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Montana Administrative Register Notice 37-685 No. 15   08/07/2014    
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BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.50.315 pertaining to the addition of a new supervision level within the foster care classification model system

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

 

TO: All Concerned Persons

 

            1. On August 27, 2014, at 10:00 a.m., the Department of Public Health and Human Services will hold a public hearing in the auditorium of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rule.

 

2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on August 20, 2014, to advise us of the nature of the accommodation that you need. Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail dphhslegal@mt.gov.

 

3. The rule as proposed to be amended provides as follows, new matter underlined, deleted matter interlined:

 

            37.50.315 FOSTER CARE CLASSIFICATION MODEL (1) Each facility shall must be classified according to the department's classification model. The model identifies seven eight levels of supervision and three levels of treatment. A model rate has been assigned to each level of supervision and treatment.

            (2) Each facility wishing to contract with the department shall must be classified according to ARM 37.50.316 to determine the daily rate the department would offer the facility for foster care services provided by the facility. The daily rate will be a percentage of the model rate for the facility's classification. The department may pay less than the daily rate if the facility requests less than the daily rate.

            (3) There are seven eight levels of supervision in the classification model:

            (a) through (c) remain the same.

            (d) In Level IV the facility provides the basic living needs of the youth and employs shift staff who provide provides 24-hour structured supervision of the youth and administrative personnel. This level of supervision utilizes planned structured supervision by trained staff. The facility provides activities and supervision based upon an assessment of the youth's needs and a specific written case plan that is monitored to determine its effectiveness in reducing the need for structured supervision.

            (e) In Level V the facility provides the basic living needs of the youth, and employs shift staff who provide provides 24-hour intensive supervision with backup staff available. The facility also employs administrative personnel. The facility provides constant control of the youth by highly trained staff in a planned treatment environment. This level of supervision requires individual assessment of the youth and the development, implementation, and monitoring of an individual written treatment plan by professional staff.

            (f) In Level VI the facility provides the basic living needs of the youth including food, shelter, transportation, and clothing. The Montana department of public health and human services pays licensed providers for the treatment portion of the per diem payment for therapeutic youth group homes currently classified as Level VI under this subsection. Therefore, no level of treatment in (4) of this rule applies to therapeutic youth group homes. However, as a prerequisite to licensure under the department's licensing rules in ARM Title 37, chapter 97, therapeutic youth group homes must abide by the applicable child/staff ratios for all staff including but not limited to program managers and lead clinical staff persons. For the purpose of calculating the ratio to check for compliance under the licensing requirements, only full-time contracted or employed program managers and lead clinical staff persons, or the equivalent number of part-time program managers and lead clinical staff persons, may be counted as "one" program manager or lead clinical staff person. Full-time program manager or lead clinical staff person means a program manager or lead clinical staff person who normally works for the therapeutic youth group home 40 hours per week.

            (g) In Level VII, a facility must be licensed as a child care agency-maternity home. A facility at this level provides the basic living needs of pregnant and parenting youth, including food, shelter, transportation, recreation, and clothing. The facility also provides the basic living needs of the child or children of the parenting youth, including food, shelter, baby formula, diapers, transportation, clothing, and access to day care services. Shift staff shall be employed to provide 24-hour intensive supervision in a home-like environment with back-up staff available. The facility may reduce the number of shift staff required for intensive supervision during hours in which the youth attend public school when a professional staff is on the premises who is able to perform all shift staff duties as necessary. In addition, the facility will employ a program manager who provides program oversight and the functions described in ARM 37.97.206(10)(6), and administrative support personnel. Professional staff shall must be employed to provide counseling and case management services, to include:

            (i) individual and group counseling designed to address the youth's mild delinquent, emotional, social, and/or behavior problems;

            (ii) development, implementation, and monitoring of individualized written case plans for each youth;

            (iii) to assist shift staff in the initial and ongoing assessment of the safety and well-being of each youth and child in residence; and

            (iv) will assist shift staff in teaching skill-building techniques, parenting, and life management skills to parenting youth to facilitate the acceptable adjustment to a community and/or family setting.

            (h) In Level VIII, a transitional living program for parents and children, a facility must be licensed as a child care agency-maternity home. A facility at this level provides the basic living needs of the parenting youth, age 16 to 21 years of age, including food, shelter, transportation, recreation, and clothing. The facility also provides the basic living needs of the child or children of the parenting youth, including food, shelter, baby formula, diapers, transportation, clothing, and access to day care services. The child of the parenting youth must be under the custody of the state or the parenting youth must be working with the state under a voluntary agreement under 41-3-302, MCA. Shift staff must be employed to provide 24-hour intensive supervision in a home-like environment with back-up staff available.  In this level, therapeutic treatment of the parenting youth may be provided as an ancillary service. In addition, the facility will employ a program manager who provides program oversight and the functions described in ARM 37.97.206(6), and administrative support personnel. The facility must employ professional staff to:

            (i) provide counseling and case management services with an emphasis on the relationship between the parenting youth and the child(ren) being the central focus;

            (ii) assist shift staff in the initial and ongoing assessment of the safety and well-being of each parenting youth and child(ren) in residence; and

            (iii) assist shift staff in teaching skill-building techniques, parenting, and life management skills to parenting youth to facilitate the acceptable adjustment to a community or family setting.

