(1) Organization of the Department of Public Health and Human Services.

(a) History The Department of Public Health and Human Services was established by 1995 Laws of Montana, Chapter 546. The department is provided for in 2-15-2201, MCA.

(b) Divisions The department consists of the following divisions:

(i) Addictive and Mental Disorders Division;

(ii) Blind and Low Vision Services Division;

(iii) Business and Financial Services Division;

(iv) Child and Family Services Division;

(v) Child Support Enforcement Division;

(vi) Disability Services Division;

(vii) Health Resources Division;

(viii) Human and Community Services Division;

(ix) Public Health and Safety Division;

(x) Quality Assurance Division;

(xi) Senior and Long Term Care Division; and

(xii) Technology Services Division.

The disability services and blind and low vision services divisions are administered by a single division administrator. Each of the other divisions is headed by an administrator. These divisions are further broken down into bureaus, sections, units, or teams.

(c) Director The director of the Department of Public Health and Human Services, appointed by the governor, heads the department.

(d) Administratively Attached Boards and Councils Attached to the department for administrative purposes only are several boards and councils created by state statutes. These boards are listed in (3). Assistance from the department for the boards and councils is provided as required by 2-15-121, MCA.

(2) Functions of the Department

(a) Director's Office The director provides direct supervision over the Child and Family Services, Child Support Enforcement, Human and Community Services, Technology Services, Public Health and Safety, and Quality Assurance Divisions. In addition, the director provides supervision to the deputy director, Office of Human Resources, the Office of Legal Affairs and to the Prevention Resource Center and the Public Information Officer.

(i) The deputy director provides direct supervision over the Addictive and Mental Disorders, Blind and Low Vision Services, Business and Financial Services, Disability Services, Health Resources and Senior and Long Term Care Divisions. In addition, the deputy director provides supervision to the Office of Budget and Finances, Office of Planning, Coordination and Analysis, and the Medicaid eligibility functions of the Human and Community Services Division.

(ii) The Office of Budget and Finance oversees the department's budgeting processes, facilitates centralized contract management and support, and conducts statistical analyses of the major benefit programs including major benefit expenditure projection modeling analyses.

(iii) The Office of Human Resources includes the administration of the classification and pay plans, employee relations, labor negotiations, leave administration and employment of the disabled, and staff development training.

(iv) The Office of Legal Affairs provides legal assistance to the department, supervises the adoption of administrative rules, and coordinates the use of external legal counsel.

(v) The function of the Office of Planning, Coordination and Analysis (OPCA) is to assist the department in maximizing, maintaining, and improving quality services to Montanans through planning, coordination, and analysis of programs. The OPCA provides overall department planning and ensures coordination of programs with CMS rules and regulations. This office provides general oversight over all the Medicaid programs in the department in terms of planning and coordination.

(vi) The Prevention Resource Center assists Montana comprehensive youth prevention programs in areas such as substance abuse, child and family safety, violence, and crime.

(vii) The Public Information Officer provides information to the public about the agency's programs and services.

(b) Addictive and Mental Disorders Division This division provides, directly and through independent providers, a statewide continuum of prevention, treatment and rehabilitation services for people with chemical dependency and mental illness. The division is divided into three bureaus and administers and supervises three state facilities.

(i) The Chemical Dependency Bureau is responsible for program development, planning, technical assistance, and contract management in support of chemical dependency programs.

(ii) The Mental Health Services Bureau is responsible for planning, funding implementation, and evaluation of community mental health programs for adults.

(iii) The Operations Bureau is responsible for budgeting, contract development and monitoring, federal fund management, information systems, and long range building.

(iv) The Montana Chemical Dependency Treatment Center at Butte provides drug and alcohol treatment services for adults.

(v) The Montana Mental Health Nursing Care Center at Lewistown provides long term care for people with mental illness who require nursing home care.

(vi) The Montana State Hospital at Warm Springs provides inpatient psychiatric hospital services to adults with serious mental illness.

