1. Program Definition and Services Provided 

Case Management services in Montana are designed to assist individuals in accessing necessary services and coordinating care among various providers. These services include developing a case management plan, identifying client needs, and ensuring self-sufficiency in obtaining services. They are crucial for individuals with complex needs, such as those with disabilities or serious emotional disturbances. 

2. Regulations 

Key regulations governing Case Management services include: 

• Mont. Admin. r. 37.86.3305: This regulation outlines general provisions for case management services, emphasizing coordination and client self-sufficiency. 

• Mont. Admin. r. 37.87.823: This rule specifies requirements for targeted case management services for youth with serious emotional disturbances. 

3. Licensing or Certification 

To provide Case Management services, providers must be enrolled as Medicaid providers if they are to be reimbursed through Medicaid. For targeted case management services, providers must meet specific requirements, such as being licensed mental health centers. Staff certifications like the Certified Case Manager (CCM) credential can be beneficial. 

4. Responsible State Agency 

The Montana Department of Public Health & Human Services (DPHHS) is responsible for overseeing Medicaid-funded case management services. 

5. Application Process 

For Medicaid provider enrollment, agencies must submit an application through the state's Medicaid enrollment process. For targeted case management services, providers must meet specific licensure and enrollment criteria. 

6. Required Documentation 

For Medicaid provider enrollment: 

• Completed application form 

• Proof of licensure (if applicable) 

• Proof of liability insurance 

• Staff training records 

For clients seeking services: 

• Proof of Medicaid eligibility 

• Documentation of need for case management services 

7. Timeline for Approval 

The timeline for Medicaid provider enrollment can vary, typically taking several weeks to a few months. 

8. Pre-Application Process 

There is no specific pre-license application process, but providers must ensure they meet Medicaid enrollment criteria. 

9. Pre-Application Training 

While not mandated, training in case management principles and practices can enhance provider expertise. For targeted case management services, case managers must receive specific training, including initial and ongoing education requirements. 

10. Additional Notes 

• Case Management services are essential for coordinating care and ensuring access to necessary services for individuals with complex needs. 

• Programs like Yellowstone Boys and Girls Ranch offer case management services to youth and young adults, focusing on mental health and supportive services.