Los Amigos, LLC is now providing Supports Waiver Services in the state of New Mexico!
The Centers for Medicare and Medicaid Services (CMS) approved the Supports Waiver effective July 1, 2020.
The Supports Waiver program is administered through a partnership between the Department of Health (DOH) and Human Services Department (HSD).
What is the Supports Waiver?
New Mexico’s Supports Waiver is a Home and Community Based Services (HCBS) waiver that is designed to provide an option for support to individuals who are on the Developmental Disabilities (DD) Waiver Wait List. Supports Waiver services are intended to complement unpaid supports that are provided to individuals by family and others. Supports Waiver services are not intended to nor do they provide twenty-four (24) paid supports.
Individuals who are on the DD Waiver Wait List will receive an Offer Letter from DDSD for the Supports Waiver. The number of offers to the Supports Waiver are based on legislative funding. Individuals keep their place on the DD Waiver Wait List, for the DD Waiver or the Mi Via Waiver, while they access the Supports Waiver.
Guiding Principles of the Supports Waiver
All participants:
1. Have value and potential.
2. Will be viewed in terms of their abilities.
3. Have the right to participate and be fully included in their communities.
4. Have the right to live, work, learn, and receive services and supports to meet
their individual needs, in the most integrated settings possible in their
community.
What is a Community Support Coordinator or CSC?
Community Support Coordinator (CSC) Services are intended to educate, guide, assist and monitor the participant to make informed planning decisions about
services and supports through a person-centered planning process. This leads to the development of an individual service plan (ISP) based on the participants needs
within the budget limit of $10,000. CSCs serve as advocates for the participant and help the participant identify supports, services and goods that meet their need for covered waiver services and are specific to the participant’s disability or qualifying condition and help prevent institutionalization. CSC services help the participant identify non-waiver specific supports, services and goods.
The CSC assists the participants with implementation and quality assurance related to the Individual Service Plan (ISP) and Authorized Annual Budget (AAB). CSC services provide support to participants to maximize their ability to access and direct their Supports Waiver participation through an agency-based service delivery model or participant-directed service delivery model.
Supports Waiver Information Sheet
Supports Waiver vs. Community Benefits
For more information, please visit: https://www.nmhealth.org/about/ddsd/pgsv/csw
What are the available Supports Waiver services?
Please see below for a list of services that can be mixed and matched based on the participant’s needs. The Supports Waiver services selected must be within the annual $10,000 budget allocated to qualifying participant.
Assistive Technology
Assistive Technology (AT) services allow individuals to purchase and maintain needed items to develop low-tech augmentative communication, environmental
access, mobility systems and other functional AT not covered through the individual’s State plan benefits. The service is intended to promote independence and quality of life,
to offer opportunity to live safely and as independently as possible in one’s home, and to ensure the health and safety of the individual in services.
Behavior Support Consultation
Behavior support consultation (BSC) services consist of functional support assessments, positive behavior support plan/treatment plan development, training
and support coordination for a participant related to the acquisition of positive skills and intervention in behaviors that compromise a participant’s quality of life.
BSC identifies skills and capacities that contribute to a person’s ability to experience success and satisfaction in a range of settings.
Customized Community Supports-Group
Customized Community Supports Group (CCS-G) can include participation in congregate community day programs and centers that offer functional meaningful
activities that assist with acquisition, retention, or improvement in self-help, socialization and adaptive skills for an eligible recipient.
Customized Community Supports-Individual
Customized Community Supports consist of individualized services and support that enable an individual to acquire, maintain, and improve opportunities for
independence, community membership, and inclusion.
Environmental Modifications
Environmental Modification Services: Environmental modification services include the purchase and/or installation of equipment and/or making physical adaptations
to a participant’s residence that are necessary to ensure the health, welfare, and safety of the participant or enhance the participant’s level of independence.
Personal Care
Personal Care Services are provided on an episodic or continuing basis to assist the participant with activities of daily living (ADLs) and Instrumental Activities of Daily
Living (IADLs) to enable the participant to accomplish tasks he/she would normally do for him/herself if he/she did not have a disability.
Non-Medical Transportation
Non-Medical Transportation services are offered in order to enable participants to gain access to waiver and other community services, activities and resources. Transportation services under Supports Waiver are nonmedical in nature.
Supported Employment
Supported Employment offers one-to-one support to individuals placed in inclusive jobs or self-employment in the community and support is provided at the worksite
as needed for the individual to learn and perform the tasks associated with the job in the workplace. The service encourages development of natural supports in the
workplace to decrease the reliance of paid supports. Support Employment includes job development and job coaching and is available for participants age 16 and older.
Respite
Respite is a flexible family support service that provides support to the participant and gives the primary, unpaid caregiver time away from his/her duties.
Vehicle Modifications
Vehicle Modification Services are vehicle adaptations or alterations to an automobile or van that is the waiver participant’s primary means of transportation
in order to accommodate the special needs of the participant.
