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0208 Comprehensive DD Waiver Services

Qualified Provider Standards
Effective 7/1/2013

Adult Companion Services

Service Delivery Method (check each that applies):
checkbox   Participant-directed as specified in Appendix E
checkbox   Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox   Relative
checkbox Legal Guardian

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP.
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

  • Adult Foster Support

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP - Residential Training Support Only.
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Residential Training Supports is reimbursable only when delivered to a person living in a licensed adult foster home funded under Adult Foster Supports.
The staffing rule as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP - Adult Foster Supports & RTS.
Provider Qualifications
License (specify):
MCA 50-5-101 through
MCA 50-5-216
Certificate (specify):
Other Standard (specify):
ARM 37.100.101 through 37.100.175
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service. Quality Assurance Division of DPHHS
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the DD service provider agency, prior to authorization of payment. Licensure status reviewed annually by Quality Assurance Division of DPHHS
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Licensed Adult Foster Supports enrolled as a Montana Medicaid provider and contracting directly with
DDP
Provider Qualifications
License (specify):
Licensed in accordance with MCA 50-5-101 through 50-5-216
Certificate (specify):
Other Standard (specify):
ARM 37.100.101 through 37.100.175
Verification of Provider Qualifications
Entity Responsible for Verification: Quality Assurance Division of DPHHS
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.
Licensure status reviewed annually by Quality Assurance Division of DPHHS

Adult Foster Support

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox Legal Guardian

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP - Residential Training Support Only.
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Residential Training Supports is reimbursable only when delivered to a person living in a licensed adult foster home funded under Adult Foster Supports.
The staffing rule as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP - Adult Foster Supports & RTS.
Provider Qualifications
License (specify):
MCA 50-5-101 through
MCA 50-5-216
Certificate (specify):
Other Standard (specify):
ARM 37.100.101 through 37.100.175
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service. Quality Assurance Division of DPHHS
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the DD service provider agency, prior to authorization of payment. Licensure status reviewed annually by Quality Assurance Division of DPHHS
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Licensed Adult Foster Supports enrolled as a Montana Medicaid provider and contracting directly with
DDP
Provider Qualifications
License (specify):
Licensed in accordance with MCA 50-5-101 through 50-5-216
Certificate (specify):
Other Standard (specify):
ARM 37.100.101 through 37.100.175
Verification of Provider Qualifications
Entity Responsible for Verification: Quality Assurance Division of DPHHS
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.
Licensure status reviewed annually by Quality Assurance Division of DPHHS

Assisted Living

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
Licensed Assisted Living Facility enrolled as a Montana Medicaid provider and contracting directly with
DDP
Provider Qualifications
License (specify):
Licensed in accordance with MCA 50-5-101
MCA 50-5-225 through 50-5-228
Certificate (specify):
Other Standard (specify):
ARMs 37.106.2801 through 37.106.2908 apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Quality Assurance Division of DPHHS
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
Licensure status reviewed annually by Quality Assurance Division of DPHHS
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Behavioral Support Services

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for Behavioral Support
Services
Provider Qualifications
License (specify):
Certificate (specify):
A person who meets the requirements of ARM 37.34.1422 (2)
Other Standard (specify):
A Montana Department of Justice background check is required.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the DD service provider agency, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
A person who meets the requirements of ARM 37.34.1422 (2)
Other Standard (specify):
A Montana Department of Justice background check is required.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
An individual enrolled as a Montana Medicaid provider and contracting directly with DDP
Provider Qualifications
License (specify):
Certificate (specify):
A person who meets the requirements of ARM 37.34.1422 (2)
Other Standard (specify):
A Montana Department of Justice background check is required.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Caregiver Training and Support

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for CTS services to persons
0 through 15 years of age
Provider Qualifications
License (specify):
Certificate (specify):
Family Support Specialist certification in accordance with DDP policies regarding FSS certification for CTS services.
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for CTS services to persons
16 years of age and older
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
This position requires a BA degree in a human services field and a minimum of 3 years of experience in the field of developmental disabilities services.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DDP Service Provider Agency under contract with the DDP for CTS services to persons 0 through 15 years.DD provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Family Support Specialist certification in accordance with DDP policies regarding FSS certification
for CTS services.
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP for CTS to persons 16 and older.DD provider
agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
This position requires a BA degree in a human services field and a minimum of 3 years of experience in the field of developmental disabilities services.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Community Transition Services

