- What Programs Are Available To Assist People With Disabilities in New Mexico?
Is there a Medicaid waiver program in New Mexico? New Mexico has several waivers & programs including:
- Coordinated Long Term Services;
- Mi Via-ICF/MR (Self-Directed Waiver) ;
- Mi Via NF (Self-Directed Waiver) ;
- Developmental Disabilities Waiver (DD Waiver)
- Medically Fragile
- Centennial Care 1115 Waiver
What state department handles the Medicaid waiver program in New Mexico? The Human Services Department, Medical Assistance Division (HSD/MAD), provides home and community based waivers for persons with disabilities.
What programs assist people who have developmental disabilities in New Mexico? The Developmental Disabilities Waiver (DD Waiver) provides assistance to persons with disabilities.
What is the best number to call to get started? Phone: (505) 476-8973 or Toll Free:1-877-696-1472
Another option is the Information Center for New Mexicans with Disabilities toll free number at (800) 552-8195 for more information. You can also call the New Mexico Aging and Long Term Services Department Resource Center at (800) 432-2080. The Aging & Disability Resource Center can guide you to services such as health care, transportation, assisted living, independent living centers, home-delivered meals, and more.
- Who Qualifies For Assistance?
What is considered a developmental disability in New Mexico? Definition of Developmental Disability Approved by Centers for Medicare and Medicaid Services (CMS) in the New Mexico Developmental Disability Waiver Application: The individual must have a developmental disability and mental retardation or a specific related condition. Related conditions are limited to cerebral palsy, autism (including asperger syndrome), seizure disorder, chromosomal disorders (e.g., Downs), syndrome disorders, inborn errors of metabolism, and developmental disorders of brain formation. Developmental Disability is defined as a severe chronic disability, other than mental illness that: a) is attributable to a mental or physical impairment, including the result of trauma to the brain or a combination of mental and physical impairment; b) is manifested before the person reaches the age of twenty-two (22); c) is expected to continue indefinitely; d) results in a substantial functional limitation in three or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency; and e) reflects the person’s need for a combination and sequence of special or interdisciplinary treatment, generic or other support and services that are of lifelong or extended duration and are individually planned and coordinated.
Are there income limits to receive waiver services in New Mexico? Yes, up to 300 % of the SSI Federal Benefit Rate. An individual may be clinically eligible for the waiver, but not financially eligible. State General Funded services are available for those who do not meet medical and financial eligibility requirements for the Developmental Disabilities Waiver Program. Services are available include respite (birth to adult), residential services and vocational habilitation services. For more information, call toll free 1-800-283-5548.
How old do you have to be to start receiving services? This varies by waiver and program, but some services such as respite may be avail be as soon as birth.
- Is There a Waiting List For Services?
How long is the waiting list for waiver services in New Mexico? You can expect to wait ten years or more before receiving waiver services in New Mexico.
How many people are on the waiting list in New Mexico for the Medicaid waiver? There are 6300 people waiting for waiver services in New Mexico.
How many people are currently receiving Medicaid waiver services in New Mexico? There are about 3500 people with disabilities receiving waiver services.
What assistance is available while you wait? The New Mexico Aging and Long Term Services Department Resource Center may be able to refer you to services in your community. Call (800) 432-2080.
Is there priority preference for people who are in crisis in New Mexico? Individuals can receive an expedited allocation if the DDSD Expedited Referral Review Team determines a crisis situation exists and the individual meets the criteria for expedited allocation.
- What Services Are Offered & What Are The Service Limitations?
What services does the Medicaid waiver program offer in New Mexico? Services include Case Management, Day Services, Living Supports, and Therapies (Physical, Occupational Speech/Language and Behavioral). Other services and supports include Independent Living Transition Service, Community Integrated Employment Services, Customized Community Supports, Customized In-Home Supports, Adult Nursing, Nutritional Counseling, Personal Care, Crisis Support, Supplemental Dental Care, Respite, Environmental Accessibility Adaptations, and Non-Medical Transportation. Evaluation services include Specialty Seating and Wheelchair Evaluation Clinic, a Supports and Assessment for Feeding and Eating (SAFE)Program and Augmentative and Alternative Communication (AAC) evaluation and Aspiration Risk Evaluation services.
The Support Intensity Scale® (SIS) assessment, published by the American Association on Intellectual and Developmental Disabilities (AAIDD) has been chosen by New Mexico to use as a valid assessment tool to identify the support needs for all adult individuals receiving services through the New Mexico Home and Community Based Medicaid Waiver (DDW) program.
Does New Mexico offer community group homes? New Mexico offers both group homes and assisted living facilities.
Does New Mexico offer supported living? New Mexico offers Supported Living Services. Services are furnished in a home or apartment setting of 3 or fewer individuals with developmental disabilities who receive various personal care, daily living and social skills training services on a 24-hour basis.
Are there still state owned institutions? There are no state institutions to seclude those with developmental disabilities.
- How Do You Select A Provider?
Do waiver providers work for the state in New Mexico? No, Services are provided statewide through local providers coordinated through five Regional Offices. New Mexico utilizes both Sole Providers and Agency Providers.
About how many providers are there in New Mexico? There are about 70 Medicaid waiver provider agencies available in New Mexico. The state also utilizes family living substitute care in which they hire a person's relatives at a reduced rate to provided care.
Do you have a choice in providers in New Mexico? A participant may select any willing provider to furnish waiver services included in the service plan. There are two levels of freedom of choice. Primary freedom of choice means that an individual applying for waiver services is assured the opportunity to choose his/her own case manager. Secondary freedom of choice refers to the individual’s right to choose authorized service providers.
- How Do You Become A Provider?
To become a Developmental Disabilities Supports Division (DDSD) provider of services for the various programs offered to New Mexicans an application can be downloaded online. For assistance in completing the application, please contact Tammy M. Barth at (505) 476-8910. Proof of Professional Liability Insurance (one million dollars minimum), naming Department of Health as an additional insured is required of all providers within 30 days. A current New Mexico Business License is also required.
New Mexico Provider APPLICATION
- Additional Information
The Family Infant Toddler (FIT) Program helps families with children birth to three years old (ages 0-3) who have or are at risk for Developmental Delay and who are New Mexico residents. Respite services are also available for children (ages 3-21) and adults (22 and over). Call toll free at 1-877-696-1472 for more information on the FIT Respite program.
Beginning January 1, 2014, the new name of the New Mexico Medicaid program will be Centennial Care. Centennial Care services will be provided by four managed care organizations (MCOs). These services include physical health, behavioral health, long-term care and community benefits.