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Community Benefit Program
Community Benefit Program
The Community Benefit offers services for members who qualify for nursing facility services but want to live at home. This program is an alternative option to placement in a nursing facility and is based on your needs. The Community Benefit is not available for 24-hour care. This benefit supplements your natural support.
If you are already eligible for Medicaid, please speak with your Managed Care Organization to discuss the next steps. If you are otherwise not eligible to apply for this program, please contact the New Mexico Aging and Long-Term Services Division at 1-800-432-2080 to be placed on the Central Registry.
For more information about this program and a list of frequently asked questions, click here.
For more information about the New Mexico Aging and Long-Term Services Department (ALTSD) please visit http://www.nmaging.state.nm.us/
ALTSD Contact information:
Santa Fe: 1-505-476-4846
If you are a provider and wish to apply to provide services for the Agency-Based Community Benefit, click the link below.
For more information about Home and Community Based Electronic Visit Verification (EVV), please click the link below.
American Rescue Plan Act (ARPA)
On March 11, 2021, President Biden signed the American Rescue Plan Act (ARPA) into law, enacting a $1.9 trillion COVID-19 relief package. The legislation includes a number of provisions that impact state and federal health care policies and programs, including the availability of enhanced federal funding for state Medicaid spending on HCBS. These services help older adults, people with disabilities and people with behavioral health needs live independently in the community by providing a variety of supports.
In particular, Section 9817 of the American Rescue Plan provides states with a one-year, 10 percentage point increase in their federal medical assistance percentage (FMAP)—the share of state Medicaid spending paid for by the federal government—for certain Medicaid HCBS expenditures. This 10-percentage point increase will apply only to HCBS expenditures provided between April 1, 2021 and March 31, 2022.
States must use the federal funds attributable to the one-year increased FMAP by March 31, 2024 and funding must supplement, not supplant, existing state funds expended for Medicaid HCBS in effect as of April 1, 2021. In addition, states must use state funds equivalent to the amount of federal funds attributable to the increased FMAP to implement or supplement the implementation of one or more activities to enhance, expand, or strengthen HCBS under the Medicaid program.
In developing our plan, New Mexico Medical Assistance Division (MAD) drew on expertise within the division in addition to requesting input from HCBS provider organizations, advocacy groups, other HSD divisions, sister state agencies, and individuals. Our proposal reflects the recommendations that we received. We propose to use federal funds attributed to the increase FMAP to supplement, not supplant, existing state funds expended for Medicaid HCBS in effect as of April 1, 2021, in both fee-for-service and managed care. Our commitment remains to strengthen our program through implementing activities that support the following four pillars:
- Investing in our Medicaid HCBS workforce
- Expanding our HCBS infrastructure
- Improving and expanding access to HCBS services through navigation systems
- Providing new and/or expanding existing HCBS services
You can review the presentation presented at the most recent stakeholder session here: ARPA HCBS Stakeholder Briefing
New Mexico’s initial spending plan proposal is available for review here: NM HCBS ARPA Spending Plan
Public Comment here: https://www.hsd.state.nm.us/public-information-and-communications/opportunity-for-public-comment/public-notices-proposed-waiver-changes-and-opportunities-to-comment/comment-period-open/
Centers for Medicare and Medicaid Services (CMS) Request for Additional Information (RAI) is available here: CMS RAI 9.27.21
New Mexico’s Response to the RAI is available here: