New
Mexico Register / Volume XXXIV, Issue 17 / September 12, 2023
NOTICE
OF RULEMAKING
The Human Services Department (the
Department), through the Medical Assistance Division (MAD), is proposing to
amend the New Mexico Administrative Code (NMAC) rule 8.314.5 NMAC, Long Term
Care Services - Waivers, Developmental Disabilities Home
and Community-Based Services Waiver.
Section 9-8-6 NMSA 1978, authorizes
the Department Secretary to promulgate rules and regulations that may be
necessary to carry out the duties of the Department and its divisions.
Notice Date: September 12, 2023
Hearing Date: October 13, 2023
Adoption Date: Proposed as February 1, 2024
Technical Citations: 42 CFR Part 441
The Department
is proposing to amend the rule as follows:
Throughout the rule the following changes have
been made:
All references of the “Outside Reviewer” have been
removed and replaced with the “Third Party Accessor (TPA)”.
Changes have been made to align with formatting
requirements.
Section 7
Subsection A
HSD is proposing to add language to clarify the
definition of activities for daily living (ADLs).
Subsection E
HSD is proposing to remove the subsection regarding
the definition of Clinical Documentation as it is being renamed to Supporting
Documentation in Subsection I. Subsequent sections are being renumbered due
to addition/deletion of items.
Subsection F
HSD is proposing to remove the subsection regarding
Clinical Justification in Definitions as justification documentation policy
will be added in later section 15. Subsequent
sections are being renumbered due to addition/deletion of items.
Subsection E
HSD is proposing to add language defining the
developmental disabilities support division (DDSD), as they are the Operating
agency for the daily administration of the 1915c waiver programs. Subsequent sections are being renumbered
due to addition/deletion of items.
Subsection I
HSD is proposing to add the definition of Supporting
Documentation, replacing Clinical Documentation to clarify and remain
consistent with language throughout the rule. Subsequent sections are being renumbered
due to addition/deletion of items.
Subsection J
HSD is proposing to add the definition of the Third
Party Assessor as they are the contractor that will perform level of cares and
medical eligibility. Subsequent sections are being renumbered
due to addition/deletion of items.
Section
8
Subparagraph
(j) of Paragraph (1) of Subsection B
HSD
proposes adding language clarifying unacceptable intervention of public or
private humiliation.
Subparagraph
(k) of Paragraph (1) of Subsection B
HSD
proposes removing privacy violations language and replacing with the
application of water mist, noxious taste, smell, or skin agents as an
unacceptable intervention.
Subparagraph
(l) of Paragraph (1) of Subsection B
HSD
proposes to remove the unacceptable intervention of restricting exit and
replacing with privacy violations previously from Subparagraph
(k) of Paragraph (1) of Subsection B and expanding on the definition.
Subparagraph
(m) of Paragraph (1) of Subsection B
HSD
proposes to remove the unacceptable intervention of water mist as it is being
moved to Subparagraph (k) of Paragraph (1) of Subsection B and replacing with
the unacceptable intervention of restricting exit of a home and expanding on
the language.
Subparagraph
(n) of Paragraph (1) of Subsection B
HSD
proposes to remove this item as the language mentioned in the item, the
unacceptable intervention of application of noxious tastes, smells, etc., has
been combined with Subparagraph (k) of Paragraph (1) of Subsection B.
Paragraph (4) of Subsection B
HSD proposes to expand on direct support personnel
(DSP) by adding the full spelling of direct support personnel.
Paragraph (8) of Subsection B
HSD proposes to remove the word ‘super’ to correct
it being placed there in error.
Section
10
Subparagraph (d) of Paragraph (2)
of Subsection D
HSD proposes to add the required qualification of
having a high school diploma or GED and a minimum of 6 years of direct
experience related to the delivery of social services to people with
disabilities.
Subsection H
HSD proposes to expand on the language regarding
living supports provider direct support personnel to include subcontractor or
employee.
Subsection I
HSD proposes to expand on the language regarding
customized community supports provider direct support personnel to include
subcontractor or employee.
Subsection J
HSD proposes to expand on the language regarding
community integrated employment provider direct support personnel to include
subcontractor or employee.
Section
11
Paragraph (1) of Subsection C
HSD Proposes to add subcontractor to language
regarding employees of a developmental disabilities waiver (DDW) provider.
Section
14
Paragraph (11) of Subsection B
HSD proposes to add crisis supports as a service
option that are available outside of the annual resource allotment (ARA).
Section
15
HSD proposes clarifying language that DDW covered
services must be based on assessed need.
Subsection A
HSD proposes removing the existing subsection
regarding budget levels that the OR approved and replace with language
detailing the documentation justification of services.
Subsection C
HSD proposes removing language regarding budget
levels.
Paragraph (2) of Subsection C
HSD proposes to add amounts and units of respite
available per individual service plan (ISP) year to eligible recipients must
comply with limits outlined in the DDSD issued service standards.
Paragraph (3) of Subsection C
HSD proposes to add amounts and units of adult
nursing services available per ISP year to eligible recipients must comply with
limits outlined in the DDSD issued service standards.
Paragraph (4) of Subsection C
HSD proposes to add amounts and units of therapy
services available per ISP year to eligible recipients must comply with limits
outlined in the DDSD issued.
Subparagraph (a) of Paragraph (5)
of Subsection C
HSD proposes to add clarifying language stating the
recipient lives in the same residence as the direct support personnel for
family living services.
