New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 314 - LONG TERM CARE SERVICES - WAIVERS › Part 7 - SUPPORTS WAIVER › Section 8.314.7.12 - SUPPORTS WAIVER CONTRACTED ENTITIES AND PROVIDERS

Current through Register Vol. 35, No. 13, July 16, 2024
Services are to be provided in the least restrictive manner.
				  The HSD does not allow for the use of any restraints, restrictive
				  interventions, or seclusions to an eligible supports waiver recipient. The
				  following resources and services have been established to assist eligible
				  recipients to access supports waiver services through the agency-based service
				  delivery model or the participant directed service delivery model. These
				  include the following:
A.
Community supports coordinator (CSC) services:
CSC services are
				direct services intended to assist the eligible recipient in attaining and
				maintaining medical and financial eligibility; educating, guiding and assisting
				the eligible recipient to make informed planning decisions about service and
				supports; developing an ISP through a person-centered planning process;
				implementing and monitoring the ISP and AAB; and under the agency-based service
				delivery model, arranging for, directing, and managing supports waiver services
				and supports.
B.
Financial
				management agency (FMA):
For eligible recipients selecting the
				participant directed service delivery model, the FMA acts as the intermediary
				between the eligible recipient and the MAD payment system and assists the
				eligible recipient or the EOR with employer-related responsibilities. The FMA
				pays employees and vendors based upon an approved AAB. The FMA assures there is
				eligible recipient and program compliance with state and federal employment
				requirements and monitors and makes available to the eligible recipient the
				reports related to utilization of services and budget expenditures. Based on
				the eligible recipient's approved ISP and AAB, the FMA must:
(1) verify that the recipient is eligible for
				MAD services prior to making payment;
(2) receive and verify all required employee
				and vendor documentation;
(3)
				establish an accounting for each eligible recipient's AAB;
(4) process and pay invoices for goods,
				services and supports approved in the ISP and the AAB and supported by required
				documentation;
(5) process all
				payroll functions on behalf of the eligible recipient and EORs including:
(a) collect and process timesheets of
				employees;
(b) process payroll,
				withholding, filing, and payment of applicable federal, state and local
				employment-related taxes and insurance; and
(c) track and report disbursements and
				balances of the eligible recipient's AAB and provide a monthly report of
				expenditures and budget status to the eligible recipient and their CSC, and
				quarterly and annual documentation of expenditures to the MAD;
(6) receive and verify employee
				and vendor agreements, including collecting required provider
				qualifications;
(7) monitor hours,
				the total amounts billed for all goods and services during the month;
(8) process and report on employee background
				checks;
(9) answer inquiries from
				the eligible recipient and solve problems related to the FMA responsibilities;
				and
(10) report to the CSC
				provider, MAD and DOH any concerns related to the health and safety of an
				eligible recipient, or if the eligible recipient is not following the approved
				ISP and AAB.