1. Program Definition and Services 

Residential Support Services in New Mexico provide short-term support to children and adults with intellectual/developmental disabilities and chronic conditions. 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 (Assistance with Activities of Daily Living, Skill Development, Community Engagement, Health and Safety Monitoring, and Behavioral Support) 
• Residential Personal Care: Supervision and care in a licensed residential, community-based setting (24/7 Residential Care, Emergency and Crisis Intervention, Personalized Care Plans, Medication Management, and Documentation)

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 3 (Medically Fragile Home and Community-Based Services Waiver) 
• New Mexico Department of Health Developmental Disabilities Supports Division (DDSD) 
• Waiver Service Standards New Mexico Administrative Code, Title 7, Chapter 8, Part 2 (Assisted Living Facilities Licensing Rules, if applicable to community residential models)

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. Community-based group residential settings must also secure appropriate facility licensure from the Division of Health Improvement.

4. Responsible State Agency 

The New Mexico Health Care Authority (HCA), in coordination with the Department of Health (NMDOH) Developmental Disabilities Supports Division (DDSD), is responsible for reviewing applications, conducting readiness inspections, and certifying residential support services providers.

5. Application Process 

The application process is conducted through the electronic New Mexico Medicaid Provider Enrollment Portal. Providers must submit forms online to initiate the application process after clearing regional DDSD open-enrollment requirements.

6. Required Documentation 

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

• Proof of compliance with state safety, physical site, and operational rules 
• Agency policies and procedures (including behavior intervention and emergency safety plans) 
• Staff qualifications, training records, and Direct Support Professional certifications 
• Proof of general and professional liability 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 and secure necessary federal identification numbers (such as an EIN and a 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 intensive care settings, homes, and community living hubs meet all state accessibility and environmental safety guidelines 
• In-Home Personal Care must be provided directly by the certified agency's employed personnel 
• All direct care staff must conduct mandatory background clearances and fingerprinting screenings through the New Mexico Caregivers Criminal History Screening program 
• Providers must maintain detailed records of face-to-face services, daily logs, and behavioral tracking charts for Medicaid documentation and billing

Why Choose Waiver Consulting Group? 

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state. 

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

To get started, click the link to request portal access