New Mexico Medicaid Home & Community Based Services
Home and Community Based Services (HCBS) is a state Medicaid program for individuals with disabilities who qualify for nursing facility services and prefer to continue living in their homes and communities.
- HCBS provides in-home support and assistance (In-Home Caregiver/Personal Care Assistant.)
- A trusted friend or family member can be paid to help you stay in your home.
- The level of services is decided based on the specific needs of the person with the disability.
Available Services
- Personal Care: Assistance with daily living activities, such as bathing, dressing, cooking, and shopping.
- Skilled Therapies: Occupational, Physical, Speech, and Language Therapy for adults twenty-one and older.
- Environmental Modifications: Changes to your home to enhance safety and independence.
- Respite Care: Substitute provider to give the primary caregiver a break or in case of illness.
- Behavioral Health Services
- Transportation
- Translation Services
Accessing In-Home Services
- Contact the Medicaid Program or Case Coordinator (examples of Medicaid Programs are BlueCross Blue Shield, Presbyterian Health Plan, Molina Healthcare, United HealthCare)
- Apply for services
- The program will assess the needs and develop a plan
If you are denied services or disagree with the level of services, you can contest the decision with the Medicaid program.
If you do not qualify for Medicaid, call the Aging and Disability Resource Center (ADRC) at 1-800-432-2080 for similar programs.
There are Two Types of Services to Choose From in HCBS
- Agency-Based: In-home care agency provides in-home support and assistance.
- Self-Directed: HCBS Case Coordinator helps you manage the paperwork of in-home support and assistance.
Both allow for you to have your trusted friend or family member who can be paid to provide in-home support and assistance.
Other State Medicaid Programs for In-Home Care
- Developmental Disabilities Waiver
- Mi Via Waiver
Frequently Asked Questions (FAQ)
What is In-Home Caregiver/Personal care Assistant? The role is to provide in-home support and assistance to individuals with disabilities with daily living activities, such as bathing, dressing, cooking, and shopping.
Who Can provide In-Home Caregiving/Personal Care Assistant? In-home care services can be provided by staff from a Home Care Agency or through a Medicaid program, depending on which type of services you choose. A trusted friend or family member may also serve as your in-home caregiver. To do so, they must apply to become an employee of the Home Care Agency (for the Agency-Based Program) or coordinate with the Case Coordinator (for the Self-Directed Program), based on the Home and Community-Based Services (HCBS) program selected.
What is the pay rate of an In-Home Caregiver? The pay would be through the home health care agency or the Medicaid provider, depending on the type of service chosen (Agency-Based or Self- Directed.) The pay rate depends on area that you work in and is above the minimum wage.
What requirements are there to be In-Home Caregiver? Background check is needed. The home care agency or the Medicaid provider will decide if a Driver’s License is needed.
Is there training needed? The home care agency provides training and ongoing support.
When and how much care will they provide? The number of care hours will depend on the result of the HCBS assessment that occurs during the HCBS application process. Based on the individual’s needs, the application process will determine and approve the amount of care they are eligible to receive.
What employee benefits given? The home care agency will provide employee benefits. Driving while on the clock can result in mileage reimbursement.
How long with the application process take? It could take a few months during the application process.
If you’re interested in becoming a paid Caregiver and require assistance with the application process, you are encouraged to contact the Law Center.