 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PROVIDER REQUIREMENTS The waiver program services may only be provided by a provider that: is enrolled as a Montana Medicaid provider except as provided in (2); meets all facility, li…

37.90.408 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: REIMBURSEMENT The department adopts and incorporates by reference the Medicaid Home and Community-Based Services for Adults with Severe and Disabling Mental Illness fee schedule. Unle…

37.90.409 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SEVERE AND DISABLING MENTAL ILLNESS CRITERIA To be found to have a qualifying SDMI diagnosis, an individual must: be 18 years of age or older; have a minimum of three areas of high-le…

37.90.410 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: CONSIDERATION FOR PROGRAM ELIGIBILITY AND ENROLLMENT SELECTION An applicant may be considered for enrollment in the program if the applicant meets the following criteria: is at least …

37.90.412 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PERSON-CENTERED RECOVERY PLAN The PCRP is developed by the enrolled member and the case management team to meet the enrolled member's identified needs as well as cost of identified se…

37.90.413 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: COST OF PERSON-CENTERED RECOVERY PLAN In order to maintain the program cost within the appropriated federal and state funds, the cost of a member's Person-Centered Recovery Plan (PCRP…

37.90.414 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: ENVIRONMENTAL ACCESSIBILITY ADAPTATIONS Environmental accessibility adaptations are modifications to a member's home that are necessary to increase accessibility, independence, and pr…

37.90.415 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: COMMUNITY TRANSITION SERVICES Community transition services are nonrecurring set-up expenses for members who are transitioning from an institutional setting into a community living se…

37.90.416 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PAIN AND SYMPTOM MANAGEMENT Pain and symptom management is defined as a service that provides traditional and nontraditional methods of pain reduction or management. Allowable non-tra…

37.90.417 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: HEALTH AND WELLNESS Health and wellness services are services that assist a member in acquiring, retaining, and improving self-help, socialization, and adaptive skills to reside succe…

37.90.418 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: CONSULTATIVE CLINICAL AND THERAPEUTIC SERVICES Consultative clinical and therapeutic services provide comprehensive expertise, training, and technical assistance to improve the abilit…

37.90.419 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: HOMEMAKER CHORE Homemaker chore services are extensive cleaning beyond the scope of general household cleaning under Community First Choice/Personal Assistance Service (CFC/PAS) state…

37.90.420 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: NOTICE AND FAIR HEARING The department provides written notice to a member when a determination is made by the department concerning: Medicaid eligibility; eligibility for the SDMI HC…

37.90.425 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: CASE MANAGEMENT Case management means case management as defined in the Code of Federal Regulations (CFR) at 42 CFR 440.169(d)(e). Case management services offered under the Severe an…

37.90.426 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: MEALS Meal service is the provision of hot or cold meals to a member up to twice daily. Meals may be provided by: a non-profit entity or public agency that provides congregate or home…

37.90.428 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: ADULT RESIDENTIAL CARE, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 10/27/06; AMD, …

37.90.429 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: SUPPORTED LIVING, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 10/27/06; R…

37.90.430 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: ADULT DAY HEALTH Adult day health is a supervised daytime program that offers health and social services for adults with severe and disabling mental illness to ensure optimal function…

37.90.431 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PERSONAL ASSISTANCE SERVICE Personal assistance service (PAS) is the provision of long term service and supports in a member's home and in the community tailored to each member's need…

37.90.432 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: HABILITATION, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 10/27/06; REP, …

37.90.433 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: BEHAVIORAL INTERVENTION ASSISTANT Behavioral Intervention Assistant service is provided when the PAS available in the waiver and CFC/PAS provided in the state plan are insufficient in…

37.90.434 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: LIFE COACH Life coach focuses on social determinants of health (SDoH) that impact a enrolled member's overall health and well-being, and addresses the obstacles that impede an enrolle…

37.90.435 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SUPPORTED EMPLOYMENT Supported employment services assist members to prepare for, find, and keep competitive jobs that exist in the open labor market, pay at least minimum wage, and a…

37.90.436 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: SPECIALLY TRAINED ATTENDANT CARE, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, …