For more information visit: https://www.nmhealth.org/about/ddsd/pgsv/csw
What is Person Centered Planning?
Person centered planning is a process that places a person at the center of planning their life and supports. It is an ongoing process that is the foundation for all aspects of the Supports Waiver and provider’s work with individuals with I/DD. The process is designed to identify the strengths, capacities, preferences, needs, and desired outcomes of the eligible recipient. The process may include other persons, freely chosen by the eligible recipient who are able to serve as important contributors to the process. It involves person centered thinking, person centered service planning and person-centered practice. The PCP enables and assists the recipients’ strengths, capacities, preferences, needs, and desired outcomes of the eligible recipient.
Person-Centered Thinking: Values and supports individuals with intellectual and developmental disabilities to make informed choices and exercise the same basic, civil and human rights as other citizens, including dignity of risk.
Person-Centered Planning: Person centered planning discovers and acts on what is important to a person. Participants decide who they want to assist them with planning and managing their services and supports. The individual is at the center of the process and is encouraged to direct the process as much as possible.
Person-Centered Practice: Person centered practice aligns service resources that give people access to the full benefits of community living and ensure they receive services in a way that helps them achieve their individual goals.
What are the Supports Waiver Service Delivery Models?
Agency-Based Service Delivery Model
In the agency-based service delivery model, the participant works with their selected Circle of Support to identify services through the person-centered
planning process. Agency-based services are provided by a qualified provider agency with an approved agreement with Department of Health (DOH) to provide
supports waiver services.
Participant Directed Service Delivery Model
In the participant directed service delivery model, the participant is or designates an Employer of Record (EOR) and works with their selected circle of support to identify
services through the person-centered planning process. In this model. Under the participant-directed service delivery model, the Employer of Record (EOR) is the
director of goods and service vendors and the employer of directly hired employees.
New Mexico Electronic Visit Verification (EVV)
Section 12006(a) mandates that states must implement Electronic Visit Verification (EVV) for all Medicaid Personal Care Services by January 1, 2021 (extended from January 1, 2020) and Home Health Care Services by January 1, 2023 that require an in-home visit by a provider. Otherwise, the state is subject to incremental Federal Medical Assistance Percentage reductions up to 1% unless the state has both made a “good faith effort” to comply and has encountered “unavoidable delays.”
EVV is a technology solution that electronically verifies personal care services are delivered to the people needing those services.
The EVV system must be able to electronically verify the following:
1.the type of service performed;
2.the individual receiving the service;
3.the date of the service;
4.the location of service delivery;
5.the individual providing the service; and
6.the time the service begins and ends.
Starting January 1, 2021, the following services require EVV:
- Personal Care
- Respite
For Support with EVV Please reach out to:
• Employees: Contact your Employer of Record for training and technical assistance
• Employers of Record: Contact your Service Coordinator for login credentials, training and technical assistance.
Additional Support with EVV:
If you are unable to find an answer to a particular question, you may send an email to:
NM Department of Health Developmental Disabilities Supports Division
Anysia Fernandez, Program Manager
575-476-8917
New Mexico Medicaid Web Portal
Comagine- Third Party Assessor
1-866-962-2180
Conduent- Financial Management Agency (FMA)
Mailing Address:
PO Box 27460
Albuquerque, NM 87125-7460
Physical Address:
1720-A Randolph Road SE
Albuquerque, NM 87106
Phone Numbers:
Toll Free – (866) 916-0310
Fax – (866) 302-6787
Email:
mi.via@conduent.com
Participant-Directed Service Model
Self-Directed Forms
Focosonline
Agency-Based Service Model
Secondary Freedom of Choice
Report Abuse, Neglect, and Exploitation
ANE Hotline: 1-800-445-6242
DOH ANE Online Reporting
ANE FAQs
Participant and Employer of Record Training
UNM CDD DDSD Online Training Courses
Managed Care Organizations (MCOs)
Blue Cross Blue Shield
800-325-8334 or 505-291-3585
Presbyterian Health Plan
505-923-5256
Western Sky Community Care
1-844-543-8996
Community Resources
Adult Protective Service (APS): 1-866-654-3219
Child Protective Service (CPS): 1-855-333-7233
Aging and Long-Term Services: 1-800-432-2080
Crisis Lines
NM Crisis and Access Line: 1-855-662-7474
New Mexico Suicide Hotline: 1-866-HELP-1-NM
New Mexico Poison Information: 1-800-432-6866
Other Resources
Medicaid Fraud, Waste & Abuse
Mailing Address:
NM HSD Office of Inspector General
8909 Adams St. NE, Suite A
Albuquerque, NM 87113
Telephone: 1-800- 228-4802
Fax: 505-797-5127
Email: HSDOIGFraud@state.nm.us
COVID 19
NM DOH Information for COVID 19
Coronavirus Health Hotline: 1-855-600-3453
Coronavirus Information Hotline: 1-833-551-0518
