This regulation governs the Comprehensive School and Community Treatment (CSCT) program, a school-based mental health service delivered by licensed mental health centers in partnership with school districts. It establishes referral prioritization criteria, contract requirements between mental health centers and schools, and Medicaid reimbursement rules including service day limits and billing obligations. Operators must maintain written contracts specifying service descriptions, referral processes, staff roles, and data-sharing arrangements, and must comply with applicable Medicaid billing rules.
View official source37.87.1801 COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT PROGRAM: REFERRALS (1) Comprehensive school and community treatment (CSCT) services must be provided as set forth in ARM 37.106.1916 , 37.106.1955 , 37.106.1956 , 37.106.1960 , 37.106.1961 , and 37.106.1965 in order to receive payment under this program. (2) Youth referred to the CSCT program must be served in sequential order as determined by the priorities below based upon acuity and need, regardless of payer: (a) without treatment the youth may become at risk of self-harm or harm to others; (b) the youth requires support for transition from intensive out-of-home or community-based services; (c) the youth is currently receiving CSCT services and is transitioning to a new school or provider; (d) the youth meets the serious emotional disturbance criteria; (e) the youth has not responded to positive behavior interventions and supports; or (f) the youth is not attending school due to the mental health condition of the youth. Authorizing statute(s): 53-2-201 , 53-6-113 , MCA Implementing statute(s): 50-5-103 , 53-2-201 , 53-6-101 , 53-6-111 , 53-6-113 , MCA History: NEW, 2013 MAR p. 415, Eff. 7/1/13; AMD, 2022 MAR p. 159, Eff. 1/29/22. 37.87.1802 COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT PROGRAM: CONTRACT REQUIREMENTS (1) The licensed mental health center providing a comprehensive school and community treatment (CSCT) program must have a written contract with the school district. (2) The licensed mental health center must provide a description of the mental health services provided by the licensed mental health center during and outside of normal classroom hours. (3) The school must identify: (a) the provision of transportation and classroom space during nonschool days as described in ARM 37.106.1956 (1)(i); (b) the role of the school counselor and the school psychologist, as appropriate, in the provision of mental health services and supports to youth including coordination with the CSCT program; (c) program supports, including telephone, computer access, locking file cabinet(s), and copying, that the school will make available to CSCT staff while providing services within the school; (d) office space dedicated to CSCT which must be adequate and appropriate for confidentiality and privacy for the services provided; and (e) treatment space available to CSCT large enough to host a group during both school and non-school days. (4) The school and licensed mental health center must specify a referral process to the CSCT program. (5) The school and licensed mental health center must specify an enrollment process that: (a) includes the CSCT licensed or in-training mental health professional and a school administrator or designee; (b) ensures youth have access to services prioritized according to acuity and need as specified in ARM 37.87.1801 ; and (c) considers the current caseload of the CSCT program in terms of a wait list and near-term discharges. (6) The school must describe the implementation of a school-wide positive behavior intervention and supports program, including, at a minimum, the following procedures: (a) identifying youth who exhibit inappropriate behaviors to the degree that a positive behavior intervention plan is needed and youth at risk of, or suspected to have need of, mental health services; (b) implementing and monitoring the progress of a positive behavior intervention plan for its effectiveness; and (c) referring youth to the CSCT program when positive behavior interventions and supports have not resulted in significant positive behavioral change or when a youth may have a clinical condition and may be in need of mental health services. (7) The school and licensed mental health center must describe annual training offered to school personnel, parents, and students concerning the following: (a) CSCT program and services; (b) CSCT referral process and criteria; (c) signs and symptoms that indicate a need for mental health services for a youth; and (d) information confidentiality and security requirements under the Family Education Rights and Privacy Act (FERPA) and Privacy and Security Rules issued under the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security, and the Health Information Technology for Economic and Clinical Health (HITECH) Act. (8) The contract must identify program data and information which will be shared between the school district and the licensed mental health center to evaluate program effectiveness to include ARM 37.106.1956 (10). (9) The contract must identify the responsible party for each requirement specified in this rule. (10) In the circumstance in which a school district is the licensed mental health center providing a CSCT program, the school district must adopt an operational plan that is substantially similar to the contractual requirements set forth in this rule. This operational plan must be kept on file and made available to the department upon request. Authorizing statute(s): 53-2-201 , 53-6-113 , MCA Implementing statute(s): 50-5-103 , 53-2-201 , 53-6-101 , 53-6-111 , 53-6-113 , MCA History: NEW, 2013 MAR p. 415, Eff. 7/1/13; AMD, 2022 MAR p. 159, Eff. 1/29/22. 37.87.1803 COMPREHENSIVE SCHOOL AND COMMUNITY TREATMENT PROGRAM: REIMBURSEMENT (1) Comprehensive school and community treatment (CSCT) services delivered by a licensed mental health center with an endorsement under ARM 37.106.1955 must be billed under the school district's provider number. (2) CSCT services may be provided to: (a) youth ages three through five who are receiving special education services from the public school in accordance with an individualized education program (IEP) under the Individuals with Disabilities Education Act (IDEA) or attending a preschool program offered through a public school; and (b) youth ages six up to age 20, if they are enrolled in a public school. (3) One team with up to three employees will not be reimbursed for more than 360 service days per team per month. (a) A service day is a minimum of 30 total minutes of core services provided by the CSCT team. (i) Core services include intake and/or annual assessment, individual therapy, family therapy, group psychotherapy or psychoeducation, behavioral interventions, crisis response during typical working hours, and care coordination. (ii) Care coordination may only be considered a core service and be billable if two other core services are provided within that week (with a week being the period from Monday to Sunday). Care coordination includes phone calls, treatment team meetings, individualized education program (IEP) meetings, referrals, and school advocacy for youth. Care coordination does not include documentation time. (4) Up to ten service days per youth, per state fiscal year, may be billed for an intervention, assessment, and if necessary, referral to other services. There is no limit on the number of youth that may be served. These service days must be billed as part of the 360 service days monthly team total. (5) For a youth to qualify for more than ten service days of CSCT, a full clinical assessment is required, and the youth must meet the SED criteria identified in the Children's Mental Health Bureau Medicaid Services Provider Manual as referenced in ARM 37.87.903 (7). (6) The school district as a Medicaid provider of CSCT is subject to all Medicaid state and federal billing rules and regulations. The school district must: (a) bill all available financial resources for support of services including third party insurance and parent payments, if applicable; and (b) document services to support the Medicaid reimbursement received. (7) The school district or the contracted provider must bill for youth not eligible for Medicaid. The school district may use a sliding-fee schedule. (8) The school district must meet the match requirements through the intergovernmental transfer (IGT) process. (9) CSCT services rendered to youth attending school in a Montana county with a per capita population of fewer than 6 people per square mile are eligible to receive a frontier community differential of 115% of the current fee schedule, as provided in ARM 37.85.106 . Authorizing statute(s): 53-2-201 , 53-6-113 , MCA Implementing statute(s): 50-5-103 , 53-2-201 , 53-6-101 , 53-6-111 , 53-6-113 , MCA History: NEW, 2013 MAR p. 415, Eff. 7/1/13; AMD, 2014 MAR p. 1401, Eff. 6/27/14; AMD, 2016 MAR p. 1706, Eff. 9/24/16; AMD, 2022 MAR p. 159, Eff. 1/29/22.