Administrative Rules of Montana
Department 37 - PUBLIC HEALTH AND HUMAN SERVICES
Chapter 37.90 - MENTAL HEALTH MEDICAID FUNDED 1115 AND 1915 WAIVERS
Subchapter 37.90.4 - Home and Community-Based Services Waiver for Adults With Severe and Disabling Mental Illness
Rule 37.90.403 - HOME AND COMMUNITY-BASED SERVICES FOR ADULTS WITH SEVERE AND DISABLING MENTAL ILLNESS: DEFINITIONS

(1) "Activities of daily living" (ADL) means basic personal everyday activities.

(2) "Applicant" means an individual requesting services but not enrolled in the SDMI program.

(3) "Community First Choice" and "Personal Assistance Service" Programs (CFC/PAS) are Medicaid state plan programs designed to provide long term supportive care in a home setting. These programs are distinct from the PAS waiver service described in ARM 37.90.431.

(4) "Critical incident" is an incident that is serious in nature and poses a risk to the health, safety, or welfare of an enrolled member or others. It is a serious occurrence that includes abuse, neglect, and exploitation, each of which are defined under 52-3-803, MCA.

(5) "Enrolled member" means an individual enrolled in the SDMI program and authorized to receive services under the SDMI program.

(6) "Institutionalization" means placement in a nursing facility, a mental health nursing facility, or a state mental health hospital.

(7) "Instrumental activities of daily living" (IADL) means household tasks which are limited to cleaning the area used by the member.

(8) "Level of care assessment" (LOC) means a functional assessment used to determine if an individual requires the level of care normally provided in a nursing facility.

(9) Level of impairment assessment" (LOI) means an assessment used to identify areas in which a member requires long term services and supports.

(10) "Mental health professional" has the meaning provided in 53-21-102, MCA.

(11) "Non-critical incidents" are minor in nature and do not pose a risk to the health, safety, or welfare of an enrolled member or others.

(12) "Person-centered recovery plan" (PCRP) is a written plan that identifies the supports and services that are necessary for the enrolled member to remain out of institutional level of care, allow the enrolled member to function at the enrolled member's maximum capacity, and enable the enrolled member to achieve personal goals toward recovery.

(13) "Quality improvement organization" (QIO) means the entity under contract with the department to complete agreed upon utilization review activities for Montana Medicaid services.

(14) "SDMI" is used in this subchapter to refer to severe and disabling mental illness, which is described in ARM 37.90.409.

(15) "SDMI HCBS waiver program" is used in this subchapter to refer to severe and disabling mental illness home and community-based services waiver services.