HOME    SEARCH    ABOUT US    CONTACT US    HELP   
           
Montana Administrative Register Notice 37-475 No. 12   06/25/2009    
Prev Next

BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the adoption of New Rules I, II, and III and the amendment of ARM 37.88.101, 37.88.901, 37.88.905, 37.88.906, and 37.88.907 pertaining to Medicaid mental health center services for adults with severe disabling mental illness

)

)

)

)

)

)

)

NOTICE OF PUBLIC HEARING ON PROPOSED ADOPTION AND AMENDMENT

 

TO:  All Concerned Persons

 

            1.  On July 22, 2009, at 1:30 p.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed adoption and amendment of the above-stated rules.

 

            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 Department of Public Health and Human Services no later than 5:00 p.m. on July 13, 2009, to advise us of the nature of the accommodation that you need.  Please contact Rhonda Lesofski, 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:

 

            RULE I  MENTAL HEALTH CENTER SERVICES FOR ADULTS, DEFINED

            (1)  A mental health center must provide:

            (a)  adult day treatment services;

            (b)  community-based psychiatric rehabilitation and support;

            (c)  respite care;

            (d)  in-training practitioner services;

            (e)  the therapeutic component of crisis intervention services;

            (f)  foster care for mentally ill adults;

            (g)  mental health group home services; and

            (h)  programs of assertive community treatment, as defined at ARM 37.88.901.

            (2)  All mental health center services must be co-occurring capable as defined at ARM 37.88.901.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, MCA

 

            RULE II  MENTAL HEALTH CENTER SERVICES FOR ADULTS, PROGRAM OF ASSERTIVE COMMUNITY TREATMENT (PACT)  (1)  A program of assertive community treatment (PACT) is a self-contained clinical treatment:

            (a)  provides needed treatment, rehabilitation, and support services to identified individuals with severe disabling mental illness;

            (b)  minimally refers individuals to services outside the program;

            (c)  provides services on a long term basis;

            (d)  delivers 75% or more of team service time outside program offices;

            (e)  serves individuals with severe disabling mental illness who are at least 18 years old, have severe symptoms and impairments not effectively treated by other available, less intensive services, or who have a history of avoiding mental health services;

            (f)  provides psychiatric services at the rate of at least 20 hours per week for each 70 persons served;

            (g)  maintains a ratio of at least one staff person, not including a psychiatrist, for each nine persons served.  Assertive community treatment teams must be approved by the Addictive and Mental Disorders Division; and

            (h)   complies with the Montana Program of Assertive Community Treatment (PACT) Standards.  The department adopts and incorporates by reference the Montana PACT Standards (2009) which set forth the standards of treatment for adults with SDMI.  A copy of the standards may be obtained from the Addictive and Mental Disorders Division, P.O. Box 202905, Helena, MT 59620-2905.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, MCA

 

            RULE III  MENTAL HEALTH CENTER SERVICES FOR ADULTS, INTENSIVE COMMUNITY-BASED REHABILITATION FACILITY  (1)  "Intensive community-based rehabilitation facility" means an adult mental health group home that provides medically necessary rehabilitation services to adults with severe disabling mental illness who have a history of institutional placements due to mental illness and a history of repeated unsuccessful placements in less intensive community-based programs.  The provider must provide the following services to individuals:

            (a)  close supervision and support of daily living activities;

            (b)  assistance with medications including administration of medications as necessary;

            (c)  rehabilitation in the following areas as needed by each client:

            (i)  maintenance of physical health and wellness;

            (ii)  personal hygiene;

            (iii)  safety;

            (iv)  symptom management;

            (v)  communication skills;

            (vi)  vocational activities;

            (vii)  community integration;

            (viii)  social skills;

            (ix)  leisure and recreation skills;

            (x)  establishment and maintenance of a community support network;

            (xi)  establishment and maintenance of meaningful daily structure; and

            (xii)  management of personal finances;

            (d)  case management to assure all necessary community services and supports, including services and supports for nonpsychiatric medical conditions, are available;

            (e)  discharge planning for transition to a less restrictive setting when appropriate; and

            (f)  transportation to assure appropriate community resources are accessible.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, MCA

 

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

 

            37.88.101  MEDICAID MENTAL HEALTH SERVICES FOR ADULTS, AUTHORIZATION REQUIREMENTS  (1) remains the same.

            (2)  For mental health services provided to an adult Medicaid client under the Montana Medicaid program, prior authorization is not required for the first 16 visits in the 12-month period beginning July 1, 2003 and each 12-month period thereafter for outpatient mental health counseling services a maximum of 24 sessions may be reimbursed per state fiscal year for individual and family outpatient therapy billed under Current Procedure Terminology 4th Edition (CPT4) codes 90804, 90806, 90810, 90812, 90846, and 90847 only.

            (3)  Adult intensive outpatient therapy services may be medically necessary for a person with safety and security needs who has demonstrated the ability and likelihood of benefit from continued outpatient therapy.  The person must meet the requirements of (3)(a) or (b).  The person must also meet the requirements of (3)(c). The person has:

            (a)  a DSM-IV diagnosis with a severity specifier of moderate or severe of mood disorder (293.31, 293.33, 293.34, 293.83, 295.70, 296.2x, 296.3x, 296.4x, 296.5x, 296.6x, 296.7, 296.22, 296.23, 296.24, 296.42, 296.43, 296.44, 296.80, 296.89, 296.90, 396.40); or

            (b)  a DSM-IV diagnosis borderline personality disorder (301.83), personality disorder (NOS) (301.9) with prominent features of 301.83; and

            (c) through (6) remain the same.

            (7)  Review of authorization requests by the department or its designee will be made with consideration of the adult intensive outpatient therapy services clinical management guidelines (2006).  A copy of the adult intensive outpatient therapy services clinical management guidelines (2006) can be obtained from the department by a request in writing to the Department of Public Health and Human Services, Addictive and Mental Disorders Division, Mental Health Services Bureau, 555 Fuller, P.O. Box 202905, Helena, MT  59620-2905.

            (8) and (9) remain the same.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA

 

            37.88.901  MENTAL HEALTH CENTER SERVICES FOR ADULTS, DEFINITIONS  (1)  "Adult" means a person who is not a child or adolescent as defined in this rule 18 years of age or older.

            (2)  "Adult day treatment" means a program which provides, in accordance with mental health center license requirements, a variety of evidence-based, recovery-oriented mental health services to adults with severe disabling mental illness.

            (3)  "Child or adolescent" means a person 17 years of age and younger or a person who is under 20 years of age and is enrolled in secondary school.

            (4)  "Child and adolescent day treatment" means a program which provides, in accordance with mental health center license requirements, an integrated set of mental health, education, and family intervention services to children or adolescents with severe emotional disturbance.

            (5) (3)  "Community-based psychiatric rehabilitation and support" means services provided in home, school, workplace, and community settings for adults with severe and disabling mental illness and youth with serious emotional disturbance.  Services are provided by trained mental health personnel under the direction of and according to individualized treatment plans prepared by licensed professionals.  The services are may be provided outside of normal clinical or mental health program settings and are designed to assist individuals in developing the skills, and behaviors, and emotional stability necessary for recovery to live successfully in the community.  Community-based psychiatric rehabilitation and support services are provided on a face-to-face basis with the recipient individuals, family members, teachers, employers or other key individuals in the recipient's individual's life when such contacts are clearly necessary to meet goals established in the recipient's individual individualized strength-based treatment plan. 

            (a)  Community-based psychiatric rehabilitation and support includes but is not limited to the following services:

            (i) remains the same.

            (ii)  assisting the consumer individual to develop communication skills, develop self-management of psychiatric symptoms, and develop the social networks necessary to minimize social isolation and increase opportunities for a socially integrated life;

            (iii)  assisting the consumer individual to develop daily living skills and behaviors necessary for maintenance of a home, and family relationships and responsibilities, an appropriate education, employment or vocational situation, and productive leisure and social activities;

            (iv) remains the same.