(c) Business and Financial Services Division The division provides fiscal and internal support services to the agency, and administers the statewide vital records programs. The division develops, implements and monitors accounting and fiscal processes and systems in accordance with state and federal fiscal regulations and departmental mission, and guidelines of other departments of state government and agencies of the federal government. The division manages records, assets, office space agreements and building safety and maintenance. The division is composed of three bureaus.

(i) The Fiscal Operations Bureau manages the department's fiscal processes and provides input to the state accounting system for benefit payments and operating expenditures, drawing and recording federal cash, obtaining reimbursement for services provided by the department's institutions, preparing and filing federal financial reports, and managing payroll functions for the department.

(ii) The Business Services Bureau provides leadership and guidance to the department in the development and implementation of accounting policies and procedures that are consistently applied in compliance with professional standards, state statutes, federal regulations, and legislative intent. The Business Services Bureau provides leadership and guidance in the development and implementation of innovative, effective and efficient business processes that represent best practice, while considering program needs and perspectives. The Business Services Bureau processes accounts receivable for collecting and depositing agency monies received in the Business and Financial Services Division, submits the department's cost allocation plan to the federal government, manages the department's monthly cost allocation process, purchases supplies and equipment, manages fixed assets, and maintains the department's chart of account codes.

(iii) The Support and Vital Records Bureau is responsible for development and management of the division budget, statewide office space management, mail operations, forms distribution, records management, property accounting, vehicle fleet management, and Cogswell and Sanders Street building maintenance. It also administers the statewide vital records, which includes the registration of all births, deaths, fetal deaths, marriages, dissolutions of marriage, adoptions, and abortions.

(d) Child and Family Services Division This division administers programs to protect children and youth from abuse, neglect, and abandonment. The division works with communities and providers to support the strengths of families to increase their ability to nurture and provide for their children. The division provides child protective services (including investigatory services, emergency protective services, voluntary protective services, court-ordered protective services, and permanency services) to children and families; licenses family foster homes, child placing agencies and adoption agencies; and provides adoption services to children in the custody of the State of Montana. The division has three bureaus and five field regions.

(i) The division administrator is responsible for the overall administration of the division's programs including direct supervision of the regional administrators and bureau chiefs, developing the division's legislative plan, and allocation of resources throughout the division.

(A) The Centralized Intake Bureau is responsible for the operation of the statewide centralized intake system. This bureau receives all reports of suspected child abuse, neglect, or abandonment statewide from both mandatory and discretionary reporters seven days a week, 24 hours a day.

(B) The Operations and Fiscal Bureau is responsible for the management and coordination of financial activities, information systems liaison, legislative budget preparation, evaluation and benchmark analysis, and coordination of supplies, leases, and equipment. This bureau is also responsible for securing and managing Social Security benefits for children in foster care. In addition, this bureau is responsible for initial and ongoing Title IV-E eligibility determinations.

(C) The Program Bureau is responsible for employee training, administration of interstate compacts for foster care and adoption, licensing adoption agencies, administering grants for programs involving domestic violence, child abuse and neglect, access and visitation, Children's Trust Fund, and the Children's Justice Act. The bureau is also responsible for coordinating state and federal relations including the development of federally required state plans, contract monitoring, and program compliance. The bureau drafts administrative rules and policy and provides technical assistance and support to field staff in the areas of in-home services, family support and preservation, child protective services, foster care, guardianship, adoption and permanency, independent living, and Indian child welfare.

(e) Child Support Enforcement Division The Child Support Enforcement Division establishes paternity, locates obligated parents, establishes and modifies legal obligations requiring parents to provide medical and financial support for their children, and enforces those obligations. Services are provided to families receiving assistance under Montana's FAIM (Families Achieving Independence in Montana) program, or under the federal TANF (Temporary Assistance for Needy Families), Medicaid, or IV-E programs. Services are also provided to parents or custodians who apply for CSED services, or who are referred through the interstate IV-D system. The division is divided into six bureaus.

(i) The Administrative Services Bureau acts as the State Disbursement Unit (SDU) for child support payments. Child support payments are received and processed through the SDU. This bureau oversees electronic funds transfers, direct deposits, warrants, debit card disbursements, and financial interfaces between other agencies. Responsibilities also include federal financial reporting.

