Montana Administrative Register Notice 37-614 No. 4   02/28/2013    
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In the matter of the amendment of ARM 37.87.102, 37.87.1216, 37.87.1217, 37.87.1222, and 37.87.1223 pertaining to psychiatric residential treatment facility (PRTF)








TO:  All Concerned Persons


1.  On November 8, 2012, the Department of Public Health and Human Services published MAR Notice No. 37-614 pertaining to the public hearing on the proposed amendment of the above-stated rules at page 2258 of the 2012 Montana Administrative Register, Issue Number 21.


2.  The department has amended ARM 37.87.1216, 37.87.1217, 37.87.1222, and 37.87.1223 as proposed.


3.  The department has amended the following rule as proposed, but with the following changes from the original proposal, new matter underlined, deleted matter interlined:


            37.87.102  Mental Health SERVICES (MHS) for YOUTH with serious emotional disturbance (SED), Definitions  As used in this chapter, the following terms apply:

            (1)  "Accredited secondary school" means a secondary school located in the state of Montana accredited in accordance with Montana Board of Public Education standards for secondary education or the Northwest Accreditation Commission.

            (2) through (16) remain as proposed.


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

IMP:     53-1-601, 53-1-602, 53-1-603, 53-2-201, 53-21-201, 53-21-202, 53-21-701, 53-21-702, MCA


4.  The department has thoroughly considered the comments and testimony received.  A summary of the comments received and the department's responses are as follows:


COMMENT #1:  One commenter stated the change in the definition of youth in ARM 37.87.102 which requires that a secondary school be accredited by the Montana Board of Public Education eliminates a number of secondary schools across the state from serving youth receiving Medicaid funded services and requested the department include accreditation by the Northwest Accreditation Commission.  The commenter also questioned why accreditation standards are being placed in the PRTF rules.


RESPONSE #1:  The department agrees with the commenter and will amend the proposed rule to include the Northwest Accreditation Commission, as long as the secondary school is located in Montana.  The definition of youth located in ARM 37.87.102 applies to other mental health services covered by Medicaid and is not limited to PRTFs.


COMMENT #2:  One commenter suggested greater definition be added in ARM 37.87.1217(3)(a) and (b) as to what information the developmental disabilities program (DDP) needs to determine eligibility.


RESPONSE #2:  The department disagrees with this comment.  As stated in ARM 37.87.1217(3)(a), the initial request for an eligibility determination with the DDP requires only a cover letter, psychological testing, and assessments.  Any further information required to make the determination must be established on a case-by-case basis.


COMMENT #3:  One commenter noted a functional assessment approved by the department will be required at admission and discharge in a PRTF.  The commenter also noted the department is not planning to reimburse for PRTFs to complete this assessment.


RESPONSE #3:  The commenter is correct.  Based on a survey completed by CMHB approximately half of PRTFs are currently using a functional assessment.  For those that do not currently use a functional assessment, the department determined that, after the initial staff training, the assessments take minimal time to complete.


            5.  The department intends ARM 37.87.1217(4) pertaining to the use of a functional assessment to be effective on July 1, 2013.




/s/ John Koch                                                /s/ Richard H. Opper                        

John Koch                                                      Richard H. Opper, Director

Rule Reviewer                                               Public Health and Human Services


Certified to the Secretary of State February 19, 2013


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