New Mexico Administrative Code

See: Appendix B, Dispute Resolution Process (DRP) for Individual Transition Plans.

A. Within seven days of the completion of the DRP, if any, the health care authority shall inform the parties to the DRP in writing whether, on the basis of the cost of the individual's ITP or the aggregate costs of individual ITPs, or because the health care authority believes t…

Activities 20 - 23 shall take place in the time frame specified unless delayed because of the DRP, or extraordinary circumstances.

TIDT members shall carry out their assigned pre-placement responsibilities. The TIDT is responsible for assuring the completion of placement activities and the readiness of the placement unless delayed pursuant to the policies of Appendix B, Section IV.F., dispute resolution proc…

The assigned Jackson office representative shall check and document progress twice per month beginning 60 days prior to the placement date on fulfillment of responsibilities assigned in the ITP. If the representative learns of serious implementation problems the Jackson office sh…

Every other week the division's Jackson office representative shall send to TIDT members a report on the status of pre-placement activity. The Jackson coordinator shall report specifically on the status of all agreements and community service provider plans of care. Any delay in …

Pre-placement visits with staff and to the new home and work site shall take place as provided in the ITP. Placement shall be accomplished on the date established by the TIDT consistent with the timelines established in Section 13 above.

A. Absent extraordinary circumstances or an administrative (DRP) or judicial stay order, placement shall occur when planned pre-placement ITP activities have been completed. Moving is a stressful experience for anyone. Change in an individual's environment may result in changes i…

Permanent.

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

A. These regulations are promulgated, in part, to satisfy requirements arising from the implementation of the decision in Jackson, et al, v. Fort Stanton, et al., N.M. Dist. Ct. No. Civ. No. 87-839. The transition process appearing in these regulations has evolved over time, init…

The transition interdisciplinary team: A. The individual: The individual with a developmental disability must participate to the greatest extent possible. There must be a serious effort to ensure that the individual is present and that they, even when lacking verbal skills, are g…

A. There are two planning components that must be accomplished concurrently: (1) planning and effecting the move for each individual who will be moving; and (2) planning and preparing the system of community supports. B. This document provides the process by which each individual…

A. Individual transition planning is founded on the following basic concepts: (1) Individual transition planning strives for the goal that the individual can live in and be a part of a community in the same manner and to the same extent as would any other person of like age and i…

New Mexico Health Care Authority, Developmental Disabilities Division.

The state retains the discretion to provide, within current and future resources, individualized plans which may exceed what is required by law. To this end, the DRP provides guidelines for hearing officer decisions in Paragraphs (7) and (8) of Subsection D of 8.371.8.12 NMAC tha…

A. Prior to or at the facility IPP or community ISP meeting, the social worker or case manager shall explain the DRP to the individual, the parent/guardian and helper, if any. Prior to or at the initial meeting of the transition interdisciplinary team (TIDT), the case manager sha…

A. Request for facilitated conference: The DRP is initiated by a request for a facilitated conference by any of the parties identified in Section 7 in the capacities specified in that section. The request must be directed to the Jackson coordinator or dispute resolution process c…

A. This dispute resolution process (DRP) provides for the resolution of disputes concerning the content of or the substantial failure to implement individual program, transition or community plans for class members in Jackson et al. v. Fort Stanton, et al., Civ. No. 87839 JP. B. …

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 exercise functions relating to health care purchasing and regulation.

Permanent.

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

A. These regulations amend the authority's previously adopted provisions for resolution of disputes arising from the community transition plans of individuals residing at Fort Stanton hospital and training school and Los Lunas hospital and training school. They provide a process …

A. "Coordinator": The Jackson coordinator or the dispute resolution process coordinator or their designees. B. "Days": Calendar days, except where otherwise specified. C. "Defendants": The defendants in Jackson et al. v. Fort Stanton, et al., Civ. No. 87-839 JP who are represente…

A. Facility IPP: This DRP may be used for the resolution of disputes concerning the content of or the substantial failure to implement individual program plans for residents of Fort Stanton and Los Lunas hospitals and training schools. B. Transition planning: (1) If the dispute i…

This DRP may be utilized by: the individual; the individual's parent/ guardian; or the authority. The participants may be represented by legal counsel or other representatives.

