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Montana Administrative Register Notice 37-507 No. 8   04/29/2010    
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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 37.90.401 and 37.90.410 pertaining to home and community-based services for adults with severe disabling mental illness

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO:  All Concerned Persons

 

            1.  On May 20, 2010, at 3:00 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 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 11, 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 rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:

 

            37.90.401  HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS:  FEDERAL AUTHORIZATION AND STATE ADMINISTRATION  (1)  The department has submitted a proposal seeking approval from the U.S. Department of Health and Human Services (HHS), under 42 CFS 441.300 through 441.310, to established a program of Medicaid funded home and community-based services for persons who have severe disabling mental illness, as defined in ARM 37.89.103, and who would otherwise have to reside in and receive Medicaid reimbursed care in a nursing facility or a hospital.  Upon formal approval, the department will initiate the program in accordance with the conditions of approval governing federal and state authorities and these rules.

            (2) through (3) remain the same.

            (4)  The state has received federal approval to waive statewide coverage in the provision of program services.  Program services may only be delivered to recipients in the following service areas for which federal approval of coverage has been received:

            (a) remains the same.

            (b)  Cascade County Region, inclusive of the counties of Cascade, Blaine, Chouteau, Glacier, Hill, Liberty, Pondera, Teton, and Toole; and

            (c)  Butte-Silver Bow County Region, inclusive of the counties of Butte-Silver Bow, Beaverhead, Deer Lodge, Granite, and Powell., and Jefferson; and

            (d)  Missoula County.

 

AUTH:  53-2-201, 53-6-402, MCA

IMP:  53-2-401, 53-6-402, MCA

 

            37.90.410  HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS:  ELIGIBILITY AND SELECTION

            (1) and (2) remain the same.

            (3)  A person is qualified to be considered for enrollment in the program if the person meets the following criteria:

            (a) through (f) remain the same.

            (g)  resides in one of the following service areas for which federal approval of coverage has been received:

            (i) remains the same.

            (ii)  Cascade County Region, inclusive of the counties of Cascade, Blaine, Chouteau, Glacier, Hill, Liberty, Pondera, Teton, and Toole; and

            (iii)  Butte-Silver Bow County Region, inclusive of the counties of Butte-Silver Bow, Beaverhead, Deer Lodge, Granite, and Powell., and Jefferson; and

            (iv)  Missoula County.

            (4) through (7)(h) remain the same.

 

AUTH:  53-2-201, 53-6-402, MCA

IMP:  53-2-401, 53-6-402, MCA

 

            4.  The Department of Public Health and Human Services (the department) is proposing the amendment of ARM 37.90.401 and 37.90.410 pertaining to home and community-based services (HCBS) for adults with severe disabling mental illness (SDMI).  The proposed amendments are necessary to expand the services to Jefferson and Missoula Counties.

 

The SDMI HCBS waiver was approved in 2006 for three sites, Billings, Great Falls, and Butte.  The department is proposing an expansion of the Butte site to include Jefferson County without an increase in the number of persons who can participate.  The department also proposes the creation of a fourth site by authorizing waiver services to Missoula County with the ability to serve a maximum of 30 individuals for fiscal year 2010.

 

ARM 37.90.401

 

The department is proposing an amendment to ARM 37.90.401 to reflect the federal authorization of the HCBS waiver for adults with severe and disabling mental illness.  The waiver proposal was approved December 1, 2006.

 

The department is also proposing an amendment to ARM 37.90.401 to add Jefferson County to the Butte-Silver Bow County region and to add a fourth region that includes Missoula County.  The expansion of the SDMI HCBS waiver service areas was approved by the 2009 Montana Legislature. 

 

ARM 37.90.410

 

The department is proposing an amendment to ARM 37.90.410 to add Jefferson and Missoula Counties to the list of counties in which individuals can be eligible for HCBS for adults with SDMI.

 

The program is administered under an approved waiver pursuant to section 1915(c) of the Social Security Act that identifies specific counties in which waiver services are available.  An amendment to the waiver and to administrative rules must be submitted prior to implementing changes to the approved waiver application.  The proposed rule change will serve as public notice of the waiver expansion. 

 

The department rejected the alternative of not expanding waiver services.  This program has been successful in allowing persons with mental illness to live independently in their communities as an alternative to nursing home level of care.  With national studies indicating that persons with mental illness have a life expectancy that is 20 years shorter than the national average, this program allows people with mental illness to enjoy a higher quality life that meets both mental and physical health needs.

 

Estimated financial and budget impacts

 

The 2009 Legislature approved expansion of the SDMI waiver.  In fiscal year 2010 waiver services will expand to Missoula County with a total cost of $810,000 ($190,917 state special revenue and $619,083 federal funds).  In fiscal year 2011, the cost will be $993,792 ($225,690 state special revenue and $768,102 federal funds).  The addition of Jefferson County to the Butte site has no fiscal impact because the number of persons served will not change.

 

            5.  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., May 28, 2010.

 

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

 

7.  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 5 above or may be made by completing a request form at any rules hearing held by the department.

 

8.  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.

 

9.  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 April 19, 2010.

 

 

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