Allocation Process
I am eligible. Now what?
Once you have been determined to meet the criteria for the DD Waivers (DD Waiver or Mi Via), your name will be added to the Central Registry wait list. You will be offered services through the DD Waiver based on your application date when there is funding available.
While you are on the wait list, you may be eligible for other services, including State General Funds (SGF), Centennial Care Community Benefits, and other community resources.
State General Funds
State General Funds (SGF) are a limited amount of services and supports available to individuals who have completed the eligibility process and are on the wait list for services. To find out more information and what State General Funded Services are available, contact your State General Funds liaison at one of our Regional Offices.
Centennial Care
If you are not covered by Centennial Care or are uncertain if you are, contact the Income Support Division’s Information Line at 1-855-309-3766.
Please see the Centennial Care Community Benefits Brochure to learn more.
Allocation
When funding is made available and your name comes to the top of the wait list, you will be mailed a Letter of Interest and a Primary Freedom of Choice. The letter will be mailed to the address DDSD has listed in the Central Registry, so it is critical that you contact your Eligibility Worker on a regular basis to ensure your contact information is current. If DDSD does not receive a response to the Letter of Interest within 30 days, a closure warning letter will be mailed. This letter advises you that you have 30 days to return the Primary Freedom of Choice or their allocation will be closed.
Primary Freedom of Choice
The Primary Freedom of Choice Form asks you to select between Home and Community Based Services (DD Waivers) or an Intermediate Care Facility for Individuals with Intellectual/Developmental Disabilities (ICF/IDD). If you want to receive services through the traditional DD Waiver or Mi Via Self Directed Waiver, check the box next to Home and Community Based Services. Then, you will also need to indicate whether you want services through the traditional DD Waiver or through Mi Via Self Directed Waiver. If you select the traditional DD Waiver, you will also select a select a Case Management agency and if you select Mi Via, you will select a Mi Via Consultant Agency.
If you do not need waiver services right now, but might in the future, you have the option of placing your allocation on hold. If you chose this option, you would need to notify DDSD when you want the allocation taken off hold and your name would go back on the wait list according to your application date. If you do not want DD Waiver services now or in the future, you have that option as well. If you refuse services, your name will be removed from the wait list and if you want to receive DD Waiver services in the future, you will have to re-apply and complete the eligibility process again.
Next Steps
When the Intake & Eligibility Bureau receives the Primary Freedom of Choice form, copies are made and sent with a letter of allocation to the appropriate parties; including the individual, the chosen case management agency, Medicaid Utilization Review, and HSD’s Income Support Division. You must then be approved both medically and financially before DD Waiver services can begin. Your Case Manager or Mi Via Consultant will help guide you through the medical and financial eligibility.
Financial Eligibility
You must complete a Medicaid Application and turn it into the Income Support Division, even if you already have Medicaid. You will see “DD WAIVER” written on the top of the page, although you will use this form if you selected traditional DD Waiver or Mi Via Waiver.
Return this application to the Income Support Division’s Institutional Care Waiver Unit at:
Central ASPEN Scanning Area
PO Box 830
Bernalillo, NM 87004
1-855-804-8960 (Fax)
Medical Eligibility
You will also need to meet the level of care required for the DD Waiver program. Your Case Manager or Mi Via Consultant can provide you with blank copies of the forms your physician must complete. These forms must be returned to the Third Party Assessor for processing.
Service Plan and Budget
Your Case Manager or Mi Via Consultant will assist with you with creating a service plan and supporting budget. These items will shape what type of services and supports you will receive. Your service plan and budget is person-centered and reflects what you need.
Traditional DD Waiver – Individual Service Plan
If you selected traditional DD Waiver, you will work on an Individual Service Plan (ISP), that details what types of services and supports you would like to receive. Your ISP, budget and accompanying documentation will then be processed at the Outside Review. The Outside Review makes a written clinical determination on whether the requested services are needed and will recommend whether your requested annual budget should be approved.
Mi Via Self Directed Waiver – Services and Supports Plan
If you selected Mi Via Self Directed Waiver, you will work on a Services and Supports Plan (SSP), that details what types of services and supports you would like to receive. Your SSP and budget, along with the results from an in-home assessment, will be processed by the Third Party Assessor (TPA). The TPA will make a clinical determination on whether the requested services are needed and will recommend whether your requested annual budget should be approved.
Once your ISP/SSP and budget are approved, you will have a start date in which you can begin to receive DD Waiver services.
If you have any questions, please contact your Case Manager or Mi Via Consultant.
Technical Assistance
The Intake & Eligibility: Allocation Checklist and Intake & Eligibility: Allocation Glossary will help explain the allocation process and the terms used throughout the process. Contact your eligibility worker or the Intake & Eligibility Bureau at 505-350-0034 if you need assistance.