Montana Medicaid Resources:

• State Medicaid Website: Montana
• Montana Council on Developmental Disabilities Website

Montana Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 19,600 people with disabilities covered by Medicaid in Montana. Montana spent $13,578 on each Medicaid recipient with a disability in 2007.

18% of all people covered by Medicaid in Montana have a disability, while the national percentage of people covered by Medicaid who have a disability is 15%.

However, Montana only spends 38% of all the money it spends on Medicaid on services for people with disabilities. The national percentage of Medicaid spending on these services is 42%.

NurseFirst Disease Management PAHP:

This program provides disease management services to children and adults with disabilities who do not receive these services under an HCBS waiver and who do not live in nursing or intermediate care facilities. You may not get to choose your service provider under this waiver.

• Health: disease management

Passport to Health:

This program provides adults and children with disabilities access to basic medical services. You may not get to choose your service provider under this program.

• Community: transportation
• Health: chiropractic, dental, dialysis, durable medical equipment, early and periodic screening, diagnosis and treatment, family planning, hearing, hospice, immunization, hospital, mental health, substance abuse treatment, laboratory, occupational therapy, pharmacy, physical therapy, physician, podiatry, speech therapy, vision, x-ray
• Home: home health care, home infusion therapy
• Social Services: case management

Program of All-Inclusive Care for the Elderly (PACE):

PACE programs are designed for people 55 and older who need nursing care, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care. PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary. Services are provided through PACE centers, so people must live close enough to an approved center to be eligible.

Ages: 55 and older

Level of Care: nursing

Restrictions: You must live close to an approved PACE center.

• Community: health-related transportation, day care
• Health: primary and specialty care, nursing, physical therapy, occupational therapy, speech therapy, recreation therapy, prescription drugs
• Home: home care, home and environmental modifications
• Social Services: social services

Community Supports waiver:

This waiver is intended to give people with intellectual and developmental disabilities the support they need to live in their own homes or in community living arrangements instead of in institutions.

Ages: 18 and over

• Community: social and recreational supports, transportation
• Health: day habilitation, adaptive equipment, specialized medical equipment and supplies, health maintenance and safety supports, personal emergency response systems, private duty nursing
• Home: homemaker services, personal care, residential habilitation, respite care, adult companion services, environmental modifications
• Work: supported employment

HCBS Waiver for Individuals with Developmental Disabilities / DD Comprehensive waiver:

This waiver provides comprehensive support for people with intellectual and developmental disabilities, so that they can receive services in their homes and communities without having to live in nursing facilities or intermediate care facilities.

Elderly and Disabled waiver:

This waiver is intended to help people who are older or who have disabilities and might need a nursing home. This waiver program helps pay for services delivered in the home so that people don’t have to live in nursing facilities.

Level of Care: nursing

• Community: adult day care
• Health: emergency response
• Home: respite care, adult residential care, environmental modifications
• Social Services: case management

Big Sky Bonanza waiver:

The Big Sky Bonanza waiver is a consumer-directed program that lets capable individuals plan and direct their own care. Eligible applicants have to complete a short training session on planning, budgeting, and spending in order to enroll in the program. Consumers are given an Independence Advisor and a Financial Manager to help them plan out long-term care, and they can choose to pick a Personal Representative (like a spouse, family member, or loved one) to help them as well. Under this plan, the person with the disability becomes their own case manager.

Options for Self-Direction: This plan helps give people with disabilities they need to manage their own care, and choose from a list of services to meet their needs.

• Community: adult day care, independence advisor, community support services
• Health: habilitation, occupational therapy, physical therapy, speech therapy and audiology, medical supplies, nutrition and dietitian services, respiratory therapy, specialized medical equipment