Medicaid & Waiver Programs

New Mexico Department of Health’s (NMDOH) Developmental Disabilities Supports Division (DDSD):

The Developmental Disabilities Supports Division (DDSD) oversees four home and community-based Medicaid waiver programs, or HCBS 1915 (c) Waivers. These are considered “waivers” because they “waive” an individual’s right to a bed in an institution or nursing home in favor of community-based services. These include:

  • Developmental Disabilities (DD) Waiver, also known as the “traditional waiver”
  • Medically Fragile Waiver
  • Mi Via Self-Directed Waiver
  • Supports Waiver

DDSD’s Intake and Eligibility Bureau manages the Central Registry for individuals waiting for services, provides several State General Funded Services, and administers the Family Infant Toddler (FIT) Program.

Find out more: https://www.nmhealth.org/about/ddsd/

Developmental Disabilities (DD) Waiver

The Developmental Disabilities (DD) Waiver program, also known in New Mexico as the “traditional DD waiver”, is designed to provide services and supports that assist eligible children and adults with Intellectual and Developmental Disabilities (IDD) to participate as active members of their communities. This is one of several waivers available in New Mexico. The program serves as an alternative to institutional care. New Mexico’s traditional DD Waiver Program is a person-centered, community-oriented approach to deliver supports for people with intellectual and developmental disabilities (IDD).

Find out more: https://www.nmhealth.org/about/ddsd/pgsv/ddw/

DD Waiver contact: Marie Velasco marie.velasco@doh.nm.gov or (505) 660-0766

Medically Fragile Waiver

This waiver provides services to individuals who have both a medically fragile condition and a Developmental Disability. Services may include case management, private duty nursing, physical or occupational therapy, respite, specialized medical equipment, and more. “Medically fragile” means needing ongoing skilled nursing care, evaluation, and decision making due to a complex chronic medical condition.

Like the Developmental Disabilities Waiver, Medically Fragile Waiver recipients will also receive Centennial benefits. The Medically Fragile Waiver is not age restrictive—participants cannot “age out”.

Find out more: https://www.nmhealth.org/about/ddsd/pgsv/mfw/

Medically Fragile Waiver contact: Iris Clevenger at iris.clevenger@doh.nm.gov or (505) 231-2304.

Mi Via Self-Directed Waiver

This waiver program allows individuals to self-direct their own waiver services. It allows for greater flexibility in using non-traditional supports to meet needs directly related to their disability.

  • Mi Via recipients are referred to as Participants and receive assistance from a consultant. Together, a Service and Support Plan (SSP) and a budget.
  • Individuals who receive the DDW or MFW are eligible for Mi Via. Those already receiving

Medicaid can change to the Mi Via Self-Directed waiver by completing a Waiver Request Form.

Services through Mi Via may include home health aides, in-home living, specialized therapies, respite, transportation, and more.

  • Employers of Record (EOR) arrange for the delivery of services, support and goods as approved in the Service and Support Plan (SSP) and submit required documents to the Fiscal

Management Agent (FMA).

Find out more: https://www.nmhealth.org/about/ddsd/pgsv/sdw/

Mi Via Waiver contact: Elaine Hill at elaine.hill@doh.nm.gov or (505) 506-6103

Supports Waiver

The newest Home and Community Based Services (HCBS) waiver is an option for individuals who are on the Developmental Disabilities (DD) Waiver Wait List. Supports Waiver services are intended to complement unpaid supports provided to individuals by family and others. Individuals on the Wait List keep their place on the Wait List, whether they choose to accept Supports Waiver offer or not.

Contact the Intake and Eligibility Bureau for more information about the Wait List.

Find out more: https://www.nmhealth.org/about/ddsd/pgsv/csw

Supports Waiver Contact: Anysia Fernandez at anysia.fernandez@doh.nm.gov or (505) 629-7476.

State General Funds

State General Funds (SGF) pays for services for individuals who are eligible for Developmental Disabilities Waiver or Medically Fragile Waivers but are not currently receiving services.

  • To be eligible, someone must complete the registration process for Developmental Disabilities of Medical Fragile Waivers and be placed on the Central Registry. Children under the age of 3 may qualify while receiving services through an early intervention program.
  • Services include independent living, respite, adult day habilitation services, and behavior support consultation.
  • Might need to ask around different agencies to see if they have spaces; many do not and have their own wait lists for State General Funds services. Budget amounts can also vary greatly, just depends on what the state is able to offer.

Find out more: https://www.nmhealth.org/about/ddsd/pgsv/sgf/

State General Funds contact: Juanita Salas (505) 553-0117 or juanita.salas@doh.nm.gov

Intake And Eligibility Bureau

Eligibility Determination through NMDOH/DDSD Intake and Eligibility Bureau: Individuals with intellectual and developmental disabilities who meet the definition of developmental disability in accordance with New Mexico Administrative are eligible for the DD Waiver. In general, to match the definition of a developmental disability the individual must:

  • Have an Intellectual Disability, onset by age 18.
  • A specific related condition (Cerebral Palsy, Autistic Disorder, Down Syndrome, Epilepsy, etc.)
  • Have significant limitations in at least 3 areas of major life activity that began prior to age 22.
Intake and Eligibility Bureau’s Application Process (seeking waiver services)

The Development Disabilities Waiver application packet includes a cover letter, instructions for completing the application, and contact information for DDSD/their eligibility worker.

Find out more on their website: www.nmhealth.org/about/ddsd/region/

Centennial Community Care:

Centennial Care is the name of the New Mexico Medicaid program with services provided by four managed care organizations (MCOs). These services include physical health, behavioral health, long-term care, and community benefits.

Eligibility for all Medicaid programs requires that individuals meet certain federal guidelines. These include citizenship, residency, and income requirements. To apply for Centennial Care Medicaid, check eligibility, or enroll in or switch your managed care organization (MCO), visit the YesNM Online Portal at this link: https://www.yes.state.nm.us/yesnm/home/index

Income Support Division Contact Information:

  • Consolidated Customer Service Center: (800) 283-4465
  • Customer Service Automated Response: (855) 309-3766
  • Low-Income Home Energy Assistance Program: (888) 523-0051
  • Constituent Services: (505) 827-7263

Website:  https://www.hsd.state.nm.us/LookingForAssistance/centennial-care-overview/

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