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
This includes supports to persons living in a residence that is owned, leased or rented by the individual and must be considered their private residence.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A person or representative choosing to self-direct with employer authority may elect to purchase community transition services and supports, in accordance with the requirements outlined in the service definition, and receive reimbursement from the FMS.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is responsible for ensuring that services and supports purchased on behalf of the person do not exceed individual cost plan allocation for this service, and all documentation requirements have
been met prior to issuing reimbursement.
Frequency of Verification:
The DDP QIS annually reviews a sample of the service standards with one or more performance
measures to ensure that services comply with the QP standards and documentation requirements.

Day Supports and Activities

Service Delivery Method (check each that applies):
checkbox Participant-directed as specified in Appendix E
checkbox Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Environmental Modifications/Adaptive Equipment

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
Independent Contractor qualified to perform environmental modifications, enrolled as a Montana
Medicaid provider and contracting directly with DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A qualified provider designated to either reimburse the individual for the procurement of individual goods and services, or for providing the requested goods and services is responsible for meeting all
the requirements outlined in the DDP contract.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP - Environmental modifications.DD service
provider agency under contract with the DDP and subcontracting for Environmental Mods/Adaptive Eqip
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A qualified provider designated to either reimburse the individual for the procurement of individual goods and services, or for providing the requested goods and services is responsible for meeting all the requirements outlined in the DDP contract.
The staffing rule as outlined in ARM 37.34.2101-37.34.2111.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Independent Contractor qualified to provide adaptive equipment, enrolled as a Montana Medicaid
provider and contracting directly with DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A qualified provider designated to either reimburse the individual for the procurement of individual goods and services, or for providing the requested goods and services is responsible for meeting all the requirements outlined in the DDP contract.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A person or representative choosing to self-direct with employer authority may elect to purchase environmental modifications and adaptive equipment from an approved vendor, in accordance with the requirements outlined in the service definition, and receive reimbursement from the FMS.
Upon hiring of a person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is responsible for ensuring that services and supports purchased on behalf of the person do
not exceed individual cost plan allocation for this service, and all documentation requirements have been met prior to issuing reimbursement.
Frequency of Verification:
The DDP QIS annually reviews a sample of the service standards with one or more performance measures to ensure that services are in compliance with the QP standards and documentation requirements.

Homemaker

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for Homemaker services
Provider Qualifications
License (specify):
Workers are employees of a business entity, licensed, bonded and insured to deliver professional homemaker services
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
Qualifications of the person providing the homemaker service will be reviewed and approved by the contracting agency and the individual and family, if applicable.
The family or individual can request the provider subcontracting with the business entity to complete a background check of the worker at no cost to the employer/person in services.
Verification of Provider Qualifications
Entity Responsible for Verification:
DDP waiver funded agency subcontracting for homemaker services. Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Homemaker entity enrolled as a Montana Medicaid Provider and contracting directly with the DDP
Provider Qualifications
License (specify):
Workers are employees of a business entity, licensed, bonded and insured to deliver professional homemaker services
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
Qualifications of the person providing the homemaker service will be reviewed and approved by the contracting agency and the individual and family, if applicable.
The family or individual can request the business entity complete a background check of the worker at no cost to the person in services.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Individual Goods and Services

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A qualified provider designated to either reimburse the individual for the procurement of individual goods and services, or for providing the requested goods and services is responsible for meeting all
the requirements outlined in the DDP contract.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A person, or the representative choosing to self-direct with employer authority may elect to purchase goods and services, in accordance with the requirements outlined in the service definition, and receive reimbursement from the FMS.
Upon hiring of a person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is responsible for ensuring that goods and services purchased on behalf of the individual do not exceed individual cost plan allocation for this service, and all documentation requirements have been met prior to issuing reimbursement.
Frequency of Verification:

The DDP QIS annually reviews a sample of the service standards with one or more performance measures to ensure that services are in compliance with the QP standards and documentation requirements.