(ii) The budget officer is responsible for the overall management of division budget and has broad authority and responsibility in proposing and implementing fiscal and management policies that impact administration and programs involved in all division bureaus, and acts as the division coordinator of the Executive Planning Process.

(iii) The Field Services Bureau locates obligated parents; establishes paternity for out-of-wedlock children; establishes, modifies, and enforces financial and medical support obligations; and ensures division caseworking activities comply with federal regulations and performance standards.

(iv) The Legal Services Bureau represents the program in administrative and judicial matters, provides legal advice to program employees in their daily enforcement work, prepares legal opinions, and reviews program policy to ensure compliance with state law and federal regulations.

(v) The Office of the Administrative law judge adjudicates contested child support cases as defined by the Montana Administrative Procedure Act, issues and compels obedience to division orders and subpoenas, maintains the division's paternity and lien registries, and functions as the contested case record keeper for the division.

(vi) The Program and Training Bureau develops, implements, and monitors program, administrative, audit, and training operations in order to ensure a coordinated and effective Child Support Enforcement Program. This includes designing, evaluating, and monitoring program compliance with statutory and regulatory provisions, development of policies and procedures, and providing program support to the division.

(f) Disability Services Division/Blind and Low Vision Services Division The Disability Services Division provides for community-based training and residential services for persons with developmental disabilities. The division also provides vocational rehabilitation services to eligible Montanans who have a physical or mental disability in an effort to help them become employed. The division is responsible for the operation of the Montana Developmental Center. Adjudications of disability are also provided for the U.S. Social Security Administration. The Blind and Low Vision Services Division provides services to the visually impaired.

(i) The Developmental Disabilities (DD) Program is served by the following bureaus and residential facilities:

(A) The DD Community Support Bureau includes the regional offices which represent the state on the local level and ensures appropriate services and placement for persons with developmental disabilities. It provides technical assistance and monitoring of local department contractors of developmental disabilities services.

(B) The DD Program Support Bureau is responsible for information and data analysis, coordination of technical assistance, and provision of materials and curriculum development in support of program staff and contracted service providers.

(ii) The Financial Services Bureau is responsible for overall fiscal management of the Developmental Services Division.

(iii) The Montana Developmental Center is a residential facility for persons with a severe developmental disability.

(iv) The Vocational Rehabilitation (VR) Program and Blind and Low Vision Programs are administered by three bureaus:

(A) The VR Disability Determination Bureau is responsible for disability evaluations on applications for social security disability and supplemental security income for Montana residents.

(B) The VR Field Services Bureau provides services to eligible consumers. It also provides orientation and mobility training, rehabilitation teaching, blind and low vision services, and other independent living services that assist persons in achieving employment and to function independently. The VR Program Support Bureau provides grant and contract negotiating and monitoring, special fund supervision, human resource development, technical assistance, planning and evaluation, rehabilitation technology, and budget and systems oversight. This bureau has general oversight for the Montana Telecommunications Access Program which serves those who are deaf, and hard of hearing, speech impaired, or mobility impaired with specialized telecommunications needs.

(C) The VR Program Support Bureau provides grant and contract negotiating and monitoring, special fund supervision, human resource development, technical assistance, planning and evaluation, rehabilitation technology, and budget and systems oversight. This bureau has general oversight for the Montana Telecommunications Access Program and Blind and Low Vision Services Division programs which serves those who are deaf, and hard of hearing, speech impaired, or mobility impaired with specialized telecommunications needs.

(g) Health Resources Division This division administers children's mental health, the Children's Health Insurance Plan (CHIP), and acute care Medicaid services for both adults and children.

(i) The Acute Services Bureau manages the Medicaid programs for home infusion therapy, dental, durable medical equipment, school based services, eyeglasses, audiology, therapies, prescription drugs, and transportation programs.

(ii) The Children's Mental Health Services Bureau has responsibility for planning, operating, coordinating, and ensuring quality services in all aspects of a statewide program for publicly funded mental health services for children and adolescents.

