Montana Case Management Services Policy Manual

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The Montana Case Management Services Provider Policy Manual establishes a comprehensive framework for delivering state-compliant case management services to individuals with diverse needs, including those with severe disabling mental illness (SDMI), serious emotional disturbance (SED), or other conditions requiring coordinated care. This manual aligns with Montana Medicaid regulations, the Administrative Rules of Montana (ARM), and federal Centers for Medicare & Medicaid Services (CMS) standards to ensure compliance with state and federal guidelines while promoting person-centered, high-quality care.
The manual includes policies on:
Eligibility and Assessment:
Guidelines for determining client eligibility for case management services based on medical, behavioral, or social needs. 
Person-Centered Planning:
Standards for creating individualized care plans that prioritize client preferences, strengths, and goals. 
Scope of Services:
Policies outlining core case management activities, including:
Comprehensive assessments.
Service coordination and referrals to medical, behavioral health, and community resources.
Monitoring service delivery to ensure effectiveness.
Advocacy for client rights to access appropriate services.
Service Delivery Models:
Flexibility in providing services through face-to-face meetings, telehealth options, or community visits based on client needs. 
Provider Qualifications:
Requirements for case managers to hold relevant licenses or certifications (e.g., social workers, nurses) and have experience in serving populations such as adults with SDMI or youth with SED.
Documentation Standards:
Protocols for maintaining accurate records of assessments, care plans, service delivery dates, progress notes, and coordination activities. Documentation complies with ARM record-keeping requirements (ARM 37.85.414) to demonstrate medical necessity and support billing claims.
Quality Assurance:
Procedures for monitoring service quality through periodic reviews of client outcomes, satisfaction surveys, and adherence to care plans. 
Compliance with Medicaid Regulations:
Policies ensuring that case management services adhere to Medicaid billing requirements under ARM guidelines (e.g., ARM 37.87.823). 
This policy manual serves as an essential resource for case management service providers in Montana. It supports the delivery of coordinated, person-centered care that empowers individuals to achieve their goals while adhering to Montana’s regulatory framework for case management services.