SUPPORTED LIVING SERVICES PROVIDER IN NEW MEXICO

PROMOTING INDEPENDENCE THROUGH SAFE, ASSISTED LIVING ENVIRONMENTS

Supported Living Services in New Mexico provide individuals with intellectual or developmental disabilities with safe, community-based living environments while promoting autonomy and inclusion. These services support individuals in their homes, offering personal care, skill development, and community integration. Supported 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 Supported 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 Supported Living Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

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

2. SUPPORTED LIVING SERVICES OVERVIEW

Supported Living Services offer individualized support to help individuals with disabilities maintain independence in a residential setting while fostering community participation.

Approved providers may deliver:

• 24/7 Staff Support: Assistance with personal care, safety, and daily activities.

• Personal Care Assistance: Help with bathing, grooming, dressing, and mobility.

• Skill Development: Training in daily living skills, personal care, and household management.

• Community Integration: Facilitating social engagement, employment support, and recreational activities.

• Health and Wellness Monitoring: Administering medication, monitoring health conditions, and promoting self-care.

• Behavioral Support: Managing challenging behaviors and promoting positive interactions.

• Emergency and Crisis Intervention: Ensuring safety during unexpected situations.

• Individualized Planning: Developing and implementing tailored support plans.

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

• Obtain facility licensure from HSD or NMDOH if operating a group home.

• Maintain general liability and professional liability insurance.

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

• Ensure staff meet background checks, health screenings, and supported living 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 Supported Living 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 safety protocols, staff qualifications, and care plans.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Supported 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

• Facility License (if applicable)

• Proof of general and professional liability insurance

• Supported Living Services Policy & Procedure Manual including:

  • Participant intake, care planning, and individualized support protocols

  • Health and safety monitoring, medication administration, and wellness checks

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for care tracking and Medicaid billing

  • HIPAA compliance, participant rights, and grievance handling

  • Safety protocols, emergency response, and crisis management

  • Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Supported Living Program Director

Requirements: Bachelor’s degree in human services, social work, or healthcare administration; supervisory experience preferred.

Role: Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; CPR/First Aid certification; training in personal care and community integration; background clearance.

Role: Residential Support Coordinators

Requirements: Experience in supported living management; supervisory experience; 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 residential care and personal safety

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety training, including emergency preparedness and behavioral management

• Infection control and wellness monitoring education

7. MEDICAID WAIVER PROGRAMS

Supported 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 assisted living with personal care support

• Skill development in daily living and self-care

• Community integration and social engagement activities

• Health monitoring and medication administration

• Behavioral support and crisis intervention

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Facility Licensing and Compliance Documentation

Timeline: 2–3 months

Phase: Staff Hiring, 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 Supported Living Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

New Mexico Human Services Department (HSD)

Website: https://www.hsd.state.nm.us/

Developmental Disabilities Supports Division (DDSD)

Website: https://www.nmhealth.org/about/ddsd/

New Mexico Medicaid Provider Enrollment Portal

Website: https://nmmedicaid.portal.conduent.com/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

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

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

Scope of Work:

• Business registration, Medicaid enrollment, and facility licensure support

• Policy manual development for supported living care and community integration

• Staff credentialing, training program templates, and documentation guidance

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and community outreach strategies

• Quality assurance systems for supported living safety and compliance

• Collaboration with healthcare and community organizations

Continue To Our Client Portal To Get Started

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