reglab/statecodes huggingface dataset:
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.501 - SELF-SUFFICIENCY TRUSTS: PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) These rules
				provide for the acceptance by the state of monies from a certain type of trust,
				known as a self-sufficiency trust, to be used to purchase services to
				supplement the services that a person with a disability receives from the
				state. These rules also provide for the receipt of donated monies to be used
				for the purchase of certain human services.
(2) A properly constituted self-sufficiency
				trust allows a person to obtain additional resources for enhancing the quality
				of the person's life while maintaining the person's eligibility for certain
				state funded human services.
(3)
				These rules are not written to correspond to or to provide guidance concerning
				any requirements that may be necessary for a trust to be in compliance with
				state laws relating to trusts or the federal and state tax codes.
(4) The department is not responsible for
				advising or directing a party in the various legal requirements necessary for
				the establishment of a trust in relation to state trust law and federal and
				state tax codes.
Sec.
					 53-2-201
					 and
					 53-18-103,
					 MCA; IMP, Sec.
					 53-18-101,
					 53-18-102,
					 53-18-103,
					 53-18-104
					 and
					 53-18-105,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.503 - SELF-SUFFICIENCY TRUSTS: ELIGIBLE BENEFICIARY

Current through Register Vol. 13, July 5, 2024
(1)
				The beneficiary of a self-sufficiency trust must be:
(a) a resident of the state of
				Montana;
(b) a person with a
				disability; and
(c) potentially
				eligible for services provided by the department or for mental health services
				provided by the department of corrections.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.505 - SELF-SUFFICIENCY TRUSTS: QUALIFYING TRUSTS

Current through Register Vol. 13, July 5, 2024
(1)
				To qualify as a self-sufficiency trust, an individual trust must meet the
				following criteria:
(a) The individual trust
				must be established and managed by a nonprofit corporation which has as one of
				its principal purposes the use of trust monies for the care and treatment of a
				person or persons with disabilities who are or could be the recipients of state
				funded services;
(b) The individual
				trust must be for the sole benefit of a person or persons with disabilities who
				are or could be the recipients of the state funded services listed in ARM
				37.2.503(3);
(c) The individual trust must be funded by
				the beneficiary, by a parent, grandparent or legal guardian of the beneficiary,
				or at the direction of a court;
(d)
				The individual trust must provide that the trust monies may only be expended on
				supplemental services;
(e) The
				individual trust must provide that upon the death of the beneficiary the state
				be reimbursed, to the extent the monies remaining in the trust allow, an amount
				equal to the total cost to the state of providing medicaid services to the
				beneficiary;
(f) The individual
				trust must provide that upon the death of the beneficiary, in accordance with
				IRS codes, rulings and interpretations, monies are donated from the remainder
				of the trust to the special charitable account as described in ARM
				37.2.511;
(g) The expenditure of monies from the
				individual trust on behalf of a beneficiary must be governed by a life care
				plan approved by the department in accordance with ARM
				37.2.508; and
(h) The individual trust must be established
				in accordance with state laws governing trusts and with relevant federal and
				state tax codes, rulings and interpretations.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.508 - SELF-SUFFICIENCY TRUSTS: LIFE CARE PLAN APPROVAL AND PAYMENT

Current through Register Vol. 13, July 5, 2024
(1) A life care plan must include:
(a) the name and address of the
				beneficiary;
(b) a description of
				the specific supplemental services to be purchased;
(c) the amount of the supplemental services
				to be purchased;
(d) the amount of
				money available to purchase the supplemental services; and
(e) any other information necessary for the
				department to be able to decide whether it is feasible to purchase the
				specified supplemental services.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.509 - SELF-SUFFICIENCY TRUSTS: LIFE CARE PLAN IMPLEMENTATION

Current through Register Vol. 13, July 5, 2024
(1) The department manages the purchase and
				delivery of the supplemental services specified in an approved life care
				plan.
(2) The department may
				contract with a service provider to manage on behalf of the department the
				delivery of supplemental services specified in a life care plan.
(3) A contract for the management of the
				purchase and delivery of supplemental services specified in a life care plan
				must provide the following:
(a) the name and
				address of the beneficiary;
(b) the
				supplemental services to be purchased and delivered;
(c) the amount of money available in the life
				care plan to purchase the supplemental services;
(d) the types and quantity of the
				supplemental services to be delivered;
(e) the amount of any reasonable
				administrative cost the service provider may charge for the management of the
				purchase and delivery of the supplemental services; and
(f) any other information necessary to secure
				the purchase and delivery of supplemental services.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.511 - SELF-SUFFICIENCY TRUSTS: SPECIAL CHARITABLE ACCOUNT