(iii) The Fiscal Bureau projects and monitors division expenditures, monitors division contracts, and assists other division bureaus with fiscal management.

(iv) The Children's Health Insurance Plan (CHIP) Bureau determines eligibility for CHIP and provides health coverage to low-income children up to age 19. The CHIP benefit package includes medical, mental health, pharmacy, dental, and vision services.

(v) The Hospital and Clinical Services Bureau manages the Medicaid inpatient and outpatient hospital services, Indian health services, end stage renal disease, ambulatory surgical centers, freestanding dialysis clinics, federally qualified health centers, rural health clinics, and critical access hospitals.

(vi) The Managed Care Bureau manages the Medicaid programs for physician related services including physicians (except psychiatrists) , midlevel practitioners (nurse practitioners, nurse anesthetists, nurse midwives) , podiatrists; laboratories, claims resolution, Passport, EPSDT, claims management, chiropractic, respiratory therapy, and nutrition.

(h) Human and Community Services Division The Human and Community Services Division provides support for low-income Montanans in securing basic needs such as food, energy, child care, and income. In addition, the division assists Montanans in achieving self-sufficiency through employment and training. The division is divided into four bureaus.

(i) The Early Childhood Services Bureau consists of the child care unit, the child and adult care food program, and the Head Start collaboration grant. The child care unit provides child care payments for families who are either on welfare or who are low-income and working. Also, quality improvement programs are in place to improve the quality and availability of child care. The child and adult care food program provides food reimbursement and nutrition education for child and adult care providers. Head Start collaboration helps partner Head Start with programs in eight target areas. These include child care, health/mental health, welfare, education, family literacy, children with disabilities, homelessness, and volunteerism.

(ii) The Fiscal Bureau is responsible for the management and coordination of fiscal activities, legislative budget preparation, evaluation and benchmark analysis, and coordination of supplies, leases, and equipment.

(iii) The Intergovernmental Human Services Bureau plans, develops, implements and evaluates a range of services designed to help low-income people obtain the resources and skills to address the causes and conditions of poverty. Using a network of local agencies, the bureau provides weatherization, energy assistance, commodities, and emergency services statewide.

(iv) The Public Assistance Bureau is responsible for administering Montana's public assistance programs including the Temporary Assistance for Needy Families (TANF) block grant, the Food Stamp Program, and eligibility determination services for Medicaid. The bureau is also responsible for the administration of Montana's welfare reform initiative.

(i) Public Health and Safety Division This division has primary responsibility for implementing the core functions of public health (assessment, policy development, assurance) to prevent epidemics and the spread of disease, protect against environmental hazards, prevent injuries, promote and encourage healthy behaviors, respond to disasters, and assist communities in recovery, and assure the quality and accessibility of health services. The division is divided into six bureaus.

(i) The Chronic Disease and Health Promotion Bureau manages comprehensive planning and prevention efforts for cancer control, cardiovascular health, diabetes, obesity prevention/disease management, and emergency medical services.

(ii) The Communicable Disease Control and Prevention Bureau manages communicable disease and epidemiology, immunization, HIV/AIDS/STD, and food and consumer safety programs.

(iii) The Family and Community Health Bureau, in partnership with local providers, provides services to families and communities including infants, children, pregnant women, and women of childbearing age. Bureau services include community assessment, referral, case finding, home visiting, public and professional education, family planning services, nutrition education, services for children with special health care needs, and supplemental food distribution.

(iv) The Financial Services and Operations Bureau proposes, constructs, and manages the division budget and tracks expenditures as well as finalizes the more than 700 contracts for the division.

(v) The Laboratory Services Bureau provides clinical and environmental public health laboratory services.

(vi) The Public Health System Improvement and Preparedness Bureau works across all division bureaus and in partnership with local health departments and tribal entities to increase state level health status planning, create a formal public health advisory and policy-setting structure, continue evolving preparedness activities and plans, continue training and developing the public health workforce, and implement a communications strategy for the public.

