(1) Adult services must be provided in accordance with the performance requirements in this rule.

(2) A contractor providing adult services, other than a contractor providing transportation services that are also available to the general public and contracting with the department to provide only transportation services, must comply with the performance requirements in this rule. All performance requirements are to be met as provided in department rules and the contract with the department.

(3) In the provision of adult services, the contractor must:

(a) ensure that all facilities used in the provision of services meet all applicable licensure requirements and health and safety codes;

(b) maintain and implement policies and procedures for a safe, healthy environment for all individuals served;

(c) maintain and implement policies and procedures which ensure health monitoring occurs and necessary medical assistance is provided or sought for all individuals served;

(d) provide supervision, support, care, education, and training according to the needs of the individual and as specified by the personal support plan (PSP);

(e) implement any assigned activities of the PSP;

(f) maintain and implement policies and procedures to assist individuals and staff in emergencies such as medical problems, behavior intervention, disasters, and other similar emergencies;

(g) participate in the PSP team process, recommending objectives, as applicable, to the PSP team for the individual; and 

(h) coordinate transportation to assist the individual in meeting the individual's needs.

(4) A contractor providing adult services must ensure that any contractor-owned or contractor-controlled setting:

(a) is integrated in and facilitates full access of the individual to the greater community;

(b) ensures the individual receives services in the community to the same degree of access as individuals not receiving Medicaid Home and Community-Based Services;

(c) is selected by the individual from among setting options, including non-disability specific settings and an option for a private unit in a residential setting;

(d) ensures the individual's rights of privacy, dignity, and respect, and freedom from coercion and restraint;

(e)  supports health and safety based upon the individual's needs, decisions, or desires;

(f) optimizes, but does not regiment, individual initiative, autonomy, and independence in making life choices, including but not limited to daily activities, physical environment, and with whom to interact;

(g)  provides an opportunity to seek employment and work in competitive integrated settings; and

(h)  facilitates individual choice of services and supports, and who provides them.

(5) Service options and funding sources may have specific requirements that must be met.

(6) In the provision of intensive adult services, the contractor, in addition to the criteria in (3), must:

(a) provide the level of care, habilitation and guidance necessary to meet the intensive needs of the individual; and

(b) ensure, when specified in the contract, other support services needs are addressed to enhance the ability of the individual to benefit from all services and activities.

(7) In the provision of senior services, the contractor, in addition to the criteria in (3), must:

(a) implement a plan, when specified by the IP team, to allow the individual, based on individual interests and desires, to choose daily routines, including remaining at home.

(8)  The department adopts and incorporates by reference 42 CFR 441.301(c)(4), as amended January 16, 2014.  A copy of this regulation may be obtained at https://www.ecfr.gov/ or by contacting the Department of Public Health and Human Services, Behavioral Health and Developmental Disabilities Division, Developmental Disabilities Program, 111 N. Sanders, P.O. Box 4210, Helena, MT 59604-4210.