Tu-Via New Mexico waiver guide for families

The whole path

How the process works, start to finish

Application, eligibility, wait list, allocation, intake, planning, services, renewal. Nine stages, and most families are surprised by the same three.

Nothing here is fast, and almost none of it is in your control. What is in your control: getting the application date early, keeping your contact information current, answering letters inside their deadlines, and knowing what a document is before you sign it.

The nine stages

  1. Application

    You send the HCBS Waivers and ICF/IID application to the Pre-Service Intake Bureau. The date they receive the completed packet becomes your application date.

  2. Eligibility decision

    A Pre-Service Specialist reviews your documentation against the state's definition of developmental disability. Certain conditions and mental health diagnoses get a second review by a licensed practitioner. You get a "Yes Match" or "No Match" letter.

  3. The Central Registry wait list

    A Yes Match puts your child on the Central Registry, ordered by application date. Offers go out as the Legislature funds them, which is why this stage is measured in years rather than months.

    This is the stage nobody warns you about. Plan your child's next few years as though the waiver will not arrive in them.

  4. Allocation

    When funding is available and your name reaches the top, DDSD mails a Letter of Interest and a Primary Freedom of Choice form. You have 30 days to respond. Miss it and a closure warning letter gives you another 30 days before the allocation closes.

    The letter goes to the address in the Central Registry. Call your Pre-Service Specialist periodically to confirm what they have on file.

  5. Choosing your program and your agencies

    The Primary Freedom of Choice is where you pick between the traditional DD Waiver and Mi Via. A Secondary Freedom of Choice picks the specific case management or consultant agency. You are choosing, not being assigned, and you can ask for a provider list before you sign.

  6. Intake, level of care, and financial eligibility

    Now the medical and financial sides get confirmed. Level of care (LOC) means an assessment showing your child needs the level of support an ICF/IID would provide. Medicaid financial eligibility is verified separately. Both get renewed every year.

  7. Planning

    This is the good part. On the DD Waiver your case manager compiles an Individual Service Plan (ISP). On Mi Via, you and your consultant write a Service and Support Plan (SSP). Both are supposed to start from your child's actual life, strengths, and goals, then work backward to services.

    Come with your own list. A plan built around a blank page tends to get filled with whatever services the agency already staffs.

  8. Budget approval

    The plan turns into a budget, which goes to the state's Third Party Assessor (TPA) for review. Approved, it becomes the amount available for the year: the Authorized Annual Budget (AAB) on Mi Via. Then services can be authorized and start.

  9. Every year after

    Annual medical and financial recertification, an updated plan, a new budget. If your child's needs change mid-year, you ask for a revision rather than waiting for the anniversary.

On the wait list right now? Two things worth doing this month: confirm your address and phone with the Central Registry (505-630-9555 or 575-997-7980), and ask your regional DDSD office what State General Funded services you can use while you wait.

When you disagree with a decision

You have appeal rights at several of these stages, and they run on short clocks. A denial letter should say what the deadline is; read it the day it arrives rather than the week you have the energy for it.

For help pushing back, Disability Rights New Mexico (opens an outside website) is the state's protection and advocacy organization, and the Health Care Authority's Office of Constituent Support (opens an outside website) handles complaints about the programs themselves.