37.90.437 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: HOMEMAKING REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 10/27/06; REP, 202…

37.90.438 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: RESPITE CARE Respite care is planned or emergency care provided to a member with need for support and supervision in order to provide temporary relief to the unpaid caregiver of the m…

37.90.439 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SELF-DIRECTED SERVICES Enrolled members in the waiver program must be offered an opportunity to utilize self-directed services as a co-employer. Once an enrolled member's comprehensiv…

37.90.440 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: OUTPATIENT OCCUPATIONAL THERAPY, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, E…

37.90.441 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: PSYCHO-SOCIAL CONSULTATION, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 1…

37.90.442 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: SUBSTANCE-RELATED DISORDERS SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 1…

37.90.445 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: DIETETIC SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 10/27/06; …

37.90.446 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: NUTRITION, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Eff. 10/27/06; REP, 202…

37.90.447 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PRIVATE DUTY NURSING Private duty nursing are medically necessary nursing services delivered to a member in their place of residence. Private duty nursing may be provided by: a licens…

37.90.448 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PERSONAL EMERGENCY RESPONSE SYSTEMS A personal emergency response system (PERS) is an electronic device used to secure assistance in an emergency situation to allow a member to gain g…

37.90.449 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SPECIALIZED MEDICAL EQUIPMENT AND SUPPLIES Specialized medical equipment and supplies service is the provision of items of medical equipment and supplies to an enrolled member for the…

37.90.450 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: NONMEDICAL TRANSPORTATION Nonmedical transportation is the provision to a member of transportation through common carrier or private vehicle for access to social or other nonmedical a…

37.90.451 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: RESIDENTIAL HABILITATION, ASSISTED LIVING Residential habilitation, assisted living, provides 24-hour services and supports designed to ensure the health, safety, and welfare of a mem…

37.90.452 HOME AND COMMUNITY BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: RESIDENTIAL HABILITATION, INTENSIVE MENTAL HEALTH GROUP HOME Residential habilitation, intensive mental health group home, provides 24-hour care designed to ensure the health, safety,…

37.90.453 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: RESIDENTIAL HABILITATION, MENTAL HEALTH GROUP HOME Residential habilitation, mental health group home, provides 24 hours of available services and supports designed to ensure health, …

37.90.454 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: RESIDENTIAL HABILITATION, ADULT GROUP HOME Residential habilitation, adult group home, provides 24-hour available services and supports designed to ensure health, safety, and welfare …

37.90.455 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: RESIDENTIAL HABILITATION, FOSTER CARE Residential habilitation, foster care, provides 24-hour services and supports designed to ensure the health, safety, and welfare of a member and …

37.90.460 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: ILLNESS MANAGEMENT AND RECOVERY SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-6-402, MCA History: NEW, 2006 MAR p. 2665, Ef…

37.90.461 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS: WELLNESS RECOVERY ACTION PLAN (WRAP) SERVICES, REQUIREMENTS (REPEALED) Authorizing statute(s): 53-2-201, 53-6-402, MCA Implementing statute(s): 53-2-401, 53-6-402, MCA History: NEW, 2006 …

37.90.462 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: PROVISION OF SERVICES BY LEGALLY RESPONSIBLE INDIVIDUALS A legally responsible individual (LRI) is an enrolled member's spouse or a court-appointed guardian for the enrolled member. T…

37.90.463 HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SPECIALIZED MEDICAL EQUIPMENT AND SUPPLIES –SERVICE ANIMALS A service animal is an animal trained to undertake a particular task or tasks on behalf of an enrolled member that the enro…

37.91.101 PROFESSIONAL PERSON CERTIFICATION The purpose of this chapter is to: adopt a procedure whereby persons may be certified as mental health professional persons as authorized in 53-21-106 , MCA; set forth specific conditions and qualifications which must be met before cert…

37.91.102 EXEMPTIONS Medical doctors who are licensed to practice in Montana by the board of medical examiners are designated mental health professional persons by 53-21-102, MCA and are therefore exempt from the provisions of ARM 37.91.106. Advanced practice registered nurses wi…