BEFORE THE DEPARTMENT OF PUBLIC

HEALTH AND HUMAN SERVICES OF THE

STATE OF MONTANA

 

In the matter of the amendment of ARM 37.88.901 and 37.88.908 pertaining to the mental health services for adults program of assertive community treatment (PACT)

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NOTICE OF PUBLIC HEARING ON PROPOSED AMENDMENT

 

TO:  All Concerned Persons

 

            1.  On November 16, 2011, at 1:30 p.m., the Department of Public Health and Human Services will hold a public hearing in Room 207 of the Department of Public Health and Human Services Building, 111 North Sanders, Helena, Montana, to consider the proposed amendment of the above-stated rules.

 

2.  The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice.  If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on November 9, 2011, to advise us of the nature of the accommodation that you need.  Please contact Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; telephone (406) 444-4094; fax (406) 444-9744; or e-mail [email protected].

 

3.  The rules as proposed to be amended provide as follows, new matter underlined, deleted matter interlined:

 

            37.88.901  MENTAL HEALTH CENTER SERVICES FOR ADULTS, DEFINITIONS  (1) through (3) remain the same.

            (a)  Community-based psychiatric rehabilitation and support includes, but is not limited to, the following services:

            (i) and (ii) remain the same.

            (iii)  assisting the individual to develop daily living skills and behaviors necessary for maintenance of a home, family relationships and responsibilities, an appropriate education, employment or vocational situation, and productive leisure and social activities; and

            (iv) through (11) remain the same.

            (12)  "Program of assertive community treatment (PACT)" or PACT" means a self-contained clinical team that is a client-centered, recovery-oriented mental health service delivery model that has received substantial empirical support for facilitating community living, psychosocial rehabilitation, and recovery for persons who have the most severe and disabling mental illnesses.  Individuals served in PACT have severe symptoms and impairments, and have not benefited from traditional outpatient programs.  A PACT must meets the requirements of ARM 37.88.908.

            (13) through (18) remains the same.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, 53-6-113, MCA

 

            37.88.908  MENTAL HEALTH CENTER SERVICES FOR ADULTS, PROGRAM OF ASSERTIVE COMMUNITY TREATMENT (PACT)  (1)  A "program of assertive community treatment (PACT)" is a self-contained clinical treatment: defined in ARM 37.88.901.

            (a)  provides needed treatment, rehabilitation, and support services to identified individuals with severe disabling mental illness;

            (b)  minimally refers individuals to services outside the program;

            (c)  provides services on a long term basis;

            (d)  delivers 75% or more of team service time outside program offices;

            (e)  serves individuals with severe disabling mental illness who are at least 18 years old, have severe symptoms and impairments not effectively treated by other available, less intensive services, or who have a history of avoiding mental health services;

            (f)  provides psychiatric services at the rate of at least 20 hours per week for each 70 persons served;

            (g)  maintains a ratio of at least one staff person, not including a psychiatrist, or peer specialist for each nine persons served.

            (2)  Assertive community treatment teams must be approved by the Addictive and Mental Disorders Division; and .

            (h) (3)  Assertive community treatment teams must be approved by the Addictive and Mental Disorders Division, and comply with the Montana Program of Assertive Community Treatment (PACT) Standards.  The department adopts and incorporates by reference the Montana PACT Standards (2009) (2011) which set forth the standards of treatment for adults with a severe disabling mental illness (SDMI).  A copy of the standards may be obtained from the Addictive and Mental Disorders Division, P.O. Box 202905, Helena, MT 59620-2905 or the following web site: http://www.dphhs.mt.gov/amdd/services/index.shtml.

 

AUTH:  53-2-201, 53-6-113, MCA

IMP:     53-2-201, 53-6-101, 53-6-111, MCA

 

            4.  STATEMENT OF REASONABLE NECESSITY

 

The Department of Public Health and Human Services (the department) is proposing to amend the above-stated administrative rules pertaining to Mental Health Services for Adults, Program of Assertive Community Treatment (PACT).  These rule changes are necessary because some PACT programs have misinterpreted the standards.  Updating and clarifying program standards will ensure consistent and effective application of program requirements and standards across agencies.  PACT providers and department program staff have collaborated on the revisions to develop appropriate language and terminology.  The following is a description of each proposed rule amendment.

 

ARM 37.88.901

 

The department is proposing to amend the definition of "program of assertive community treatment (PACT)" to one that is descriptive of the program’s service delivery model, purpose, and targeted population.

 

ARM 37.88.908

 

A reference to the amended definition of PACT services from ARM 37.88.901 is now included in this rule.

 

The amendment also incorporates the 2011 standards by reference.  The 2011 standards were added to update those from 2009.  Current rule identifies several program requirements that are included in the standards.  The department is proposing to delete these program requirements describing staffing, services, and eligibility.  The 2011 standards are available at the following web site: http://www.dphhs.mt.gov/amdd/services/index.shtml.

 

Fiscal Impact

 

There is no fiscal impact due to amending these rules.

 

            5.  Concerned persons may submit their data, views, or arguments either orally or in writing at the hearing.  Written data, views, or arguments may also be submitted to: Kenneth Mordan, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail [email protected], and must be received no later than 5:00 p.m., November 25, 2011.

 

6.  The Office of Legal Affairs, Department of Public Health and Human Services, has been designated to preside over and conduct this hearing.

 

7.  The department maintains a list of interested persons who wish to receive notices of rulemaking actions proposed by this agency.  Persons who wish to have their name added to the list shall make a written request that includes the name, e-mail, and mailing address of the person to receive notices and specifies for which program the person wishes to receive notices.  Notices will be sent by e-mail unless a mailing preference is noted in the request.  Such written request may be mailed or delivered to the contact person in 5 above or may be made by completing a request form at any rules hearing held by the department.

 

8.  An electronic copy of this proposal notice is available through the Secretary of State's web site at http://sos.mt.gov/ARM/Register.  The Secretary of State strives to make the electronic copy of the notice conform to the official version of the notice, as printed in the Montana Administrative Register, but advises all concerned persons that in the event of a discrepancy between the official printed text of the notice and the electronic version of the notice, only the official printed text will be considered.  In addition, although the Secretary of State works to keep its web site accessible at all times, concerned persons should be aware that the web site may be unavailable during some periods, due to system maintenance or technical problems.

 

9.  The bill sponsor contact requirements of 2-4-302, MCA do not apply.

 

 

 

/s/ Michelle Maltese                                     /s/ Mary E. Dalton acting for                      

Rule Reviewer                                             Anna Whiting Sorrell, Director

                                                                        Public Health and Human Services

           

Certified to the Secretary of State October 17, 2011.