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Montana Administrative Register Notice 37-631 No. 8   04/25/2013    
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BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.34.901 and the repeal of ARM 37.34.902, 37.34.906, 37.34.907, 37.34.911, 37.34.912, 37.34.913, 37.34.917, 37.34.918, 37.34.919, 37.34.925, 37.34.926, 37.34.929, 37.34.930, 37.34.933, 37.34.934, 37.34.937, 37.34.938, 37.34.941, 37.34.942, 37.34.946, 37.34.947, 37.34.950, 37.34.951, 37.34.954, 37.34.955, 37.34.956, 37.34.957, 37.34.960, 37.34.961, 37.34.962, 37.34.963, 37.34.967, 37.34.968, 37.34.971, 37.34.972, 37.34.973, 37.34.974, 37.34.978, 37.34.979, 37.34.980, 37.34.981, 37.34.985, 37.34.986, 37.34.987, and 37.34.988 pertaining to Medicaid home and community-based service program for individuals with developmental disabilities

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT AND

REPEAL

 

 

TO:  All Concerned Persons

 

            1.  On May 16, 2013, at 10:00 a.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 and repeal of the above-stated rules.

 

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 May 9, 2013, to advise us of the nature of the accommodation that you need.  Please contact Kenneth Mordan, 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:

 

            37.34.901  MEDICAID HOME AND COMMUNITY-BASED SERVICES WAIVER PROGRAM: AUTHORITY  (1)  The department has been granted by the United States department of health and human services (HHS) the authority, through 42 USC 1396n(c) and 42 CFR 441.300 through 441.310, to provide Medicaid home and community-based services (HCBS) to persons with developmental disabilities.  The authority to implement this program is provided in 42 USC 1396n(c) and 42 CFR 441.300 through 441.310.  These rules implement in Montana the Medicaid home and community-based services waiver program for persons with developmental disabilities.

            (2)  In accordance with the state and federal statutes and rules generally governing the provision of Medicaid-funded home and community-based services and the federal-state agreement specifically governing the provision of the Medicaid-funded home and community-based services to be delivered through this program, and within the fiscal limitations of the funding appropriated and available for the program, the department may determine within its discretion the following features of the program:

            (a)  the types of services to be available;

            (b)  the amount, scope, and duration of the services;

            (c)  the target population;

            (d)  individual eligibility; and

            (e)  delivery approach. 

            (3)  The 1915(c) Home and Community-Based Waiver Services for Individuals with Developmental Disabilities waiver program must be delivered in accordance with the requirements and limitations of the 1915(c) Home and Community-Based Services for Individuals with Developmental Disabilities Manual for the 0208 Waiver Program, dated July 1, 2013.

            (4)  The department adopts and incorporates by this reference the 1915(c) Home and Community-Based Services for Individuals with Developmental Disabilities Manual for the 0208 Waiver Program, dated July 1, 2013.  A copy of the 1915(c) Home and Community-Based Services for Individuals with Developmental Disabilities Manual for the 0208 Waiver Program, may be obtained through the Department of Public Health and Human Services, Developmental Services Division, Developmental Disabilities Program, 111 N. Sanders, P. O. Box 4210, Helena, MT  59604 and at http://www.dphhs.mt.gov/dsd/ddp/medicaidwaivers.shtml.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

4.  The department proposes to repeal the following rules:

 

            37.34.902  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: GENERALLY, found on page 37-7393 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.906  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ELIGIBILITY, found on page 37-7397 of the Administrative Rules of Montana.

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:       53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.907  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: INTENSIVE SERVICES REVIEW COMMITTEE, found on page 37-7398 of the Administrative Rules of Montana.

 

AUTH:     53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:        53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.911  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: AVAILABLE SERVICES, found on page 37-7401 of the Administrative Rules of Montana. 

 

AUTH:      53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:        53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.912  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  GENERAL PROVIDER REQUIREMENTS, found on page 37-7402 of the Administrative Rules of Montana. 

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:       53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.913  0208 COMPREHENSIVE PROGRAM OF MEDICAID HOME AND COMMUNITY SERVICES: REIMBURSEMENT, found on page 37-7403 of the Administrative Rules of Montana.

