DAY HABILITATION SERVICES PROVIDER IN NEW MEXICO

Fatumata Kaba
Sep 5
4 min read

PROMOTING INDEPENDENCE AND SKILL DEVELOPMENT THROUGH STRUCTURED DAY PROGRAMS

Day Habilitation Services in New Mexico offer individuals with intellectual or developmental disabilities structured programs designed to build essential life skills, promote independence, and encourage community involvement. These services are delivered in community-based settings or specialized facilities, providing participants with social, educational, and recreational opportunities. Day Habilitation 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 Day Habilitation Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Developmental Disabilities Supports Division (DDSD)

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

Agency: Centers for Medicare & Medicaid Services (CMS)

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

2. DAY HABILITATION SERVICES OVERVIEW

Day Habilitation Services help individuals acquire, maintain, and improve self-help, socialization, and adaptive skills through structured, goal-oriented activities.

Approved providers may deliver:

Skill Development Activities: Training in self-care, communication, and daily living skills.
Community Integration: Participating in social, educational, and recreational activities within the community.
Social Skills Training: Building relationships, communication, and interpersonal skills.
Cognitive Enrichment: Engaging in activities that stimulate memory, problem-solving, and creative thinking.
Health and Wellness Programs: Exercise, nutrition education, and personal care routines.
Arts and Recreation: Creative projects, music, art therapy, and group exercises.
Vocational Skills Development: Pre-employment skills and task-oriented activities.
Safety and Mobility Training: Teaching safe navigation within the facility and community.

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

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 Day Habilitation provider via the New Mexico Medicaid Provider Enrollment Portal.
Obtain facility licensure from HSD or NMDOH if providing site-based day habilitation.
Maintain general liability and professional liability insurance.
Develop policies for daily programming, safety protocols, and staff training.
Ensure staff meet background checks, health screenings, and habilitation 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 Day Habilitation Services under HCBS waivers.

Application and Documentation Submission:

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

Program Readiness Review:

HSD and DDSD evaluate provider readiness, including activity plans, safety measures, and staff qualifications.

Approval & Medicaid Enrollment:

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

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New Mexico Secretary of State)
IRS EIN confirmation
NPI confirmation
Facility License (if providing site-based services)
Proof of general and professional liability insurance
Day Habilitation Services Policy & Procedure Manual including:
- Activity planning, skill development, and community engagement protocols
- Staff credentialing, background checks, and training requirements
- Documentation standards for activity tracking and Medicaid billing
- HIPAA compliance, participant rights, and grievance handling
- Safety protocols, emergency response, and infection control measures
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Day Habilitation Program Director

Requirements: Bachelor’s degree in human services, special education, or related field; experience managing day programs.

Role: Habilitation Specialists

Requirements: Experience in skill development and community integration; training in adaptive programming; background clearance.

Role: Direct Support Professionals (DSPs)Requirements: High school diploma or GED; CPR/First Aid certification; experience in personal care and community activities; background clearance.

Role: Activity Coordinators

Requirements: Experience in planning and facilitating group activities; background clearance.

All staff must complete: