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Community Services Bureau

Community Services for Seniors and People with Disabilities

Mission

The mission of the Community Services Bureau is to address the needs of Medicaid eligible Montanans who require assistance and support in meeting their on-going health needs by developing, managing, funding, and ensuring quality in home-based services that foster independence and dignity, contain costs, and provide options to consumers.

A wide range of community-based long term care services have been developed. They are designed to keep people independent and living in their communities for as long as possible.

Many individuals in need of long term care services choose to remain in their own homes or select other community options to meet their needs. The Community Services Bureau administers a number of Medicaid-funded options that enable people who are aged or disabled and have limited income and resources to remain in their homes, rather than receive services in a hospital or nursing facility.

Community Services Bureau staff are located throughout the State. Staff monitor services, provide training for local staff, assist people in accessing services and implement policy.

Montana Big Sky Waiver Program

Montana Big Sky Home and Community Based Services Program

The Home and Community Based Services program allows people, who would otherwise be institutionalized, to live in their own home and community. The services are made available through the Department of Public Health & Human Services (DPHHS) and the Senior and Long Term Care Division (SLTC).

HCBS Services

Case Management Teams (CMT) consist of a nurse and social worker and provide a holistic approach to care planning. They look at each individual’s medical and psychosocial needs and then develop a plan of care based on the person’s needs and choices. Each Case Management Team has a fixed number of individuals they can serve per year. The following are examples of services that may be available through HCBS:

  • Adult Residential Living
  • Adult Day Health
  • Case Management
  • Chemical Dependency Counseling
  • Dietician
  • Environmental Adaptations
  • Habilitation Services
  • Homemaker Services
  • Nutrition
  • Personal Assistance
  • PERS
  • Private Duty Nursing
  • Psychosocial Consultation
  • Respiratory Therapy
  • Respite Care
  • Special Child Care
  • Transportation
  • Therapies (OT, PT, Speech)
  • Specially Trained Attendant
  • Specialized medical equipment and supplies
  • Services for Individuals with Traumatic Brain Injury

Eligibility

To qualify for the HCBS Program, a recipient must be financially eligible for Medicaid and meet the minimum level of care requirements for nursing facility placement. Individuals must have an unmet need that can only be resolved through a home & community based service in order to qualify for the program. Currently, there are waiting lists for HCBS Services.

Where do I find assisted living and other health care facilities?

Regulated Health Care Facilities These facility lists have been compiled by the Licensure Bureau of the Quality Assurance Division. Because the information herein contained is otherwise open to public inspection, dissemination of this list does not violate the provisions of 2-6-109, Montana Code Annotated, which prohibits state agencies from distributing any mailing list without first securing the permission of those who are a part of the list. It is not the intent of the Licensure Bureau that this list be used for any unsolicited commercial activity.

How to apply for HCBS?

To make a referral for Home & Community Based Services contact the Mountain Pacific Quality Health Foundation at 1-800-219-7035.

Eligibility specialists at your County Office of Public Assistance (OPA office) can determine Medicaid eligibility.

Community First Choice (CFC)/Personal Assistance Services (PAS)

Community First Choice/Personal Assistance Programs

The Community First Choice and Personal Assistance Services (PAS) Programs are programs designed to provide long term supportive care in a home setting. These programs enable thousands of elderly and disabled citizens to remain in their homes. The type of care authorized is tailored to each individual in a person centered manner and dependent upon their needs, living situation, and availability of caregivers.

Services available through the CFC/PAS Program include the Activities of Daily Living:

  • Bathing,
  • Dressing,
  • Grooming,
  • Toileting,
  • Eating,
  • Medication assistance,
  • Ambulation and exercising.
  • Medical escort is also available.

Under the PAS program there is additional time for limited grocery shopping, housekeeping and laundry. Under the CFC program there is also additional time for community integration, yard hazard removal for the purpose of providing safe access and entry to the home, correspondence assistance and personal emergency response system.

The CFC/PAS Program does not pay for tasks such as yard work other than authorized task to assure health and safety, household repair or modifications, major cleaning, shopping for non-essential items, escort to non-medical services, pet care, or general transportation. Some of these tasks are allowed through the waiver program depending upon an individual’s needs and required level of care.