Job Discovery/Job Preparation

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Job Discovery:
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course, and
*other competencies as required by DDP.
*training in areas specific to the needs of the individual, as outlined in the training plan included in
the Self-Direct with Employer Authority Plan of Care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Completion of Employment Specialist Training Curriculum in accordance with DDP requirements.
Any other training requirements as outlined by the Department.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
In addition, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Job Preparation
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course, and
*other competencies as required by DDP.
*training in areas specific to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Any other training requirements as outlined by the Department.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
In addition, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is initially responsible for ensuring that a worker meets the qualified provider standards and the FMS maintains records serving to document the compliance with these standards.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Job Discovery:
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Job Preparation:
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Job Discovery:
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course,
*training in areas specific  to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care, and
*other competencies as required by DDP.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Completion of Employment Specialist Training Curriculum in accordance with DDP requirements.
Any other training requirements as outlined by the Department.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Job Preparation:
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course,
*training in areas specific to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care, and
*other competencies as required by DDP.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Any other training requirements as outlined by the Department.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Live-in Caregiver (42 CFR §441.303(f)(8))

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox Relative
checkbox Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP.DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify): Certificate (specify):
Other Standard (specify):
The staffing rule as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP
requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Meals

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
Meals service provider enrolled as a Montana Medicaid provider and contracting directly with DDP.DD
service provider agency under contract with the DDP and subcontracting for Meals
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Program authorized as outlined in 42 USC 3030e Subpart b2, Sections 336 and 337
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A person or representative choosing to self-direct with employer authority may elect to purchase meals from an approved vendor for the person, in accordance with the requirements outlined in the service definition, and receive reimbursement from the FMS.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is responsible for ensuring that services and supports purchased on behalf of the person do not exceed individual cost plan allocation for this service, and all documentation requirements have been met prior to issuing reimbursement.
Frequency of Verification:
The DDP QIS annually reviews a sample of the service standards with one or more performance measures to ensure that services are in compliance with the QP standards and documentation requirements.

Nutritionist

Service Delivery Method (check each that applies)
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
Licensed Nutritionist, enrolled as a Montana Medicaid provider and contracting directly with DDP
Provider Qualifications
License (specify):
Licensed nutritionist- MCA 37-25-101 through 37-25-308
Certificate (specify):
Other Standard (specify):
Licensed Nutritionist- ARM 24.156.1301 through ARM 24.156.1308
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for Nutritionist Services
Provider Qualifications
License (specify):
Licensed nutritionist- MCA 37-25-101 through 37-25-308
Certificate (specify):
Other Standard (specify):
Licensed Nutritionist- ARM 24.156.1301 through ARM 24.156.1308
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Licensed nutritionist- MCA 37-25-101 through 37-25-308
Certificate (specify):
Other Standard (specify):
Licensed Nutritionist- ARM 24.156.1301 through ARM 24.156.1308
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified  by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Occupational Therapy

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian
Provider Category:
Individual
Provider Type:
Licensed occupational therapist enrolled as a Montana Medicaid provider and contracting directly with
DDP
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 24.165.401 through 24.165.2301
Certificate (specify):
Other Standard (specify):
MCA 37-24-101 through 37-24-311apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 24.165.401 through 24.165.2301
Certificate (specify):
Other Standard (specify):
MCA 37-24-101 through 37-24-311 apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP & subcontracting for OT Services
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 24.165.401 through 24.165.2301
Certificate (specify):
Other Standard (specify):
MCA 37-24-101 through 37-24-311 apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the DD service provider agency, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Personal Care

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for Personal Care services
Provider Qualifications
License (specify):
Agencies are licensed, bonded and insured to deliver personal care services, and enrolled as a Medicaid provider.
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency contracting with the home health agency providing the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialized training unique to the needs of the individual, as outlined in the plan of care.
Completion of first aid and CPR in accordance with DDP requirements.
Persons assisting with meds will be med certified in accordance with ARM 37.34.114.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

Prior to initiating a DDP contract and annually thereafter.
Personal Emergency Response System (PERS)

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian
Provider Category:
Individual
Provider Type:
A person or representative self directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A person or representative choosing to self-direct with employer authority may elect to purchase personal emergency response goods and services, in accordance with the requirements outlined in the service definition, and receive reimbursement from the FMS.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is responsible for ensuring that services and supports purchased on behalf of the person do
not exceed individual cost plan allocation for this service, and all documentation requirements have been met prior to issuing reimbursement.
Frequency of Verification:
The DDP QIS annually reviews a sample of the service standards with one or more performance measures to ensure that services are in compliance with the QP standards and documentation requirements.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP.DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A qualified provider designated to either reimburse the individual for the procurement of individual goods and services, or for providing the requested goods and services is responsible for meeting all
the requirements outlined in the DDP contract.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Personal Supports

