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| Montana Administrative Register Notice 37-870 | No. 20 10/19/2018 | |
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BEFORE THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES OF THE STATE OF MONTANA
TO: All Concerned Persons
1. On November 8, 2018, 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 the Department of Public Health and Human Services no later than 5:00 p.m. on November 1, 2018, to advise us of the nature of the accommodation that you need. Please contact Gwen Knight, 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:
37.34.3005 REIMBURSEMENT FOR SERVICES OF MEDICAID FUNDED DEVELOPMENTAL DISABILITIES HOME AND COMMUNITY-BASED SERVICES (HCBS) WAIVER PROGRAMS (1) remains the same. (2) The department adopts and incorporates by this reference the rates of reimbursement for the delivery of services and items available through each Home and Community-Based Services Waiver Program as specified in the Montana Developmental Disabilities Program Manual of Service Rates and Procedures of Reimbursement for Home and Community-Based Services (HCBS) 1915c, 0208, and 0667 Waiver Programs, effective July 1, 2018, as revised and labeled
4. STATEMENT OF REASONABLE NECESSITY
The Department of Public Health and Human Services (department) proposes to amend ARM 37.34.3005, which adopts and incorporates by reference the developmental disabilities program manual containing rates of reimbursement for the delivery of services and items available through each Home and Community-Based Services Waiver Program. House Bill 638, which became law as a result of the 65th Montana Legislative Session, appropriated funding for a rate increase of at least 75 cents per hour for workers who provide direct care to people with developmental disabilities. The proposed amendment would give a $1 per hour wage increase to the following direct care workers:
July 1, 2018 Direct-Care Wage Rate Increases Residential Community Home (small/no geographic factor) Residential Community Home (medium/no geographic factor) Residential Community Home (large/no geographic factor) Residential Community Home (small/medium geographic factor) Residential Community Home (medium/medium geographic factor) Residential Community Home (large/medium geographic factor) Residential Community Home (small/high geographic factor) Residential Community Home (medium/high geographic factor) Residential Community Home (large/high geographic factor) Residential Community Home (Medically Intensive/no geographic factor) Residential Community Home (Medically Intensive/Medium geographic factor) Residential Community Home (Medically Intensive/high geographic factor) Residential Community Home (Children’s Group Home/no geographic factor) Residential Community Home (Children’s Group Home/medium geographic factor) Residential Community Home (Children’s Group Home/high geographic factor) Supported Living Hourly/no geographic factor Supported Living Hourly/medium geographic factor Supported Living Hourly/high geographic factor Supported Living Hourly/Rural Remote Supported Living Flex Supported Living Base Supported Living (SMALL Agency/no geographic factor) Supported Living (SMALL Agency/medium geographic factor) Supported Living (SMALL Agency/high geographic factor) Residential Training Supports (no geographic factor) Residential Training Supports (medium geographic factor) Residential Training Supports (high geographic factor) Residential Training Supports (SMALL Agency/no geographic factor) Residential Training Supports (SMALL Agency/medium geographic factor) Residential Training Supports (SMALL Agency/High geographic factor) Adult Foster Support (Low Supervision) Adult Foster Support (Moderate Supervision) Adult Foster Support (Enhanced Supervision) Adult Foster Support (Intensive Supervision) Assisted Living Personal Care Companion Respite Small Group Employment Support – no geographic factor Small Group Employment Support – medium geographic factor Small Group Employment Support – high geographic factor Day Supports & Activities – no geographic factor Day Supports & Activities – medium geographic factor Day Supports & Activities – high geographic factor SMALL Day Supports & Activities – no geographic factor SMALL Day Supports & Activities – medium geographic factor SMALL Day Supports & Activities – high geographic factor Retirement Services – no geographic factor Retirement Services – medium geographic factor Retirement Services – high geographic factor SMALL Retirement Services – no geographic factor SMALL Retirement Services – medium geographic factor SMALL Retirement Services – high geographic factor Personal Supports
The proposed rate increase would be effective retroactively to July 1, 2018. The department is proposing this rule at this time because it has funding to do so based upon the governor's budget restoration announced in October of 2018.
ARM 37.34.3005
The department is proposing the amendment of an updated fee schedule effective July 1, 2018, as revised and labeled "version 3." The rates contained in the proposed fee schedule were modified to implement direct care wage increases as intended by the passing of HB 638 during the 65th Montana Legislative Session.
The department further proposes to incorporate into rule this new "version 3" of the manual effective July 1, 2018, which includes changes in the rates of reimbursement.
Fiscal Impact
The department estimates that the proposed amendment would cost approximately $5,715,284 federal dollars and $3,009,008 state general fund dollars annually.
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: Gwen Knight, 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., November 16, 2018.
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. The bill sponsor contact requirements of 2-4-302, MCA, apply and have been fulfilled. The primary bill sponsor was notified by letter, telephone, and email on October 5, 2018.
9. 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.
10. Section 53-6-196, MCA, requires that the department, when adopting by rule proposed changes in the delivery of services funded with Medicaid monies, make a determination of whether the principal reasons and rationale for the rule can be assessed by performance-based measures and, if the requirement is applicable, the method of such measurement. The statute provides that the requirement is not applicable if the rule is for the implementation of rate increases or of federal law.
The department has determined that the proposed program changes presented in this notice are not appropriate for performance-based measurement and therefore are not subject to the performance-based measures requirement of 53-6-196, MCA.
/s/ Jennifer C. Kaleczyc /s/ Sheila Hogan Jennifer C. Kaleczyc Sheila Hogan, Director Rule Reviewer Public Health and Human Services
Certified to the Secretary of State October 9, 2018.
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