            (b)  Community-based psychiatric rehabilitation and support does not include the following services:

            (i) and (ii) remain the same.

            (iii)  interventions provided by staff of crisis facilities, group homes, or therapeutic adult foster care providers in such facilities, homes, or settings;

            (iv)  services provided as part of the recipient's intensive case management plan case planning activities, including but not limited to attending meetings, completing paperwork and other documentation requirements, traveling to and from the individual's home;

            (v)  therapeutic interventions by licensed practitioners, regardless of the location of the service; and

            (vi)  activities which are purely recreational in nature; and.

            (vii)  services provided within the school classroom that are educational, including, but not limited to educational aides.

            (6)  "Community mental health center" means a licensed mental health center, governed by a regional mental health corporation board created by 53-21-204, MCA, that provides the comprehensive mental health services listed in 53-21-201(1), MCA.

            (4)  "Co-occurring capability" means a mental health program can:

            (a)  screen all individuals for substance use disorders;

            (b)  provide access to outpatient therapists trained to diagnose and work with substance abusers;

            (c)  explicitly address some specific treatment needs of individuals with substance use disorders; and

            (d)  collaborate with another provider to access necessary consultation when an individual also requires services from that provider.

            (7) (5)  "Crisis intervention services" means a program which provides, in accordance with mental health center license requirements, emergency short term 24-hour care, treatment and supervision in a crisis intervention stabilization facility or other community setting for persons age 18 or older with mental illness experiencing a mental health crisis.

            (6)  "Evidence-based practice" means a practice that, based on research findings and expert or consensus opinion, is expected to produce a specific measurable clinical outcome or change in client status.

            (7)  "Illness management and recovery" means a program to help individuals who have experienced psychiatric symptoms to develop personalized strategies for managing their mental illness and moving toward recovery.  Such a program can be provided in an individual or group format.

            (8)  "Day treatment services" means adult day treatment services and child and adolescent day treatment services.

            (9)  "Intensive community based rehabilitation facility" means an adult mental health group home that provides medically necessary rehabilitation services to adults with severe and disabling mental illness who have a history of institutional placements due to mental illness and a history of repeated unsuccessful placements in less intensive community based programs.  The provider must provide the following services to residents:

            (a)  close supervision and support of daily living activities;

            (b)  assistance with medications including administration of medications as necessary;

            (c)  rehabilitation in the following areas as needed by each client:

            (i)  maintenance of physical health and wellness;

            (ii)  personal hygiene;

            (iii)  safety;

            (iv)  symptom management;

            (v)  communication skills;

            (vi)  vocational activities;

            (vii)  community integration;

            (viii)  social skills;

            (ix)  leisure and recreation skills;

            (x)  establishment and maintenance of a community support network;

            (xi)  establishment and maintenance of meaningful daily structure; and

            (xii)  management of personal finances;

            (d)  case management to assure all necessary community services and supports, including services and supports for non-psychiatric medical conditions, are available;

            (e)  discharge planning for transition to a less restrictive setting when appropriate; and

            (f)  transportation to assure appropriate community resources are accessible.

            (10) and (11) remain the same but are renumbered (8) and (9).

            (12) (10)  "Mental health center services" are defined in [RULE I]. means child and adolescent day treatment services, adult day treatment services, community based psychiatric rehabilitation and support respite care, in-training practitioner services, and the therapeutic component of crisis intervention services, foster care for mentally ill adults, and mental health group home services and programs of assertive community treatment, as defined in these rules.

            (13) remains the same but is renumbered (11).

            (14) (12)  "Program of assertive community treatment or PACT" means a self-contained clinical team that meets the requirements of [RULE II]. which:

            (a)  provides needed treatment, rehabilitation and support services to identified clients with severe disabling mental illness;

            (b)  minimally refers clients to outside service providers;

            (c)  provides services on a long term basis;

            (d)  delivers 75% or more of team service time outside program offices;

            (e)  serves individuals with severe disabling mental illness (SDMI) who are at least 18 years old, have severe symptoms and impairments not effectively treated by other available, less intensive services, or who have a history of avoiding mental health services;

            (f)  provides psychiatric services at the rate of at least 20 hours per week for each 70 persons served; and

            (g)  maintains a ratio of at least one staff person, not including the psychiatrist, for each nine persons served.  Assertive community treatment teams must be approved by the addictive and mental disorders division.

