Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.34 - DEVELOPMENTAL DISABILITIES PROGRAM
Subchapter 37.34.9 - 0208 Medicaid Home and Community-Based Services Program
Rule 37.34.906 - 0208 MEDICAID HOME AND COMMUNITY-BASED SERVICES PROGRAM: ELIGIBILITY
Current through Register Vol. 18, September 20, 2024
(1) A determination that a person is eligible to be considered for acceptance into the Medicaid Home and Community-Based Services (HCBS) Waiver Program does not entitle a person to selection and entry into the HCBS Waiver Program.
(2) A person is eligible to be considered for acceptance into the Medicaid HCBS Waiver Program if the person:
(3) The level of care of an ICF/IID is needed when a person who is intellectually disabled:
(4) A person who has been admitted to an ICF/IID and who is discharged to enter services under the 0208 Medicaid HCBS Waiver Program for persons with developmental disabilities is considered to be of the level of care of an ICF/IID and need not be evaluated as provided in (2).
(5) For a person through the age of seven, the eligibility review panel (ERP) must make the determination of eligibility.
(6) The ERP must consist of the following members:
(7) The waiver-funded children's case manager must submit the following to the ERP for a determination of eligibility:
(8) For eligibility determinations made by the ERP, The Determining Eligibility for Services to Persons with Developmental Disabilities in Montana: A Staff Reference Manual does not apply to an eligibility determination for a child up to age seven.
(9) The ERP may determine a child is eligible if:
(10) The department designee must annually administer a level of care re-determination.
(11) A child who has previously been determined eligible for services by the ERP must have a determination of eligibility by the department's eligibility specialist prior to the child's eighth birthday.
(12) For a person age eight and older, the department must make a determination of eligibility for consideration of acceptance into the 0208 HCBS Waiver Program.
(13) The department may make a determination of eligibility for acceptance into the 0208 HCBS Waiver Program as early as the age of six.
(14) The following documents must be submitted to the department's eligibility specialist to make a determination of eligibility for acceptance into the 0208 HCBS Waiver Program:
(15) The Determining Eligibility for Services to Persons with Developmental Disabilities in Montana: A Staff Reference Manual, as adopted in ARM 37.34.201, sets forth the requirements for eligibility of the DDP's service programs.
(16) Upon a determination of ineligibility, if the person is:
53-6-113, 53-6-402, MCA; IMP, 53-6-101, 53-6-402, MCA;