Medicaid Waiver Guide – New Mexico

What is New Mexico Medicaid?

New Mexico has rolled many of its waiver programs for those with physical and medical disabilities into a comprehensive 1115 demonstration waiver called Turquoise Care (previously Centennial Care). New Mexico retains three 1915(c) HCBS waivers for people with developmental disabilities and one for individuals who are medically fragile. The DD waiver and Medically Fragile waiver do not count parent income; we are unsure whether the Mi Via and Supports waivers count parent income or not. See the Turquoise page for information on Turquoise Care, and the Division of Developmental Disabilities for information on continuing 1915(c) waivers. See also this chart comparing waivers.

Types of Programs

Medically Fragile Waiver

• Description from medicaid.gov: Provides case management, customized community group supports, home health aide, respite, nutritional counseling, skilled therapy for adults, behavior support consultation, environmental modifications, individual directed goods and services, private duty nursing, specialized medical equipment and supplies, specialized therapies, and vehicle modifications for individuals who are medically fragile, ages 0 – no max age.
• Online State Information: Medically Fragile Waiver
• Official Federal Information
• How to Apply: Call 505-670-8954 for the Program Manager or 800-283-8415 for more information.

Developmental Disabilities Waiver Program

• Description from medicaid.gov: Provides case management, community integrated employment, customized community supports, living supports, respite, nutritional counseling, occupational therapy for adults, physical therapy for adults, speech and language therapy for adults, supplemental dental care, adult nursing, assistive technology, behavioral support consultation, crisis support, customized in-home supports, environmental modifications, independent living transition service, non-medical transportation, preliminary risk screening and consultation, remote personal support technology, and socialization and sexuality education for individuals with autism, intellectual disabilities, and developmental disabilities, ages 0 – no max age.
• Online State Information: DD waiver
• Official Federal Information
• How to Apply: Contact your Pre-Service Intake Specialist at 505-350-0034 or 505-470-5825 or contact your Pre-Service Intake Bureau directly.

Mi Via ICF/IDD Waiver

• Description from medicaid.gov: Provides consultant services, customized community group supports, employment supports, home health aide services, homemaker/direct support services, respite, skilled therapy for adults, personal plan facilitation, behavior support consultation, community direct support, emergency response services, environmental modifications, in-home living supports, individual directed goods and services, nutritional counseling, private duty nursing for adults, specialized therapies, and transportation for individuals who are medically fragile, with autism, DD, and ID, ages 0 – no max age.
• Online State Information: Mi Via
• Official Federal Information
• How to Apply: Contact your Pre-Service Intake Specialist at 505-350-0034 or 505-470-5825 or contact your Pre-Service Intake Bureau directly.

Supports Waiver

• Description from medicaid.gov: Provides community supports coordinator, customized community supports – individual, customized community supports –group, employment supports, personal care, assistive technology, behavior support consultation, environmental modifications, non-medical transportation, respite, vehicle modifications for individuals with autism, DD, and ID, ages 0+ to no max age.
• Online State Information: Supports Waiver
• Official Federal Information
• How to Apply: Contact your Pre-Service Intake Specialist at 505-350-0034 or 505-470-5825 or contact your Pre-Service Intake Bureau directly.

Turquoise Care

• Description from medicaid.gov: Turquoise Care seeks to modernize the New Mexico Medicaid program to assure that the state is providing the most effective, efficient health care possible for its most vulnerable and needy citizens and to create a sustainable program for the future. This new demonstration creates a comprehensive service delivery system for the New Mexico Medicaid program that is as unique as the State and designed to provide beneficiaries the right care, delivered at the right time, in the right setting. The state seeks to develop and implement a service delivery system that not only integrates care now but ensures that the State can afford to continue the program in future years. The demonstration will enroll most New Mexico Medicaid beneficiaries and New Mexico Medicaid expansion Children’s Health Insurance Program (CHIP) beneficiaries in managed care for a full range of services, including physical health, behavioral health and long term services and supports (home and community based services and institutional care). The demonstration consolidates [most] existing delivery system waivers into a single comprehensive managed care product.
• Online State Information: Turquoise Care
• Official Federal Information
• How to Apply: Apply online or visit your nearest field office.

Other online resources for New Mexico:

• New Mexico Autism Society has tons of resources from waivers to therapy providers to support groups.
• A page with information on New Mexico’s Department of Health’s resources for autism.
• Parents Reaching Out can help you with advice, information, and support from other parents in New Mexico

Telephone Resources

• Statewide Case Management Coordinator Leah Manning — 505-476-8915
• University of New Mexico offers Autism Programs that include clinical services. Call (505) 272-1852 or 1-800-270-1861 to find out more.

Ordering Goally with a Medicaid Waiver

Talk with your case manager to see if the waiver program you have will cover Goally. If so, have your case manager email us at: [email protected] to place an order on your behalf.