1.Program Definition and Services 

Supported Living Services in New Mexico provide individualized residential supports for up to four individuals living in a single, integrated community residence. The program aims to help maintain individuals with intellectual or developmental disabilities in the community, promoting autonomy and inclusion while averting the need for institutional care. Services include:

• In-Home Personal Care: Individual support in the home or community setting (Personal Care Assistance with ADLs, Independent Living Skill Development, Household Management Coaching, Wellness and Self-Care Promotion, and Behavioral Support Modeling)
• Residential Personal Care: Supervision and care in a coordinated community-based living arrangement (24/7 Awake or Shift Staff Support, Health and Medication Administration Monitoring, Community Engagement and Employment Support Tracking, Emergency and Crisis Intervention, and Interdisciplinary Individual Service Plan [ISP] Compliance Monitoring)

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 Health Care Authority (HCA) Developmental Disabilities Supports Division (DDSD) Waiver Service Standards (Living Supports - Supported Living Category 1-4 Standards)
• The New Mexico Nurse Practice Act (NMSA 1978, Chapter 61, Article 3, concerning medication delegation rules for Direct Support Professionals)

3. Licensing or Certification

Providers must be certified as a Living Supports provider by the New Mexico Health Care Authority (HCA) and the Developmental Disabilities Supports Division (DDSD), adhering to all federal Home and Community-Based Services (HCBS) Settings Rules. Agencies operating residential group homes or shared community properties must pass environmental safety inspections and obtain appropriate facility clearances monitored by the Health Care Authority's Division of Health Improvement (DHI).

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), is responsible for reviewing applications, assessing agency infrastructure, executing programmatic readiness reviews, and certifying supported living 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 regional DDSD provider capacity reviews, verifying fiscal soundness, and demonstrating the ability to meet state-mandated staffing ratios.

6. Required Documentation

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

• Proof of compliance with state safety, corporate registration, and residential setting operational rules
• Agency policies and procedures (including shift staffing protocols, incident management systems [Abuse, Neglect, and Exploitation reporting], medication administration workflows, and financial exploitation safeguards)
• Staff qualifications, high school diploma or equivalent verifications, and ongoing direct support training tracking sheets
• Proof of general liability, professional liability, and comprehensive property/auto insurance for the agency and transported participants

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. The provider enrollment application and state-level physical readiness review process typically takes approximately 60 to 90 days once a complete package is submitted.

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, secure necessary federal identification numbers (such as an IRS EIN and an applicable Type 2 NPI), and verify local municipal zoning allowances for small group home settings.

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 through the state's provider learning management system.

10. Additional Notes

• Providers must ensure that all managed residential properties conform to community integration expectations, allowing participants full access to their living spaces, private bedrooms with locks, and choice of roommates.
• In-Home Personal Care actions (such as continuous daily living support or specialized behavior plan implementation) must be directly provided by the certified agency's employed Direct Support Professionals (DSPs).
• All supervisors, residential coordinators, DSPs, and behavioral staff must complete mandatory background clearances via the New Mexico Caregivers Criminal History Screening (CCHS) program.
• Providers must maintain detailed records of daily progress notes, individual service plans (ISP), medication administration records (MAR), and annual physical environmental safety checks 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.

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