Current through Register Vol. 13, July 5, 2024
(1) The special charitable account provides
				monies to fund services for recipients of the programs of services specified in
				ARM 37.2.503(3) on an
				individual or group basis.
(2) The
				special charitable account is funded with monies donated by individual trust
				accounts as provided in ARM
				37.2.505(1) (f) 
				by other charitable donations, and by any other permissible means.
(3) The expenditure of monies from the
				special charitable account is subject to the legislative appropriation
				process.
(4) Services for a person
				are provided in accordance with the provisions of a life care plan developed by
				the department and approved by the special charitable account review
				board.
(5) The special charitable
				account review board is a 3 person board appointed by the department director
				to review and approve proposed life care plans developed by the department to
				purchase services for persons with funds from the special charitable account
				and to review and approve other expenditures from the account.
(6) The special charitable account review
				board consists of the following members:
(a)
				a department employee;
(b) a member
				of the board of directors of an organization which provides self-sufficiency
				trust services; and
(c) an employee
				of a service provider.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.512 - SELF-SUFFICIENCY TRUSTS: REPORTING REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) A service provider, managing the purchase
				and delivery of supplemental services must provide an annual report to the
				department.
(2) The department must
				provide an annual report on an active individual self-sufficiency trust to the
				managing self-sufficiency trust corporation specifying the following:
(a) the name and address of the eligible
				beneficiary who received supplemental services;
(b) a description of the supplemental
				services provided;
(c) the amount
				of the supplemental services provided;
(d) the cost of the supplemental services
				provided; and
(e) information about
				the impact of the supplemental services on the beneficiary.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.513 - SELF-SUFFICIENCY TRUSTS: STATE SELF-SUFFICIENCY TRUST ACCOUNT

Current through Register Vol. 13, July 5, 2024
(1) Monies of a self-sufficiency trust, in
				order to be expended by the state, must be transferred to the department for
				deposit to the state self-sufficiency trust account.
(2) Monies from a self-sufficiency trust
				received by the department are deposited in the state's self-sufficiency trust
				account. The monies for each beneficiary are individually accounted for in the
				trust account.
(3) The department
				must return monies to a self-sufficiency trust along with any interest earned
				on the monies if the department is unable to obtain the supplemental services
				specified in the life care plan and the life care plan is not
				revised.
(4) The department must
				disburse monies from the special charitable account in the self-sufficiency
				trust account in accord with the appropriation process and the direction of the
				special charitable account review board.
Sec.
					 53-2-201
					 and
					 53-18-103,
					 MCA; IMP, Sec.
					 53-18-101,
					 53-18-102,
					 53-18-103,
					 53-18-104
					 and
					 53-18-105,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.520 - ACHIEVING A BETTER LIFE EXPERIENCE (ABLE) PROGRAM: PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of
				the ABLE program is to provide Montana residents with access to a tax-favored
				program designed to provide secure funding for qualified disability-related
				expenses on behalf of individuals with disabilities that will supplement, but
				not supplant, benefits provided through public or private sources.
AUTH:
					 53-25-104,
					 MCA IMP:
					 53-25-102,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.521 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
The following definitions, found in
				  53-25-103,
				  MCA, apply to this subchapter:
(1)
				"Account" means an eligible participating account established under Title 53,
				chapter 25, MCA, by or on behalf of an eligible individual.
(2) "Account owner" means the designated
				beneficiary of the account.
(3)
				"Annual contribution limit" means the limit established in section 529A(b)(2)
				of the Internal Revenue Code,
				26 U.S.C.
				529A(b)(2).
(4) "Application" means a form executed by or
				on behalf of a prospective account owner to enter into a participating trust
				agreement and open an account. The application incorporates the participating
				trust agreement by reference.
(5)
				"Committee" means the achieving a better life experience program oversight
				committee established in
				53-25-105,
				MCA.
(6) "Contribution" means a
				payment to an account for the benefit of a designated beneficiary.
(7) "Department" means the Department of
				Public Health and Human Services provided for in
				2-15-2201,
				MCA.
(8) "Designated beneficiary"
				means the eligible individual on whose behalf an account is
				established.
(9) "Eligible
				individual" means an eligible individual as defined in section 529A(e)(1) of
				the Internal Revenue Code,
				26 U.S.C.
				529A(e)(1).
(10) "Financial institution" means a bank,
				commercial bank, national bank, savings bank, savings and loan association,
				credit union, insurance company, trust company, investment adviser, or other
				similar entity that is authorized to do business in this state.
(11) "Investment products" means, without
				limitation, certificates of deposit, savings accounts paying fixed or variable
				interest, financial instruments, one or more mutual funds, and a mix of mutual
				funds.
(12) "Member of the family"
				means, with respect to a designated beneficiary, a member of the family of the
				designated beneficiary as defined in section 529A(e)(4) of the Internal Revenue
				Code,
				26 U.S.C.
				529A(e)(4).
(13) "Nonqualified withdrawal" means a
				withdrawal from the account that is not:
(a)
				a qualified withdrawal;
(b) a
				withdrawal made as the result of the death of the designated beneficiary of an
				account; or
(c) a rollover
				distribution or a change of designated beneficiary described in
				53-25-111,
				MCA.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.522 - FEES

