Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.40 - SENIOR AND LONG TERM CARE SERVICES
Subchapter 37.40.11 - Personal Assistance Services
Rule 37.40.1114 - AGENCY-BASED AND SELF-DIRECTED PERSONAL ASSISTANCE SERVICES: PERSON-CENTERED PLAN REQUIREMENTS

(1) In order to receive Personal Assistance Services (PAS), the member must be capable of making choices about activities of daily living and instrumental activities of daily living. The member must be able to understand the impact of these choices and assume responsibility for the choices. If the member is unable to meet these criteria, the member may have someone assist them in decision making and directing their activities. The PAS person-centered planning process includes multiple steps to protect a member's health and safety while ensuring that member choice and control are an integral component of service delivery. Prior to delivering PAS, the following person-centered planning requirements must be met:

(2) The person-centered planning requirements in (1) may be delayed in the circumstances outlined in (7).

(3) The quality improvement organization will define the member's medical and functional needs in a functional assessment and service profile. The functional assessment and service profile must meet the following criteria:

(4) The member and plan facilitator must meet to complete a person-centered plan that identifies, in writing, member-specific goals and objectives for the delivery of PAS. The plan facilitator must ensure the person-centered plan is completed prior to service and renewed at least annually. The person-centered plan will be based on the member's functional assessment and service profile as provided by the quality improvement organization.

(5) The service plan will identify the type and amount of PAS and will govern the delivery of service. The service plan must meet the following criteria:

(6) A member will not receive PAS beyond the service profile authorization unless one of two conditions is met:

(7) If a member is at high risk for institutionalization or in need of temporary PAS, the provider agency may implement services immediately that include activities of daily living without the functional assessment, service profile, and person-centered plan in place. In this case the provider agency must implement a temporary service plan. The provider agency must use a department-approved form to document the temporary service plan. The temporary service plan must prescribe in writing the member's medical and functional need for service. The provider must refer the member to the quality improvement organization for a functional assessment by the 28th day of the temporary service plan or they must discharge the member.

(8) The member must agree to accept the provision of PAS as specified in the person-centered service plan.

(9) The PAS provider must have a written complaint process. The member may receive a copy upon request. The provider must adhere to the process for any member complaints related to the person-centered planning and service-delivery process.

(10) The delivery of agency-based PAS must be supervised by a licensed agency nurse. Supervision includes oversight of the training and orientation of direct-care workers.