RESIDENTIAL SUPPORT SERVICES PROVIDER IN MONTANA

Fatumata Kaba
Aug 6
4 min read

CREATING SAFE, PERSON-CENTERED LIVING ENVIRONMENTS FOR INDIVIDUALS WITH DISABILITIES AND LONG-TERM SUPPORT NEEDS

Residential Support Services in Montana provide 24-hour or intermittent assistance in licensed or certified living environments for individuals with developmental disabilities, chronic medical conditions, or behavioral health needs. These services are designed to help individuals live as independently as possible while receiving the supervision, skill-building, and personal care they need. Residential supports are offered under Montana Medicaid’s Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Montana Department of Public Health and Human Services (DPHHS)Role: Oversees Medicaid waivers, provider enrollment, and residential services licensing through the Developmental Disabilities Program (DDP) and Senior & Long Term Care Division.

Agency: Montana Developmental Disabilities Program (DDP)Role: Administers the 1915(c) DD waiver and authorizes residential support for individuals with intellectual and developmental disabilities (IDD).

Agency: Montana Senior and Long Term Care Division (SLTC)Role: Oversees residential options for older adults and adults with physical disabilities through the Big Sky Waiver and Community First Choice (CFC).

Agency: Centers for Medicare & Medicaid Services (CMS)**Role: Provides federal oversight for Medicaid-funded residential services and ensures HCBS compliance.

2. RESIDENTIAL SUPPORT SERVICES OVERVIEW

Residential Support Services help individuals live in their own homes, shared settings, or provider-managed group homes with necessary supports in place.

Approved providers may deliver:

24-Hour Residential Habilitation: Round-the-clock supervision and support in licensed group settings.
Supported Living: Scheduled, intermittent assistance in the individual's own apartment or home.
Intensive Behavioral Residential Support: Structured care environments for individuals with high behavioral needs.
Skill-Building and ADL Support: Help with cooking, cleaning, dressing, budgeting, and personal hygiene.
Health Monitoring and Medication Assistance: Administering or observing medication, managing medical appointments.
Community Integration: Encouraging participation in activities, work, and recreation.
Transportation Coordination: Assistance with transportation to services and activities.
Documentation: Service delivery logs, incident reports, care plans, and billing documentation.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business with the Montana Secretary of State.
Obtain an EIN from the IRS and NPI (Type 2).
Apply for provider enrollment through DPHHS (DDP or SLTC, depending on target population).
Obtain licensure or certification as a Residential Habilitation or Community Services Provider.
Maintain liability insurance and workers’ compensation coverage.
Develop policy manuals covering supervision, personal care, medication management, and emergency protocols.
Ensure all staff complete background checks, CPR/First Aid, and required habilitation training.

4. MONTANA PROVIDER ENROLLMENT PROCESS

Initial Application:

Complete provider application and waiver service selection via the DPHHS Provider Services Portal.

Documentation Submission:

Submit articles of incorporation, service descriptions, policies, insurance, staff credentials, and program manuals.

Program Readiness Review:

DPHHS or regional offices conduct a review of site readiness, staff training, service capacity, and compliance procedures.

Licensing & Medicaid Approval:

Upon successful review, providers receive certification/licensure and Medicaid billing authorization.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License
IRS EIN and NPI confirmation
Proof of liability and workers' compensation insurance
Residential Support Services Policy & Procedure Manual including:
- Supervision and personal care protocols
- Medication administration and health monitoring policies
- Staff credentialing, training logs, and job descriptions
- Incident reporting and behavior support plan guidelines
- Fire and emergency preparedness plans
- HIPAA and participant rights protections
- Medicaid billing and documentation templates
- Quality assurance and grievance handling protocols

6. STAFFING REQUIREMENTS

Role: Program Administrator

Requirements: Experience managing residential programs; knowledge of Montana Medicaid waiver services and DPHHS regulations.

Role: Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; background check clearance; CPR/First Aid certification; completion of DDP or SLTC-required training.

Role: House Manager / Site Supervisor

Requirements: Leadership experience in residential settings; ability to oversee scheduling, documentation, and staffing.

Role: Licensed Nurse (if medication administration or skilled care required)**Requirements: Montana RN or LPN license; supports delegated nursing tasks and health care coordination.

All staff must complete:

Individualized training based on participant needs and service plans
Rights-based education and HIPAA compliance
Annual training updates and performance evaluations
Crisis prevention, de-escalation, and emergency response training

7. MEDICAID WAIVER PROGRAMS

Residential Support Services in Montana are available through:

1915(c) DD Waiver – for individuals with intellectual or developmental disabilities
Big Sky Waiver (BSW) – for seniors and adults with physical disabilities
Community First Choice (CFC) – limited in-home residential assistance
State Plan Personal Assistance – supplemental support with ADLs

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Development

Timeline: 1–2 months

Phase: Staff Hiring, Training & Licensing Prep

Timeline: 2–3 months

Phase: DPHHS Application & On-Site Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup & Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Montana Department of Public Health and Human Services (DPHHS)Website: https://dphhs.mt.gov

Montana Developmental Disabilities Program (DDP)Website: https://dphhs.mt.gov/dsd/developmentaldisabilities

Senior and Long Term Care Division (SLTC)Website: https://dphhs.mt.gov/sltc

Centers for Medicare & Medicaid Services (CMS)Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — MONTANA RESIDENTIAL SUPPORT SERVICES PROVIDER

WCG supports agencies launching Medicaid-compliant Residential Support Services in Montana, including:

Scope of Work:

Business formation, DPHHS enrollment, and Medicaid certification
Policy manual creation tailored to residential habilitation and community integration
Staff credentialing tools, training resources, and compliance checklists
Medicaid billing setup, care plan documentation templates, and quality assurance systems
Branding, website design, and partnership-building with case managers and regional offices
Ongoing consulting for audit preparation, staff retention, and waiver compliance tracking