BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.87.1331 pertaining to home and community-based services (HCBS) for youth with serious emotional disturbance (SED)

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO:  All Concerned Persons

 

            1.  On November 23, 2010, at 1:30 p.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rule.

 

2.  The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice.  If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on November 15, 2010, to advise us of the nature of the accommodation that you need.  Please contact Rhonda Lesofski, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.

 

            3.  The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:

 

            37.87.1331  HOME AND COMMUNITY-BASED SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE:  PROVIDER REQUIREMENTS

            (1)  Services funded through the program may only be provided by or through a provider that:

            (a) and (b) remain the same.

            (c)  has been determined by the department to be qualified to provide services to youth with serious emotional disturbance in accordance with the criteria set forth in these rules;:

            (i)  a wraparound facilitator and home-based therapist cannot be employed by the same agency when serving on the treatment team and providing services to a specific youth enrolled in the HCBS waiver for youth with serious emotional disturbance.

            (d) through (2) remain the same.

 

AUTH:  53-2-201, 53-6-113, 53-6-402, MCA

IMP:  53-6-402, MCA

 

            4.  The Department of Public Health and Human Services (the department) is proposing the amendment of ARM 37.87.1331 pertaining to home and community-based services (HCBS) for youth with serious emotional disturbance (SED).

 

The department is proposing to add new language that a wraparound facilitator and a home-based therapist cannot be employed by the same agency for the provision of waiver services to an enrolled youth.  The wraparound facilitator is responsible for developing the plan of care and arranging for all the services provided to the youth enrolled in the waiver program.  There is a concern that if the wraparound facilitator and the home-based therapist are employed by the same agency, that the youth and family may feel obligated to choose a home-based therapist from the agency that employs the wraparound facilitator.  There is also financial incentive for the wraparound facilitator to use the home-based therapist from the same agency that employs both.

 

The proposed changes will remove any concerns of financial gains or conflicts of interest that may occur if the wraparound facilitator and the home-based therapist are employed by the same agency.  Furthermore, the youth and families are often in crisis at the time the youth is enrolled into the program and may feel obligated or pressured to use the home-based therapist that is employed by the same provider.  The youth will be able to benefit from a diversified team approach when the home-based therapy is provided outside the agency that employs the wraparound facilitator.

 

The department chose to add this language in order to avoid any conflicts of interest or financial gains for the providers.  This will allow the families and youth the opportunities to select home-based therapists from a list of enrolled providers in the communities.  The wraparound facilitator and the home-based therapist are key providers of waiver services and the best approach for continual evaluation and oversight is having these two waiver service providers not employed by the same provider.

 

Fiscal Impact

 

The youth enrolled in the HCBS Waiver program will not be affected by the proposed rule amendment.  There are no providers currently providing home-based therapy services and wraparound facilitation services to youth who are enrolled in the HCBS Waiver program.  The department is not proposing to cut services or reimbursement. 

 

The HCBS Waiver for Youth with SED is not available statewide and has the capacity to serve up to 100 youth upon full implementation.  Waiver Year Four begins October 1, 2010 with the capacity to serve 80 youth.  Enrollment has never been at maximum capacity; 37 youth to date have been served in the waiver since it became operational in February 2008.

 

            5.  The department intends the rule amendment to be applied effective January 1, 2010.

 

            6.  Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing.  Written data, views, or arguments may also be submitted to: Rhonda Lesofski, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., November 26, 2010.

 

7.  The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

8.  The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices.  Notices will be sent by e-mail unless a mailing preference is noted in the request.  Such written request may be mailed or delivered to the contact person in 6 above or may be made by completing a request form at any rules hearing held by the department.

 

9.  An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

10.  The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

 

 

 

/s/  John Koch                                                /s/  Anna Whiting Sorrell                              

Rule Reviewer                                               Anna Whiting Sorrell, Director

                                                                        Public Health and Human Services

           

Certified to the Secretary of State October 18, 2010.