New Mexico Administrative Code

A. The ISP for recipients of the medicaid developmental disabilities waiver services (including Jackson class members) must be reviewed by the DDSD as to the cost of the individual's ISP and aggregate costs of ISPs and as to compliance with DDSD standards and medicaid regulations…

The ISP shall be implemented according to the timelines determined by the IDT and as specified in the ISP for each stated desired outcome and action plan.

A. The case manager shall provide copies of the completed ISP, with all relevant service provider strategies attached, within 14 days of ISP approval to: (1) the individual; (2) the guardian (if applicable); (3) all relevant staff of the service provider agencies in which the ISP…

The authority or other governmental agency having regulatory enforcement authority for community based services provider agencies who have entered into contracts or medicaid provider agreements with the health care authority, developmental disabilities supports division, may sanc…

A. For each individual with developmental disabilities receiving services in the community, either through state general funds or federal funding through the developmental disabilities medicaid waiver, there shall exist a single, unified individual service plan, or ISP. This ISP …

Subsection E Section 9-7-6 NMSA 1978. Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (authority) as a single, unified department to administer laws and exercise functions relating to health care facility licensure and health care purchasing and regulation.

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

A. These regulations contain a process for development of an individual service plan for persons with a developmental disability. The requirements set out in these regulations apply, with some exceptions, to providers of services to persons with developmental disabilities living …

A. The Interdisciplinary Team (IDT): (1) The "interdisciplinary team (IDT)" is responsible for the development of the individual service plan (ISP) and for identifying the agencies and individuals responsible for providing the services and supports identified in the ISP. (2) The …

A. For all recipients of the developmental disabilities medicaid waiver services, this interdisciplinary team shall be chaired by the individual, if they so desire, or by the independent case manager. Services called for in the ISP shall be coordinated by the independent case man…

The following principles shall provide direction and purpose in planning with individuals with developmental disabilities. A. Principle No. 1: The individual with developmental disabilities has choices in, and ownership of, the planning process. If the individual is unable to ind…

New Mexico Health Care Authority, Developmental Disabilities Division.

A. If the person served is found able to consent and agrees to be admitted to the community living-setting they shall record their signature or make other appropriate designation of approval on the admissions document. B. If the person served is found able to consent and the IDT …

The authority shall maintain an up-to-date waiting list consisting of all persons who need placement in a community living-setting, but are not yet placed in a community living setting. Any program with an opening in a community living-setting may select any person from the waiti…

A. Services in a community living setting may be provided on an emergency basis to any person believed to be developmentally disabled when a community agency determines that there is imminent danger that the physical health or safety of the person will be seriously impaired if th…

A. The agency shall have policies and procedures regarding the death of a person under supervision of the agency. These policies and procedures shall include: (1) staff responsibilities and protocols for handling the immediate situation; (2) person(s) to be notified and procedure…

Community agencies governed by these regulations are required to meet applicable provisions of the most current edition of the "CARF standards manual for organizations serving people with disabilities". Sections of the CARF standards may be waived by the authority when deemed not…

These regulations apply to all community agencies who have entered into contracts or medicaid provider agreements with the health care authority, developmental disabilities division, to provide services to persons with developmental disabilities.

Sections 2816-7 and 28-16-8, NMSA 1978, (the Developmental Disabilities Community Services Act) and Subsection E of Section 9-8-6 NMSA 1978. Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (authority) as a single, unified department to administer laws and ex…

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

A. These regulations are being promulgated to promote and assure the provision of quality services to persons with developmental disabilities residing in community agencies. B. These regulations are being promulgated as part of a quality assurance initiative requiring all communi…

A. "Adult" means an individual who has attained the age of 18 years. B. "Community agency" means any nonprofit or for profit corporation, tribal organization, unit of local government, or other organization which has entered into a contract with the authority for the purpose of p…

A. Community agencies shall establish clearly written criteria for eligibility which correspond with the definitions of "developmental disability", "developmental delay" and "at risk for developmental delay" as defined within these regulations: B. Community agencies shall have wr…

A. Prior to admission into a community living setting, community agencies shall convene an interdisciplinary team (IDT) to determine if the person served has the ability to consent to a residential placement or is likely to need consent screening. This determination and its justi…

New Mexico Health Care Authority, Developmental Disabilities Division.

