Montana currently has two HCBS 1915(c) waivers that serve children and waive parent income. See Montana’s Long Term Care page for more information on Montana’s programs. Montana also has a Community First Choice program that allows anyone enrolled in Medicaid to receive personal care services.

Montana Advocacy Organizations:

Last updated 9/28/23

Programs in Montana

Also called Comprehensive Waiver

  • Target Population: Children and adults with developmental or intellectual disabilities.
  • Ages: all
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 2880
  • Expiration Date: 6/30/2028
  • Description from medicaid.gov: Provides day supports and activities, homemaker, residential habilitation, respite, nutritionist services, occupational therapy, physical therapy, private duty nursing, speech therapy, supports brokerage, adult foster support, assisted living, behavioral support services, caregiver training and support, community transition services, companion services, environmental modifications, individual goods and services, meals, personal care, personal emergency response system, personal supports, psychological evaluation/counseling and consultation services, remote monitoring equipment, remote monitoring, retirement services, specialized medical equipment and supplies, supported employment (co-worker support), supported employment (follow along support), supported employment (individual employment support), supported employment (small group employment support), and transportation services to individuals with intellectual disabilities or developmental disabilities ages 0 or older who meet an ICF/IID level of care.
  • Online State Information: Developmental Disability page
  • Official Federal Information
  • How to Apply: Contact the nearest DDP Regional Office.
  • Waiting List: Montana has 2184 people with developmental disabilities on its waiting list.
  • Target Population: Children and adults with physical or other health disabilities.
  • Ages: all
  • Levels of Care: Nursing Facility
  • Income Waiver: Yes, the waiver is based on the child’s income only. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 2580
  • Expiration Date: 12/31/2022; waiver renewal in progress
  • Description from medicaid.gov: Provides adult day health, case management, community adult group homes, community first choice/personal assistance and specially trained attendant care, day habilitation, homemaker, prevocational services, respite, supported employment, audiology, respiratory therapy, financial management services, independence advisor, adult foster care, community supports, community transition, consultative clinical and therapeutic services, consumer goods and services, dietetic services, environmental accessibility adaptations, family training and support, health and wellness, homemaker chore, level 1 assisted living, level 2 assisted living, level 3 assisted living, non-medical transportation, nutrition, occupational therapy, pain and symptom management, personal emergency response systems, physical therapy, post-acute rehabilitation services, private duty nursing, senior companion, specialized child care for medically fragile children, specialized medical equipment and supplies, speech therapy, supported living, and vehicle modification services to individuals ages 65 or older and individuals with physical disabilities or other disabilities ages 0-64 years who meet a nursing facility level of care. This waiver operates with a concurrent 1915(b)(4) authority.
  • Online State Information: Big Sky Page
  • Official Federal Information
  • How to Apply: Contact the Mountain Pacific Quality Health Foundation at 1-800-219-7035.
  • Waiting List: Montana has 2184 people with developmental disabilities and 222 people with physical/health disabilities on its waiting list.

Additional Information

  • According to its 2023 Waiver Application, the DD Waiver allows parents/guardians of minors to be paid for care. “A legally responsible individual is a biological or adoptive parent of a recipient under 18, or a spouse of an adult recipient. The services legally responsible individuals may provide include: Residential Habilitation, Supported Employment-Follow Along Support, Companion Services, Personal Care, Personal Supports, Supported Employment-Co-Worker Support, Supported Employment-Individual Employment Support, and Supported Employment- Small Group Employment Support. For a legally responsible person to be paid for the provision of any of the aforementioned services all of the following authorization criteria and monitoring provisions must be met. The service(s) must: 1) Meet the definition of a service/support as outlined in the federally approved waiver plan; 2) Be necessary to avoid institutionalization; 3) Be a service/support that is specified in the member service and support plan; 4) Be provided by a parent or spouse who meets the provider qualifications and training standards specified in the waiver for that service; 5) Be paid at a rate that does not exceed what is allowed by the department for the payment of similar services; and 6) Not be an activity that the family would ordinarily perform or is responsible to perform. Extraordinary care means care exceeding the range of activities that a legally responsible individual would ordinarily perform in the household on behalf of a person without a disability or chronic illness of the same age, and which are necessary to assure the health and welfare of the participant and avoid institutionalization.”
  • In the Waiver Application for Big Sky, parents/guardians may be paid for personal care. “For a legally responsible individual, including biological and adoptive parents of recipients under 18, spouses of adult recipients, and court appointed guardians to be paid for the provision of HCBS services all of the following authorization criteria and monitoring provisions must be met. The service must: 1) meet the definition of a service/support as outlined in the federally approved waiver plan; 2) be necessary to avoid institutionalization; 3) be a service/support that is specified in the member service and support plan; 4) be provided by a parent or spouse who meets the provider qualifications and training standards specified in the waiver for that service; 5) be paid at a rate that does not exceed what is allowed by the department for the payment of similar services; and 6) not be an activity that the family would ordinarily perform or is responsible to perform. The family member who is a service provider will comply with the following: 1) for self-directed personal assistance the family member must maintain and submit time sheets and other required documentation for hours paid; and 2) married individuals must be offered a choice of providers. If they choose a spouse as their care provider, it must be documented in the service plan.”
  • Montana recently approved a Pediatric Complex Care Assistant Program. View the legislation here. Parents/guardians will be able to provide tube feedings, trach care, medications, and personal care services. More information will be provided when it becomes available.