Current through Register Vol. 13, July 5, 2024
(1) There is a
				one-time application fee of $25 for opening a new account. The fee must be paid
				when the new account is established.
(2) Financial institutions acting as program
				managers may impose fees upon account owners. Program management fees must be
				approved by the department before they can be imposed.
(3) Application fees collected must be
				remitted to the department and placed in a state special revenue account and
				only be used for administration of the program.
(4) Program management fees will be retained
				by each program manager as compensation for program management
				services.
AUTH:
					 53-25-104,
					 MCA; IMP:
					 53-25-109,
					 53-25-112,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.525 - DUTIES OF PROGRAM MANAGER

Current through Register Vol. 13, July 5, 2024
(1) Each program
				manager must do the following:
(a) generally
				administer and carry out the program according to the directions and policies
				of the department and applicable law;
(b) keep adequate records of each account
				that is under its direction, keep such account segregated from other accounts
				and post contributions to accounts within no later than the business day that
				it receives verification that such contributions consist of fully collected
				funds;
(c) provide the department
				and all appropriate governmental and regulatory agencies all reports and
				information as may be required or deemed necessary to obtain tax advantages
				available under state or federal laws;
(d) provide regular statements at least
				annually, within 31 days of the annual period to which they apply, to each
				account owner showing all contributions, withdrawals, and earnings posted to
				each account during the previous reporting period;
(e) comply with the terms and conditions of
				its contract with the department;
(f) take all actions required to keep the
				program in compliance with the requirements of the ABLE Act and all reasonable
				action not contrary to the ABLE Act, these rules or the depository or program
				manager's contract to manage its program accounts so that it is treated as a
				qualified ABLE Act program under section 529A(b) of the Internal Revenue Code,
				26 USC
				529A(b);
(g) comply with all other laws and
				regulations applicable to the program manager;
(h) retain or provide copies to the
				department of all applications and related documentation received pursuant to
				these rules;
(i) include in any
				application, participating trust agreement, contract, offering or disclosure
				document, and any other document identified by the department that may be used
				in connection with a contribution to an account an express statement that the
				account is not insured by the state and that the principal deposited and any
				investment return are not guaranteed by the state; and
(j) include in any application or
				participating trust agreement a statement that the program must provide that a
				portion or all of the balance remaining in the account of a deceased designated
				beneficiary must be distributed to a state that files a claim against the
				designated beneficiary or the account itself with respect to benefits provided
				to the designated beneficiary under that state's Medicaid plan.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.526 - OPENING OF ACCOUNTS: QUALIFICATIONS

Current through Register Vol. 13, July 5, 2024
(1) An account may
				be opened by or on behalf of an eligible individual who is a resident of
				Montana or a resident of a state that has entered into a contract with Montana
				to provide its residents access to the program.
(2) An eligible individual or the eligible
				individual's legal guardian or agent under a power of attorney may open an
				account for the benefit of the eligible individual by:
(a) completing an application and a
				participating trust agreement supplied by the program manager;
(b) making the minimum contribution required
				by the program manager; and
(c)
				paying the one-time application fee.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.527 - CONTRIBUTIONS AND LIMITS

Current through Register Vol. 13, July 5, 2024
(1) Subject to the
				limitations in (2), any person, including a nonresident of Montana and an
				individual who is not the account owner, may make a contribution to an
				account.
(2) All contributions to
				accounts must be in cash and may not exceed the annual contribution limit found
				in section 529(A)(b)(2) of the Internal Revenue Code,
				26 USC
				529(b)(2).
(3) Contributions may be made following
				payroll deduction plans to which the contributor and his or her employer are
				parties. In such case, the employer, on behalf of the contributor, will send
				the contribution to the program manager, as agent for the trustee.
AUTH:
					 53-25-104,
					 MCA; IMP:
					 53-25-109,
					 MCA
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.530 - WITHDRAWALS

Current through Register Vol. 13, July 5, 2024
(1) Qualified
				withdrawals from an account are:
(a) a
				withdrawal from an account to pay the qualified disability expenses of an
				account owner;
(b) a withdrawal
				made as the result of the death of the account owner; or
(c) a rollover distribution or a change of
				designated beneficiary and account owner.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.531 - REPORTING REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) At least
				annually, within 31 days of the annual period to which they apply, the program
				manager must provide to each account owner an account statement. The statement
				must include:
(a) a balance of the account at
				the beginning of the reporting period;
(b) all activity during the reporting period
				including deposits, withdrawals, penalties paid, and income earned;
				and
(c) the balance at the end of
				the reporting period.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.5 - Self-sufficiency Trusts › Rule 37.2.532 - TERMINATION OF PROGRAM MANAGER

Current through Register Vol. 13, July 5, 2024
(1) If the
				department determines not to renew a contract with an existing program manager,
				then the department, as trustee of the trust, may take appropriate action
				consistent with the interest of the program and the accounts.
(2) Except as provided in (3), if the
				department does not renew a contract with a program manager, at the end of the
				term of the nonrenewed contract, the program manager must:
(a) continue to administer accounts already
				established with the program manager, including accepting additional
				contributions;
(b) not establish
				new accounts unless and until a new program contract is executed with the
				department; and
(c) comply with all
				rules or policies established by the department or the terms of a contract
				between the department and the nonrenewed program manager executed for the
				purpose of administering and managing the existing accounts.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.701 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
(1) "Department" means the department of
				public health and human services.
(2) "Discretionary income" is determined by
				subtracting fixed expenses from the total gross income or adjusted gross income
				from the most recent IRS tax return plus depreciation and voluntary retirement
				contributions which are deducted from the gross income on the tax
				return.
(3) "Financially
				responsible person" means a spouse of a resident, the natural or adoptive
				parents of a resident under 18 years of age or a guardian or conservator to the
				extent of the guardian's or conservator's responsibility for the financial
				affairs of the person who is a resident under applicable Montana law
				establishing the duties and limitations of guardianship or
				conservatorships.
(4) "Fixed
				expenses" means the amount determined by the department under ARM
				37.2.703.
(5) "Income" means the amount determined by
				the department under ARM
				37.2.702.
(6) "Liquid assets" means stocks, bonds,
				certificates of deposit, etc. which can be readily converted to cash.
(7) "Personal needs" means the reasonable
				cost of toiletries, newspapers, or other personal comfort items not normally
				supplied by an institution. The department will use the standards for medicaid
				guidelines as a minimum. The standards for medicaid guidelines are published in
				the Department Medical Assistance Guidelines Manual (see MA 904-1 and 904-3). A
				copy of these standards can be obtained from the Department of Public Health
				and Human Services, Fiscal Services Division, 111 N. Sanders, P.O. Box 6429,
				Helena, MT 59604-6429.
(8) "Real
				property" means land and permanent attachments including trees, buildings and
				infrastructure.
Sec.
					 53-1-403, MCA;
					 IMP, Sec.
					 53-1-401,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.702 - INCOME