Each individual residing at Los Lunas or Fort Stanton hospital and training school has an interdisciplinary team (IDT), which is responsible for developing the individual program plan (IPP) as long as the individual resides in the facility. It is the individual's IDT that, among …

A. In order to develop a transition plan that is tailored to the individual, and in order to help achieve successful placement of the individual in the community, the IDT shall expand to include a number of non-professionals, managers and prospective community service providers, …

In order to prepare team members for participation in the team process, the following activities, as provided in the Jackson systemic plan and management manual should occur: A. Team members who are staff of the health care authority or of the case management agencies providing s…

A. The individual transition plan (ITP) process provides timelines by which specific actions are scheduled to occur. Although the health care authority intends to accomplish the specified activities within the time lines provided, the quality of individual program planning and th…

A. Prior to the start of the formal transition process, the facility interdisciplinary team (FIDT) shall convene to conduct the annual IPP meeting. At this facility IDT meeting, the following transition activities shall be conducted: (1) Review individual for community placement;…

At least 90 days before the TIDT meeting identified in Activity 11, the social worker shall contact the individual and, using appropriate communication assistance or aids, explain to the individual their right to identify a helper or representative to assist in the upcoming TIDT …

A. For the individual moving to the community the social worker shall, after identification of the probable area of relocation, provide the individual and mail to the parent/guardian a listing of eligible case management agencies that serve the individual's probable area of reloc…

A. The case manager shall meet with and, using appropriate communication assistance or aids and observation, get to know the individual. The case manager and the helper shall meet with and provide assistance to the individual so the individual understands and is prepared to parti…

Specified staff at the facility where the individual resides shall prepare a summary of the individual's record as set forth in the Jackson management manual, with particular attention to those historic events, medical or otherwise, that may affect community living design. The re…

A. The case manager shall meet with the individual's parent/guardian to explain the case manager's role and the process by which the individual's placement will be designed and implemented, including the TIDT activities for developing a placement plan, the state's implementation …

A. The regulations provide a systematic process for the individualized planning and implementation of a developmentally disabled resident's transition from the two large, state-operated institutional facilities into a community setting. B. The ITP process described in this docume…

A. At the first meeting between the case manager and the individual, and the case manager and the parent/guardian(s), the case manager shall explain the basic community service models, including alternatives to traditional service providers; explain the selection of community ser…

A. The parent/ guardian, in consultation with the individual, shall select community service provider(s) to be included in the TIDT and shall notify the case manager of the community service provider selection(s). Community service providers could be selected as early as the faci…

After completing the activities specified above, but at least 26 days before the TIDT meeting described in Activity 11, the case manager shall complete, with the individual and helper, a written assessment of the individual's strengths, interests, likes and dislikes. This assessm…

After completing the activities specified above, but at least 26 days before the TIDT meeting described in Activity 11, the case manager shall prepare a written assessment of the resources and services available in the community or relocation. At the TIDT, this assessment shall b…

The Jackson transition representative (JTR), shall schedule the full TIDT meeting, which shall be held as promptly as possible after completion of the activities required by Activities 6 and 7. Notice of the date, time and place of the TIDT meeting shall be sent to all participan…

A. The purpose of the TIDT meeting is to develop the individual transition plan (ITP). The ITP is the document developed by TIDT participants identifying the proposed steps to be taken before and after placement and until implementation of a new annual community individual servic…

A. Within 14 days of the conclusion of the TIDT meeting, the Jackson transition representative (JTR) shall produce and distribute the ITP to the case manager, the parent/ guardian, the facility Jackson office (for distribution to the facility TIDT members), the community service …

No later than 30 days after the distribution of the ITP, each community service provider identified in the ITP shall submit, in writing, to the health care authority its cost proposal, including the following information: A. start up funds required; B. staff training that will be…

The health care authority shall review the community service provider's proposal and may discuss or clarify any aspect of the proposal with the community service provider. The cost proposals shall be negotiated and approved, according to agreed upon costs, by the division's commu…

Unless delayed because of extraordinary circumstances or an administrative (DRP) or judicial stay order, within 30 days of the community service provider's submittal described in Activity 13 above, providers of service and the health care authority shall negotiate and execute agr…

Section 9-7-6 NMSA 1978. Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (authority) as a single, unified department to administer laws and exercise functions relating to health care facility licensure and health care purchasing and regulation.

A. An ITP quality assurance review meeting shall be held within 30 - 45 days prior to the placement date specified in the ITP. The purpose of this meeting is to assure that the ITP is being successfully implemented, assigned responsibilities have been or are being met and that ac…