DD Waiver Eligibility and Application Process: New Mexico Guide for Individuals and Families
Learn about the eligibility criteria and application process for New Mexico’s DD Waiver Eligibility, supporting individuals with developmental disabilities.
Understanding the DD Waiver in New Mexico
The Developmental Disabilities (DD) Waiver is a Medicaid-funded program in New Mexico designed to provide essential services and supports for individuals with intellectual and developmental disabilities (IDD). Eligibility for the DD Waiver is determined based on specific medical and functional criteria outlined in New Mexico Administrative Code (NMAC) 8.290.4.
Every five years, New Mexico submits a renewal application to the Centers for Medicare and Medicaid Services (CMS) to continue offering DD Waiver services. This ensures that eligibility criteria and available supports align with federal regulations and best practices in disability services.
Who is Eligible for the DD Waiver?
To qualify for the DD Waiver, an individual must meet the following conditions:
1. Have a Qualifying Developmental Disability
The individual must have:
- An Intellectual Disability with onset before age 18 OR
- A specific related condition such as:
- Cerebral Palsy
- Autistic Disorder
- Down Syndrome
- Epilepsy
- Other conditions similar to an intellectual disability that impair daily functioning
2. Demonstrate Significant Limitations
The disability must result in substantial limitations in at least three (3) major life activities, including:
- Self-care (eating, dressing, personal hygiene)
- Receptive and expressive language (understanding and communicating needs)
- Learning (adapting to new skills or environments)
- Mobility (independently moving around safely)
- Self-direction (decision-making and problem-solving)
- Capacity for independent living (performing daily tasks without assistance)
- Economic self-sufficiency (maintaining employment or managing finances)
These limitations must have begun before the age of 22 and require long-term support.
How to Apply for the DD Waiver
Applying for the DD Waiver involves several steps to ensure individuals meet the eligibility criteria.
Step 1: Submit an Interest List Application
- To initiate the process, individuals or their guardians must submit an application to be placed on the DD Waiver Waitlist through the New Mexico Department of Health’s Developmental Disabilities Supports Division (DDSD).
- Applications can be submitted online, by mail, or in person at a DDSD Regional Office.
Step 2: Complete an Eligibility Determination Assessment
Once a waiver slot is available, the individual must undergo an eligibility determination assessment to confirm they meet medical and functional criteria. This involves:
- Medical and psychological evaluations.
- A review of past assessments, education records, and therapy reports.
- An interview with caregivers and healthcare providers.
Step 3: Medicaid Financial Eligibility Verification
- The individual must meet Medicaid financial eligibility guidelines, which are determined by the New Mexico Human Services Department (HSD).
- Income and asset limits apply to ensure services are available to those with the greatest need.
Step 4: Service Plan Development
Once eligibility is confirmed, the individual works with a Community Support Coordinator (CSC) to develop an Individual Support Plan (ISP) that outlines the services and supports needed.
Step 5: Begin DD Waiver Services
After final approval, individuals can start receiving services, which may include:
- Personal care assistance
- Behavioral and therapy services
- Respite care
- Supported employment
- Assistive technology
How the New Mexico Support Network Can Assist
At New Mexico Support Network (NMSN), we understand that navigating the DD Waiver application process can be overwhelming. Our team provides expert assistance in:
✅ Understanding eligibility requirements and gathering the necessary documentation.
✅ Completing the DD Waiver Interest List Application and Medicaid paperwork.
✅ Assisting with the eligibility determination process to ensure a smooth transition into services.
✅ Connecting individuals with home care, medical staffing, and specialized support tailored to their needs.
Whether you’re applying for the first time or need help navigating the waiver renewal process, our team is here to guide you every step of the way.
Take Action Today
If you or a loved one may be eligible for the DD Waiver in New Mexico, don’t wait to start the process. Contact the New Mexico Support Network for expert guidance on eligibility, applications, and accessing essential services.
Contact NMSN:
📞 Phone: +1 800 973 0060
📩 Email: care@nmsupport.com
🌐 Visit: New Mexico Support Network
Let us help you navigate the path to comprehensive care and support!
