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.

Settings Requirements

 On January 16, 2014, Centers for Medicare and Medicaid Services (CMS) published a Final Rule addressing new settings and person-centered planning requirements for governing the 1915 (c) HCBS waiver programs. The intent of the CMS Final Rule is to ensure that people receiving long-term services and supports through the 1915 (c) HCBS waiver programs under Medicaid authority, have maximum independence and choice, have full access to benefits of community living, and can receive services in the most integrated setting appropriate. The HCBS setting requirements focus on the nature and quality of individual experiences. All HCBS settings (residential and non-residential) must:

  • be integrated in and facilitate full access to the greater community;
  • ensure the person receives services in the community to the same degree of access as people not receiving Medicaid HCBS services;
  • maximize independence in making life choices;
  • be chosen by the person (in consultation with the guardian if applicable) from all available residential and day options, including non-disability specific settings;
  • ensure the right to privacy, dignity, respect, and freedom from coercion and restraint;
  • optimize individual initiative, autonomy, and independence in making life choices;
  • provide an opportunity to seek competitive employment;
  • provide people an option to choose a private unit in a residential setting; and
  • facilitate choice of services and who provides the services.

For more information on compliance with the settings requirements please see :

The DDSD has incorporated requirements in each waivers service standards and in the provider enrollment initial and renewal applications.

Campaigns

The DDSD has also partnered with the DDC, NM Allies for Advocacy, providers and other advocacy organizations to host Town Halls around the state initially as part of a Know Your Rights Campaign. Later building off of that initial campaign, an Advocate Rights and Responsibilities Campaign grew. The campaigns have included interactive presentations with stories of advocacy, responsibility and success from Waiver participants as well as discussion and conversation with the audience.

Resources