Subparagraph (b) of Paragraph (5)
of Subsection C
HSD proposes to add language clarifying amounts
and units of supported living services available per ISP year to eligible
recipients must comply with limits outlined in the DDSD issued service
standards. As well as clarifying documentation requirements.
Subparagraph (c) of Paragraph (5)
of Subsection C
HSD proposes adding the language of approval for
supported living intensive medical supports requires a IMLS parameter tool with
a score of 20 or above. As well as subsequent item is being renumbered due to the
addition.
Paragraph (6) of Subsection C
HSD proposes adding the language of amounts and units
of customized community supports (CCS) available per ISP year to eligible
recipients must comply with limits outlined in the DDSD issued service
standards.
Paragraph (7) of Subsection C
HSD proposes adding language stating requests from
eligible recipients for community integrated employment (CIE) intensive
services must include a letter of justification and the eligibility recipient's
work hours or proposed schedule.
Subparagraph (a) of Paragraph (7)
of Subsection C
HSD proposes adding language stating requests to
utilize the DDW for job development must have prior written approval by DDSD.
Subparagraph (b) of Paragraph (7)
of Subsection C
HSD proposes adding language stating requests
to utilize the DDW for short term job coaching must have prior written approval
by DDSD.
Subparagraph (e) of Paragraph (7)
of Subsection C
HSD proposes to remove reference to job aid. As well
as subsequent items are being renumbered due to
the removal.
Paragraph (8) of Subsection C
HSD proposes to add language clarifying the amounts
and units for support consultation available to the recipient as it is subject
to DDSD services standards as well as guidance on requesting units over limits.
Subparagraph (c) of Paragraph (8)
of Subsection C
HSD proposes to adjust language referring to direct
support personnel to be DSP.
Subparagraph (a) of Paragraph (10)
of Subsection C
HSD proposes to add language allowing the purchase
and installation of grab bars for environmental modification services.
Subparagraph (d) of Paragraph (10)
of Subsection C
HSD proposes to add language clarifying the amounts
and units for environmental modification services available to the recipient as
it is subject to DDSD services standards as well as documentation requirements.
Subsequent item is being renumbered due to the addition.
Paragraph (11) of Subsection C
HSD proposes to add language of Crisis Supports must
be prior authorized by the DDSD Bureau of Behavioral Supports (BBS).
Paragraph (12) of Subsection C
HSD proposes to add language of reimbursement is
allowable for eligible ride share programs identified through ISP. Amounts and
units of non-medical transportation available per ISP year to eligible
recipients must comply with limits outlined in the DDSD issued service standards.
Paragraph (14) of Subsection C
HSD proposes to add the language of amounts and
units of assistive technology available
to eligible recipients per ISP year must comply with limits outlined in the
DDSD issued service standards.
Paragraph (15) of Subsection C
HSD proposes to add the language of requests from
eligible recipients for independent living transition services must include
DDSD verification of eligibility form.
Amounts and units of independent living transition services available
per ISP year to eligible recipients must comply with limits outlined in the
DDSD issued service standards.
Paragraph (16) of Subsection C
HSD proposes to add the language of amounts and
units of remote support technology available per ISP year to eligible recipients
must comply with limits outlined in the DDSD issued service standards.
Paragraph (17) of Subsection C
HSD proposes to add the language of amounts and
units of preliminary risk screening and consultation (PRSC) available per ISP
year to eligible recipients must comply with limits outlined in the DDSD issued
service standards.
Paragraph (18) of Subsection C
HSD proposes to add the language of amounts and
units of socialization and sexuality education (SSE) available per ISP year to
eligible recipients must comply with limits outlined in the DDSD issued service
standards.
Paragraph (19) of Subsection C
HSD proposes to add the language of requests for
customized in-home living supports for over 11 hours a day must be approved the
DDSD.
Section 17
Subsection F
HSD proposes to remove this
section as the Jackson lawsuit has been dismissed. Subsequent subsections are being renumbered
due to the deletion.
The
register for these proposed amendments to this rule will be available September
12, 2023 on the HSD web site at https://www.hsd.state.nm.us/lookingforinformation/registers/
or at https://www.hsd.state.nm.us/public-information-and-communications/opportunity-for-public-comment/public-notices-proposed-waiver-changes-and-opportunities-to-comment/comment-period-open/. If you do not have Internet access, a copy of
the proposed rule may be requested by contacting MAD in Santa Fe at 505-827-1337.
The Department proposes to implement this rule
effective February 1, 2024. A public hearing to receive testimony on this
proposed rule will be held on October 13, 2023, at 10:30 a.m. The hearing will be held at the
Administrative Services Division (ASD), 1474 Rodeo Rd, Santa Fe, NM 87505 and via
conference call. Conference phone number:
1-800-747-5150. Access Code: 2284263.
Interested
parties may submit written comments directly to: Human Services Department, Office of the
Secretary, ATT: Medical Assistance Division Public Comments, P.O. Box 2348,
Santa Fe, New Mexico 87504-2348.
If
you are a person with a disability and you require this information in an
alternative format or require a special accommodation to participate in the
public hearing, please contact MAD in Santa Fe at 505-827-1337. The Department requests at least ten (10)
days advance notice to provide requested alternative formats and special
accommodations.
Copies
of all comments will be made available by the MAD upon request by providing
copies directly to a requestor or by making them available on the MAD website
or at a location within the county of the requestor.