            (15) remains the same but is renumbered (13).

            (16) (14)  "Practitioner services" means services provided by a practitioner which could be covered and reimbursed by the Montana Medicaid program if the individual practitioner were enrolled in the program and had provided the services according to applicable Medicaid requirements.

            (15)  "Recovery" means a process that enables an individual to live a meaningful life in the community.  The fundamental components of recovery include self-direction, person-centered strength-based treatment, empowerment, respect, responsibility, and hope.

            (16)  "Recovery-oriented mental health services" means:

            (a)  respect for and appreciation of the individual that ensures inclusion and participation in all aspects of his or her life;

            (b)  individualized and person-centered treatment, based on the individual's unique strengths and resiliencies as well as his or her needs, preferences, experiences (including trauma), and cultural background; and

            (c)  empowerment of the individual to choose from a range of options and to participate in decisions and to receive education and support in so doing, and to promote personal responsibility for his or her own recovery.

            (17)  "Respite care" means relief services that allow family members, who are regular care givers for an adult with severe disabling mental illness or a youth with serious emotional disturbance, to be relieved of their care giver responsibilities for a temporary, short term period.

            (18)  "Treatment day" means a calendar day, including night, daytime or evening, during which a patient an individual is present at the provider's facility and receiving services according to applicable requirements.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA

 

            37.88.905  MENTAL HEALTH CENTER SERVICES FOR ADULTS, REQUIREMENTS  (1) remains the same.

            (2)  Mental health center services may be provided only by a facility which that is licensed as a mental health center by the department in accordance with the provisions of Title 50, chapter 5, part 2, MCA, and implementing administrative rules.

            (3) remains the same.

            (4)  Mental health center services must be available to recipients individuals continuously throughout the year.

            (5)  Mental health center services must be provided to a recipient an individual in accordance with an individualized strength-based treatment plan developed and maintained in accordance with license requirements.

            (6)  In addition to the clinical records required by mental health center license rules, the provider must maintain for day treatment services the records required by ARM 37.85.414, which shall include, but are not limited to, documentation of the recipient's individual's attendance and activities for the required period of time for the service billed and entry of progress notes in the recipient's individual's record at least every 30 days and upon any significant change in the recipient's individual's condition.

            (7)  For purposes of Medicaid billing and reimbursement of day treatment services, a half day requires that the recipient has attended the day treatment program for a minimum of two hours during the treatment day.

            (8)  For purposes of meeting the minimum hours required in (7), the provider may not include time during which the recipient is receiving practitioner services which are actually billed separately as practitioner services as permitted under ARM 37.88.906, up to a maximum of four hours during the treatment day.

            (9)  Services billed as community-based psychiatric rehabilitation and support may not be counted toward the time requirements for any other service or billed by the provider as any other type or category of service.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA

 

            37.88.906  MENTAL HEALTH CENTER SERVICES FOR ADULTS, COVERED SERVICES  (1)  Mental health center services, covered by the Medicaid program, include the following:

            (a) remains the same.

            (b)  child and adolescent day treatment services;

            (c) through (g)(iii) remain the same but are renumbered (b) through (f)(iii).

            (2) remains the same.

            (3)  A mental health center may provide case management services for youth with serious emotional disturbance and adults with severe disabling mental illness if enrolled as a provider of such services and in accordance with the requirement of Medicaid rules applicable to those service categories.  Case management services will be reimbursed only to the extent allowable and according to the Medicaid rules applicable to the particular category of service.

