1. Program Definition and Services

Behavioral Support Services in New Mexico provide short-term support to children and adults with intellectual/developmental disabilities and behavioral health challenges. The program aims to help maintain individuals with disabilities in the community, averting the need for long-term services and supports. Services include:

• In-Home Personal Care: Individual support in the individual/family home or community (Behavioral Assessment, Behavioral Intervention Planning, Skill-Building Activities, Individual Counseling, and Positive Behavior Support)
• Residential Personal Care: Supervision and care in a licensed residential, community-based setting (Group Counseling, Crisis Intervention, Family Training and Support, Progress Monitoring, and De-escalation Techniques)

2. Regulations

The program is governed by the following regulations:

• New Mexico Administrative Code, Title 8, Chapter 314, Part 5 (Developmental Disabilities Home and Community-Based Services Waiver)
• New Mexico Administrative Code, Title 8, Chapter 314, Part 6 (Mi Via Home and Community-Based Services Waiver)
• New Mexico Health Care Authority (HCA) Developmental Disabilities Supports Division (DDSD) Waiver Service Standards (Behavior Support Consultation Standards)
• New Mexico Administrative Code, Title 16, Chapter 27 (Counseling and Therapy Practice Board regulations regarding behavioral health licensure)

3. Licensing or Certification

Providers must be certified by the New Mexico Health Care Authority (HCA) and the Developmental Disabilities Supports Division (DDSD), following all Home and Community-Based Services (HCBS) requirements. Agencies and individual practitioners delivering behavioral therapy, counseling, or clinical interventions must also secure and maintain valid behavioral health licensure from the New Mexico Regulation and Licensing Department (RLD) Counseling and Therapy Practice Board or applicable psychology boards.

4. Responsible State Agency

The New Mexico Health Care Authority (HCA), through its Medical Assistance Division and in coordination with the Department of Health (NMDOH) Developmental Disabilities Supports Division (DDSD) Bureau of Behavioral Support (BBS), is responsible for reviewing applications, verifying behavioral compliance guidelines, and certifying behavioral support services providers.

5. Application Process

The application process is conducted through the electronic New Mexico Medicaid Provider Enrollment Portal (YES.NM.GOV). Providers must submit forms online to initiate the application process after clearing background criteria and demonstrating capacity to meet New Mexico state-approved behavioral assessment, positive behavior support (PBS), and crisis intervention benchmarks.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state clinical, professional licensing, and commercial operational rules
• Agency policies and procedures (including behavioral assessment workflows, positive behavior support models, and crisis response protocols)
• Staff qualifications, Board Certified Behavior Analyst (BCBA) or Licensed Professional Counselor (LPC) verifications, and training records for behavioral technicians
• Proof of general liability, professional clinical liability, and malpractice insurance

7.Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact their regional office for detailed information on current processing timeframes.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the New Mexico Secretary of State and secure necessary federal identification numbers (such as an EIN and an applicable Type 2 NPI).

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details are sent to qualified applicants once preliminary paperwork is reviewed.

10. Additional Notes

• Providers must ensure that clinical therapy rooms, administrative hubs, and community intervention protocols meet all state privacy (HIPAA), accessibility, and environmental safety guidelines
• In-Home Personal Care (such as direct individual counseling or positive behavior modeling) must be provided directly by the certified agency's employed personnel holding appropriate clinical credentials
• All behavioral therapists, registered behavior technicians, and administrative staff must conduct mandatory background clearances and screening evaluations in accordance with New Mexico Caregivers Criminal History Screening (CCHS) program rules
• Providers must maintain detailed records of face-to-face services, behavioral incident tracking logs, Individualized Service Plans (ISP), and progress notes for Medicaid documentation and billing

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