BEHAVIORAL SUPPORT SERVICES PROVIDER IN NEW MEXICO

Fatumata Kaba
Sep 5
4 min read

PROMOTING POSITIVE BEHAVIORAL OUTCOMES THROUGH INDIVIDUALIZED SUPPORT

Behavioral Support Services in New Mexico provide therapeutic interventions, counseling, and support to individuals with intellectual, developmental, or behavioral health challenges. These services aim to reduce challenging behaviors, enhance social skills, and promote emotional well-being. Behavioral Support Services are authorized under New Mexico Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New Mexico Human Services Department (HSD)

Role: Administers Medicaid waiver funding for Behavioral Support Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Developmental Disabilities Supports Division (DDSD)

Role: Ensures quality standards, service delivery, and compliance for Behavioral Support Services under HCBS waiver programs.

Agency: Behavioral Health Services Division (BHSD)

Role: Monitors the quality of behavioral health care and supports provider compliance with state regulations.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Behavioral Support Services meet HCBS quality, person-centered planning, and participant protection standards.

2. BEHAVIORAL SUPPORT SERVICES OVERVIEW

Behavioral Support Services help individuals manage challenging behaviors and develop coping strategies through therapeutic interventions, counseling, and personalized support.

Approved providers may deliver:

Behavioral Assessment: Identifying behavioral triggers and patterns through comprehensive evaluations.
Behavioral Intervention Planning: Developing structured, evidence-based plans to address challenging behaviors.
Skill-Building Activities: Teaching coping strategies, social skills, and emotional regulation.
Individual Counseling: Providing therapeutic support to address emotional and behavioral challenges.
Group Counseling: Facilitating peer interactions and group-based behavioral interventions.
Crisis Intervention: Immediate support during behavioral crises to ensure safety and stability.
Positive Behavior Support (PBS): Implementing strategies to reinforce positive behaviors.
Family Training and Support: Educating caregivers on managing and responding to behavioral issues.
Progress Monitoring: Regular evaluations to track progress and adjust intervention plans as needed.

All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s behavioral and emotional support needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the New Mexico Secretary of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Behavioral Support provider via the New Mexico Medicaid Provider Enrollment Portal.
Obtain behavioral health licensure from the New Mexico Regulation and Licensing Department (RLD) if applicable.
Maintain general liability and professional liability insurance.
Develop policies for behavioral intervention planning, safety protocols, and crisis management.
Ensure staff meet background checks, health screenings, and behavioral health training requirements.

4. NEW MEXICO PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application through the New Mexico Medicaid Provider Enrollment Portal for Behavioral Support Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, behavioral health licenses (if applicable), insurance certificates, and policy manuals.

Program Readiness Review:

HSD, DDSD, and BHSD evaluate provider readiness, including safety protocols, staff qualifications, and intervention strategies.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Behavioral Support Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New Mexico Secretary of State)
IRS EIN confirmation
NPI confirmation
Behavioral Health License (if applicable)
Proof of general and professional liability insurance
Behavioral Support Services Policy & Procedure Manual including:
- Behavioral assessment, intervention planning, and crisis response protocols
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for behavioral tracking and Medicaid billing
- HIPAA compliance, participant rights, and grievance handling
- Safety protocols, emergency response, and de-escalation techniques
- Family involvement and caregiver support guidelines
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Behavioral Support Program Director

Requirements: Master’s degree in psychology, social work, or a related field; certification in behavioral analysis preferred; supervisory experience.

Role: Behavioral Therapists

Requirements: Licensure as a Board Certified Behavior Analyst (BCBA) or Licensed Professional Counselor (LPC); experience in behavioral interventions; background clearance.

Role: Behavioral Technicians

Requirements: Certification as a Registered Behavior Technician (RBT) or similar; training in behavioral support; background clearance.

Role: Crisis Intervention Specialists

Requirements: Certification in crisis management and de-escalation techniques; experience in behavioral support; background clearance.

All staff must complete: