(1) This subchapter is not intended to and does not establish an entitlement for any youth to be determined eligible for or to receive any services under the plan. The department may, in its discretion, limit services, rates, eligibility, and the number of youth determined eligible under the plan based upon such factors as availability of funding, the degree of financial need, the degree of medical need, or other factors.

(a) If the department determines with respect to the MHS plan that it is necessary to reduce, limit, suspend, or terminate eligibility or benefits, reduce provider reimbursement rates, reduce or eliminate service coverage or otherwise limit services, benefits, or provider participation rates, in a manner other than provided in this subchapter, the department may implement such changes by providing ten days advance notice published in Montana major daily newspapers with statewide circulation, and by providing:

(i) ten days advance written notice of any individual eligibility and coverage changes to affected

(ii) ten days advance written notice of coverage, rate, and provider participation changes to affected providers.

(2) If the department determines that the average per-case cost of Mental Health Services Plan expenditures times the number of enrollees will exceed total appropriations, it will suspend enrollment of new recipients.

(a) The department will place the names of youth applying for enrollment who would be eligible but for the suspension of new enrollments on a waiting list.

(b) When total MHSP enrollment falls below the number which, when multiplied by the average per-case cost, equals total appropriations, the department will enroll youth whose names appear on the waiting list. Enrollment from the waiting list will be made in order of severity of need, with qualified applicants whose needs are most severe first as determined by the department based on the following:

(i) diagnosis;

(ii) functional impairment as evaluated by a licensed mental health professional designated by the department; or

(iii) availability of appropriate alternative means to obtain treatment.