Current through Register Vol. 13, July 5, 2024
(1) Income means economic benefit received by
				a resident or financially responsible person from any source, and includes, but
				is not limited to:
(a) gross wages, salaries,
				tips, commissions, bonuses and other earnings;
(b) draws or advances against future
				earnings;
(c) allowances, flat rate
				payments or per diem compensation for employment expenses;
(d) net receipts from nonfarm self-employment
				(receipts from a nonfarm business, profession or occupation, after deductions
				for reasonable operating expenses) ;
(e) net receipts from farm self-employment,
				whether an owner, tenant, or sharecropper (receipts from a farm or ranch, after
				deductions for reasonable operating expenses) ;
(f) net rental income (receipts from rental
				property after deductions for reasonable operating expenses) ;
(g) periodic payments from social security,
				unemployment compensation insurance, union strike funds, workers compensation,
				veterans benefits, public assistance (including, but not limited to, aid to
				families with dependent children or temporary assistance for needy families,
				supplemental security income and non-federally funded general assistance or
				general relief) and other government payments or benefits, disability benefits
				and training stipends;
(h) alimony,
				child support and military family allotments or other regular support from an
				absent family member or someone not living in the household;
(i) private pensions, government employee
				pensions (including military retirement pay), railroad retirement and regular
				insurance, trust or annuity payments;
(j) college or university scholarships,
				grants, fellowships and assistantships;
(k) dividends, interest or net
				royalties;
(l) distributions from
				estates or trusts, net gambling and lottery winnings; capital gains; proceeds
				from the sale of personal or real property (house, automobile, etc.) ; tax
				refunds, federal earned income credit, government subsidies or grants; gifts,
				one-time insurance payments, recoveries for injury or loss; and
(m) the value of non-cash benefits (including
				but not limited to inkind compensation, personal use of a business vehicle,
				housing, food, utilities and payment of personal expenses or
				obligations).
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.703 - FIXED EXPENSES

Current through Register Vol. 13, July 5, 2024
(1) Fixed expenses
				shall be limited to reasonable and necessary living and mandatory expenses over
				which the resident or responsible person has little or no control, and which
				have been incurred or committed to prior to admission. These expenses may
				include, but are not limited to:
(a) housing
				expenses such as:
(i) rent payment;
(ii) lease payment;
(iii) mortgage;
(iv) property taxes;
(v) property insurance;
(vi) mortgage insurance;
(vii) heat;
(viii) electricity;
(ix) water and sewer;
(x) waste disposal;
(xi) phone; and
(xii) special improvement districts (SIDs)
				and rural improvement districts (RIDs) ;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.705 - ABILITY TO PAY DETERMINATION

Current through Register Vol. 13, July 5, 2024
(1) Upon
				receipt of sufficient financial information and documentation, the department
				may determine the fixed expenses of the resident or financially responsible
				person. The following shall apply to food, clothing and transportation
				expenses:
(a) allowances for food and
				clothing needs shall be based on data reported periodically by the USDA center
				for nutrition policy and promotion. A copy of the allowances for food and
				clothing are available upon request from the Department of Public Health and
				Human Services, Fiscal Services Division, 111 N. Sanders, P.O. Box 6429,
				Helena, MT 59604-6429; and
(b)
				transportation expenses shall be allowed for the actual cost of operating one
				vehicle per family, unless a second vehicle is essential to the production of
				income. If no vehicle is owned, the actual cost of public transportation shall
				be allowed.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.706 - PROCEDURE TO OBTAIN FINANCIAL INFORMATION FOR ABILITY TO PAY DETERMINATION

Current through Register Vol. 13, July 5, 2024
(1) Upon admission or commitment to one of
				the institutions listed in
				53-1-402,
				MCA, a representative of the department shall contact the resident or
				financially responsible person to obtain information and documentation for use
				in assessing the resident's or financially responsible person's ability to pay
				the resident's cost of care.
(2)
				The department shall allow the resident or financially responsible person 30
				days from the date of the request or date of mailing to respond. If the
				resident or financially responsible person is contacted by mail, the department
				shall allow an additional three days for the response.
(3) If the resident or financially
				responsible person does not provide or cooperate with the department in
				obtaining the requested financial information and documentation within 30 days,
				the department may determine ability to pay, up to the full cost of care based
				on the information gathered by the department under
				53-1-406,
				MCA.
Sec.
					 53-1-403, MCA;
					 IMP, Sec.
					 53-1-406,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.707 - MONTHLY PAYMENT AMOUNT

Current through Register Vol. 13, July 5, 2024
(1) The charge
				assessed against each resident or financially responsible person shall be the
				lower of:
(a) the full cost of care, as
				determined by recorded charges, less any payments received from other sources,
				except that payments received from a managed care organization administering a
				mental health managed care program under contract with the department shall not
				reduce the charge;
(b) the amount
				of the adjusted ability to pay determination; or
(c) the maximum parental liability, for
				parents of a long-term resident shall be based on data reported periodically by
				the United States department of agriculture (USDA) center for nutrition policy
				and promotion. The liability shall commence on the 121st day of care. The
				current maximum parental liability amount is available upon request from the
				Department of Public Health and Human Services, Fiscal Services Division, 111
				N. Sanders, P.O. Box 6429, Helena, MT 59604-6429.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.710 - THIRD PARTY RESOURCES