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course,
*training in areas specific to the needs of the individual, as outlined in the training plan included in
the Self-Direct with Employer Authority Plan of Care, and
*other competencies as required by DDP.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Any other training requirements as outlined by the Department.
Upon hiring of a direct care staff person, the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
In addition, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is initially responsible for ensuring that a worker meets the qualified provider standards and the FMS maintains records serving to document the compliance with these standards.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course,
*training in areas specific  to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care, and
*other competencies as required by DDP.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Any other training requirements as outlined by the Department.
In addition, Employer will maintain documentation verifying the person providing direct services
has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Physical Therapy

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian
Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 8.42.101 through 8.42.503
Certificate (specify):
Other Standard (specify):
MCA 37-11-101 through 37-11-322 shall apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP & subcontracting for PT Services
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 8.42.101 through 8.42.503
Certificate (specify):
Other Standard (specify):
MCA 37-11-101 through 37-11-322 shall apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the DD service provider agency, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Licensed physical therapist enrolled as a Montana Medicaid provider and contracting directly with DDP
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 8.42.101 through 8.42.503
Certificate (specify):
Other Standard (specify):
MCA 37-11-101 through 37-11-322 shall apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Private Duty Nursing

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
An agency providing qualified LPN or RN services and enrolled as a Montana Medicaid  provider  and contracting directly with DDP
Provider Qualifications
License (specify):
Registered in accordance with MCA 37-8-101 through 37-8-444
Certificate (specify):
Other Standard (specify):
ARMS 8.32.101 through 8.32.507 apply
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Registered in accordance with MCA 37-8-101 through 37-8-444
Certificate (specify):
Other Standard (specify):
ARMS 8.32.101 through 8.32.507 apply
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Psychological Services

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox Relative
checkbox Legal Guardian

Provider Category:
Individual
Provider Type:
Licensed Clinical Social Worker enrolled as a Montana Medicaid provider and contracting directly with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with Montana ARM
24.219.504
Certificate (specify):
Other Standard (specify):
ARMS 24.219.101 through 24.219.615 govern the licensure of persons licensed to practice clinical social work
MCA-37.22.101 through 37.22.411 outlining the requirements for licensed clinical social workers.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with Montana ARM
24.219.504 and 24.219.604
Certificate (specify):
Other Standard (specify):
In addition, the ARM and MCA site references for these professionals apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP & subcontracting for Psychological Services
Provider Qualifications
License (specify):
Licensed in accordance with Montana ARM
24.219.504 and 24.29.604
Certificate (specify):
Other Standard (specify):
The ARM and MCA site references for these professionals apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Applicable standards are verified by the DD service provider agency.
Frequency of Verification:
Prior to initiating a DDP contract and annually thereafter.
As needed by the provider, prior to authorization of payment.

Provider Category:
Individual
Provider Type:
Licensed Professional Counselor, enrolled as a Montana Medicaid provider and contracting directly with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with Montana ARM
24.219.504 and 24.219.604
Certificate (specify):
Other Standard (specify):
ARM 24.219.101 through 24.219.615 governing the licensure of persons practicing professional counseling
MCA 37-23-101 through 37.23.311 outlines the licensure requirements for a licensed professional counselor.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Licensed Psychologist, enrolled as a Montana Medicaid provider and contracting directly with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with Montana ARM 24.189.601
Certificate (specify):
Other Standard (specify):
ARM 24.189.101 through 24.189.2401 governing the licensure of persons licensed to practice psychology.
MCA 37-17-101 through 37-17-318 outlining the qualifications of a licensed psychologist
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Remote Monitoring

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox Relative
checkbox Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP.DDP provider agency under contract with the DDP and subcontracting for Remote Monitoring services
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the needs of the individual served, as outlined in the plan of care.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Remote Monitoring Equipment

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox Relative
checkbox Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP.DDP provider agency under contract with the DDP and subcontracting for Remote Monitoring Equipment
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
A qualified provider designated to either reimburse the subcontractor for the procurement of remote
monitoring equipment, or for providing the requested remote monitoring equipment is responsible for meeting all the requirements outlined in the DDP contract.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.

