Under 21
Children, school, and the years before adulthood
A waiver is one of four or five systems your child may be in at once. This page is about how they fit together, and which door to knock on for what.
The waiver is designed to add to what your child already has, not replace it. When someone says a service is not covered, the real question is usually which system covers it, not whether anyone does.
The systems, and what each is for
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Birth to 3
Family Infant Toddler (FIT)
Early intervention for infants and toddlers with a delay or a diagnosed condition, run through the Early Childhood Education and Care Department. Do not wait for a waiver to start here.
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Age 3 through high school
School and the IEP
Special education runs on federal education law, not Medicaid. The IEP is a separate document from the ISP or SSP, decided by a separate team. Both should know the other exists.
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Under 21
EPSDT
Medicaid's child benefit, and the most underused tool in the box. It covers medically necessary services for anyone under 21, often beyond what adult Medicaid or the waiver would pay for.
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Under 18
The DD Waiver children's category
Case management, behavior support consultation, individual customized community support, respite, non-medical transportation, supplemental dental, nutritional counseling, environmental modifications.
If your child is medically fragile
There is a separate waiver for it. The Medically Fragile Waiver serves people diagnosed with a medically fragile condition before age 22 who also have a developmental disability or delay, or are at risk of one. "Medically fragile" means a chronic physical condition with prolonged dependence on medical care where daily skilled nursing is medically necessary.
It covers nurse case management, home health care, respite, private duty nursing, physical, occupational and speech therapies, behavior support consultation, nutritional counseling, and specialized medical equipment and supplies. To learn more or apply, call 1-800-283-8415.
Autism evaluations and family support
DDSD funds two university programs that do diagnostic evaluations, family support, in-home training, school consultation, and support groups for parents, teens, and siblings: the UNM Center for Development and Disability (opens an outside website) autism programs, and the NMSU Papen-Aprendamos Autism Diagnostic Center (opens an outside website). Either is a reasonable first call if you are stuck on getting a diagnosis at all.
The transition years, roughly 14 to 22
This is the stretch that catches families off guard, because several deadlines land at once and none of them announce themselves.
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Around 14 to 16: transition planning starts in the IEP
The IEP must start addressing life after school. Push for specifics: work experience, travel training, self-advocacy, not just a line about "exploring options."
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Before 18: decide about guardianship, or its alternatives
At 18 your child is legally an adult and signs their own paperwork. Full guardianship is one answer and often more than is needed. Supported decision-making, a power of attorney, or a limited guardianship may fit better. Get advice early rather than in a panic at the birthday.
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At 18: more waiver services open up
Several living and employment supports on both waivers start at 18 or 21. Ask for a plan revision at the birthday rather than waiting for the annual meeting.
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At 21: EPSDT ends
The most common hard landing. Services your child got through EPSDT because they were medically necessary for a child may not continue as an adult. Start asking at 19 what replaces each one.
For the organizations that help families with school disputes and transition planning, see resources.