            (4) through (6)(c) remain the same.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA

 

            37.88.907  MENTAL HEALTH CENTER SERVICES FOR ADULTS, REIMBURSEMENT  (1)  Medicaid reimbursement for mental health center services shall be the lowest of:

            (a)  the provider's actual (submitted) charge for the service; or

            (b)  for services provided to adults, the department's Medicaid fee for the service as specified in the department's Medicaid Mental Health and or Mental Health Services Plan Fee Schedule for Individuals 18 Years of Age and Older Fee Schedule; or.

            (c)  for services provided to children and adolescents, the Medicaid Mental Health and Mental Health Services Plan Individuals Under 18 Years of Age Fee Schedule adopted in ARM 37.86.2207 for services provided to youths as that term is defined at ARM 37.89.103, and a direct care wage add-on as provided in ARM 37.88.1111, if applicable.

            (2)  For day treatment, program of assertive community treatment, and crisis intervention services, Medicaid will not reimburse a mental health center provider for more than one fee per treatment day per recipient individual.  This does not apply to practitioner services to the extent such services are separately billed in accordance with these rules.

            (3)  For purposes of Medicaid billing and reimbursement of day treatment services, a "half day" means that the individual has attended the day treatment program for a minimum of two hours during the treatment day.

            (4)  For purposes of meeting the minimum hours required in (3), the provider may not include time during which the individual is receiving practitioner services that are billed separately as practitioner services under ARM 37.88.906, up to a maximum of four hours during the treatment day.

            (5)  Services billed as community-based psychiatric rehabilitation and support may not be counted toward the time requirements for any other service or billed by the provider as any other type or category of service.

            (3) (6)  Reimbursement will be made to a provider for reserving an adult foster care or mental health adult group home bed only if:

            (a)  the recipient's individual's plan of care documents the medical need for a therapeutic visit as part of a therapeutic plan;

            (b)  the recipient individual is temporarily absent on a therapeutic visit;

            (c)  the provider clearly documents staff contact and recipient individual achievements or regressions during and following the therapeutic visit; and

            (d)  no more than 14 patient days per recipient individual in each rate year will be reimbursed for therapeutic visits.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:  53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA

 

            5.  The Department of Public Health and Human Services (the department) is proposing the adoption of new Rules I, II, and III and the amendment of ARM 37.88.101, 37.88.901, 37.88.905, 37.88.906, and 37.88.907 pertaining to Medicaid mental health center services for adults with severe disabling mental illness (SDMI).  The amendments are necessary to reflect the transfer of mental health center services for youth with serious emotional disturbance (SED) rules to ARM Title 37, chapter 87 effective February 17, 2009.  For more information about the transfer of mental health services for youth with SED, please see MAR Notice Number 37-463, 2008 MAR Notice No. 24 at page 2603 dated December 24, 2008.  The amendments proposed in this notice would update ARM 37.88.101 Medicaid Mental Health Services For Adults, Authorization Requirements; 37.88.901, Mental Health Center Services, Definitions; ARM 37.88.905, Service Requirements; ARM 37.88.906, Covered Services; and ARM 37.88.907, Reimbursement for Mental Health Centers.  The proposed amendments include the addition of definitions for co-occurring capability, evidence-based practice, illness management and recovery, recovery, and recovery-oriented mental health services.  The proposed amendments would also relocate provisions related to billing and reimbursement from ARM 37.88.905 to 37.88.907, where it is more appropriate.

 

The department is taking this opportunity to reformat the rules to conform to current terminology and rule format standards.

 

The proposed rule amendments will not increase or decrease Medicaid fees, costs, or benefits.  No fiscal or benefit effects are expected as a result of the proposed rules and amendments.

 

The proposed amendments are described below.

 

ARM 37.88.101

 

The department is proposing amendments to this rule governing prior authorization requirements that would remove all references to Medicaid mental health services to youths with Serious Emotional Disturbances (SED).  This would continue the department's reorganization of its rules to separate provisions related to adult mental health services and those for youths.  Since youth and adult mental health services were administratively separated in 2003, the programs have become distinct, with few common requirements.  Separate rules for each population would be easier for providers and consumers to reference and for the department to maintain.