Prior to initiating a DDP contract and annually thereafter.
Residential Habilitation

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Residential habilitation is reimbursable in all community based residential settings, except the provision of this service in DD community group homes is contingent upon State licensure for these facilities. DD group home licensure requirements may be reviewed in ARM 37.100.301 through 37.100.340 and MCA 53-20-301 through 53-20-307.
Certificate (specify):
Other Standard (specify):
The staffing rule as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care. Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP
requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
DPHHS Quality Assurance Division (QAD) for compliance with group home licensing standards, if applicable.
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
QAD licensing study is annual.

As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Respite

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 16 years of age. Only employees 18 years of age and over are permitted to provide services that are medical in nature.
Within 30 days of hire receive training in:
*must complete a first aid course, and
*have training in areas specific  to the needs of the individual, as outlined in the training plan included in the Self-Direct with Employer Authority Plan of Care.
* the person is subject to a criminal background check (at the request of the individual or legal representative).
For self-directed respite using the fiscal agent a background check is optional. In the self-direct using the fiscal agent respite employees can be 16 years of age and background checks may not be accurate for someone under 18 in the state of Montana.  Employers are typically hiring a family member to the waiver participant or someone they already know, therefore the background check is optional.
If a background check is requested, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is initially responsible for ensuring that a respite worker meets the qualified provider standards and the FMS maintains records serving to document the compliance with these standards.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP.DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*must complete a first aid course, and
*have training in areas specific  to the needs of the individual, as outlined in the training plan included in the Self-Direct with Employer Authority Plan of Care.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.
Retirement Services

Service Delivery Method (check each that applies):
checkbox Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox   Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Retirement services is reimbursable in all community based residential settings, except the provision of this service in DD community group homes is contingent upon State licensure for these facilities.  DD group home licensure requirements may be reviewed in ARM 37.100.301 through 37.100.340 and MCA 53-20-301 through 53-20-307.
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality,
*any specialty training relating to the need of the individual served, as outlined in the plan of care. Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
DPHHS Quality Assurance Division (QAD) for compliance with group home licensing standards, if applicable.
Applicable standards are verified by the DD service provider agency. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
QAD licensing study is annual.

As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.
Speech Therapy

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian
Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 24.222.101 through 24.222.2407
Certificate (specify):
Other Standard (specify):
MCA 37-15-101 through 37-15-323 shall apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
Licensed speech language pathologist (speech therapist), enrolled as a Montana Medicaid provider and
contracting directly with the DDP
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 24.222.101 through 24.222.2407
Certificate (specify):
Other Standard (specify):
MCA 37-15-101 through 37-15-323 shall apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP subcontracting for Speech Therapy Services
Provider Qualifications
License (specify):
Licensed in accordance with applicable ARMs 24.222.101 through 24.222.2407
Certificate (specify):
Other Standard (specify):
MCA 37-15-101 through 37-15-323 shall apply.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service. Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

As needed by the DD service provider agency, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.

Supported Employment - Co-Worker Support

Service Delivery Method (check each that applies):
checkbox Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
Employer enrolled as a Montana Medicaid provider and contracting directly with DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The co-worker is the person who must meet the qualified provider standards of the waiver while the stipend is reimbursed to the employer.
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Any specialty training relating to the needs of the individual served, as outlined in the plan of care.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process.
Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP offering agency with choice employer authority. DD service provider agency under contract with the DDP subcontracting with employer
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The co-worker is the person who must meet the qualified provider standards of the waiver while the
stipend is reimbursed to the employer.
The staffing rules as outlined in ARM 37.34.2101-37.34.2111. Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Any specialty training relating to the needs of the individual served, as outlined in the plan of care.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The co-worker is a qualified provider of the waiver.
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Any specialty training relating to the needs of the individual served, as outlined in the plan of care. Upon hiring of a person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is initially responsible for ensuring that a worker meets the qualified provider standards and the FMS maintains records serving to document the compliance with these standards.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Supported Employment - Follow Along Support

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox   Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
* abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
In addition, the employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course,
*training in areas specific  to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care, and
*other competencies as required by the department.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. Any other training requirements as outlined by the Department.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
In addition, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is initially responsible for ensuring that a worker meets the qualified provider standards and the FMS maintains records serving to document the compliance with these standards.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP offering Agency with Choice Employer
Authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course, and
*training in areas specific  to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. Any other training requirements as outlined by the Department.
In addition, Employer will maintain documentation verifying the person providing direct services
has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Supported Employment - Individual Employment Support

