Mont. Medicaid Hospice Policy Manual, Policy 702

FURNISHING

NON-CORE

SERVICES

A hospice must ensure that physical therapy, occupational therapy

and speech-language pathology services are provided by the

hospice or under arrangements made by the hospice (Refer to

37.40.805 Hospice Policy 705).

PHYSICAL,

OCCUPATIONAL THERAPY,

SPEECH-LANGUAGE

PATHOLOGY

Physical therapy services; occupational therapy services, and

speech-language pathology services must be available, and when

provided, offered in a manner consistent with accepted standards

of practice.

WAIVER OF

REQUIREMENT

A hospice located in a non-urbanized area may submit a written

request for a waiver of the requirement for providing physical

therapy, occupational therapy, speech-language pathology, and

dietary counseling services. The hospice may seek a waiver of the

requirement that it make physical therapy, occupational therapy,

speech language pathology, and dietary counseling services (as

needed) available on a 24-hour basis. The hospice may also seek a

waiver of the requirement that it provide dietary counseling directly.

The hospice must provide evidence that it has made a good faith

effort to meet the requirements for these services before it seeks a

waiver.

The Department may approve a waiver application on the basis of

the following criteria:

1. The hospice is located in a non-urbanized area

as determined by the Bureau of the Census.

2. The hospice provides evidence that it had

made a good faith effort to make available

physical therapy, occupational therapy,

speech-language pathology, and dietary

counseling services on a 24-hour basis and/or

to hire a dietary counselor to furnish services

directly. This evidence must include the

following:

a. Copies of advertisements in local

newspapers that demonstrate

recruitment efforts;

b. Physical therapy, occupational

therapy, speech-language

pathology, and dietary counselor

job descriptions;

c. Evidence that salary and benefits

are competitive for the area; and

d. Evidence of any other recruiting

activities (for example, recruiting

efforts at health fairs and contact

discussions with physical

therapy, occupational therapy,

speech-language pathology, and

dietary counseling service

providers in the area).

Any waiver request is deemed to be granted unless it is denied

within 60 days after it is received.

An initial waiver will remain effective for one year at a time from the

date of the request.

If a hospice wishes to receive a one year extension, it must submit

a request to the Department before the expiration of the waiver

period and certify that conditions under which it originally requested

the waiver have not changed since the initial waiver was granted.