The short answer Montana has no comprehensive fingerprint mandate for home care; DPHHS licensure and Medicaid rules require criminal background and registry checks (nurse aide registry, APS records) for direct care staff, generally via name-based DOJ checks.
What Montana requires
Montana
Licensure rules. Montana licenses home health agencies under MCA Title 50, ch. 5, and DPHHS rules require agencies to establish background screening for direct care staff, typically a Montana Department of Justice name-based criminal history check.
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Medicaid personal assistance. Medicaid personal assistance and community-first-choice providers must screen workers per ARM Title 37 provider requirements, including criminal history and abuse registry review before unsupervised contact with members.
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Registry checks. Employers verify the Montana Nurse Aide Registry (CNA certification and abuse findings) and screen sex offender registry and OIG exclusion lists for Medicaid compliance.
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Public record checks. Montana DOJ offers public name-based criminal history searches (CHOPRS), the customary tool for home care employers absent a fingerprint mandate.
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The federal baseline (applies in every state)
Federal
No universal federal mandate. There is no federal law requiring criminal background checks for private-pay home care workers; requirements are set state by state. HHS OIG found wide variation in state home health background check requirements, and Medicare Conditions of Participation for home health agencies defer to state law on screening.
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National Background Check Program (ACA Section 6201). Section 6201 of the Affordable Care Act created the CMS National Background Check Program, which awarded grants to more than 25 states to build fingerprint-based, comprehensive background check systems for direct patient access employees of long-term care providers, including home health agencies and personal care providers.
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FCRA obligations. When an agency uses a consumer reporting agency (third-party background check vendor), the federal Fair Credit Reporting Act requires a standalone written disclosure, the applicant's written authorization, and the pre-adverse action / adverse action notice process (copy of the report and Summary of Rights) before rejecting a candidate based on the report.
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OIG exclusion list (LEIE). Home care providers that bill Medicare or Medicaid must not employ or contract with individuals excluded from federal health care programs. HHS OIG maintains the List of Excluded Individuals/Entities (LEIE); CMS and state Medicaid agencies expect screening at hire and monthly thereafter, and payments tied to excluded persons are subject to recovery and civil monetary penalties.
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