AUTISM-SPECIFIC SERVICES PROVIDER IN MONTANA

Fatumata Kaba
Aug 6
4 min read

EMPOWERING INDIVIDUALS WITH AUTISM THROUGH PERSONALIZED SUPPORT AND INTEGRATED CARE

Autism-Specific Services in Montana provide targeted support for individuals with Autism Spectrum Disorder (ASD) to enhance their daily living skills, social interactions, and community engagement. These services focus on individualized, person-centered care that supports independence and quality of life. Autism-specific services are authorized under the Montana Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Montana Department of Public Health and Human Services (DPHHS)

Role: Administers Medicaid waiver funding for Autism-Specific Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Children's Autism Waiver Program (CAWP) within DPHHS

Role: Oversees service quality, participant protections, and compliance specifically for autism-related services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures federal oversight, compliance with Medicaid standards, and adherence to person-centered planning principles for autism care.

2. AUTISM-SPECIFIC SERVICES OVERVIEW

Autism-Specific Services are designed to support individuals with ASD by addressing challenges related to communication, social interaction, sensory processing, and daily living skills.

Approved providers may deliver:

Behavioral Therapy: Applied Behavior Analysis (ABA) to address behavioral challenges and develop adaptive skills.
Communication Support: Speech and language therapy to enhance verbal and non-verbal communication.
Social Skills Training: Guided activities that promote social interaction, teamwork, and community engagement.
Occupational Therapy: Sensory integration techniques to improve daily functioning and coordination.
Family Support and Training: Educating family members to better understand and support the individual's needs.
Individualized Skill Development: Enhancing personal care, self-regulation, and independent living skills.

All services are provided in alignment with the Individualized Service Plan (ISP) to meet the unique needs of each participant.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the Montana Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Autism Services provider via the Montana Medicaid Provider Enrollment Portal.
Obtain relevant professional licenses (e.g., Board Certified Behavior Analyst (BCBA), Speech-Language Pathologist).
Maintain general liability and professional liability insurance.
Develop comprehensive policies for behavior intervention, safety protocols, and participant rights.
Ensure staff meet background checks, health screenings, and specialized autism training requirements.

4. MONTANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application through the Montana Medicaid Provider Enrollment Portal for Autism-Specific Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, professional licenses, insurance certificates, and staff qualifications.

Program Readiness Review:

DPHHS evaluates provider readiness, including therapeutic approaches, safety protocols, and staff qualifications.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Autism-Specific Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Montana Secretary of State)
IRS EIN confirmation
NPI confirmation
Professional licenses (e.g., BCBA, Speech Therapist)
Proof of general and professional liability insurance
Autism-Specific Services Policy & Procedure Manual including:
- Assessment and behavior intervention protocols
- Communication and social skills development procedures
- Sensory processing and occupational therapy guidelines
- Family education and support strategies
- Staff training, credentialing, and ongoing professional development
- HIPAA compliance, participant rights, and grievance handling
- Documentation standards for progress tracking and Medicaid billing

6. STAFFING REQUIREMENTS

Role: Autism Services Program Director

Requirements: Master’s degree in psychology, behavioral sciences, or a related field; BCBA certification preferred; experience in autism services supervision.

Role: Behavioral Therapists (BCBA, RBT)

Requirements: State licensure or certification; training in ABA and autism-specific interventions; background clearance.

Role: Speech-Language Pathologists

Requirements: State licensure, CCC-SLP certification; experience in working with individuals with ASD; background clearance.

All staff must complete: