Printer Friendly Version Printer Friendly Version| 37.89.103 | MENTAL HEALTH SERVICES PLAN, DEFINITIONS |
This rule has been repealed.
| 37.89.106 | MENTAL HEALTH SERVICES PLAN, MEMBER ELIGIBILITY |
This rule has been repealed.
| 37.89.112 | MENTAL HEALTH SERVICES PLAN, OUTPATIENT DRUGS FOR BENEFICIARIES ELIGIBLE FOR MEDICARE |
This rule has been repealed.
| 37.89.114 | MENTAL HEALTH SERVICES PLAN, COVERED SERVICES |
This rule has been repealed.
| 37.89.115 | MENTAL HEALTH SERVICES PLAN, PROVIDER PARTICIPATION |
This rule has been repealed.
| 37.89.118 | MENTAL HEALTH SERVICES PLAN, AUTHORIZATION REQUIREMENTS |
This rule has been repealed.
| 37.89.119 | MENTAL HEALTH SERVICES PLAN, PREMIUM PAYMENTS, AND MEMBER COPAYMENTS |
This rule has been repealed.
| 37.89.125 | MENTAL HEALTH SERVICES PLAN, PROVIDER REIMBURSEMENT |
This rule has been repealed.
| 37.89.131 | MENTAL HEALTH SERVICES PLAN, MEMBER NOTICE, GRIEVANCE AND RECONSIDERATION AND RIGHTS |
This rule has been repealed.
| 37.89.135 | MENTAL HEALTH SERVICES PLAN, TRANSITION FROM RULES IN EFFECT PRIOR TO JULY 1, 1999 |
This rule has been repealed.
| 37.89.201 | NON-MEDICAID MENTAL HEALTH SERVICES FOR ADULTS: REQUIREMENTS |
(1) In addition to requirements contained in rule, the department has developed and published the Behavioral Health and Developmental Disabilities Division Non-Medicaid Services Provider Manual for Substance Use Disorder and Adult Mental Health, dated July 1, 2023, which provides information and policies pertaining to state-funded behavioral health services and substance use disorder services and implements requirements for utilization management and services. The department adopts and incorporates by reference the manual as part of this rule. A copy of the manual may be obtained from the department by a request in writing to the Department of Public Health and Human Services, Addictive and Mental Disorders Division, 100 N. Park, Ste. 300, P.O. Box 202905, Helena, MT 59620-2905 or at https://dphhs.mt.gov/bhdd/BHDDMedicaidServicesProviderManual.
| 37.89.501 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: DEFINITIONS |
This rule has been repealed.
| 37.89.503 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: LIMITATIONS |
This rule has been repealed.
| 37.89.505 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CRISIS MANAGEMENT SERVICES |
This rule has been repealed.
| 37.89.507 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CRISIS STABILIZATION PLAN |
This rule has been repealed.
| 37.89.509 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CLAIMS AND REIMBURSEMENT |
This rule has been repealed.
| 37.89.521 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSABLE SERVICES |
This rule has been repealed.
| 37.89.523 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSEMENT FOR SERVICES |
This rule has been repealed.
| 37.89.525 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: REIMBURSEMENT FOR EXCLUSIONS |
This rule has been repealed.
| 37.89.531 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: WHERE SERVICES MAY BE PROVIDED |
This rule has been repealed.
| 37.89.541 | 72-HOUR PRESUMPTIVE ELIGIBILITY FOR ADULT CRISIS STABILIZATION SERVICES: CONFIDENTIALITY REQUIREMENTS |
This rule has been repealed.
| 37.89.1001 | CRISIS DIVERSION GRANTS, PURPOSE |
(1) Crisis Diversion Grants, as provided under Title 53, chapter 21, part 12, MCA, provide funding to eligible county and federally recognized tribal governments to support the implementation of community-based jail diversion, crisis intervention services, and short-term inpatient treatment services for individuals with mental illness. The grants are in the form of matching state funds awarded based on criteria set forth in 53-21-1203, MCA.
| 37.89.1003 | CRISIS DIVERSION GRANTS, APPLICATION AND PARTICIPANTS |
(1) At the beginning of the program's funding cycle, the department will issue a request for proposal (RFP) describing the program requirements, evaluation criteria, and eligibility criteria for award of Crisis Diversion Grant funding.
(2) The following entities may submit an application for Crisis Diversion Grants awarded under this subchapter:
(a) a county government as defined in ARM 37.2.902;
(b) a federally recognized tribal government; or
(c) any combination of (a) and (b).
(3) A county or group of counties that includes tribal lands must demonstrate coordination efforts with tribal representatives to be eligible for Crisis Diversion Grants.
(4) The department will evaluate applications as set forth in the RFP and determine eligibility for a Crisis Diversion Grant. Counties and federally recognized tribal governments who the department determines are eligible for grants must enter into a contract with the department to receive the funding award.
| 37.89.1005 | CRISIS DIVERSION GRANTS, DETERMINING GRANT AMOUNTS |
(1) The department will base Crisis Diversion Grants awarded under this subchapter on the criteria specified in 53-21-1203, MCA.
(2) The total amount of Crisis Diversion Grants will not exceed available funding.
