BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the adoption of New Rules I, II, and III and the amendment of ARM 37.87.1303, 37.87.1305, 37.87.1306, 37.87.1307, 37.87.1321, 37. 87.1323, 37.87.1325, 37.87.1331, 37.87.1333, 37.87.1335, 37.87.1338, 37.87.1339, 37.87.1340, 37.87.1341, 37.87.1342, and 37.87.1343 pertaining to home and community-based services (HCBS) for youth with serious emotional disturbance (SED)

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NOTICE OF ADOPTION AND AMENDMENT

 

TO: All Concerned Persons

 

1. On September 24, 2009, the Department of Public Health and Human Services published MAR Notice No. 37-486 pertaining to the public hearing on the proposed adoption and amendment of the above-stated rules at page 1630 of the 2009 Montana Administrative Register, Issue Number 18.

 

2. The department has adopted New Rule II (37.87.1345) and Rule III (37.87.1346) as proposed.  The department has amended the above-stated rules as proposed.

 

3. The department has adopted the following rule as proposed with the following changes from the original proposal. Matter to be added is underlined. Matter to be deleted is interlined.

 

            RULE I (37.87.1344)  HOME AND COMMUNITY-BASED SERVICES FOR YOUTH WITH SERIOUS EMOTIONAL DISTURBANCE : FAMILY SUPPORT SPECIALIST SERVICES  (1) through (2) remain as proposed.

            (3)  The provider of family support specialists must:

            (a) through (c) remain as proposed.

            (d)  provide supervision of ensure the family support specialists by a licensed mental health professional (MHP) follow the plan of care developed by the wraparound team; and

            (e) through (5) remain as proposed.

 

AUTH: 53-2-201, 53-6-113, 53-6-402, MCA

IMP: 53-6-402, MCA

 

            4. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:

 

COMMENT #1: We are concerned about the low rate of reimbursement proposed for wraparound facilitation services. The requirements for training, certification, and scope of work imply a level of skill greater than the department recognizes in the proposed reimbursement rate. Without an adequate rate of reimbursement, the department would have a difficult time developing a pool of qualified providers to deliver this waiver service.

 

RESPONSE #1: The department concurs with the comments about wraparound facilitation reimbursement and has adopted a rate of $14.50 for a 15 minute unit. The rate coincides with the rate for family support specialist services and will avoid disparity within an agency providing both family support specialist services and wraparound facilitation services.

 

COMMENT #2: Not all agencies hiring family support specialists have licensed mental health professionals on staff. Under the proposed rules, the agency would have to find a licensed mental health professional to supervise the family support specialist. Even if such a professional could be found, supervision might be difficult because the family support specialist is not an employee of the mental health professional. This may present issues with labor laws. We recommend changing Rule I (37.87.1344) to eliminate the mental health professional requirement.

 

RESPONSE #2: The department agrees and has changed Rule I (37.87.1344) accordingly.

 

            5.  The department intends to apply these rules retroactively to August 1, 2009. A retroactive application of the proposed rules does not result in a negative impact on providers or recipients.

 

 

 

 

/s/ John Koch                                                /s/ Anna Whiting Sorrell                              

Rule Reviewer                                               Anna Whiting Sorrell, Director

                                                                        Public Health and Human Services

           

Certified to the Secretary of State November 30, 2009.