(j) Quality Assurance Division The Quality Assurance Division is divided into four bureaus and an Office of Fair Hearings. The division is responsible for a comprehensive and coordinated quality assurance program, and protecting and advocating for individual client's rights while operating under a complex set of state and federal regulations.

(i) The Audit Bureau is responsible for audit services.

(ii) The Certification Bureau is responsible for conducting health care facility and service surveys according to federal requirements in Title XVIII (Medicare) and Title XIX (Medicaid) of the Social Security Act.

(iii) The Licensure Bureau is responsible for processing certificate of need applications, conducting licensure surveys according to state licensure standards for health care facilities, and day care facility licensing and registration. All health care facilities are required by law to have a state license. Construction and design of a new or renovated health facility must be approved through the licensure bureau.

(iv) The Office of Fair Hearings is responsible for administrative hearings for the department except for child support.

(v) The Program Compliance Bureau is responsible for program compliance of AFDC, food stamps, Medicaid, Medicaid surveillance and utilization review, third party liability, fraud and recovery, and assessment programs.

(k) Senior and Long Term Care Division The Senior and Long Term Care Division plans and coordinates the delivery of publicly funded long term care and support services to elderly Montanans and Montanans with physical and other disabilities. The division is served by five bureaus, and two nursing facilities for veterans.

(i) The Adult Protective Services Bureau provides vulnerable senior citizens, disabled, and people with disabilities with protection from abuse, neglect, and exploitation.

(ii) The Aging Services Bureau develops the state plan on aging and approves and monitors service delivery programs set up by ten area agencies on aging. These services include senior centers, congregate and home delivered meals, health, transportation, homemaker, and information and referral services. This office includes the state long term care ombudsman, elderly legal assistance, and health insurance and pension counseling.

(iii) The Centralized Services Bureau prepares budget plans and monitors expenditures and contracts for the division.

(iv) The Community Services Bureau manages in-home services (including personal care, home health, home dialysis, hospice, and the home and community based services waiver program) for elderly and disabled persons that are eligible for Medicaid.

(v) The Nursing Facilities Services Bureau provides payment for nursing facility services for Medicaid eligible persons.

(vi) The Nursing Facilities for Veterans are located in Columbia Falls and Glendive, Montana.

(l) Technology Services Division The division provides operational support services for the agency. The division is responsible for technology planning, design, development, implementation and operation of information technology systems, and for management and planning of other electronic government applications. In addition, the division services also include telecommunications and network management, security, internal support services such as facility and lease management, mailroom services, and management of vital records and statistics. Three bureaus accomplish these functions.

(i) The Business Strategy and Operations Bureau provides oversight to the business side of maintaining large computer systems necessary to the efficient and effective implementation of department programs. This unit provides full strategic, financial, human resource, and facilities management to the Technology Services Division.

(ii) The External System Bureau is responsible for providing state of the art support in technological areas critical to the efficient and effective implementation of department programs. That support includes administration of facilities management contracts with private vendors and systems security functions for the department. The bureau is also responsible for leading the statutorily mandated information technology planning process. This planning process will ensure that the agency deployment of information technology is carefully managed and coordinated throughout the department.

(iii) The Information Systems Bureau provides computer operations system development, help desk, database and web page support, and information technology management service to the department including regional and county offices, four institutions, and various advisory boards. This bureau also provides coordination and liaison support for information systems operated by fiscal intermediaries. Services provided to all department entities include: system purchase, integration and installation, information system analysis, design, development, and implementation, and report generation.

(iv) The Network and Communications Bureau provides information technology support (network management services, computer support, communication services) to DPHHS staff and contractors. This bureau manages 100 networks and 3500 computers statewide located in the central office, regional and county offices, and the institutions. Other services provided include management of a computer training center and a video conference center, network security services, researching and evaluating new information technologies for the department.

(3) Administratively attached entities:

(a) Board of Public Assistance created by 2-15-2203, MCA.

(b) Committee on Telecommunications Access Services for Persons with Disabilities created by 2-15-2212, MCA.