            (4) There are three levels of treatment in the classification model:

            (a) In basic treatment, professional staff employed by the facility provide structured individual and group therapeutic services designed to address the youth's mild delinquent, emotional, social, and/or behavior problems. Staff implements skill-building techniques to assist the youth in progressing toward an acceptable adjustment to his family, school, and/or community. This level of treatment requires more than the day-to-day supervision by caretakers.

            (b) In intermediate treatment, trained shift staff, under the supervision of professionals, perform assessments, develop and implement planned interventions designed to address an individual youth's serious delinquent, emotional, social, and/or behavior problems. Structured group and individual therapeutic services are provided according to the youth's written case plan.

            (c) In intensive treatment, intensive group and individual therapeutic services are provided by the facility to youth experiencing severe delinquent, emotional, social, and/or behavior problems which prevent an acceptable adjustment to the youth's family, school, and/or community. Treatment strategies are based upon an individual assessment of the youth and are administered according to a written treatment plan developed by the facility's professional staff. Group, individual, and family therapy are provided by the facility's professional staff. The youth's medical and psychological needs are addressed in the youth's treatment plan and qualified, professional staff monitors the medical and psychological needs of the youth. All services are provided by the facility as part of the regular services provided.

            (5) Facilities shall will be classified by the department according to the above criteria. Each level of supervision and treatment is assigned a model rate on the model rate matrix of the department. Each classified facility will be offered a daily rate, which is a percentage of the model rate assigned to facilities in that classification.

            (6) The department's model rate matrix, effective May 1, 2002, is hereby adopted and incorporated by this reference.  The department adopts and incorporates by reference the department's model rate matrix, effective July 1, 2014.  A Copies copy of the model rate matrix of the department are is available upon request from the Department of Public Health and Human Services, Child and Family Services Division, Operations and Fiscal Bureau, Cogswell Building, 1400 Broadway, P.O. Box 8005, Helena, MT 59604-8005. A copy may also be obtained at this web site: http://www.dphhs.mt.gov/cfsd/.  The department shall will review and revise its model rate matrix at least once every two years.

 

AUTH: 41-3-1103, 52-1-103, 52-2-603, MCA

IMP:     41-3-1103, 41-3-1122, 52-1-103, 52-2-611, MCA

 

            4. STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (the department) is proposing to amend ARM 37.50.315 by adding an additional level of care to the Foster Care Classification Model. The transitional living program will allow parenting youth, 16 years of age through 20 years of age, to remain with their child if the child is in custodial care of the state or if the parenting youth is working with the state under a voluntary agreement, pursuant to 41-3-302, MCA. This proposed amendment is necessary to allow the parenting youth and the child to remain unified, while the mother receives services.

 

The department is proposing minor corrections and revisions to the rule to ensure consistent use of terminology and to comply with current grammar and formatting requirements. The department is also updating the model rate matrix adoption date to correspond with the current rates. The model rate matrix may be obtained at the following web site: http://www.dphhs.mt.gov/cfsd/.

 

ARM 37.50.315

 

The proposed amendment to the transitional living program will allow parenting youth, 16 years of age through 20 years of age, to remain with their child if the child is in custodial care of the state or if the parenting youth is working with the state under a voluntary agreement, pursuant to 41-3-302, MCA. This proposed amendment is necessary to allow the parenting youth and the child to remain unified, while the mother receives services.

 

Fiscal Impact

 

This rule would impact youth of mothers age 16 to 21, where the Child and Family Services Division (CFSD) has temporary legal custody of their children. Based on a 50% utilization of care days available under this rule, the net annual fiscal impact would be $919,975.  Of this, $714,719.53 is general fund, $205,255.67 is federal fund.  It is expected that this impact will be positively offset by the cost of care that would otherwise be incurred if the youth was placed in family foster care.

 

            5. Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing. Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail dphhslegal@mt.gov, and must be received no later than 5:00 p.m., September 4, 2014.

 

6. The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

7. The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices. Notices will be sent by e-mail unless a mailing preference is noted in the request. Such written request may be mailed or delivered to the contact person in 5 above or may be made by completing a request form at any rules hearing held by the department.

 

8. An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

9. The bill sponsor contact requirements of 2-4-302, MCA, do not apply.

 

10. With regard to the requirements of 2-4-111, MCA, the department has determined that the amendment of the above-referenced rule will not significantly and directly impact small businesses.

 

 

 

 

 

 

 

/s/ Susan Callaghan                                               /s/ Richard H. Opper                                   

Susan Callaghan                                                   Richard H. Opper, Director

Rule Reviewer                                                      Public Health and Human Services

           

Certified to the Secretary of State July 28, 2014.

 

 

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