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 repeal of ARM 37.89.103, 37.89.106, 37.89.112, 37.89.114, 37.89.115, 37.89.118, 37.89.119, 37.89.125, 37.89.131, 37.89.501, 37.89.503, 37.89.505, 37.89.507, 37.89.509, 37.89.521, 37.89.523, 37.89.525, 37.89.531, and 37.89.541 pertaining to crisis system restructuring

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NOTICE OF PUBLIC HEARING ON PROPOSED REPEAL

TO: All Concerned Persons

1. On August 30, 2022, at 1:00 p.m., the Department of Public Health and Human Services will hold a public hearing via remote conferencing to consider the proposed repeal of the above-stated rules. Interested parties may access the remote conferencing platform in the following ways:

(a) Join Zoom Meeting at: https://mt-gov.zoom.us/j/89983601796?pwd=S1o5NTNCYjNrOE1IVDhjamprMW85Zz09, Meeting ID: 899 8360 1796, and Password: 079179; or

(b) Dial by Telephone: +1 646 558 8656, Meeting ID: 899 8360 1796, and Password: 079179. Find your local number: https://mt-gov.zoom.us/u/kdZyPYrCSo

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 August 16, 2022, to advise us of the nature of the accommodation that you need. Please contact Kassie Thompson, 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 department proposes to repeal the following rules:

37.89.103 MENTAL HEALTH SERVICES PLAN, DEFINITIONS

AUTH: 41-3-1103, 52-1-103, 53-2-201, 53-6-113, 53-6-131, 53-6-701, 53-21-703, MCA

IMP: 41-3-1103, 52-1-103, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-117, 53-6-131, 53-6-701, 53-6-705, 53-21-139, 53-21-201, 53-21-202, 53-21-701, 53-21-702, MCA

37.89.106 MENTAL HEALTH SERVICES PLAN, MEMBER ELIGIBILITY

AUTH: 41-3-1103, 52-2-603, 53-2-201, 53-6-113, 53-6-131, 53-6-701, 53-6-706, 53-21-703, MCA

IMP: 41-3-1103, 52-2-603, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-117, 53-6-131, 53-6-701, 53-6-705, 53-6-706, 53-21-139, 53-21-202, 53-21-701, 53-21-702, MCA

37.89.112 MENTAL HEALTH SERVICES PLAN, OUTPATIENT DRUGS FOR BENEFICIARIES ELIGIBLE FOR MEDICARE

AUTH: 53-2-201, MCA

IMP: 53-21-701, MCA

37.89.114 MENTAL HEALTH SERVICES PLAN, COVERED SERVICES

AUTH: 41-3-1103, 52-1-103, 52-2-603, 53-2-201, 53-6-113, 53-6-131, 53-6-706, 53-21-703, MCA

IMP: 41-3-1103, 52-1-103, 52-2-603, 53-1-405, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-701, 53-6-705, 53-6-706, 53-21-139, 53-21-202, 53-21-701, 53-21-702, MCA

37.89.115 MENTAL HEALTH SERVICES PLAN, PROVIDER PARTICIPATION

AUTH: 2-4-201, 41-3-1103, 53-2-201, 53-6-113, 53-21-703, MCA

IMP: 2-4-201, 41-3-1103, 53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-6-113, 53-6-116, 53-6-701, 53-6-705, 53-21-202, 53-21-701, 53-21-702, MCA

37.89.118 MENTAL HEALTH SERVICES PLAN, AUTHORIZATION REQUIREMENTS

AUTH: 53-2-201, 53-21-703, MCA

IMP: 53-2-201, 53-21-202, 53-21-701, 53-21-702, MCA

37.89.119 MENTAL HEALTH SERVICES PLAN, PREMIUM PAYMENTS, AND MEMBER COPAYMENTS

AUTH: 53-2-201, 53-6-113, 53-6-131, 53-21-703, MCA

IMP: 53-1-405, 53-1-601, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-131, 53-21-701, 53-21-702, MCA

37.89.125 MENTAL HEALTH SERVICES PLAN, PROVIDER REIMBURSEMENT

AUTH: 53-2-201, 53-6-113, 53-21-703, MCA

IMP: 53-1-601, 53-2-201, 53-6-101, 53-6-116, 53-6-701, 53-6-705, 53-21-202, 53-21-702, MCA

37.89.131 MENTAL HEALTH SERVICES PLAN, MEMBER NOTICE, GRIEVANCE AND RECONSIDERATION AND RIGHTS

AUTH: 2-4-201, 53-2-201, 53-6-113, 53-6-706, 53-21-703, MCA

IMP: 2-4-201, 53-1-601, 53-2-201, 53-6-101, 53-6-113, 53-6-116, 53-6-706, 53-21-202, 53-21-701, 53-21-703, MCA

37.89.501 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: DEFINITIONS

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.503 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: LIMITATIONS

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.505 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CRISIS MANAGEMENT SERVICES

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.507 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CRISIS STABILIZATION PLAN

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.509 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CLAIMS AND REIMBURSEMENT

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.521 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSABLE SERVICES

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.523 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSEMENT FOR SERVICES

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.525 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSEMENT EXCLUSIONS

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.531 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: WHERE SERVICES MAY BE PROVIDED

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

37.89.541 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CONFIDENTIALITY REQUIREMENTS

AUTH: 53-6-101, 53-6-113, MCA

IMP: 53-6-101, MCA

4. STATEMENT OF REASONABLE NECESSITY

This rulemaking notice is part of the department's Healing and Ending Addiction through Recovery and Treatment (HEART) Initiative. The HEART Initiative will establish a comprehensive continuum of care to address Montana's behavioral health needs, which include services for mental health conditions and substance use disorder treatment. The HEART Initiative represents the state's commitment to expanding coverage and promoting access to mental health prevention, crisis intervention, treatment, and recovery services for eligible Montanans.

In this rulemaking notice, the department's Behavioral Health and Developmental Disabilities Division (BHDD) proposes to repeal all rules relating to the department's Mental Health Services Plan and the 72-Hour Presumptive Eligibility program, which are services for individuals who do not qualify for Medicaid services but whose income qualifies them for non-Medicaid mental health services paid for with state funds. Previously operated separately, the department proposes to align non-Medicaid mental health services with such services provided through the Medicaid program. By aligning the services, the state will have a unified and efficient system of mental health and crisis stabilization services for eligible Montanans, and there will be no distinction between Medicaid and non-Medicaid mental health services.

Through the HEART Initiative, BHDD can develop succinct, crisis-related programming, create administrative efficiencies, and enhance quality oversight. The object is to design a statewide, high quality mental health crisis system through Medicaid and mirror that in Montana's state funded programs.

Non-Medicaid mental health services will be aligned with Medicaid services in a rulemaking notice filed concurrently with this rule notice.

Fiscal Impact

This proposed rule amendment has no fiscal impact.

5. The proposed rule repeals are intended to be effective upon the day after the date of publication of the adoption notice.

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: Kassie Thompson, 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., September 2, 2022.

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 repeal of the above-referenced rules will not significantly and directly impact small businesses.

/s/ BRENDA K. ELIAS /s/ CHARLES T. BRERETON

Brenda K. Elias Charles T. Brereton, Director

Rule Reviewer Department of Public Health and Human Services

Certified to the Secretary of State July 26, 2022.