Self-Direct Service Options

There two options under which CFC/PAS eligible individuals can choose to receive their services: Agency Based CFC/PAS (AB-CFC/PAS) or Self-Direct CFC/PAS (SD-CFC/PAS). The SD-CFC/PAS program was developed for individuals who wish to direct their own care. The person or their Personal Representative is responsible for hiring, training, and managing their Personal Care Attendants (PCA). Under the SD-CFC/PAS program only, individuals can be authorized by their health care professional to receive the above mentioned services provided by their personal care attendant as well as any of the following four skilled services: bowel program, catheter care, medication assistance, or wound care. Anytime a consumer chooses Self-Direct CFC/PAS, they must obtain authorization from their health care professional. The consumer or their personal representative must also meet capacity, which means they can demonstrate a thorough understanding of the program requirements.

Eligibility

Eligibility requirements for both AB-CFC/PAS and SD-CFC/PAS include:

  1. have a health condition that limits your ability to perform activities of daily living,
  2. participate in the screening process; and
  3. be eligible for Medicaid.

In order to qualify for the CFC program a consumer must also meet level of care.

For information on eligibility and member services go to: http://dphhs.mt.gov/MontanaHealthcarePrograms.

For more information please contact:

Abby Holm, Program Manager, 406-444-4564

Home Health

Home Health Program

Home Health services are part-time nursing and restorative therapy services provided in the home to eligible people who require these services. The goal of the Home Health Services Program is to avoid unnecessary hospital or nursing facility stays by providing skilled nursing or therapy services in the home.

Who is eligible?

To receive Medicare covered home health services, a physician must certify that the member is confined to his/her home (i.e. homebound). The member's condition should be such that there is a normal inability to leave home, and consequently, leaving home would require a considerable and taxing effort.

A patient is considered home bound if the following two criteria are met:

Criteria One: The patient must either:

  • Because of illness or injury, need the aid of supportive devices or the assistance of another person to leave their place of residence

OR

  • Have a condition such that leaving the home is contraindicated.

If the member meets one of the Criteria-One conditions, then the member must ALSO meet the two additional requirements defined in Criteria-Two.

Criteria-Two:

  • There must exist a normal inability to leave home;

AND

  • Leaving home must require a considerable and taxing effort.

If the member does leave home, they may still be considered homebound if the absences are infrequent, for short periods, or to receive health care. These may include:

  • Attendance at adult day care
  • Ongoing outpatient kidney dialysis
  • Receive outpatient chemotherapy or radiation.

Contact Information

Micky Brown, Home Health Program Manager, (406) 444-6064

Hospice

Hospice

Hospice is a program of care and support for people who are terminally ill and have chosen not to pursue curative treatment.  Hospice is palliative care only, in other words, services are aimed at comfort not curing an illness . (Children under the age of 18 years of age may continue curative treatment while receiving hospice services.) A specially trained team of professionals and caregivers provide care for the "whole person," including his or her physical, emotional, social and spiritual needs. Services include physical care, counseling, drugs, equipment, and supplies for the terminal illness and related condition. Support is given to the individual and his or her family members.

Who is eligible?

A member is eligible for hospice services if he or she meets all of the following conditions:

  • the individual is eligible for Medicaid;

  • the individual's doctor and the hospice medical director certify that the individual is terminally ill;and has six months or less to live if the illness runs its normal course;

  • the individual signs a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness. Medicare will pay for covered benefits for any health problems that are not related to the individual's terminal illness; and

  • treatment is delivered by a Medicare-approved hospice program.

If you are interested in more information about Hospice services, please contact: Micky Brown, Hospice Program Manager, at (406) 444-6064.

Aging Services to Improve Independence

Aging Services

The State Unit on aging administers a wide variety of senior based services for Montana residents who are age 60 or older. Programs and services are primarily delivered by a network of 10 Area Agencies on Aging which reach all geographic areas of the state. Our goal is to provide services that allow seniors to remain independent.

Older adults are offered a choice in living and care arrangements. We also have programs to protect their rights and personal autonomy. Please review the column on the left for more information on the programs we provide.

Newsletter - Aging Horizons

What's New in Aging

Area Agencies on Aging

Montana's Older American Act

Long Term Care Insurance

Montana Senior Medicare Patrol (SMP)

Aging and Disability Resource Center