(c) Governor's Advisory Council on Aging created by 2-15-2206, MCA.

(d) Montana Children's Trust Fund Board created by 2-15-2214and 52-7-101, MCA.

(e) State Trauma Care Committee created by 2-15-2216, MCA.

(f) Traumatic Brain Injury Advisory Council created by 2-15-2217, MCA.

(4) Information or Submissions General inquiries regarding the department may be addressed to the director. Specific inquiries regarding the functions of each division may be addressed to the administrator of that division. Requests for fair hearings should be addressed to the county or state office whose action is contested or to the Department of Public Health and Human Services, Quality Assurance Division, Office of Fair Hearings, Colonial Building, 2401 Colonial Drive, P.O. Box 202953, Helena, MT 59620-2953. Requests for fair hearings pertaining to child support should be addressed to the Office of Administrative Law Judge, 111 N. Jackson, Suite 2B, Helena, MT 59601. All requests for declaratory rulings, and for participation in rulemaking may be addressed to the Office of Legal Affairs, unless the notice in the Montana Administrative Register makes specific provisions for submissions. The general address for the department, unless otherwise stated, is P.O. Box 4210, Helena, MT 59604-4210.

(5) Personnel Roster Addresses of the director and each division administrator are as follows:

Joan Miles, Director, Department of Public Health and Human Services, 111 North Sanders Street, P.O. Box 4210, Helena, MT 59604-4210.

John Chappuis, Deputy Director, Department of Public Health and Human Services, 111 North Sanders Street, P.O. Box 4210, Helena, MT 59604-4210.

Russell E. Cater, Chief Legal Counsel, Office of Legal Affairs, 111 North Sanders Street, P.O. Box 4210, Helena, MT 59604-4210.

Carol Seaman, Chief Personnel Officer, Office of Human Resources, 111 North Sanders, P.O. Box 4210, Helena, Montana 59604-4210.

Gail Briese-Zimmer, Chief Officer, Office of Planning, Coordination and Analysis, 111 North Sanders, P.O. Box 4210, Helena, Montana 59604-4210.

Gayle Shirley, Public Information Officer, 111 North Sanders, P.O. Box 4210, Helena, Montana 59604-4210.

Joyce DeCunzo, Administrator, Addictive and Mental Disorders Division, 555 Fuller Avenue, P.O. Box 202905, Helena, Montana 59620-2905.

Mary Dalton, Administrator, Health Resources Division, 1400 Broadway, P.O. Box 202951, Helena, Montana 59620-2951.

Shirley Brown, Administrator, Child and Family Services Division, Cogswell Building, 1400 Broadway, P.O. Box 202951, Helena, Montana 59620-2951.

Lonnie Olson, Administrator, Child Support Enforcement Division, 3075 North Montana, P.O. Box 202943, Helena, Montana 59620-2943.

Joe Mathews, Administrator, Disability Services Division/Blind and Low Vision Services Division, 111 North Sanders, P.O. Box 4210, Helena, Montana 59604-4210.

Laurie Lamson, Administrator, Business and Financial Services Division, 111 North Sanders, P.O. Box 4210, Helena, Montana 59604-4210.

Hank Hudson, Administrator, Human and Community Services Division, Arcade Building, 111 N. Jackson, P.O. Box 202925, Helena, Montana 59620-2925.

Mary Angela Collins, Administrator, Technology Services Division, Colonial Building, 2401 Colonial Drive, P.O. Box 202953, Helena, Montana 59620-2953.

Jane Smilie, Administrator, Public Health and Safety Division, Cogswell Building, 1400 Broadway, P.O. Box 202951, Helena, Montana 59620-2951.

Jeff Buska, Administrator, Quality Assurance Division, Colonial Building, 2401 Colonial Drive, P.O. Box 202953, Helena, Montana 59620-2953.

Kelly Williams, Administrator, Senior and Long Term Care Division, 111 North Sanders, P.O. Box 4210, Helena, Montana 59604-4210.

(6) Charts of Agency Organization Descriptive charts of the Department of Public Health and Human Services are attached on the following pages.