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care, and
*other competencies as required by DDP.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. Any other training requirements as outlined by the Department.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course, and
*other competencies as required by DDP.
*training in areas specific  to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114. Completion of Employment Specialist Training Curriculum in accordance with DDP requirements.
*any other training requirements as outlined by the Department.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person appears on the list, must report the listing to the department and the employer immediately.
In addition, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is initially responsible for ensuring that a worker meets the qualified provider standards and the FMS maintains records serving to document the compliance with these standards.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*service documentation requirements,
*completion of a first aid course, and
*other competencies as required by DDP.
*training in areas specific  to the needs of the individual, as outlined  in the training plan included in the Self-Direct with Employer Authority Plan of Care.
*other competencies as required by the department.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. Any other training requirements as outlined by the Department.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Supported Employment - Small Group Employment Support

Service Delivery Method (check each that applies):
checkbox Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP.DD service provider agency under contract with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Within 30 days of hire receive training in:
*abuse reporting,
*incident reporting,
*client confidentiality, and
*any specialty training relating to the need of the individual served, as outlined in the plan of care.
Persons assisting with meds will be certified in accordance with ARM 37.34.114.
Completion of first aid, CPR, and College of Direct Support Training in accordance with DDP requirements.
Completion of Employment Specialist Training Curriculum in accordance with DDP requirements. In addition, Employer will maintain documentation verifying the person providing direct services
has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Supports Brokerage

Service Delivery Method (check each that applies):
checkbox   Participant-directed as specified in Appendix E
checkbox   Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD Service Provider Agency under contract with the DDP.DD service provider agency under contract
with the DDP offering agency with choice employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Persons serving as support brokers must achieve initial support broker certification which includes the demonstration of competence in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*fiscal management service forms and billing procedures,
*scheduling of direct support workers,
*on call and emergency back up support models,
*person centered planning,
*individualized budgeting,
*recruitment, hiring and firing of direct support workers,
*the grievance/fair hearing process,
*negotiating service rates,
*DDP funded service options, and
*other skills and competencies as required by the Department.
Ongoing maintenance of certification in accordance with Department requirements.
Other Standard (specify):
The staffing rule as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Persons excluded from serving as a supports broker include:
*parents,
*spouses, or
*legal guardians of the individual,
*persons who work for agencies providing other DDP-funded supports to the individual, and
*persons who function as the conservator, payee, or who have any other fiduciary responsibilities for the individual.
Verification of Provider Qualifications
Entity Responsible for Verification:
The agency with a DDP contract employing the support broker is responsible for maintaining
records verifying compliance with the initial and ongoing support broker certification requirements.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the provider, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Certificate (specify):
Persons serving as support brokers must achieve initial support broker certification which includes the demonstration of competence in:
*abuse reporting,
*incident reporting,
*client confidentiality,
*fiscal management service forms and billing procedures,
*scheduling of direct support workers,
*on call and emergency back up support models,
*person centered planning,
*individualized budgeting,
*recruitment, hiring and firing of direct support workers,
*the grievance/fair hearing process,
*negotiating service rates,
*DDP funded service options, and
*other skills and competencies as required by the Department.
Ongoing maintenance of certification in accordance with Department requirements.
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
*Screening and a background check of a person prior to an offer of employment as a direct care staff.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person
appears on the list, must report the listing to the department and the employer immediately.
In addition, the fiscal agent will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Persons excluded from serving as a supports broker include:
*parents,
*spouses, or
*legal guardians of the individual,
*persons who work for agencies providing other DDP-funded supports to the individual, and
*persons who function as the conservator, payee, or who have any other fiduciary responsibilities for the individual.
Verification of Provider Qualifications
Entity Responsible for Verification:
The Fiscal Management Service provider maintains records verifying compliance with the initial
certification and ongoing certification requirements for support brokers employed.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review
process, based on the requirements of the performance measure sampling process specified.

