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37.40.1406    HOME AND COMMUNITY-BASED SERVICES FOR ELDERLY AND PHYSICALLY DISABLED PERSONS: SERVICES

(1) The services available through the program are limited to those specified in this rule.

(2) The department may determine the particular services of the program to make available to a recipient based on, but not limited to, the following criteria:

(a) the recipient's need for a service generally and specifically;

(b) the availability of a specific service through the program and any ancillary service necessary to meet the recipient's needs;

(c) the availability otherwise of alternative public and private resources and services to meet the recipient's need for the service;

(d) the recipient's risk of significant harm or of death if not in receipt of the service;

(e) the likelihood of placement into a more restrictive setting if not in receipt of the service; or

(f) the financial costs for and other impacts on the program arising out of the delivery of the service to the person.

(3) A person enrolled in the program may be denied a particular service available through the program that the person desires to receive or is currently receiving.

(4) Bases for denying a service to a person include, but are not limited to:

(a) the person requires more supervision than the service can provide;

(b) the person's needs, inclusive of health, can no longer be effectively or appropriately met by the service;

(c) access to the service, even with reasonable accommodation, is precluded by the person's health or other circumstances;

(d) a necessary ancillary service is no longer available; and

(e) the financial costs for and other impacts on the program arising out of the delivery of the service to the person.

(5) The department may make program services for persons with intensive needs available to a recipient whom it determines, based on past medical history and current medical diagnosis, would otherwise require on a long term basis the level of care of an inpatient hospital or a rehabilitation service setting.

(6) The following services, as defined in these rules, may be provided through the program:

(a) case management services;

(b) homemaking;

(c) personal assistance;

(d) adult day health;

(e) habilitation;

(f) respite care;

(g) personal emergency response systems;

(h) nutrition services;

(i) environmental accessibility adaptations;

(j) nonmedical transportation;

(k) outpatient physical therapy;

(l) outpatient occupational therapy;

(m) speech pathology and audiology;

(n) respiratory therapy;

(o) nursing;

(p) psycho-social consultation; and

(q) dietetic services;

(r) adult residential care;

(s) specially trained attendant care;

(t) chemical dependency counseling;

(u) cognitive rehabilitation;

(v) comprehensive day treatment;

(w) community residential rehabilitation;

(x) supported living;

(y) specialized medical equipment and supplies;

(z) specialized child care for children with AIDS; and

(aa) behavioral programming.

(7) Monies available through the program may not be expended on the following:

(a) room and board; and

(b) special education and related services as defined at 20 USC 1401(16) and (17) .

(8) A service available through the program is not available to any extent that a service of another program is otherwise available to a recipient to meet the recipient's need for that service.

History: Sec. 53-2-201, 53-6-101, 53-6-113 and 53-6-402, MCA; IMP, Sec. 53-2-201, 53-6-101 and 53-6-402, MCA; NEW, 1983 MAR p. 863, Eff. 7/15/83; AMD, 1986 MAR p. 2094, Eff. 1/1/87; AMD, 1988 MAR p. 1268, Eff. 7/1/88; AMD, 1991 MAR p. 470, Eff. 12/14/90; TRANS & AMD, from SRS, 2000 MAR p. 2023, Eff. 7/28/00.

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