Montana Administrative Register Notice 37-721 No. 15   08/13/2015    
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In the matter of the amendment of ARM 37.57.102 and 37.57.106 pertaining to updating federal poverty guidelines to 2015 levels and to align Children's Special Health Services (CSHS) with the Healthy Montana Kids (HMK) financial assistance eligibility criteria












TO: All Concerned Persons


1. On September 12, 2015, the Department of Public Health and Human Services proposes to amend 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 the Department of Public Health and Human Services no later than 5:00 p.m. on September 3, 2015, 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 MT 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.


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


          37.57.102 DEFINITIONS Unless otherwise indicated, the following definitions apply throughout this subchapter:

          (1) through (16) remain the same.

          (17) "Poverty income guidelines" means the poverty income guidelines published in 2014 2015 in the Federal Register by the U.S. Department of Health and Human Services. The department adopts and incorporates by reference the federal poverty guidelines that establish income thresholds according to family unit size for purposes of determining eligibility for government assistance or services and that are published in the February 2014 2015, Federal Register. A copy of the 2014 2015 poverty guidelines may be obtained from the Department of Public Health and Human Services, Public Health and Safety Division, Children's Special Health Services Program, 1400 Broadway, Rm A-116, Helena, MT 59620, telephone (406) 444-3617.

          (18) through (23) remain the same.


AUTH: 50-1-202, MCA

IMP:     50-1-202, MCA


          37.57.106 ELIGIBILITY FOR CSHS FINANCIAL ASSISTANCE (1) remains the same.

          (2) Family income must be verified to determine eligibility. The department will request documentation of income from the applicant.

          (a) remains the same.

          (b) Family income does not include:

          (i) and (ii) remain the same.

          (iii) the first $2,000 of an enrolled tribal member's per capita payment; or

          (iv) the first $2,000 of an enrolled tribal member's tribal land income;.

          (v) the interest earned on (4)(a), (4)(b), or (4)(c);

          (vi) dependent care expenses which are deducted from income under the HMK Plus coverage group;

          (vii) foster care income for any children unless the only children in the family are foster care; or

          (viii) income of any individual with whom a child resides who has no legal obligation to support the child.

          (c) Income information will be used by the department to project the family's income. The following disregards are subtracted from the family's gross earned annual income:

(i) $1,440 per year for each family member whose earned income is counted;

(ii) $2,400 per year, regardless of the actual expense amount, for each individual for whom dependent care is paid out-of-pocket and the care is provided so a parent can work, look for work, or attend school; and

          (iii)  out-of-pocket expenses for health insurance premiums.

          (d) A member of a family whose income, less any out-of-pocket expenses for health insurance premiums, care expenses for children, disabled or elderly adults while adults are working, and earned income disregards is at or less than 250% 261% of the federal poverty income guidelines and one of the following:

          (i) through (5) remain the same.

          (6) CSHS financial eligibility will be determined in accordance with the financial eligibility guidelines contained in HMK's ARM 37.79.201, with the following exceptions:

          (a) children may have health care coverage and the out-of-pocket expenses for health insurance premiums are deducted from household income; and

          (b) CSHS financial eligibility is at or below 250% of the federal poverty income guidelines.

          (7) (6)  A CYSHCN attending an interdisciplinary team pediatric specialty clinic does not need to apply for financial assistance to cover the cost of clinic visits.


AUTH: 50-1-202, MCA

IMP:     50-1-202, MCA




The Department of Public Health and Human Services (the department) proposes amendments to ARM 37.57.102 and ARM 37.57.106 pertaining to Children's Special Health Services Program (CSHS). CSHS is located in the Family and Community Health Bureau of the department and is charged by the Federal Maternal Child Health Block Grant to "support development and implementation of comprehensive, culturally competent, coordinated systems of care for children and youth who have or are at risk for chronic physical, developmental, behavioral or emotional condition and who require health and related services of a type or amount beyond that required by children generally."


ARM 37.57.102


This proposed amendment is needed to update the current poverty income guidelines published in 2014 to the 2015 poverty income guidelines published in the Federal Register by the U.S. Department of Health and Human Services. Each year the U.S. Department of Health and Human Services revises and publishes the new poverty income guidelines. The federal poverty income guidelines are the resource used to confirm that the family income falls within the CSHS rules.


ARM 37.57.106


This proposed amendment reflects the increased federal poverty level guideline used by CSHS from 250% to 261% to enable CSHS to enhance the HMK program and to clarify the intent of the rule and to remove redundant wording.  The potential impact of this proposed amendment is not expected to exceed two children.


Fiscal Impact:


The department does not anticipate any fiscal impact related to these proposed amendments.


          5. The department intends to apply these rule amendments retroactively to April 1, 2015. A retroactive application of the proposed rule amendments does not result in a negative impact to any affected party.


6. Concerned persons may submit their data, views, or arguments concerning the proposed action in writing to: Kenneth Mordan, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena MT 59604-4210, no later than 5:00 p.m. on September 10, 2015. Comments may also be faxed to (406) 444-9744 or e-mailed to dphhslegal@mt.gov.


7. If persons who are directly affected by the proposed action wish to express their data, views, or arguments orally or in writing at a public hearing, they must make written request for a hearing and submit this request along with any written comments to Kenneth Mordan at the above address no later than 5:00 p.m., September 10, 2015.


8. If the agency receives requests for a public hearing on the proposed action from either 10 percent or 25, whichever is less, of the persons directly affected by the proposed action; from the appropriate administrative rule review committee of the Legislature; from a governmental subdivision or agency; or from an association having not less than 25 members who will be directly affected, a hearing will be held at a later date. Notice of the hearing will be published in the Montana Administrative Register. Ten percent of those directly affected has been determined to be .2 persons based on the potential impact of these proposed amendments is not expected to exceed two children.


9. 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.


10. 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 this 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.


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


12. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rules will not significantly and directly impact small businesses.



/s/ Nicholas Domitrovich                        /s/ Richard H. Opper                            

Nicholas Domitrovich, Attorney              Richard H. Opper, Director

Rule Reviewer                                       Public Health and Human Services


Certified to the Secretary of State August 3, 2015.



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