N.M. Admin. Code § 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.
Notes
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