Administrative Rules of the State of Montana

BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

In the matter of the adoption of New Rules I and II and the amendment of ARM 37.27.101 pertaining to substance use disorder (SUD) state approval

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NOTICE OF PUBLIC HEARING ON PROPOSED ADOPTION AND AMENDMENT

TO: All Concerned Persons

1. On January 14, 2021, at 11:00 a.m., the Department of Public Health and Human Services will hold a public hearing via remote conferencing to consider the proposed adoption and amendment of the above-stated rules. Because there currently exists a state of emergency in Montana due to the public health crisis caused by the coronavirus, there will be no in-person hearing. Interested parties may access the remote conferencing platform in the following ways:

(a) Join Zoom Meeting at: https://mt-gov.zoom.us/j/91826711375; meeting ID: 918 2671 1375; or

(b) Dial by telephone +1 646 558 8656; meeting ID: 918 2671 1375. Find your local number: https://mt-gov.zoom.us/u/acLsnxt5OS.

2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact the Department of Public Health and Human Services no later than 5:00 p.m. on January 8, 2021, to advise us of the nature of the accommodation that you need. Please contact Heidi Clark, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.

3. The rules as proposed to be adopted provide as follows:

NEW RULE I STATE APPROVED PROGRAMS, PREVENTION PROVIDERS, REQUIREMENTS (1) In order to be reimbursed for prevention services, a prevention provider must be state approved and:

(a) have a contract with the department for substance abuse primary prevention services;

(b) be the Montana Public Health Institute; or

(2) In order to become state approved, a prevention provider must complete and submit to the department the designated application.

(3) If the application and supporting documentation do not meet the application requirements, the department will notify the applicant in writing identifying the incomplete or missing information within 30 days of receipt of the application.

(a) The applicant has 30 days from the date of notification to respond in writing to the content of the notice.

(b) If a response is not received within 30 days, the department will deny approval and will notify the applicant in writing of the denial.

(4) If the application and supporting documentation meet the application requirements, the department shall issue provisional approval. Within 90 days of granting provisional approval, the department shall inspect the provider either on-site or remotely.

(5) The provider must submit the requested documentation to the department or provide access to the provider's premises for inspection.

(6) Within 20 days of the inspection, the department shall issue final approval or deny the application and shall send written notification of full approval or denial to the applicant.

(7) Upon receiving full approval, a provider may provide prevention and early intervention services as described by the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services.

(8) The department will annually inspect the provider, on-site or remotely, to ensure the provider continues to meet requirements of this rule.

(9) Approved providers must follow the American Society of Addiction Medicine (ASAM) Criteria in the provision of services and adhere to requirements outlined in the AMDD Medicaid Services Provider Manual for SUD and Adult Mental Health located at: https://dphhs.mt.gov/amdd/policymanualmedicaid.

AUTH: 53-2-201, 53-24-204, MCA

IMP: 53-24-204, 53-24-207, MCA

NEW RULE II STATE APPROVED PROGRAMS, OUTPATIENT TREATMENT PROVIDERS (1) In order to be reimbursed for outpatient services, an outpatient treatment provider must be state approved and be a licensed addiction counselor.

(2) In order to become state approved, the outpatient provider must complete and submit the designated application to the department.

(a) The applicant has 30 days from the date of notification to respond in writing to the content of the notice.

(b) If a response is not received within 30 days, the department will deny approval and will notify the applicant in writing of the denial.

(5) The provider must submit the requested documentation to the department or allow the department access to the provider's premises for inspection.

(6) Within 20 days of the inspection, the department shall issue final approval or deny the application and shall send written notification of full approval or denial to the applicant.

(7) The department will reimburse a state approved outpatient treatment provider for American Society of Addiction Medicine (ASAM) level of care 1.0, Outpatient Services, using appropriate Common Procedural Terminology (CPT) codes.

(8) The department will annually inspect the provider, on-site or remotely, to ensure the provider continues to meet requirements of this rule.

(9) Approved providers must follow the ASAM Criteria in the provision of services and adhere to requirements outlined in the AMDD Medicaid Services Provider manual for SUD and Adult Mental Health located at: https://dphhs.mt.gov/amdd/policymanualmedicaid.

AUTH: 53-2-201, 53-24-204, MCA

IMP: 53-24-204, 53-24-207, MCA

4. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:

37.27.101 ~~CHEMICAL DEPENDENCY TREATMENT PROGRAMS~~ STATE APPROVED PROGRAMS, PURPOSE (1) ~~Purpose.~~ The purpose of ~~this rule~~ the rules in this subchapter is to establish ~~treatment~~ standards for the approval of programs ~~extending~~ providing prevention, treatment, rehabilitative, and recovery services to alcoholics, intoxicated persons, persons incapacitated by alcohol, drug abusers and family members pursuant to 53-24-208, MCA; standards for acceptance of persons into the treatment program and standards by which the administrator may determine which persons may be admitted to an approved public treatment program as an alcoholic, drug abuser or family member pursuant to 53-24-209, MCA individuals with substance use disorders and substance related issues, as provided in Title 53, chapter 24, part 2, MCA.

AUTH: 53-24-207, MCA

IMP: 53-24-207, MCA

5. STATEMENT OF REASONABLE NECESSITY

The Department of Public Health and Human Services (department) is proposing changes to ARM 37.27.101 and proposes to adopt New Rules I and II pertaining to substance use disorder (SUD) state approval.

The department is proposing to make changes to the administrative rules for SUD state approval to include prevention providers and non-facility (outpatient) treatment providers as types of state approved programs and distinguish them from SUD treatment facilities. For prevention services, this is necessary because it allows the department to distribute a portion of allocated alcohol tax funds for prevention services as described in 53-24-108, MCA. In addition, these changes will allow the department to oversee the state approval process for outpatient treatment providers who currently are required to operate as treatment facilities or be employed by a treatment facility to become state approved. This is necessary to establish equitable requirements for outpatient providers to become state approved.

Fiscal Impact

The department anticipates no fiscal impact related to these proposed rule adoptions and amendments.

6. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Heidi Clark, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., January 21, 2021.

7. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

8. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency. Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.

9. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

10. With regard to the requirements of 2-4-111, MCA, the department has determined that the adoption and amendment of the above-referenced rules will not significantly and directly impact small businesses.

11. Section 53-6-196, MCA, requires that the department, when adopting by rule proposed changes in the delivery of services funded with Medicaid monies, make a determination of whether the principal reasons and rationale for the rule can be assessed by performance-based measures and, if the requirement is applicable, the method of such measurement. The statute provides that the requirement is not applicable if the rule is for the implementation of rate increases or of federal law.

The department has determined that the proposed program changes presented in this notice are not appropriate for performance-based measurement and therefore are not subject to the performance-based measures requirement of 53-6-196, MCA.

/s/ Brenda K. Elias /s/ Erica Johnston

Brenda K. Elias Erica Johnston, Interim Director

Rule Reviewer Public Health and Human Services

Certified to the Secretary of State December 15, 2020.