 

The proposed amendments would also raise the limit for the number of individual and family therapy sessions from 16 to 24 per year.  However, the language exempting the first visits from the authorization requirement would be removed.  Authorization would be required prior to delivery of these services.

 

The department is taking this opportunity to delete obsolete Current Procedure Terminology (CPT) codes and to update the title of the clinical management guidelines.  The substantive provisions in guidelines will remain the same, but the department believes a more specific title will make it easier to distinguish the guidelines for adults from those for youths.

 

ARM 37.88.901 and Rules I, II, and III

 

The department is proposing to amend ARM 37.88.901 containing definitions applicable to mental health center services for adults with SDMI.  The proposed amendments would delete the definitions for child or adolescent, child and adolescent day treatment, and day treatment services because they do not apply to adult services.  The proposed amendments would also eliminate references to mental health center services for youth with SED.  Since youth and adult mental health services were administratively separated in 2003, the programs have become distinct with few common requirements.  Separate rules for each population are easier for providers and consumers to reference and for the department to maintain.  The definition of community mental health center would be deleted as obsolete.  The statute creating community mental health centers, 53-21-204, MCA was repealed by an act of the 2003 Montana Legislature, 2003 Laws of Montana, Chapter 602.

 

The department is proposing the addition of definitions for co-occurring capability, evidence-based practice, illness management and recovery, recovery, and recovery- oriented mental health services.  These terms are related to services provided by mental health centers to adults with SDMI.  They have been used in training that was offered to providers over the past four years.  The department has proposed the addition of these terms to this rule because it expects providers to use the treatment models introduced during the training.  Adoption of the terms would reinforce the department's intention that the new models and concepts be integrated into treatment and services for adults with SDMI.  Until now, adoption of these practices has been voluntary and limited.  The Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees administration of the Medicaid program requires states to provide some recovery-oriented services and evidence-based practices.  The department intends to implement this requirement through the proposed amendments.  The department considered and rejected the alternative of implementing the improved treatment models through voluntary provider participation.  The department believes the proposed changes will improve treatment outcomes for adults with severe disabling mental illnesses and should, therefore, be implemented statewide.

 

The proposed amendments would also move the substantive requirements for mental health centers to a new rule, [Rule I], the requirements for program of assertive community treatment (PACT) teams to new [Rule II] and the service requirements for intensive community-based rehabilitation facilities to new [Rule III].  This should make it easier for the public to access the requirements.  The department also proposes the addition of a requirement that all mental health center services have co-occurring capability.

 

ARM 37.88.905 and 37.88.907

 

The proposed amendments would relocate sections related to billing and reimbursement for mental health center services from ARM 37.88.905 Mental Health Center Services, Requirements to ARM 37.88.907 Mental Health Center Services, Reimbursement.  This should make it easier for providers and the public to access and use the rules.  No substantive effects on Mental Health Center reimbursement are intended as a result of this proposal.

 

ARM 37.88.906

 

The department proposes the deletion of child and adolescent day treatment services from this rule listing Mental Health Center covered services.  This proposal would make the rule consistent with the elimination of references to Medicaid mental health services for youth with SED.

 

Persons and entities affected

 

There are ten mental health centers and approximately 3000 individuals eligible for Medicaid mental health services in the state of Montana.  All could be affected by the proposed changes.

 

Fiscal and benefit effects

 

The department does not expect the changes proposed in this notice to affect the level of mental health services Medicaid individuals would receive.  No effects on state or federal Medicaid expenditures or provider reimbursement are expected as a result of the proposed rules 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: Rhonda Lesofski, 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., July 23, 2009.

 

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.  An electronic copy of this Proposal Notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the Notice conform to the official version of the Notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the Notice and the electronic version of the Notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

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

 

 

 

 

/s/  John Koch                                                /s/  Anna Whiting Sorrell                              

Rule Reviewer                                               Anna Whiting Sorrell, Director

                                                                        Public Health and Human Services

 

Certified to the Secretary of State June 15, 2009.

Home  |   Search  |   About Us  |   Contact Us  |   Help  |   Disclaimer  |   Privacy & Security