Mi Via Self-Directed Waiver
Since the late 1970’s there has been a national movement to provided services and supports to individuals with developmental disabilities in the community rather than in institutions. While there has been a significant shift to community-based care nationwide, New Mexico is the leader in this area.
Starting in 1999, the Centers for Medicare and Medicaid Services launched its first self-directed Home and Community-Based Services (HCBS) waiver program, named Mi Via. Mi Via, is the result of the efforts of many individuals and groups state-wide to realize the inclusion of self-direction as an option in New Mexico’s HCBS waivers.
Mi Via, which means “my path”, “my way” or “my road”, is designed to assist you in managing your own services and supports to live your best life. Mi Via is about choosing self-direction over your home and community-based services, support and goods within your approved plan and budget.
Every five years New Mexico applies to Centers for Medicare and Medicaid Services for federal approval to renew the Mi Via Waiver Program under d1915(c) HCBS waiver rules. The Mi Via Waiver program is administered through a partnership between the New Mexico Department of Health (NMDOH) and the Human Services Department (HSD).
Please visit the Medical Assistance Division Registers page to find updates on the currently approved Mi Via Waiver and any requests for public comment.
Table of Contents
- Overview
- Frequently Asked Questions
- How to Apply
- Service Standards
- Regulations
- Forms
- Training
- Know Your Rights Campaign
- Learn More
- Contact Information
Overview
This program is a person-centered, community-oriented approach to deliver services and supports that assist eligible children and adults with Intellectual and Developmental Disabilities (IDD) or Medically Fragile conditions to participate as active members of their communities.
The Mi Via Waiver is one of several waivers available in New Mexico. It is intended to provide a community-based alternative to institutional care that facilitates greater participant’s choice, direction and control over services and supports.
The approach emphasizes:
- That people with IDD oversee their lives as much as possible.
- That people with IDD have opportunities to use resources in ways that enhance their lives and help them participate in their communities
- A shared responsibility for the wise use of public dollars and the contribution that people with IDD and their families can make.
- That the system is managed in a way that is efficient and fair to everyone.
New Mexico’s self-directed waiver program’s guiding principles states that all participants:
- Have value and potential
- Will be viewed in terms of their abilities
- Have the right to participate and be fully included in their communities; and
- Have the right to live, work, learn, and receive services and supports to meet their individual needs in the most integrated settings possible within their community.
Upon allocation for services from the Department of Health and meeting medical and financial eligibility for Medicaid waiver services, a participant may choose Mi Via. With the assistance of a consultant, participants develop their own Service and Support Plan (SSP) to meet their functional, medical, and social needs. Participants decide what services they need and how to spend their Mi Via budget.
Frequently Asked Questions
Please read the Mi Via Self-Directed Waiver Frequently Asked Questions document for useful information including a general overview of the waiver program, resource allocation, service and support plans, and more.
How to Apply
If you are currently being served by the Developmental Disabilities Waiver (DDW) or Medically Fragile Waiver (MFW) programs and you decide you want to participate in Mi Via, you need to fill out a Waiver Change Form (WCF). You will receive this form upon request from the MF Waiver Program Manager or the local Department of Health/Developmental Disabilities Supports Division Office. Once this form is completed and returned, you will be contacted by a Consultant to participate in a transition meeting, enroll with the Financial Management Agency and develop your Mi Via Service and Support Plan and budget.
If you are not yet in a waiver program, you must register for services with the Intake and Eligibility unit.
Upon allocation for services, you will be able to choose to participate in Mi Via, New Mexico’s Self-Directed Waiver Program, by filling out a Primary Freedom of Choice form and choosing a Consultant Agency to assist you in self directing your services.
Please visit the Regional Offices section of our website to find the contact information for an office near you.
Service Standards
The New Mexico Mi Via Service Standards, Appendix A through Appendix H are effective July 1, 2022.
The Service Standards include program information as well as a description of approved services and provider qualifications.
- Mi Via Self-Directed Waiver Service Standards
- Appendix A: Service Descriptions in Detail
- Appendix B: Service and Support Plan
- Appendix C: Mi Via range of Rates and Service Codes
- Appendix D: Vendor Credentialing and Information
- Appendix E: Employee Credentialing Requirements
- Appendix F: Compliance Oversight and Monitoring
- Appendix G: Mi Via Training
- Mi Via Fact Sheet and Tools
- Payment Schedules
- Mi Via Self-Directed Waiver Payment Schedule for Vendors
- Mi Via Self-Directed Waiver Payment Schedule for Employees
- Public Comments
- 8.314.6 Mi Via Home and Community -Based Services Waiver Eff: 11-1-18 – 8.314.6 Mi Via Home and Community -Based Services Waiver Eff: 11-1-18
- New Mexico Human Services Register Volume 41, Register 14 – New Mexico Human Services Register Volume 41, Register 14
- SW Numbered Memo 2022-03 DDSD Individual Transition Plan Checklist
- 1915c Waivers Individual Transition Plan 10-01-2022
Employer of Record EOR
An Employer of Record EOR is the individual responsible for directing the work of Mi Via employees and vendors for Mi Via participants. The EOR is not paid. An EOR is the common law employer of workers who provide waiver services.
Regulations
The registers below link directly to documents hosted on the Human Services Department (HSD) website. Please visit their Medical Assistance Division Registers page for a complete listing of proposed and final registers.
