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Rule Title: CASE MANAGEMENT SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS, SEVERE DISABLING MENTAL ILLNESS
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Department: PUBLIC HEALTH AND HUMAN SERVICES
Chapter: MEDICAID PRIMARY CARE SERVICES
Subchapter: Case Management Services for Adults with Severe Disabling Mental Illness
 
Latest version of the adopted rule presented in Administrative Rules of Montana (ARM):

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37.86.3503    CASE MANAGEMENT SERVICES FOR ADULTS WITH SEVERE DISABLING MENTAL ILLNESS, SEVERE DISABLING MENTAL ILLNESS

(1) "Severe disabling mental illness" means with respect to a person who is 18 or more years of age that the person meets the requirements of (1)(a) or (b), and (c). The person must also meet the requirements of (1)(d). The person:

(a) has been involuntarily hospitalized for at least 30 consecutive days because of a mental disorder at Montana State Hospital within the past 12 months; or

(b) has recurrent suicidal ideation within the past 12 months, a history of suicide attempts, or a specific plan for completing suicide; and

(c) has a primary diagnosis of one of the following (excluding "mild, not otherwise specified (NOS)," unspecified, or due to "physiological disturbances and physical factors"):

(i) schizophrenia, delusional disorder, schizophreniform disorder, schizoaffective disorder;

(ii) bipolar I disorder and bipolar II disorder;

(iii) major depressive disorder;

(iv) panic disorder with agoraphobia or panic disorder without agoraphobia;

(v) obsessive-compulsive disorder;

(vi) posttraumatic stress disorder;

(vii) borderline personality disorder; or

(viii) autism spectrum disorder; and

(d) has ongoing functioning difficulties because of the mental illness for a period of at least six months or for a predictable period over six months, as indicated by the presence of at least three of the following indicators:

(i) a medical professional with prescriptive authority has determined that medication is necessary to control the symptoms of mental illness;

(ii) an inability to care for personal needs, e.g., meals, bathing, dressing, and daily chores, due to mental illness;

(iii) an inability to maintain competitive employment or education process due to mental illness;

(iv) an inability to sustain interpersonal relationships due to mental illness;

(v) the person has been determined to be disabled due to mental illness by the social security administration;

(vi) the person maintains housing only with ongoing supervision, is homeless, or is at imminent risk of homelessness due to mental illness; or

(vii) the person has had or will predictably have repeated episodes of decompensation.

History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, MCA; NEW, 2010 MAR p. 424, Eff. 2/12/10; AMD, 2015 MAR p. 2283, Eff. 12/25/15.


 

 
MAR Notices Effective From Effective To History Notes
37-724 12/25/2015 Current History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, MCA; NEW, 2010 MAR p. 424, Eff. 2/12/10; AMD, 2015 MAR p. 2283, Eff. 12/25/15.
37-481 2/12/2010 12/25/2015 History: 53-2-201, 53-6-113, MCA; IMP, 53-2-201, 53-6-101, MCA; NEW, 2010 MAR p. 424, Eff. 2/12/10.
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