Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.86 - MEDICAID PRIMARY CARE SERVICES
Subchapter 37.86.39 - Case Management Services for Children with Special Health Care Needs
Rule 37.86.3901 - TARGETED CASE MANAGEMENT SERVICES FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS, DEFINITIONS

(1) "Care plan" means a specific written plan that is based on the information collected through the comprehensive assessment and periodic reassessment process that:

(2) "Comprehensive assessment and periodic reassessment" means an evaluation to identify a child's need for any medical, educational, social, or other services. These assessment activities include:

(3) "Monitoring and follow-up activity" means activities and contacts that are necessary to ensure the care plan is implemented and adequately addresses the child's needs. The activities may be with the child, family members, service providers, or other entities or individuals and may be conducted as frequently as necessary. Monitoring may be furnished through face-to-face visits, telephone calls, and telemedicine services.

(4) "Paraprofessional" means a person to whom a particular aspect of a professional task is delegated but who is not licensed to practice as a fully qualified professional.

(5) "Referral" means activities that help link the child or child's caregiver with medical, social, or educational providers, and other programs and services that are capable of providing needed services to address identified needs and achieve goals specified in the care plan.

(6) "Targeted case management" means services that assist a child and a child's caregivers to access needed medical, social, or other resources and services by establishing and maintaining a referral process for needed and appropriate services and avoiding duplication of services.