N.M. Admin. Code § 8.326.2.12

Current through Register Vol. 36, No. 1, January 14, 2025

Section 8.326.2.12 - ELIGIBLE RECIPIENTS

A. Case management services are available for eligible medicaid recipients that meet all of the following criteria:

(1) 21 years of age or older;

(2) resident of the state of New Mexico;

(3) meet the state definition of an individual with a developmental disability;

(4) placement on the list for developmental disability services by the community services team (CST) of the developmental disabilities division of the HCA;

(5) resides outside a medicaid certified intermediate care facility for the mentally retarded (ICF-MR); and

(6) not a participant in a home and community based services waiver program.

B. Information on the individual is gathered by the CST and used to complete an assessment and assign an "urgency of need" priority. Recipients assigned a priority one are individuals who are in danger of becoming homeless or victims of abuse, if suitable placement services are not received. Recipients assigned a priority two are individuals whose condition will deteriorate without placement. Recipients assigned a priority three are individuals who could benefit from case management but whose present condition is acceptable.

N.M. Admin. Code § 8.326.2.12

2/1/95; Recompiled 11/30/01, Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024