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FAMILY LIVING SERVICES PROVIDER IN NEW MEXICO

  • Writer: Fatumata Kaba
    Fatumata Kaba
  • Sep 5
  • 4 min read

SUPPORTING INDIVIDUALS IN A FAMILY-LIKE ENVIRONMENT THROUGH INTEGRATED CARE

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Family Living Services in New Mexico provide a structured, family-like living environment for individuals with intellectual or developmental disabilities. These services focus on community integration, personal care, and fostering independence while being embedded in a supportive family setting. Family Living 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 Family Living Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Developmental Disabilities Supports Division (DDSD)

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

Agency: Centers for Medicare & Medicaid Services (CMS)

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

 

2. FAMILY LIVING SERVICES OVERVIEW

Family Living Services offer individuals with disabilities the opportunity to live in a family setting, receiving care and support from caregivers while promoting independence and community involvement.

Approved providers may deliver:

  • 24/7 Supervision and Support: Daily assistance with personal care and supervision in a home environment.

  • Personal Care Assistance: Help with Activities of Daily Living (ADLs) like bathing, grooming, dressing, and mobility.

  • Skill Building and Training: Teaching life skills such as cooking, personal hygiene, and money management.

  • Community Integration: Encouraging participation in social, recreational, and educational activities.

  • Health Monitoring: Ensuring medication management and tracking of health conditions.

  • Behavioral Support: Providing assistance with behavioral challenges and promoting positive interactions.

  • Emergency and Safety Planning: Creating a safe environment and preparing for emergencies.

  • Caregiver Support: Training and guidance for family caregivers to ensure consistent care.

All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s unique 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 Family Living Services provider via the New Mexico Medicaid Provider Enrollment Portal.

  • Obtain facility licensure if the service is offered in a group home setting.

  • Maintain general liability and professional liability insurance.

  • Develop policies for family living care, safety protocols, and staff training.

  • Ensure caregivers and staff meet background checks, health screenings, and 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 Family Living Services under HCBS waivers.

Application and Documentation Submission:

  • Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, caregiver qualifications, and policy manuals.

Program Readiness Review:

  • HSD and DDSD evaluate provider readiness, including safety protocols, care plans, and caregiver qualifications.

Approval & Medicaid Enrollment:

  • Upon approval, providers are authorized to bill Medicaid for Family Living Services using designated billing codes.

 

5. REQUIRED DOCUMENTATION

  • Articles of Incorporation or Business License (New Mexico Secretary of State)

  • IRS EIN confirmation

  • NPI confirmation

  • Family Living Facility License (if applicable)

  • Proof of general and professional liability insurance

  • Family Living Services Policy & Procedure Manual including:

    • Participant intake, assessment, and care planning procedures

    • Safety and emergency preparedness protocols

    • Staff credentialing, background checks, and caregiver training records

    • Documentation standards for care tracking and Medicaid billing

    • HIPAA compliance, participant rights, and grievance handling

    • Infection control and wellness monitoring procedures

    • Quality assurance and compliance monitoring

 

6. STAFFING REQUIREMENTS

Role: Family Living Program Director

Requirements: Bachelor’s degree in human services, social work, or healthcare administration; experience in family or residential care.

Role: Family Caregivers

Requirements: Experience in personal care or support services; CPR/First Aid certification; background clearance.

Role: Direct Support Professionals (DSPs) (if applicable)

Requirements: High school diploma or GED; training in ADL support and community integration; background clearance.

Role: Behavioral Support Specialists (if applicable)

Requirements: Certification in behavioral health support or applied behavior analysis (ABA); background clearance.

All staff must complete:

  • Training in family-centered care and daily living support

  • HIPAA compliance and participant rights education

  • Annual competency evaluations and ongoing professional development

  • Emergency preparedness and safety training

  • Infection control and health monitoring education

 

7. MEDICAID WAIVER PROGRAMS

Family Living Services are available under the following New Mexico Medicaid Waivers:

  • Developmental Disabilities (DD) Waiver

  • Mi Via Waiver

  • Medically Fragile Waiver

  • Supports Waiver

  • Home and Community-Based Services (HCBS) Waiver

Services may include:

  • 24-hour family-based care and supervision

  • Assistance with personal care and daily living tasks

  • Community engagement and social skill development

  • Health and safety monitoring

  • Behavioral support and crisis intervention

 

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Caregiver Recruitment, Credentialing, and Training

Timeline: 2–3 months

Phase: New Mexico Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Family Living Service Launch

Timeline: 30–45 days

 

9. CONTACT INFORMATION

New Mexico Human Services Department (HSD)

Developmental Disabilities Supports Division (DDSD)

New Mexico Medicaid Provider Enrollment Portal

Centers for Medicare & Medicaid Services (CMS)

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NEW MEXICO FAMILY LIVING SERVICES PROVIDER

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — NEW MEXICO FAMILY LIVING SERVICES PROVIDER

WCG supports agencies in launching Medicaid-compliant Family Living Services in New Mexico, offering:

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Scope of Work:

  • Business registration, Medicaid enrollment, and licensing assistance

  • Policy manual development for family living care and safety management

  • Caregiver credentialing, training program templates, and compliance documentation

  • Medicaid billing setup and audit-prepared financial management

  • Branding, website development, and community engagement strategies

  • Quality assurance systems for family care and participant well-being

  • Collaboration with healthcare providers and community organizations



Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements. 

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