37.86.4006    TARGETED CASE MANAGEMENT SERVICES FOR SUBSTANCE USE DISORDERS, SERVICE REQUIREMENTS

(1) Persons receiving TCM services are allowed the freedom of choice of any qualified Medicaid provider for targeted case management services.

(2) TCM service providers cannot restrict a person's access to other Medicaid services.

(3) TCM services will not duplicate payments made to public agencies or private entities under the Medicaid program and other program authorities.

(4) A person cannot be compelled to receive TCM services as a condition of receipt of other Medicaid services or condition of receipt of other Medicaid services on receipt of TCM services.

(5) TCM services must be supported by narrative documentation of all services provided.

(6) TCM services must be provided according to a TCM plan which must:

(a) be developed jointly by the case manager and the person;

(b) identify measurable objectives;

(c) specify strategies to achieve defined objectives;

(d) identify agencies and contacts which will assist in meeting the objectives;

(e) be incorporated into the treatment plan;

(f) identify natural and community supports to be utilized and developed; and

(g) include an objective to serve the person in the least restrictive and most culturally appropriate therapeutic environment possible for the person. The TCM plan should also be directed toward facilitating preservation of the person in the family unit, preventing out-of-community placement, or facilitating the person's return from inpatient or residential care.

(7) Objectives in a TCM plan must have an identified date of review no more than 90 days after the plan date. Plans will be revised to reflect changes in personal goals and needs, and services provided to the person.

(8) TCM services must be delivered in accordance with the person's needs.

(9) Comprehensive TCM services must be provided on a one-to-one basis, to one person, and through one case manager.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, 53-6-113, MCA; NEW, 2013 MAR p. 269, Eff. 3/1/13.