Current through Register Vol. 13, July 5, 2024
(1) Applicable
				medicare, medicaid, or personal insurance or similar health care benefits shall
				be considered as a resource of the resident.
(2) Upon verification of the receipt of third
				party payments made directly to a resident or financially responsible person,
				the department may enforce the automatic assignment of rights provided in
				53-1-414,
				MCA.
Sec.
					 53-1-403 and
					 53-1-405,
					 MCA; IMP, Sec.
					 53-1-405
					 and
					 53-1-414,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.711 - MAINTENANCE OF CHARGE RECORDS

Current through Register Vol. 13, July 5, 2024
(1) The
				department shall maintain records of services provided to residents, and shall
				prepare a monthly itemized statement for each resident receiving chargeable
				services. Charges shall be recorded for each service and for each day the
				resident is at the institution at midnight. No per diem charge shall be
				recorded for the day the resident leaves, unless the resident dies or is
				admitted and discharged from the institution during the same day.
Sec.
					 53-1-403, MCA;
					 IMP, Sec.
					 53-1-403 and
					 53-1-405,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.712 - PROCEDURE FOR FAILURE TO PAY

Current through Register Vol. 13, July 5, 2024
(1) Accounts
				which are delinquent shall be identified by the department at 60, 90 and 120
				day intervals. The department may notify a resident or financially responsible
				person whose account is delinquent 90 days of its intent to use the department
				of administration debt collection service for debt collection unless payment is
				received in 30 days.
(2) If no
				response or payment is received before the 120th day, the department may issue
				a second notice stating that action has been taken, and requesting that all
				correspondence and/or payment be directed to the department of
				administration.
(3) If a resident
				or financially responsible person dies owing a delinquent account, the
				department may notify the heirs, devisees, personal representative or attorney
				of its claim against any estate.
Sec.
					 53-1-403 and
					 53-1-404,
					 MCA; IMP, Sec.
					 53-1-411,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.713 - REFUNDS AND RETROACTIVE ASSESSMENTS

Current through Register Vol. 13, July 5, 2024
(1) If
				in the process of reviewing a resident ' s or responsible person ' s ability to
				pay, the department determines that information has been misrepresented on a
				previous financial statement, which if honestly represented would have resulted
				in a higher ability to pay determination, a retroactive adjustment of the
				monthly payment amount based on the increased ability to pay will be
				made.
(2) If a new determination
				results in a retroactive reduction of a prior monthly payment amount, and the
				account has been paid in full for that time period, a refund will be
				made.
(3) If combined payments from
				more than one payer are received which exceed the cost of care, a refund will
				be initiated with the appropriate party or intermediary listed as designated
				recipient.
Sec.
					 53-1-403, MCA;
					 IMP, Sec.
					 53-1-408,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.7 - State Facility Reimbursement › Rule 37.2.720 - ABILITY TO PAY, ADMINISTRATIVE REVIEW AND FAIR HEARING

Current through Register Vol. 13, July 5, 2024
(1) If the resident or a financially
				responsible person is aggrieved by the department's determination of ability to
				pay, that person may request an administrative review regarding the
				determination. The administrative review is subject to and shall be conducted
				in accordance with this rule.
(2)
				The request for administrative review must be:
(a) submitted to the department in
				writing;
(b) state the reasons the
				person contends that the determination is incorrect or fails to comply with
				legal requirements;
(c) include any
				additional information and substantiating documentation which the person wishes
				the department to consider in the administrative review;
(d) be received by the department within 30
				days of mailing of the department's ability to pay determination letter;
				and
(e) be mailed or delivered to
				the Department of Public Health and Human Services, Fiscal Services Division,
				111 N. Sanders, P.O. Box 6420, Helena, MT 59604-6420.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.901 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of the community services
				block grant is to alleviate the causes of poverty within the state.
Sec.
					 53-2-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.902 - DEFINITIONS

