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37.87.1307    HOME AND COMMUNITY-BASED SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE: LOSS OF A SERVICE AND DISENROLLMENT

(1) A service available through the program may be denied to a youth for the following reasons:

(a) the service is not appropriate for the youth;

(b) a service that is a necessary ancillary to the provision of the service is unavailable;

(c) access to the service, even with reasonable accommodation, is precluded by the youth's physical or mental health; or

(d) the financial costs and other impacts on the program due to the delivery of the service to the youth do not conform with the plan of care requirements in accordance with the Psychiatric Residential Treatment Facility Home and Community Based Services Waiver for Youth with Serious Emotional Disturbance Provider Policy Manual dated October 2010.

(2) A youth enrolled in the program may be terminated from the program by the department for the following reasons:

(a) the services, as provided for in the plan of care, are no longer appropriate or effective in relation to the youth's needs;

(b) the failure of the youth or parent(s) or responsible caregiver having physical custody to participate in or support the services as provided for in the plan of care;

(c) the behaviors of the youth place the youth, the youth's caregivers, or others at serious risk of harm or substantially impede the delivery of services as provided for in the plan of care;

(d) the youth requires more supervision than the program can provide;

(e) the youth's needs, inclusive of physical and mental health, cannot be effectively or appropriately met by the program;

(f) a necessary service or ancillary service is no longer available;

(g) the deteriorating mental health of the youth is deteriorating or in some manner so as to preclude the youth's participation in the program;

(h) the total cost of the youth's plan of care is not within the limits specified at ARM 37.87.1325;

(i) the youth no longer requires the level of care of a psychiatric residential treatment facility, in accordance with the Children's Mental Health Bureau Provider Manual and Clinical Guidelines for Utilization Management referenced in ARM 37.87.903;

(j) the youth no longer meets the clinical criteria of serious emotional disturbance as defined at ARM 37.87.303;

(k) the youth no longer resides in a geographic service area specified in ARM 37.87.1303;

(l) the youth has attained age 18; or

(m) the youth's parent(s) or the responsible caregiver having physical custody chooses to withdraw the youth from the program.

History: 53-2-201, 53-6-113, 53-6-402, MCA; IMP, 53-6-402, MCA; NEW, 2008 MAR p. 335, Eff. 2/15/08; AMD, 2009 MAR p. 2376, Eff. 12/11/09; AMD, 2011 MAR p. 1382, Eff. 7/29/11.

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