(3) For each county and federally recognized tribal government, the department will include in the request for proposal (RFP) the rate at which local funds will be matched. The match rate is based on the most recent Montana State Hospital admission data and census data, as provided in 53-21-1203, MCA.
(4) The department will bi-annually recalculate the match rate.
(5) Eligible participants may use cash or in-kind contributions as matching funds.
(6) If appropriation remains after grants have been allocated, the department will allocate remaining funds to a county or federally recognized tribal government that requests continued funding of a project funded in the previous biennium. In allocating these funds, the department will use the match rate published in the RFP.
| 37.89.1007 | CRISIS DIVERSION GRANTS, DISTRIBUTION |
(2) Points will be awarded by an evaluation committee, as described by the criteria listed within the request for proposal.
(3) If the amount requested for Crisis Diversion Grants exceeds the funding available, the department may use discretion to fund only specific activities within a proposal.
| 37.89.1009 | CRISIS DIVERSION GRANTS, STRATEGIC PLAN REQUIREMENTS |
(1) Successful grant applicants will be those submitting a grant application with at least the following elements:
(a) a jail diversion and crisis intervention strategic plan, which must include a plan for community-based or regional emergency crisis response, court-ordered detention and examination services, and short term inpatient treatment;
(b) a detailed proposal for how the grant applicant and other local entities will collaborate and commit local funds for mental health services for crisis intervention, jail diversion, involuntary precommitment, and short-term inpatient treatment costs including a plan for the collection and reporting of data and information;
(c) a detailed budget that identifies cash and in-kind local contribution amounts designated for match, anticipated expenses for each fiscal year being applied for including start up or one time only costs. Multi-jurisdiction grant applications must identify the county or federally recognized tribal government that will act as the fiduciary agent for distribution of the grant funds;
(d) a statement from the grant applicant agreeing to report key data elements according to the department's specifications; and
(e) counties that include tribal lands must demonstrate coordination efforts with tribal representatives both on and off reservations.
(2) Each successful grant applicant will submit an annual report to the department within 30 days of the end of each funding year describing implementation of the strategic plan provided for in this rule, including key data elements as defined by the department, for the funded grant period.
| 37.89.1021 | JAIL DIVERSION AND CRISIS INTERVENTION, CONTRACTS FOR PSYCHIATRIC TREATMENT BEDS |
(2) Contracts will be developed in each service area as defined in 53-21-1001, MCA.
(3) Eligible providers include:
(a) licensed mental health centers who operate a secured crisis stabilization facility (SCSF) as defined in ARM 37.106.2027; and
(b) hospitals, including critical access hospitals.
(4) Reimbursement to an eligible mental health facility under this rule is for vacant contracted psychiatric treatment beds. A contractor must prioritize placement in contracted beds for persons admitted for the purposes specified in 53-21-1204, MCA.
| 37.89.1025 | CONTRACTS FOR PAYMENT OF SHORT-TERM INPATIENT TREATMENT |
(1) The department may contract with eligible providers for payment for short-term inpatient treatment to eligible patients as provided in 53-21-1205 and 53-21-1206, MCA, to the extent of available funding.
(2) Eligible providers include:
(a) licensed mental health centers that operate inpatient crisis stabilization programs as defined in ARM 37.106.2027; and
(b) hospitals with an inpatient behavioral health unit.
(3) Documentation of services and outcomes must be provided to the department as required by contract.
(4) Eligible patients are the subjects of civil commitment petitions under Title 53, chapter 21, part 1, MCA, for whom the following conditions are met:
(a) diversion to short-term inpatient treatment has been recommended by the evaluating professional person as provided in 53-21-123(2)(a), MCA;
(b) the facility has agreed to accept the patient for up to 14 days inpatient treatment as provided in 53-21-1205, MCA, and 53-21-1206, MCA;
(c) the patient has agreed to voluntary short- term inpatient treatment as provided in 53-21-1205, MCA, and 53-21-1206, MCA;
(d) the commitment court has ordered a suspension of the civil commitment proceeding for the purpose of short-term inpatient treatment, as provided in 53-21-123(3)(b), MCA; and
(e) no known third party has a legal liability to pay for the services provided. Third party liability is defined in ARM 37.85.407, with the exception that the Montana Medicaid program is a third party for the purposes of this rule.
(5) Each contract with an eligible provider must provide that reimbursement will be made for up to 14 contiguous days of inpatient care for each eligible patient. The 14 day limit must be extended if voluntary treatment is continued pending a hearing scheduled pursuant to 53-21-1205(5), MCA. Reimbursement must be made in the order in which claims from all eligible providers are received by the department until the available funding has been exhausted. The department must notify each eligible provider who has entered into a contract under this rule in writing when 75 percent of the available funding has been exhausted.
(6) The following rates will apply:
(a) inpatient hospital behavioral health unit: an all-inclusive rate of $875 per day, which includes hospitalization, professional fees, laboratory services, medications, minor medical procedures that do not require transfer to another unit of the hospital, evaluating and assessment services, discharge planning, and therapies.
(b) inpatient crisis stabilization program: an all-inclusive rate of $575 per day, which includes crisis facility stay, professional fees, laboratory services related to psychiatric treatment, medications related to psychiatric treatment, evaluating and assessment services, case management, and therapies.
(7) This rule is effective July 1, 2015.