Current through Register Vol. 13, July 5, 2024
For purposes of this subchapter, the following definitions
				  apply:
(1) "Act" means the Omnibus
				Budget Reconciliation Act of 1981.
(2) "Contractor" means human resource
				development council, one of the state's 10 organizations designated as a
				community action agency under the provisions of section 210 of the Economic
				Opportunity Act of 1964 which is a nonprofit community organization serving low
				income persons in a multicounty area that has the same boundaries as one or
				more substate planning districts established by executive order of the
				governor.
(3) "County" means the
				board of county commissioners.
(4)
				"CSBG" means the community services block grant.
(5) "Department" means the department of
				public health and human services.
(6) "Director" means the director of the
				department of public health and human services.
(7) "Poverty line" means the official poverty
				line established by the director of the federal office of management and
				budget.
Sec.
					 53-2-201,
					 MCA; IMP, HB 2 of the First Special Session, 1981 and Sec.
					 53-10-501,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.906 - CONTRACTOR PLAN

Current through Register Vol. 13, July 5, 2024
(1) To receive its
				allotment of CSBG funds, as determined under ARM
				37.2.915, each contractor must
				submit, by October 1 of each year, its contractor plan to the department for
				review and approval. If the federal CSBG appropriation has not been determined
				to such a degree that estimates of allocations are feasible, the submittal date
				will be revised accordingly.
Sec.
					 53-2-201,
					 MCA; IMP, HB 2 of the First Special Session, 1981 and Sec.
					 53-10-504,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.907 - CONTRACTOR PLAN ASSURANCES AND CONTENT

Current through Register Vol. 13, July 5, 2024
(1) A
				contractor must assure in its contractor plan that it will only use the funds:
(a) to provide a range of services and
				activities having a measurable and potentially major impact on causes of
				poverty in the community or those areas of the community where poverty is a
				particularly acute problem;
(b) to
				provide activities designed to assist low income participants including the
				elderly poor:
(i) to secure and retain
				meaningful employment;
(ii) to
				attain an adequate education;
(iii)
				to make better use of available income;
(iv) to obtain and maintain adequate housing
				and a suitable living environment;
(v) to obtain emergency assistance through
				loans or grants to meet immediate and urgent individual and family needs,
				including the need for health services, family needs, including the need for
				health services, nutritious food, housing and employment related
				assistance;
(vi) to remove
				obstacles and solve problems which block the achievement of
				self-sufficiency;
(vii) to achieve
				greater participation in the affairs of the community; and
(viii) to make more effective use of other
				programs related to the purpose of this subchapter.
(c) to provide on an emergency basis for the
				provision of such supplies and services, nutritious foodstuffs, and related
				services, as may be necessary to counteract conditions of starvation and
				malnutrition among the poor;
(d) to
				coordinate and establish linkages between governmental and other social
				services programs to assure the effective delivery of services to low income
				individuals;
(e) to encourage the
				use of entities in the private sector of the community in efforts to ameliorate
				poverty in the community; and
(f)
				to meet department-identified priorities which address one or more of the
				eligible activities described in (1) (a) through (e).
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.908 - CONTRACTOR PLAN APPROVAL, DISAPPROVAL, AMENDMENTS

Current through Register Vol. 13, July 5, 2024
(1) The contractor shall submit the plan to
				the county governing bodies within its multicounty area. A county governing
				body may approve, disapprove, or offer amendments to the plan. If the county
				governing body and the contractor cannot agree as to the plan's components, the
				department shall prepare and approve a plan for such county.
(2) The department will, within 45 working
				days of plan receipt, notify the contractor of approval/disapproval of each
				contractor plan.
(3) The department
				will base its review of the contractor plan on whether or not:
(a) the contractor plan demonstrates that it
				provides a range of services and activities having a measurable and potentially
				major impact on causes of poverty in the community, or those areas of the
				community where poverty is a particularly acute problem;
(b) all assurances and requirements of ARM
				37.2.907 have been met.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.915 - CONTRACTOR ALLOTMENTS

Current through Register Vol. 13, July 5, 2024
(1) From the
				available CSBG funds, the department shall retain 5% for cost of administration
				of the grant and 5% for special projects.
(2) The balance of the block grant funds
				after any retention pursuant to (1) must be distributed to contractors that are
				eligible to receive such funding as follows:
(a) $500,000, or if the balance of the block
				grant funds is less than $500,000, then the entire balance of the block grant
				funds must be equally divided among the eligible contractors; and
(b) the balance of the block grant funds
				after distribution under (1) and (2) (a) must be divided among eligible
				contractors as follows:
(i) one-half based
				upon the percentage of the state's population residing within the contractor's
				area; and
(ii) one-half based upon
				the percentage of the state's population with income below the poverty line
				residing within the contractor's area.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.916 - RELEASE OF ALLOTMENTS

