How to Access and Modify Services: A Supports Waiver Guide
Understanding Service Access and Modifications
The Supports Waiver Program allows participants to adjust their services as their needs evolve. Whether switching service models, changing providers, or modifying the Individual Support Plan (ISP) and budget, the process ensures participants can maintain care that aligns with their goals and preferences.
This guide explains how to access services, change service models or providers, and effectively adjust the ISP and budget.
Switching Service Models or Providers
Participants have the option to choose between the agency-based and participant-directed service delivery models based on their needs and preferences. They can also change service providers within their chosen model at any time.
Steps to Switch Service Models
- Contact Your CSC: Notify your Community Support Coordinator (CSC) about your desire to switch models.
- Submit an Updated ISP and Budget: Work with your CSC to create a new ISP and budget tailored to the chosen model.
- Close Out Previous Budget: Ensure that expenditures from the current model are documented and accounted for.
- Approval Process: The updated ISP and budget must be approved before transitioning to the new model.
Changing Providers
Participants can switch providers within their current service model if they are dissatisfied or their needs have changed. Steps include:
- Discuss with Your CSC: Communicate your reasons for switching providers.
- Review Options: Your CSC will provide a list of available providers to choose from.
- Facilitate the Transition: Your CSC will coordinate the transition process to ensure no interruption in services.
Modifying the ISP and Budget
Adjustments to the Individual Support Plan (ISP) and budget allow participants to adapt their care as their circumstances or needs change. Common reasons for modifications include:
- Changes in health status or living conditions.
- New goals or priorities identified by the participant.
- Adjustments to services required due to evolving needs.
Steps to Modify the ISP and Budget
- Identify the Change: Work with your CSC to determine what adjustments are needed.
- Provide Documentation: Submit written documentation explaining the reason for the modification.
- Submit the Request: The CSC forwards the modification request to the Third-Party Assessor (TPA) for review.
- Approval Process: Once approved, the updated ISP and budget are implemented.
Note: Modifications cannot be submitted within the last 60 days of the current ISP unless there are critical health and safety concerns.
How the New Mexico Support Network Can Assist
The New Mexico Support Network is a valuable partner in navigating service access and modifications. They provide:
- Guidance on Service Models: Helping participants choose the best service model for their needs.
- Provider Selection Support: Assisting with the process of switching providers or identifying new options.
- Modification Assistance: Ensuring ISP and budget modifications are submitted accurately and efficiently.
- Workshops and Resources: Offering training sessions and materials to help participants understand their options and responsibilities.
With the New Mexico Support Network’s expertise, participants can make seamless transitions and maintain high-quality care.
Benefits of Service Flexibility
The ability to access and modify services ensures that participants:
- Receive Personalized Care: Services remain aligned with their evolving goals and needs.
- Stay Empowered: Participants retain control over their care and provider choices.
- Maintain Continuity: The structured process minimizes service disruptions during transitions.