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:      53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.917  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  INDIVIDUAL PLANS OF CARE, found on page 37-7409 of the Administrative Rules of Montana. 

 

AUTH:  53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.918  MEDICAID HOME AND COMMUNITY SERVICES  PROGRAM:  INFORMING BENEFICIARY OF CHOICE, found on page 37-7409 of the Administrative Rules of Montana.

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:       53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.919  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  NOTICE AND FAIR HEARING, found in page 37-7410 of the Administrative Rules of Montana. 

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:      53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.925  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  INTENSIVE SUPPORT COORDINATION SERVICES, DEFINITION, found on page 37-7413 of the Administrative Rules of Montana.

           

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.926  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  INTENSIVE SUPPORT COORDINATION SERVICES, REQUIREMENTS, found on page 37-7414 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.929  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  HOMEMAKER SERVICES, DEFINITIONS, found on page 37-7417 of the Administrative Rules of Montana. 

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.930  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  HOMEMAKER SERVICES, REQUIREMENTS, found on page 37-7417 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.933  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: PERSONAL CARE SERVICES, DEFINITIONS, found on page 37-7419 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.934  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  PERSONAL CARE SERVICES, REQUIREMENTS, found on page 37-7419 of the Administrative Rules of Montana. 

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.937  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ADULT DAY SERVICES, DEFINITIONS, found on page 37-7421 of the Administrative Rules of Montana.

 

AUTH:     53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:       53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.938  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ADULT DAY SERVICES, REQUIREMENTS, found on page 37-7421 of the Administrative Rules of Montana. 

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.941  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  HABILITATION SERVICES, DEFINITION, found on page 37-7423 of the Administrative Rules of Montana. 

 

AUTH:  53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.942  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  HABILITATION SERVICES, REQUIREMENTS, found on page 37-7424 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.946  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: RESPITE CARE, DEFINITION, found on page 37-7427 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.947  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: RESPITE CARE, REQUIREMENTS, found on page 37-7427 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.950  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: OCCUPATIONAL THERAPY SERVICES, DEFINITION, found on page 7431 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:      53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.951  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  OCCUPATIONAL THERAPY SERVICES, REQUIREMENTS, found on page 37-7431 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.954  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  PHYSICAL THERAPY SERVICES, DEFINITION, found on page 37-7433 of the Administrative Rules of Montana. 

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.955  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  PHYSICAL THERAPY SERVICES, REQUIREMENTS, found on page 37-7433 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.956  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  SPEECH THERAPY SERVICES, DEFINITION, found on page 37-7434 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.957  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  SPEECH THERAPY SERVICES, REQUIREMENTS, found on page 37-7434 of the Administrative Rules of Montana. 

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.960  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ENVIRONMENTAL MODIFICATIONS, DEFINITIONS, found on page 37-7437 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.961  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ENVIRONMENTAL MODIFICATIONS, REQUIREMENTS, found on page 37-7437 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.962  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ADAPTIVE EQUIPMENT, DEFINITIONS, found on page 37-7438 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.963  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  ADAPTIVE EQUIPMENT, REQUIREMENTS, found on page 37-7438 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.967  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  TRANSPORTATION AND ESCORT SERVICES, DEFINITION, found on page 37-7441 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.968  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  TRANSPORTATION AND ESCORT SERVICES, REQUIREMENTS, found on page 37-7441 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:      53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.971  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  PSYCHOLOGICAL AND PROFESSIONAL COUNSELING SERVICES, DEFINITION, found on page 37-7443 of the Administrative Rules of Montana.

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.972  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  PSYCHOLOGICAL AND PROFESSIONAL COUNSELING SERVICES, REQUIREMENTS, found on page 37-7443 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.973  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM: NURSING SERVICES, DEFINITION, found on page 37-7444 of the Administrative Rules of Montana. 

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.974  MEDICAID HOME AND COMMUNITY SERVICES  PROGRAM:  NURSING SERVICES, REQUIREMENTS, found on page 37-7444 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.978  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  DIETITIAN SERVICES, DEFINITION, found on page 37-7449 of the Administrative Rules of Montana.

