December 27, 2006
State Gets Option to Treat
Some with Mental Illness at Home
The state Department of Public Health and Human Services (DPHHS) has received a rare Medicaid “waiver” that will allow some Montanans who have a severe disabling mental illness to get care in their own homes rather than in nursing homes.
The waiver, which was approved by the federal Centers for Medicaid and Medicare Services (CMS), is only the second of its kind in the nation, according to Joyce DeCunzo, administrator of the DPHHS Addictive and Mental Disorders Division. It will allow the state to spend Medicaid money on in-home services that are not usually covered by Medicaid, such as home-delivered meals, private-duty nursing, and transportation.
“This is a big deal, and we’re delighted that CMS approved it so quickly,” DeCunzo said. “We hope this waiver will demonstrate that people with serious mental illness can have the opportunity for a fulfilling life in the community.”
DeCunzo said she thinks of the waiver as a “nursing home without walls.” Consumers who are eligible for the waiver will get services they need to live in a community setting, such as their own home, a group home, or an assisted living facility.
The services provided through the waiver will be available from three core sites – Billings, Butte, and Great Falls. To be eligible for the services, a consumer must live in one of those cities or its surrounding counties (Yellowstone, Big Horn, Carbon, Stillwater, Sweet Grass, Silver Bow, Powell, Beaverhead, Deer Lodge, Granite, Cascade, Blaine, Chouteau, Glacier, Hill, Liberty, Pondera, Teton, and Toole).
Each of the core sites will be able to serve up to 35 adults whose condition meets the state definition of severe disabling mental illness, or SDMI. Waiver clients must also be eligible for Medicaid and need the level of care available in nursing homes.
Some of the services offered under the waiver will be case management, homemaker services, adult residential care, habilitation, respite care, chemical dependency counseling, dietitian services, transportation, psychosocial rehabilitation, supported living, illness management and recovery, private-duty nursing, wellness recovery, personal assistance, and household chores.
The state has agreed to spend no more on services for consumers under the waiver than it would pay for care in an institutional setting.
If the waiver proves successful, DPHHS hopes to expand it to other parts of the state, DeCunzo said.
