LOOKING FOR ASSISTANCE
The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
DD Waiver Application/Eligibility Determination
Individuals with intellectual and developmental disabilities who meet the definition of developmental disability in accordance with New Mexico Administrative Code NMAC 8.290.4 are eligible for the DD Waiver.
Every 5 years, New Mexico submits a renewal application to the Centers for Medicare and Medicaid Services to continue providing DDW services and supports. The approved application contains the definition of eligibility DDSD must use when processing cases.
Please see the DDW Eligibility Definition document for the current, approved definition.
How do I apply for the DDW?
The first step in the process is to complete the DD Waiver (HCBS) Application.
You may obtain an application packet on this webpage or you can contact the Pre-Service Specialist in your region. The date the completed Application Packet is received by PSIB is your application date. The application date is important because if you are found eligible for DD Waiver services, you will receive an offer to come into service based on that application date.
After the PSIB receives the application packet, a Pre-Service Specialist will contact you if additional information is needed. All individuals applying for DDW have 60 days to return supporting documentation.
Who determines eligibility?
A Pre-Service Specialist reviews information you, your guardian, and/or your authorized representative submit to DDSD and makes a determination regarding your eligibility for DD Waiver programs. This documentation may include a/n:
- Educational Evaluations
- Individual Educational Program (IEP)
- Review of Existing Evaluation Data (REED)
- Multidisciplinary Evaluation Reports
- Neuropsychological/Psychological Evaluations
- Medical Diagnosis Records
- Autism/Autistic Spectrum Disorder (ASD) Evaluations
Please provide us copies of your paperwork and keep the originals for your records.
All documentation is accepted and reviewed based on the current definition of eligibility. Individuals who have certain conditions or mental health diagnoses, in addition to ID and/or a related condition, receive a second level review by a licensed practitioner to make sure the individual matches the DD criteria.
If you are eligible, you will receive a “Yes Match” letter indicating your name is on the wait list for services based on your registration date.
What services are available while I am on the Allocation Schedule?
If you meet the definition criteria and receive a yes match letter, your name will be placed on the Allocation Schedule for the next Allocation group. While on the allocation schedule there may be other services available to you including Intermediate Care Facility (ICF) and State General Funds (SGF).
What if I receive a letter saying I am not eligible?
If you receive a No Match letter indicating that you did not meet the eligibility criteria as defined by the applicable New Mexico Administrative Code (NMAC) you may:
- Reapply if new or additional information becomes available that may support your eligibility. Include all relevant supporting documentation with your new application.
- Contact your Pre-Service Specialist for additional information a follow up regarding No Match letter.