(1) The department has submitted a proposal seeking approval from the U.S. Department of Health and Human Services (HHS), under 42 CFS 441.300 through 441.310, to establish a program of Medicaid funded home and community-based services for persons who have severe disabling mental illness, as defined in ARM 37.89.103, and who would otherwise have to reside in and receive Medicaid reimbursed care in a nursing facility or a hospital. Upon formal approval, the department will initiate the program in accordance with the conditions of approval governing federal and state authorities and these rules.
(2) The department, in accordance with the state and federal statutes and the rules generally governing the provision of Medicaid funded home and community-based services, any federal-state agreements specifically governing the provision of the Medicaid funded home and community-based services to be delivered under this program, and within the available funding appropriated for the program, may determine within its discretion:
(a) the types of services to be available through the program;
(b) the amount, scope, and duration of the services available through the program;
(c) the categories of persons to be served through the program;
(d) the total number of persons who may receive services through the program;
(e) the total number of persons who may receive services through the program by category of eligibility, geographical area, or specific case management team; and
(f) eligibility of individual persons for the program.
(3) Enrollment in the program and the provision of services through the program are at the discretion of the department. There is no legal entitlement to enroll in the program or to receive any or all the services available through the program.
(4) The state has received federal approval to waive statewide coverage in the provision of program services. Program services may only be delivered to recipients in the following service areas for which federal approval of coverage has been received:
(a) Yellowstone County Region, inclusive of the counties of Yellowstone, Big Horn, Carbon, Stillwater, and Sweet Grass;
(b) Cascade County Region, inclusive of the counties of Cascade, Blaine, Chouteau, Glacier, Hill, Liberty, Pondera, Teton, and Toole; and
(c) Butte-Silver Bow County Region, inclusive of the counties of Butte-Silver Bow, Beaverhead, Deer Lodge, Granite, and Powell.