(DD) Waiver Service Standards - New Mexico Department of Health

The amount of reimbursement for each service is a fixed amount, indicated as a
flat fee, fifteen (15) minute, hourly, daily, monthly or per item/event units based
on each specific service definition and as specified in HSD/MAD billing
instructions and DD Waiver rate tables. The number of units across all services
shall be budgeted so as not to exceed the ARA. An individual may shift the
amount or number of units, as well as drop and add units throughout the year, to
accommodate changing needs. Revisions to the ISP may be approved by the Case
Management Provider Agency. If the individual uses all the funding in the ARA
prior to the end of the ISP year, funding for services will terminate until the
beginning of the next ISP year.
B. Services in the Young Adult Category. At the annual ISP meeting, during the
same year in which an individual turns twenty one (21), he or she may choose to
continue with services from the Young Adult Category until the next regular ISP
date, or the individual may choose to transition to the Adult Category.
(1) Case Management is funded with the ARA. Twelve (12) monthly units per
year of Case Management are required for individuals utilizing the Young
Adult Category. Case Management will be provided in accordance with
DD Waiver Standards and applicable DDSD policies for Case
Management.
(2) Young Adult Service Options Funded with the ARA: Each service shall be
provided in accordance with the corresponding DD Waiver Standards, and
applicable DDSD policies. The total budget for the selected services may
not exceed the Annual Resource Allotment. The individual, in conjunction
with the IDT members, may choose any or all of the following service
options:
(a) Community Inclusion Services (Supported Employment, Community
Access, Adult Habilitation);
(b) Behavioral Support Consultation;
(c) Occupational Therapy (with limits for individuals under age 21);
(d) Physical Therapy (with limits for individuals under age 21);
(e) Personal Support Services (with limits for individuals under age 21);
(f) Respite;
(g) Speech Therapy (with limits for individuals under age 21);
(h) Nutritional Counseling;
(i) Goods and Services;
(j) Personal Plan Facilitation;
(k) Case Management;
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