Waiver programs are Medicaid programs that allow individuals with disabilities and long-term care needs to receive services in their homes or communities instead of in a nursing facility. These programs are designed to help individuals remain independent and active in their communities.
Who is Eligible for Waiver Programs?
To be eligible for a waiver program, individuals must meet certain financial, medical, and program requirements.
- Financial Requirements:
- Individuals must have a low income.
- Individuals’ income must be below 138% of the federal poverty level.
- Medical Requirements:
- Individuals must have a disability or long-term care need that requires assistance.
- The individual’s disability or long-term care need must be expected to last at least 6 months or be life-threatening.
- Program Requirements:
- Individuals must be eligible for Medicaid.
- Individuals must be living in the state of New Mexico.
- Individuals must be able to benefit from the services provided through the waiver.
How Do I Apply for a Waiver Program?
The application process for waiver programs varies from state to state. However, the general process includes:
- Contacting the New Mexico Human Services Department (HSD) to find out more about waiver programs and to get an application.
- Completing the application and submitting it to the HSD.
- Attending an assessment to determine eligibility for the waiver program.
- Being approved for the waiver program.
Waiver Programs in New Mexico
The state of New Mexico offers a number of waiver programs, including:
- Home and Community-Based Services (HCBS) Waiver: This waiver provides a wide range of services to individuals with disabilities and long-term care needs, including personal care, home health, and respite care.
- Transitional Care Waiver: This waiver provides services to individuals who are transitioning from a nursing facility to their homes.
- Community Living Assistance Services and Supports (CLASS) Waiver: This waiver is a new program that is still under development. It is designed to provide long-term care services to individuals who are not eligible for Medicaid.
How Can HealtheFirst Help?
HealtheFirst is a platform that can help home care agencies in New Mexico run more smoothly and efficiently. HealtheFirst provides a variety of features that can help agencies improve their operations, including:
- Case management: HealtheFirst can help agencies manage their cases more effectively by providing a centralized platform for storing and tracking client information. This can help agencies to ensure that each client is receiving the care they need, and that their care is being coordinated effectively.
- Scheduling: HealtheFirst can help agencies schedule their staff more efficiently by providing a tool that allows them to view and book appointments in real time. This can help agencies to ensure that their staff is always available to meet the needs of their clients, and that clients are not left waiting for care.
- Billing: HealtheFirst can help agencies bill their clients and payers more accurately by providing a platform that automates the billing process. This can help agencies to reduce the time they spend on billing, and to improve their chances of collecting payment from their clients.
- Communication: HealtheFirst can help agencies communicate with their clients and staff more effectively by providing a secure messaging platform. This can help agencies to stay in touch with their clients and staff, and to resolve any issues that may arise quickly and efficiently.
- Reporting: HealtheFirst can help agencies generate reports that track their performance and identify areas for improvement. This can help agencies to identify areas where they can improve their services, and to make sure that they are providing the best possible care to their clients.
How to find a home care agency in New Mexico: The HSD provides a list of home care agencies that are approved to provide services under the waiver programs. You can find this list on the HSD website.