New Mexico Health Care Authority.

A. A person may be discharged from an ICF/MR when the individual/guardian requests to be discharged; when the person's interdisciplinary team recommends the facility cannot meet the individual's needs; the individual no longer requires an active treatment program in an ICF/MR set…

A. The ICF/MR will notify the HCA of any vacancy or anticipated vacancy in their facility. B. The ICF/MR will notify the HCA of any person requesting ICF/MR services and for whom state funding may be necessary. C. The HCA will notify an ICF/MR of any person on the central registr…

A. These regulations provide a systematic process for admission of persons requesting services from an intermediate care facility for the mentally retarded (ICF/MR); the transfer between ICF/ MR facilities of persons previously determined eligible; and the discharge of persons re…

Subsection E of Section 9-8-6 NMSA 1978 and Section 28-16A-15 NMSA 1978. Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as a single, unified department to administer laws and exercise functions relating to health care purchasing and regulation.

Permanent.

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

The purpose of these regulations is to: A. establish the process for the admission of any and all persons requesting admission to an ICF/MR, to be transferred between ICF/MR facilities, or to be discharged from an ICF/MR; B. establish admission, transfer and discharge procedures …

A. "Discharge" means the termination of services for a person previously admitted into an ICF/MR and the discharging facility ceases to be legally responsible for the care of the person. B. "Eligible central registry person" means a person who has requested admission to an ICF/ M…

A. No person shall be admitted into an ICF/MR unless the person has been pre-screened and referred to an ICF/MR by the health care authority central registry. B. Consistent with the provisions of 42 CFR 431.51 any person who requests to be placed on the HCA's central registry wil…

A. A person may be transferred to another ICF/MR operated by the same entity, or an ICF/MR that operates independent of the ICF/MR where the person currently resides without referral through the central registry, provided: (1) the person's interdisciplinary team recommends the tr…

New Mexico Health Care Authority.

This rule applies to the general public.

Subsection F of Section 9-7-6.4 NMSA 1978 requires the interagency behavioral health purchasing collaborative (the collaborative) to adopt rules through the health care authority (HCA). The collaborative is created by statute and comprised of the secretaries of aging and long-ter…

Permanent.

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

The objective of this rule is to provide policies for the standard of delivery for behavioral health services through contracted behavioral health entities and for approval of contracts by the collaborative.

This section contains the glossary for the New Mexico behavioral health system. The following definitions apply to terms used in this chapter and shall guide any rules promulgated by collaborative members regarding behavioral health. A. Definitions beginning with letter "A": (1) …

The mission of the collaborative is to ensure that quality behavioral health services are provided to both medicaid and nonmedicaid consumers; that providers are reimbursed timely and accurately; that services promote prevention, recovery, resilience in consumers, and that availa…

New Mexico Health Care Authority.

A. Commitment to persons served: The behavioral health entity (BHE) and provider shall provide or ensure that:(1) service delivery is individually centered and family-centered, and furthers an individual's capacity for recovery and resiliency; (2) all services are designed to enh…

A. Program structure and operations: Quality management is an integrated approach that links knowledge, structure and processes together throughout a BHE's system to assess and improve quality. The BHE's quality management (QM) and improvement (QI) structures and processes shall …

A. BHE shall be accountable as specified in its contract for the achievement of any performance measure targets identified by the collaborative. The BHE shall measure and track performance measures, report on such measures at intervals defined by the collaborative, and incorporat…

The collaborative requires appropriate utilization management (UM) standards to be implemented as well as activities to be performed so that excellent services are provided in a coordinated fashion with neither over nor under utilization. The BHE shall manage the use of resources…