Current through Register Vol. 13, July 5, 2024
(1) Release of
				allotments is contingent upon receipt by the department of the federal CSBG
				funds. As those funds are received, they will be disbursed by the
				department.
Sec.
					 53-2-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.920 - REPORTS

Current through Register Vol. 13, July 5, 2024
(1) Within 90 days of the end of the grant
				period or the completion of a contractor's planned activities, whichever comes
				first, the contractor will submit to the department certification that all
				assurances and services or activities contained in its approved plan have been
				complied with and achieved.
(2)
				Upon request, the contractor will submit to the department any reports, forms
				or documents deemed necessary in order to determine how the funds were expended
				and for which services or activities.
Sec.
					 53-2-201,
					 MCA;
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.9 - Community Services Block Grants › Rule 37.2.925 - TERMINATION OR REDUCTION OF ALLOTMENT

Current through Register Vol. 13, July 5, 2024
(1) The
				allotment of a contractor who currently receives CSBG funding or who received
				funding in the previous program period can be terminated or reduced below the
				proportional share currently being received or received in the previous program
				period only for cause. The term "cause" includes but is not limited to:
(a) a statewide redistribution of funds in
				response to:
(i) the results of the most
				recent available census or other appropriate data;
(ii) the establishment of a new entity
				eligible for funding; or
(iii)
				severe economic dislocation; or
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.11 - State Reimbursement Rate for Health Care Providers › Rule 37.2.1101 - PURPOSE

Current through Register Vol. 13, July 5, 2024
(1) The purpose of
				these rules is to implement
				53-6-1312,
				MCA, which establishes the Medicaid schedule of rates as the reimbursement
				rates that the State of Montana (State) pays for health care services provided
				to an individual who does not qualify for Medicaid, Medicare, a health insurer,
				or another private or governmental program that pays for health care costs and
				is:
(a) in the custody of the Department of
				Corrections; or
(b) a resident, by
				commitment or otherwise, of the Montana State Hospital, the Montana Mental
				Health Nursing Care Center, the Montana Chemical Dependency Center, or the
				Montana Developmental Center.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.11 - State Reimbursement Rate for Health Care Providers › Rule 37.2.1102 - A PROVIDER MUST ENROLL IN MEDICAID AND ACCEPT THE MEDICAID REIMBURSEMENT RATE TO RECEIVE PAYMENT BY STATE

Current through Register Vol. 13, July 5, 2024
(1) To receive
				payment from the State for health care services provided to an individual
				identified in
				53-6-1312,
				MCA, a provider must:
(a) be enrolled as a
				Montana Medicaid provider;
(b)
				accept the Montana Medicaid rates as full payment for all health care services;
				and
(c) comply with the
				requirements of this subchapter.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.11 - State Reimbursement Rate for Health Care Providers › Rule 37.2.1103 - PROVIDER REQUIREMENTS

Current through Register Vol. 13, July 5, 2024
(1) Except for the
				administrative rules listed in (2), the provider requirements of ARM Title 37,
				chapter 85, subchapter 4, "Provider Requirements," apply to the delivery of
				health care services provided to an individual identified in
				53-6-1312,
				MCA. For purposes of this subchapter, a reference to "Montana Medicaid" or
				"Medicaid" in ARM Title 37, chapter 85, subchapter 4 is understood to mean
				payments made under
				53-6-1312,
				MCA.
(2) The following
				administrative rules do not apply to providers receiving payment for services
				provided to an individual identified in
				53-6-1312,
				MCA:
(a) ARM
				37.85.407, Third Party
				Liability;
(b) ARM
				37.85.411, Provider
				Rights;
(c) ARM
				37.85.415, Medical Assistance
				Medicaid Payment; and
(d) ARM
				37.85.416, Statistical Sampling
				Audits.
Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.2 - DEPARTMENT PROCEDURES › Subchapter 37.2.11 - State Reimbursement Rate for Health Care Providers › Rule 37.2.1104 - COST SHARING DOES NOT APPLY

Current through Register Vol. 13, July 5, 2024
(1) The cost
				sharing requirements of ARM
				37.85.204 and 37.85.204 do not
				apply to the individuals identified in
				53-6-1312,
				MCA. An individual identified in
				53-6-1312,
				MCA, is neither a member nor a program participant as defined at
				53-6-1302,
				MCA.
AUTH:
					 53-6-1318,
					 MCA; IMP:
					 53-6-1312,
					 MCA