 

AUTH:   53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:    53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.979  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  DIETITIAN SERVICES, REQUIREMENTS, found on page 37-7449 of the Administrative Rules of Montana.

 

AUTH:    53-2-201, 53-6-113, 53-6-402, 53-20-204, MCA

IMP:     53-2-201, 53-6-101, 53-6-402, 53-20-205, MCA

 

            37.34.980  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  MEAL SERVICES, DEFINITIONS, found on page 37-7449 of the Administrative Rules of Montana.

 

AUTH:   53-6-402, 53-20-204, MCA

IMP:    53-6-402, 53-20-205, MCA

 

            37.34.981  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  MEAL SERVICES, REQUIREMENTS, found on page 37-7449 of the Administrative Rules of Montana.

 

AUTH:   53-6-402, 53-20-204, MCA

IMP:    53-6-402, 53-20-205, MCA

 

            37.34.985  MEDICAID HOME AND COMMUNITY SERVICES  PROGRAM:  SUPPORTED LIVING COORDINATION, DEFINITION, found on page 37-7451 of the Administrative Rules of Montana.

 

AUTH:   53-6-402, 53-20-204, MCA

IMP:    53-6-402, 53-20-205, MCA

 

            37.34.986  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  SUPPORTED LIVING COORDINATION, REQUIREMENTS, found on page 37-7451 of the Administrative Rules of Montana.

 

AUTH:   53-6-402, 53-20-204, MCA

IMP:    53-6-402, 53-20-205, MCA

 

            37.34.987  MEDICAID HOME AND COMMUNITY SERVICES PROGRAM:  RESPIRATORY SERVICES, DEFINITION, found on page 37-7452 of the Administrative Rules of Montana. 

 

AUTH:   53-6-402, 53-20-204, MCA

IMP:      53-6-402, 53-20-205, MCA

 

            37.34.988  MEDICAID HOME AND COMMUNITY SERVICES  PROGRAM:  RESPIRATORY SERVICES, REQUIREMENTS, found on page 37-7452 of the Administrative Rules of Montana. 

 

AUTH:   53-6-402, 53-20-204, MCA

IMP:      53-6-402, 53-20-205, MCA

 

            5.  STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (department) is proposing to amend ARM 37.34.901, Medicaid home and community-based services (HCBS) waiver program for individuals with developmental disabilities (0208 waiver) and to repeal ARM 37.34.902 through 37.34.988.  The proposed rule amendment and repeal are necessary to conform state authority for administration of the 0208 Home and Community Program with the current agreement with the federal Centers for Medicare and Medicaid Services (CMS) that govern the state's program; to place the various details for the management of the program into a comprehensive manual for ease of access and understanding by the public; and to initiate certain new services and changes in existing services.

 

The current HCBS 0208 waiver expires on June 30, 2013.  In order to continue to provide services to persons with a developmental disability, the Department of Public Health and Human Services, Developmental Services Division, Developmental Disabilities Program (DDP) has submitted a 1915(c) HCBS waiver renewal application to the Centers for Medicare and Medicaid Services.  The purpose of this program is to provide an array of home and community-based services that assist persons with a developmental disability to live in the community and avoid institutionalization.  The department has broad discretion in the design of the waiver program to address the needs of the waiver target population through the development of a range of services that are necessary and appropriate for meeting those needs.  The proposed amendments to Administrative Rules of Montana, ARM Title 37, chapter 34, subchapter 9, are specific for administering the 1915(c) HCBS waiver services.

 

ARM 37.34.901

 

ARM 37.34.901 outlines the federal authority through Section 1915(c) of the Social Security Act, providing states the option to renew their Medicaid waiver to offer Home and Community-based Services (HCBS).  In addition, the proposed rule establishes the discretion of the department to manage the various aspects of the program in conformance with federal authority and as otherwise determined appropriate by the department.  This application of discretion to the program is necessary to assure continuing conformance with the governing federal authority so as to avoid withdrawal of federal approval for the program and to avoid federal recoupment for inappropriate expenditures of federal monies. 

