Targeted Case Management for Youth with Serious Emotional Disturbance – Value-Based Payment Audit Program Application Criteria 

PLEASE DO NOT INCLUDE PROTECTED HEALTH INFORMATION IN YOUR APPLICATION.    

Background 

Strengthening Targeted Case Management (TCM) for youth with Serious Emotional Disturbance (SED) through a Value-Based Payment (VBP) approach was a goal raised by Montana behavioral health providers. Providers brought this goal to the Behavioral Health System for Future Generations (BHSFG) Commission, which prioritized it as part of its recommendations, and the Montana Legislature appropriated funding to support it. This opportunity is the result of that provider-driven work.

Program Description and Purpose 

Montana’s long-term vision is to provide robust TCM that engages families as full partners and delivers the core components of case management (comprehensive assessment, care planning, referral and linkage, and monitoring and follow-up) to keep children and adolescents in local homes, schools, and communities, at the lowest level of care necessary to safely meet their behavioral health needs. For youth served at higher levels of care, the vision includes supporting youth and families in successfully transitioning from these levels to home and community settings. 

Through its Children’s Mental Health Bureau (CMHB), the Department is launching a pilot of a VBP methodology for providers delivering TCM to youth with SED and offering incentive payments to eligible providers that meet established thresholds. The pilot is an initial assessment of the VBP methodology and will run from January 1 – June 30, 2027. This assessment will inform how the Department proceeds with incorporating a VBP methodology into Medicaid reimbursement moving forward. Please note that those requesting funds through this project must be licensed mental health centers with a youth TCM endorsement from the Montana Office of the Inspector General (OIG) to be eligible. 

Over the past 12 months, the Department worked with youth TCM providers to develop and test the standards and metrics that define excellent TCM. These standards are closely aligned with existing Administrative Rules of Montana (ARM) and Department policy, with some additional expectations. Under this pilot, DPHHS will retrospectively review a sample of TCM cases against these standards and metrics. Providers whose reviewed cases meet the thresholds will receive incentive payments based on service claims made during the performance period. These incentive payments are in addition to their standard Medicaid TCM reimbursement. 

For each successful applicant, the Department anticipates funding up to 15% of the gross amount paid for Targeted Case Management for Youth with SED services during the identified audit period.   

Each provider requesting funding under this grant opportunity is limited to one submission for this project. 

All applications must be submitted via Submittable by Nov. 27. DPHHS will review applications for completeness and compliance with the eligibility and participation requirements described in the announcement. Applications will not be comparatively scored or ranked. Approval notices will be sent out to requesters via Submittable. Approval authorizes participation in the pilot but does not guarantee an incentive payment. Payments are contingent upon meeting the published performance thresholds, verification of eligible claims, compliance with the participation agreement, and availability of funding.   

 Eligibility and Application Requirements  

To be eligible to participate, providers applying for funds to hire a TCM must demonstrate that they meet the following eligibility requirements and agree to the participation conditions below in their application:    

1. Operate as an existing licensed mental health center with a youth targeted case management endorsement from the Montana DPHHS Office of the Inspector General;  
2. Must attest that the organization has the administrative support infrastructure to meet the grant criteria; 
3. Must attest to designating a primary point of contact and a documentation lead for the audit period; 
4. Must attest that all Targeted Case Manager Supervisors and applicable agency leadership will complete the Auditor and Supervisor Training offered by the University of Montana, Center for Children, Families, and Workforce Development by February 28, 2027; 
5. Must attest that the organization will follow all Department-established processes and workflows for data submission during the audit process; 
6. Must attest to being in good financial standing; 
7. Must attest that the organization will comply with all applicable Montana Medicaid rules and manuals, e.g. CMHB Medicaid Services Provider Manual; 
8. Must attest to being able to comply with all state and federal laws, regulations, and policies applicable to the program; and 
9. Must attest that the information provided in the application is true and correct to the best of the authorized official’s knowledge and understanding. 

2025 Tribal Maternal Health Mini Grant applications will be awarded on a “first come, first served” basis. The application deadline is August 1, 2025, at 11:59pm MT. For questions about this application or program, please contact Sarah Buchanan at sarah.buchanan@mt.gov.

2026 Tribal Maternal Health Mini Grant applications will be awarded on a “first come, first served” basis. The application deadline is August 3, 2026, at 11:59pm MT. For questions about this application or program, please contact Sarah Buchanan at sarah.buchanan@mt.gov.

Program Description and Purpose 

Individuals with intellectual and developmental disabilities (IDD) often need life-long supports and services to ensure health and safety while also accessing and participating in their local communities. These supports and services are often provided on a day-to-day basis by Direct Support Professionals (DSPs).

There is a significant need and in turn value to investing in DSP workforce stabilization and promoting stronger capacity across the continuum to support people with IDD. Specifically, this initiative calls for piloting a DSP credentialing structure to test best practice approaches to DSP stabilization through career ladders. The DSP Workforce Capacity Grants provide one-time grants to five (1 per DDP region) service providers for, on average, 25 DSPs to become credentialed through the National Alliance for Direct Support Professional platform eBadge Academy, a web-based credentialing platform. The Developmental Disabilities Program (DDP) will pre-purchase access to the credentialing platform on behalf of selected agencies, as well as some technical assistance support from NADSP. Grant funds will cover staff time for DSPs participating in the credentialing program as well as “backfilled” staff to cover the shift time of staff enrolled in the credentialing program; payroll processing, grant reporting and tracking and other administrative costs incurred by selected provider agencies; and one-time incentive bonuses to DSPs once they reach credentialing tiers, as modeled below: 

DSP – I (Tier 1) –$1,000 

DSP – II (Tier 2)  – $1,500 

DSP – III (Tier 3) – $2,000

DSPs enrolled in the NADSP eBadge Academy must complete the following under each tier to be eligible for the one-time bonuses; a DSP may achieve all three Tiers. 

DSP-I 

To earn a DSP – I certification, the DSP must earn 15 total E-Badges, including: 

• The Code of Ethics Commitment E-Badge 
• The 50 hours of Accredited Education E-Badge 
• At least one E-Badge in Crisis Prevention and Intervention 
• At least one E-Badge in Person-Centered Practices 
• At least one E-Badge in Health and Wellness and 
• At least one E-Badge in Safety 

 DSP-II 

To earn DSP – II certification, the DSP must earn 30 total E-Badges, including: 

• The DSP-I E-Badge
• The 100 hours of Accredited Education E-Badge 
• At least one E-Badge in Evaluation and Observation 
• At least E-Badge in Communication 
• At least one E-Badge in Professionalism and Ethics and 
• At least one E-Badge in Community Inclusion and Networking 

DSP-III 

To earn DSP – III certification, the DSP must earn 50 total E-Badges, including: 

• The DSP-II E-Badge 
• At least one E-Badge in Empowerment and Advocacy 
• At least one E-Badge in Community Living Skills and Supports 
• At least one E-Badge in Education, Training, and Self-Development 
• At least one E-Badge in Cultural Competence