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Community Services

Self-Directed Personal Assistance Services Manual

 

 

REVISED

001 CONTENTS INDEX 08/01/11
002 ALPHA INDEX 01/01/08
003 Abbrevations 08/01/11
     
400 ELIGIBILITY FOR SERVICES  
401 Medicaid Eligibility Requirements 02/01/06
402 Program Eligibility and Medical Need 01/01/02
403 General Provisions and Services 02/01/06
404 Service Limitations and Exclusions 02/01/06
405 Consumer Identification 01/01/08
406 Reserved 02/01/06
407 Denial of Initial Services 01/01/01
408 Reserved 02/01/06
409 Private Pay 02/01/06
410 Reserved 02/01/06
411 New Admissions 01/01/08
412 Request to Change Agencies 02/01/06
413 Switch in Options 01/01/08
414 High Risk Cases 01/01/08
415 Annual Mountain Pacific Health Foundation Reviews 01/01/08
416 Shared Cases 07/01/01
417 Request to Amend Authorization 01/01/08
418 Health Care Professional Authorization 02/01/06
419 Change in Personal Representative 01/01/08
     
500 MOUNTAIN PACIFIC QUALITY HEALTH FOUNDATION  
501 Prior Authorization Contract Requirements 08/01/02
502 New Admissions 01/01/08
503 Personal Assistance Services Consumer  
  Form/Referral (DPHHS-SLTC-154) 01/01/08
504 Personal Assistance Services Profile  
  (DPHHS-SLTC-155) 01/01/08
505 Self-Directed Personal Assistance Services  
  Authorization Form (DPHHS-SLTC-152) 04/01/04
506 Contract Performance Standards 01/01/02
     
600 ADMINISTRATIVE REQUIREMENTS  
601 Consumer/Personal Representative Responsibility 01/01/08
602 Provider Eligibility/Responsibilities 02/01/06
603 Provider Enrollment 02/01/06
604 Payment Requirements 02/01/06
605 Payment Processing 01/01/08
606 Reimbursement Methodology 08/01/11
607 Provider Disenrollment/Reduction in Service Area 07/01/00
608 Records Retention 04/01/04
609 Dually Enrolled Providers 07/01/00
     
700 SERVICE REQUIREMENTS  
701 Consumer Capacity 02/01/06
702 Program Oversight 01/01/08
703 Recertification 02/01/06
704 Complaint Procedures 01/01/01
705 Termination of Services/Discharges/Temporary Absences 02/01/06
706 Training 01/01/08
707 Mileage for Escort and Shopping 01/01/08
708 Reporting of Serious Occurrences 01/01/08
709 Home and Community Based Services Program 01/01/08
710 Live-in Attendants, Family and Significant Others 02/01/03
711 Medicare Home Health Aides 01/01/08
712 Services to Individuals Under Age 21 01/01/08
713 Services to the Developmentally Disabled 04/01/04
714 Services to Pregnant Women 07/01/00
715 Personal Representative 01/01/08
     
800 RULES AND RESOURCES  
801 Provider Requirement Administrative Rules of Montana 02/01/06
802 Provider Sanction Administrative Rules of Montana 02/01/06
803 Personal Care Administrative Rules of Montana 02/01/06
804 Self-Directed Personal Assistance Services  
  Administrative Rules of Montana 02/01/06
805 Elder Abuse Law 02/01/06
806 Provider Inquiry of Medicaid Eligibility 01/01/08
807 Release of Information Form 01/01/08
     
900 FORMS  
901 General Information - Forms  
  Forms Requisition 08/01/11
902 General Utilization 05/01/09
903 Form DPHHS-SLTC-165, Self-Directed Personal Assistance Services  
  Temporary Authorization 02/01/06
904 Form DPHHS-SLTC-167, Self-Directed Personal Assistance 02/01/06
  Services Program Compliance Tool 02/01/06
905 Form DPHHS-SLTC-164, Self-Directed Personal Assistance  
  Services Oversight Documentation 08/01/11
906 Form DPHHS-SLTC-157, Personal Assistance  
  Services Change in Demographics 01/01/08
907 Form DPHHS-SLTC-158, Personal Assistance  
  Services Agency Discharge/Unable to Admit Sheet 05/01/09
908 Self-Directed Personal Assistance Services  
  Agency Admit Sheet 05/01/09
909 Reserved 05/01/09
910 Reserved 08/01/11
911 Sample of Personal Assistance Services  
  Delivery Record 08/01/11
912 Form DPHHS-SLTC-160, Self-Directed Personal Assistance  
  Services Health Care Professional Authorization 01/01/08
913 Form DPHHS-SLTC-159, Self-Directed Personal Assistance  
  Services Consumer Agreement 01/01/08
914 Form DPHHS-SLTC-166, Self-Directed Personal Assistance  
  Services Personal Representative Agreement 01/01/08
915 Self-Directed Personal Assistance Services  
  Provider Prepared Standards 01/01/08
916 Form DPHHS-MA-128, Request for Case Review 02/01/06