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37.90.409    HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: SEVERE AND DISABLING MENTAL ILLNESS CRITERIA

(1) To qualify for the SDMI HCBS waiver program, a member must:

(a) be 18 years of age or older;

(b) have a minimum of three areas of high-level impairment indicated by a score of three or higher on the Severe and Disabling Mental Illness, Home and Community-Based Waiver, Evaluation and Level of Impairment form; and

(c) have experienced one of the following in the previous 12 months:

(i) involuntarily committed because of a mental disorder to the Montana State Hospital or the Montana Mental Health Nursing Care Center for at least 30 consecutive days; or

(ii) diagnosed with one of the diagnoses in (2), excluding mild or not otherwise specified.

(2) The following qualify as a severe and disabling mental illness diagnosis:

(a) Schizophrenia, paranoid type;

(b) Schizophrenia, disorganized type;

(c) Schizophrenia, catatonic type;

(d) Schizophrenia, undifferentiated type;

(e) Schizophrenia, residual type;

(f) Delusional disorder;

(g) Schizoaffective disorder;

(h) Schizoaffective disorder, depressive type;

(i) Bipolar I disorder, manic, moderate;

(j) Bipolar I disorder, manic, severe without psychotic features;

(k) Bipolar I disorder, manic, severe with psychotic features;

(l) Bipolar I disorder, depressed, moderate;

(m) Bipolar I disorder, depressed, severe without psychotic features;

(n) Bipolar I disorder, depressed, severe with psychotic features;

(o) Bipolar I disorder, mixed, moderate;

(p) Bipolar I disorder, mixed, severe without psychotic features;

(q) Bipolar I disorder, severe with psychotic features;

(r) Bipolar II disorder;

(s) Major depressive disorder, single, moderate;

(t) Major depressive disorder, single, severe without psychotic features;

(u) Major depressive disorder, single, severe with psychotic features;

(v) Major depressive disorder, recurrent, moderate;

(w) Major depressive disorder, recurrent, severe without psychotic features;

(x) Major depressive disorder, recurrent, severe with psychotic features;

(y) Post traumatic stress disorder, acute;

(z) Post traumatic stress disorder, chronic;

(aa) Generalized anxiety disorder; and

(ab) Borderline personality disorder.

 

History: 53-2-201, 53-6-402, MCA; IMP, 53-6-402, MCA; NEW, 2020 MAR p. 1173, Eff. 7/1/20; AMD, 2021 MAR p. 1555, Eff. 11/6/21.

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