COMMUNITY INTEGRATION SERVICES PROVIDER IN MONTANA

SUPPORTING INDEPENDENCE AND COMMUNITY ENGAGEMENT THROUGH INTEGRATED SERVICES

Community Integration Services in Montana assist individuals with disabilities, chronic health conditions, or social challenges to actively participate in their communities. These services promote social engagement, life skills development, and community access while fostering independence and inclusion. Community Integration 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 Community Integration Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Developmental Disabilities Program (DDP) within DPHHS

Role: Ensures compliance, quality standards, and effective service delivery for Community Integration Services within HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded Community Integration Services meet HCBS quality, person-centered planning, and participant protection standards.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

Community Integration Services promote social inclusion and active community participation for individuals with disabilities. These services focus on building skills necessary for independent living and increasing community involvement.

Approved providers may deliver:

• Skill Development: Enhancing daily living skills, such as communication, social interactions, and personal safety.

• Social and Recreational Activities: Facilitating group outings, community events, and social clubs.

• Volunteer and Employment Support: Assisting with job readiness, vocational training, and community-based employment opportunities.

• Access to Community Resources: Connecting individuals with local support systems, such as transportation services, community centers, and educational programs.

• Peer Support and Advocacy: Promoting self-advocacy skills and connecting participants with peer networks.

• Individualized Planning: Tailoring activities and support based on the person’s preferences and Individualized Service Plan (ISP).

All services are designed to help individuals build connections, develop life skills, and actively participate in their communities.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the Montana Secretary of State.

• Obtain an EIN from the IRS and an NPI (Type 2).

• Enroll as a Medicaid Waiver Community Integration provider via the Montana Medicaid Provider Enrollment Portal.

• Maintain general liability and professional liability insurance.

• Develop policies for community participation, safety protocols, and participant rights.

• Ensure staff meet health screenings, background checks, and relevant training requirements.

4. MONTANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the Montana Medicaid Provider Enrollment Portal for Community Integration Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff qualifications, and policy manuals.

Program Readiness Review:

• DPHHS evaluates provider readiness, including staff credentials, community integration plans, and participant safety protocols.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Community Integration Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Montana Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• Community Integration Services Policy & Procedure Manual, including:

  • Intake and assessment procedures

  • Community activity planning and safety management

  • Transportation and community access protocols

  • Staff training, credentialing, and continuing education records

  • HIPAA compliance, participant rights, and grievance handling

  • Documentation standards for service tracking and billing

  • Emergency preparedness and crisis management policies

6. STAFFING REQUIREMENTS

Role: Community Integration Program Director

Requirements: Bachelor’s degree in human services, social work, or a related field; supervisory experience preferred.

Role: Community Support Workers

Requirements: High school diploma or GED; experience in community outreach or direct support; background clearance; CPR/First Aid certification.

All staff must complete:

• Community integration and life skills training

• HIPAA and participant rights education

• Safety, wellness, and crisis intervention training

• Annual competency evaluations and ongoing professional development

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are available under the following Montana Medicaid Waivers:

• Comprehensive Waiver for Individuals with Developmental Disabilities

• Big Sky Waiver (Aged and Disabled)

• Traumatic Brain Injury (TBI) Waiver

• Community Supports Waiver for Adults with Physical Disabilities

• Children's Autism Waiver

Services may include:

• Social and recreational support in community settings

• Job readiness and vocational skill development

• Access to peer mentoring and community advocacy programs

• Educational support and skill-building workshops

• Transportation coordination for community engagement

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Montana Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Community Integration Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Montana Department of Public Health and Human Services (DPHHS)

Website: https://dphhs.mt.gov/

Developmental Disabilities Program (DDP) — DPHHS

Website: https://dphhs.mt.gov/dsd/developmentaldisabilities

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — MONTANA COMMUNITY INTEGRATION SERVICES PROVIDER

WCG supports providers in launching Medicaid-compliant Community Integration Services in Montana.

Scope of Work:

• Business registration, Medicaid enrollment, and compliance setup

• Policy manual development for community integration programs

• Staff credentialing and ongoing training program templates

• Medicaid billing system setup and claims management support

• Branding, outreach, and community partnership strategies

• Quality assurance systems for safety monitoring and community engagement tracking

• Resource networking to connect clients with local support and integration opportunities

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.