37.86.3606 CASE MANAGEMENT SERVICES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES, PROVIDER REQUIREMENTS
(1) These requirements are in addition to those contained in rule and statutory provisions generally applicable to Medicaid providers.
(2) The case management provider for persons age 16 and over with developmental disabilities is the Developmental Disabilities program of the department. The program may contract for the delivery of case management services.
(3) Contractors with the program for the provision of case management services must be either accredited by one of the national accreditation agencies for developmental disabilities services specified in ARM 37.34.1801 or licensed under 50-5-201 , MCA as a health care facility by the department.
(4) A case manager must be employed by the Developmental Disabilities program of the department or by a case management provider contracting with the program.
(5) A case manager must meet the following criteria:
(a) A case manager, except as otherwise provided for in (5)(b), must:
(i) have a bachelor's degree in social work or a related field from an accredited college; and
(ii) one year experience in developmental disabilities or other human services:
(A) if the experience is in a human service other than developmental disabilities, the case manager must have completed at least 40 hours of training in the delivery of services to persons with developmental disabilities under a training curriculum reviewed by the developmental disabilities program of the department within no more than three months of hire or designation as a case manager.
(6) All services provided to the client will be monitored by the case manager and the case manager's supervisor. The IP will be reviewed and revised according to the client's needs at least annually, or when major changes are needed.
(7) A provider of direct care services to persons with developmental disabilities may not act as the case management provider for clients for whom the provider delivers services.
(8) A case manager must participate in a minimum of 20 hours of advanced training in services to persons with developmental disabilities each year under a training curriculum reviewed by the Developmental Disabilities program of the department. On-going documentation of the qualifications of case managers and completions of mandated training must be maintained by the employer of the case manager.
(9) A case management provider must:
(a) have a system for handling client grievances; and
(b) protect the confidentiality of client records.
History: Sec. 53-6-113, MCA; IMP, Sec. 53-6-101, MCA; NEW, 1991 MAR p. 1295, Eff. 7/26/91; AMD, 1994 MAR p. 3201, Eff. 12/23/94; AMD, 1997 MAR p. 496, Eff. 3/11/97; TRANS, from SRS, 2000 MAR p. 481.