APPLY FOR BENEFITS

Kevin S. Settlement

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LOOKING FOR ASSISTANCE

The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

DDW Case Management Services

Case management services play a critical role in supporting individuals to obtain their desired outcomes. For more information on case management services visit the Developmental Disabilities Supports Division (DDSD) website or contact the DDSD case management coordinators in the regional offices.

QMB provides regulatory oversight of case management agencies and conducts unannounced surveys of case management agencies to ensure compliance Centers for Medicare and Medicaid Services waiver assurances, DDSD standards and other rules and regulations.

Conditions of Participation

Case management services primarily focus of the following Centers for Medicare and Medicaid Services waiver assurance service domains: service plans; (ISP development & monitoring); level of care; qualified providers; health, safety and welfare. Identified within each service domain there are fundamental core regulations and standards identified as Conditions of Participation (COPS) essential compliance with COPS is necessary in order to ensure the health and welfare of individuals served.

Plan of Correction Process

Upon completion of a QMB survey the case management agency receives a report of findings. Upon receipt of the report of findings the case management agency must submit a Plan of Correction (POC) to address all identified deficiencies in the Report of findings within 10 working days. For instructions on how to complete the initial plan of correction see QMB Plan of Correction Process (Attachment A).

The submitted POC is then approved by QMB. The agency has 45 days from the date of receiving the Report of Findings to implement their Plan of Correction.

On rare occasions, it may be necessary to request a time extension to complete a component of a POC. A written request for a time extension must be submitted to the POC coordinator with an explanation as to why the addition time is needed and when it will be completed. QMB will review the request for the extension and notify the provider if approved or not approved.

Requests for technical assistance must be requested through your regional DDSD Office.

Survey Field Tools

The QMB Field Tools are available to the public and case management agencies. The case management survey field tools identifies the criteria used to assess if an agency is in compliance with requirements. Case management agencies my find them helpful when conducting a self-test to measure their own performance to identify opportunities for quality improvement.

Report of Findings

Previously completed survey reports appear below sorted by provider, region, and date.

A Step Above Case Management

Metro & Northwest & Southwest

Metro & Northwest

Metro & Northeast & Northwest & Southwest

Advocates of New Mexico, LLC

Metro

Amigo Case Management, Inc.

Metro

Metro & Southwest

Behavioral Health Institute (NMBHI)

Northeast

Northeast & Southeast

Carino Case Management

Metro

Excel Case Management Inc.

Northwest

Southeast

Heart of NM Case Management

Southwest

J & J Home Care, Inc.

Southeast

New Vision Case Management

Metro

Metro & Northeast

Peak Development Services, Inc.

Metro & Northeast & Northwest

Metro & Northwest

Southeast & Southwest

Professional Case Coordination Services,LLC

Metro & Northwest & Southeast

Quality Case Management, Inc.

Metro

Metro & Northwest

Rio Puerco Case Management, LLC

Northwest

Sun Country Case Management

Southwest

Unidas Case Management, Inc.

Metro & Northeast & Southwest

Metro & Northeast

Southwest

Unique Opportunities Case Management

Metro

Albuquerque (Carlisle)
Albuquerque (San Pedro)

Visions Case Management

Northeast

Metro & Northeast