Forms
Please visit the New Mexico Medicaid Provider Portal: Self-Directed Forms web page to access all Self-Directed Waiver forms, provided by the Centers for Medicare and Medicaid Services.
Incident Reporting
The following guide will assist with reporting critical incidents in the Mi Via Self-Directed Waiver program and is available in both English and Spanish.
Individual Transition Plan
Training
Please visit the Mi Via Self-Directed Waiver Training section of our website to learn more.
Know Your Rights Campaign
On January 16, 2014, the Centers for Medicare and Medicaid Services published a final rule addressing several sections of the Social Security Act. The final rule amends the regulations which govern the Home and Community-Based Services (HCBS) waiver programs. All states are required to comply with the new rule by March 2022 and this rule affects everyone receiving Mi Via Waiver services.
DDSD launched the Know Your Rights Campaign based on this final rule. It is designed to raise awareness for the rights of individuals with intellectual and developmental disabilities to participate in integrated living, vocational, educational, recreational, social and leisure activities in the community.
It is an important step forward in federal policy, supporting inclusion and integration of people with intellectual and developmental disabilities to be included in their community and make decisions about their life. It is important all Mi Via participants continue to exercise their rights and make informed choices.
DDSD has developed a letter for both Mi Via participants and Vendors of Mi Via Services to provide information about the Centers for Medicare and Medicaid Services Final Rule. The letters outline the focus of this Campaign and the way the Centers for Medicare and Medicaid Services Final Rules impact waiver services.
Please visit the Know Your Rights Campaign section of our website to learn more.
Learn More
Below are some useful links we hope you will find helpful.
Centennial Care
Please visit the Centennial Care website to learn more and find the most recent updates provided by the New Mexico Human Services Department.
Social Services Resource Directory
The New Mexico Social Services Resource Directory (SSRD) website is provided by the New Mexico Aging and Long-Term Services department. The SSRD provides a wealth of information about New Mexico's social services such as health care, transportation, assisted living, independent living centers, legal assistance or home-delivered meals.
Family Caregiver Alliance
The Family Caregiver Alliance (FCA) offers programs to support and sustain the important work of families and friends caring for loved ones with chronic, disabling health conditions. FCA offers programs at national, state and local levels. A wealth of caregiving advice, resource listings, newsletters, fact sheets, research reports, policy updates and discussion groups are freely available. In addition to visiting their website, you may also call them at 1-800-445-8106 for more information.
New Mexico Direct Caregivers Coalition
The New Mexico Direct Caregivers Coalition (NMDCC) is a coalition created to enhance and promote family and professional direct care workers. NMDCC is led by caregivers who share common causes, common needs, and common goals with you! The NMDCC offers caregivers; monthly meetings, support groups, communications and information important to the field of caregiving. In addition, they offer advocacy supports, training and an annual summit with seminars available on topics that are important to you and your career. In addition to visiting their website, you may also call them at 505-867-6046 for more information.
Contact Information
Please visit the Mi Via Self-Directed Waiver Staff Directory page for a listing of staff members for this waiver program. Additional contact information for Consultant Agency Providers, Third-Party Assessor, Financial Management Agency, and Human Services Department are provided below.
Consultant Agency Providers
Consultants help Mi Via participants navigate throughout all the Mi Via processes. Consultant agencies must be approved by the state. Consultants provide education, assistance and guidance, such as with eligibility, pre-planning and development of the Service and Support Plan and the emergency back-up plan. The consultant offers information and tools, such as but not limited to, training and support with implementation of the approved plan and budget, hiring and supervising employees and providers, managing services, ensuring supports and monitoring the health and safety of a Mi Via participant.
Please see our Mi Via Self-Directed Waiver: Consultant Agency Provider Listing to find contact information for a consultant agency near you.
Third-Party Assessor
The Third-Party Assessor (TPA) is Comagine Health (formerly Qualis Health) and they are responsible for determining medical eligibility for the Mi Via participants, and approving the Service and Support Plan and budget.
Comagine Health
ATTN: Mi Via
P.O. Box 20910
Albuquerque, NM 87154-0190
866-962-2180 Toll-Free
https://comagine.org/program/new-mexico-medicaid
Financial Management Agency
The Financial Management Agency (FMA) is Conduent (Formerly Xerox) and makes payment to employees for services rendered to the waiver participant. The FMA also processes employee timesheets or invoices, and bills Medicaid for services and goods approved on the Service and Support Plan.
Conduent
1720-A Randolph Road SE, PO Box 27460
Albuquerque, NM 87125-7460
505-924-2010 Phone
866-916-0310 Toll-Free
866-302-6787 Fax
Human Services Department Medical Assistance Division
The Exempt Services and Program Bureau of the Human Services Department (HSD) Medical Assistance Division (MAD) manages the FMA and TPA contracts referenced above.
Mi Via & Medical Fragile Staff Manager
Mi Via & Medically Fragile Unit
Deanna DeHerrera
505-629-7260
Mi Via Social & Community Service Coordinator/Eligibility Specialist
Mi Via Unit
Jennifer Romero
505-469-8522
Mi Via Social & Community Coordinator/Billing Specialist
Mi Via Unit
Rachel Gonzales
505-490-3721
Mi Via General Email Address
MVWaiverHSD@hsd.nm.gov