The short answer Montana licenses home health agencies through DPHHS (with Medicare certification required for Medicaid participation), deferring to the federal 75-hour aide standard. There is no state licensure of private-pay non-medical home care agencies; Medicaid personal assistance service (PAS) attendants are trained and supervised under agency enrollment rules in ARM Title 37, ch. 40.
What Montana requires
Montana
HHA licensure. Home health agencies must be licensed by DPHHS and Medicare-certified to participate in Montana Medicaid (ARM 37.40.702, implementing the facility licensure provisions of Title 50, ch. 5, MCA); aide training follows the federal 75-hour standard.
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No PCA license. Montana's health care facility licensure law (Mont. Code Ann. § 50-5-101) contains no license category for non-medical personal care/companion agencies, so private-pay home care agencies operate without state licensure or training mandates.
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Medicaid PAS attendants. Agency-based personal assistance service providers must enroll with Montana Medicaid and meet the PAS program rules (ARM 37.40.1101 et seq., including provider enrollment at ARM 37.40.1122), under which attendants are trained by the agency and supervised, with no fixed state hour minimum.
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In-service. Home health aides at certified agencies must complete 12 hours of in-service training per 12-month period per 42 CFR 484.80.
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The federal baseline (applies in every state)
Federal
75-hour HHA training standard. Under 42 CFR 484.80(b), home health aides at Medicare-certified home health agencies must complete a training program of at least 75 hours, including at least 16 hours of classroom training completed before beginning at least 16 hours of supervised practical (hands-on) training.
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Competency evaluation / CNA pathway. 42 CFR 484.80(a) allows aides to qualify by completing the 75-hour training and competency evaluation program, by passing a competency evaluation alone, or by completing a state nurse aide training and competency evaluation program (CNA) and being in good standing on the state nurse aide registry.
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12-hour annual in-service. 42 CFR 484.80(d) requires home health aides to receive at least 12 hours of in-service training during each 12-month period, which may occur while the aide is furnishing care and must be supervised by a registered nurse.
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RN trainer requirements. Under 42 CFR 484.80(b)(3) and (c)(2), classroom and supervised practical training must be performed by or under the general supervision of a registered nurse with at least 2 years of nursing experience, at least 1 year of which must be in home health care; competency evaluations must likewise be performed by an RN in consultation with other professionals.
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Primary sources for this page
- https://rules.mt.gov/gateway/RuleNo.asp?RN=37.40.702
- https://leg.mt.gov/bills/mca/title_0500/chapter_0050/part_0010/section_0010/0500-0050-0010-0010.html
- https://rules.mt.gov/gateway/RuleNo.asp?RN=37.40.1122
- https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-484/subpart-B/section-484.80
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