 

This proposed rule adopts and incorporates by reference, the 1915(c) Home and Community-Based Services (0208) Waiver Program for Individuals with Developmental Disabilities Manual for the 0208 Waiver Program, dated July 1, 2013.  This is necessary because the 1915(c) HCBS 0208 waiver program manual defines the population eligible to be served; screening and placement criteria and procedures; the provision of services available under the program; plans of care management processes and responsibilities; provider requirements; and provider reimbursement.

 

ARM 37.34.902 through ARM 37.34.988

 

The department is proposing to repeal ARM 37.34.902 through 37.34.988.  This is necessary because of the proposed amendment in ARM 37.34.901, which adopts and incorporates the 1915(c) Home and Community-Based Services for Individuals with Developmental Disabilities Manual for the 0208 Waiver Program, dated July 1, 2013 (manual).  The information currently contained in ARM 37.34.902 through ARM 37.34.988 is incorporated into the manual.

 

Manual

 

The department is proposing adoption and incorporation into rule the 1915(c) Home and Community-Based Services for Individuals with Developmental Disabilities Manual for the 0208 Waiver Program, dated July 1, 2013 (manual) to administer the 1915(c) HCBS waiver program (0208 comprehensive waiver).  Eligibility, screening and placement, transitioning, service definitions, general provider requirements, plan of care, notice and fair hearings, and freedom of choice that were previously in ARM 37.34.902 through 37.34.988, are included in the new proposed manual and have not been substantively changed.

 

The key changes for the waiver program renewal which are reflected in the manual are as follows:

 

            (1)  Merge the community supports waiver (0371) into the 0208 waiver effective July 1, 2013.  Persons currently receiving services in the 0371 waiver will transition into the 0208 waiver with equivalent services.  Merging these two waivers allows the department to pool resources and provides for a more streamlined management.  All of the services currently available in the 0371 waiver are also available in the 0208 waiver, therefore persons receiving services will not be directly affected by this merger.

            (2)  The addition of new services definitions including individual employment support, follow along support, small group employment support, and co-worker support.  The expected outcome for these services is integrated competitive employment for people with developmental disabilities.  The purpose of these added services is to promote progressive change to enable persons with developmental disability opportunity to advance economically and participate as productive members of society.  The expected outcome for these services is integrated competitive employment for people with developmental disabilities.

            (3)  Remove current definitions for day habilitation, supported employment, and respiratory therapy.  In the waiver renewal, day habilitation is being unbundled and will be replaced with adult day health, day supports and activities, and job discovery/job preparation. This allows more accurate billing.  Services under supported employment are being divided into individual employment support, follow along support, small group employment support, and co-worker support in order to provide more options for persons with disabilities to seek competitive employment.  Respiratory therapy is being removed as a program service due to underutilization.

            (4)  Remove family support specialist (FSS) certification as a qualified provider requirement of waiver-funded children's case management.  The provider must have education and experience equal to a FSS.  Removing the certification requirement is necessary as it allows for a more open qualified provider enrollment process.

            (5)  Remove the requirement that a provider's board of directors must approve purchases over $4000 for environmental modifications/adaptive equipment because not all providers have a board of directors.

            (6)  The department is also requesting to add service definitions for remote monitoring equipment and remote monitoring.  The addition of remote monitoring services follows a national movement towards providing persons safety oversight services in a less intrusive, more cost effective manner.

            (7)  Change "board certified behavior analyst" to "behavioral support services" and add it as a service option for facilities such as licensed adult foster homes, developmental disabilities licensed group homes, assisted living, and transitional living apartments.  This change is due to recent changes in ARM 37.34.1422, which allows for other professionals to also approve positive behavior support plans.

 

Fiscal Impact

 

There are no changes in the number of persons to be served through merging the community supports waiver (0371) into the 0208 waiver and the expenditures on services are expected to remain unchanged.  Therefore, there is no fiscal impact expected.

 

            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: Kenneth Mordan, 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., May 23, 2013.

 

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/ Cary B. Lund                                           /s/ Richard H. Opper                                   

Cary B. Lund                                                Richard H. Opper, Director

Rule Reviewer                                             Public Health and Human Services

           

Certified to the Secretary of State April 15, 2013.

 

 

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