Transportation

Service Delivery Method (check each that applies):
checkbox  Participant-directed as specified in Appendix E
checkbox  Provider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Individual
Provider Type:
A person or a representative self-directing the service with common law employer authority
Provider Qualifications
License (specify):
Operator will have a valid motor vehicle license, liability insurance and proof of vehicle registration, in accordance with state laws
Certificate (specify):
Other Standard (specify):
Prior to hire:
*Be at least 18 years of age.
Upon hiring of a direct care staff person the FMS must review the list of excluded individuals and entities maintained at the System for Award Management maintained by the federal General
Services Administration (GSA) to determine whether the person appears on the list and if the person
appears on the list, must report the listing to the department and the employer immediately.
Payment for escort services may not be made under the transportation category.
Verification of Provider Qualifications
Entity Responsible for Verification:
The FMS is responsible for ensuring that services and supports purchased on behalf of the individual
do not exceed individual cost plan allocation for this service, and all documentation requirements have been met prior to issuing reimbursement.
Frequency of Verification:
Annually, the DDP QIS reviews compliance of workers during the annual quality assurance review process, based on the requirements of the performance measure sampling process specified.

Provider Category:
Agency
Provider Type:
Dedicated transportation provider agency enrolled as a Montana Medicaid provider and contracting directly with DDP
Provider Qualifications
License (specify):
Operator will have a valid motor vehicle license, liability insurance and proof of vehicle registration,
in accordance with state laws.
Certificate (specify):
Other Standard (specify):
Person providing the service must be 18 or older.
Payment for escort services may not be made under the transportation category. Terms of minimum liability insurance are outlined in the provider contract, under the
section Automobile Liability Insurance Coverage.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DDP provider agency under contract with the DDP and/or subcontracting for transportation services.DD
service provider agency under contract with the DDP offering Agency with Choice Employer Authority
Provider Qualifications
License (specify):
Operator will have a valid motor vehicle license, liability insurance and proof of vehicle registration, in accordance with state laws.
Certificate (specify):
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
Payment for escort services may not be made under the transportation category.
Verification of Provider Qualifications
Entity Responsible for Verification:
The agency reimbursing the transportation service is responsible for verifying that the motor vehicle is registered and insured, and the vehicle operator is licensed to operate the vehicle.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

As needed by the provider, prior to authorization of payment. Prior to initiating a DDP contract and annually thereafter.
WCCM- Waiver-funded Children's Case Management

Service Delivery Method (check each that applies):
checkboxParticipant-directed as specified in Appendix E
checkboxProvider managed
Specify whether the service may be provided by (check each that applies):
checkbox  Legally Responsible Person
checkbox  Relative
checkbox  Legal Guardian

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP and subcontracting for WCCM services
Provider Qualifications
License (specify):
Certificate (specify):
If providing case management to persons 16-21 years of age must be Personal Support Plan (PSP)
certified.
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
A bachelor’s degree in social work or a related field from an accredited college and have one year of experience in human services, or have provided case management services, comparable  in scope and responsibility to that provided by case managers, to persons with developmental disabilities for at least five years; and must have at least one year’s experience in the field of developmental disabilities or, if lacking such experience, complete at least 40 hours of training in the delivery of services to persons with developmental disabilities under a training plan reviewed by the department within no more than three months of hire or designation as a case manager.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Applicable standards are verified by the DD service provider agency subcontracting for the service.
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:
As needed by the DD service provider agency, prior to authorization of payment.
Prior to initiating a DDP contract and annually thereafter.

Provider Category:
Agency
Provider Type:
DD service provider agency under contract with the DDP.DD service provider agency under contract with the DDP offering Agency with Choice Employer Authority
Provider Qualifications
License (specify):
Certificate (specify):
If providing case management to persons 16-21 years of age must be PSP certified.
Other Standard (specify):
The staffing rules as outlined in ARM 37.34.2101-37.34.2111.
Prior to hire:
*Be at least 18 years of age.
A bachelor’s degree in social work or a related field from an accredited college and have one year of experience in human services, or have provided case management services, comparable  in scope and responsibility to that provided by case managers, to persons with developmental disabilities for at least five years; and must have at least one year’s experience in the field of developmental disabilities or, if lacking such experience, complete at least 40 hours of training in the delivery of services to persons with developmental disabilities under a training plan reviewed by the department within no more than three months of hire or designation as a case manager.
In addition, Employer will maintain documentation verifying the person providing direct services has an acceptable criminal background check.
Verification of Provider Qualifications
Entity Responsible for Verification:
Initially - The DDP as part of the Qualified Provider Application Process. Ongoing - The QIS as part of the QA review process.
Frequency of Verification:

Prior to initiating a DDP contract and annually thereafter.

08/29/2013 Page last updated