Mi Via means “my path,” “my way” or “my road,” and is New Mexico’s Medicaid Self-Directed Waiver Program. Mi Via is designed to assist participants in directing their own home and community-based services and supports. Eligible participants will have the option to control, direct and purchase services, supports and goods related to their disability or condition and Medicaid funds, using the essential elements of person-centered planning, individual budgeting, participant protections, and quality assurance and quality improvement.
- If you are currently being served in any of the four (4) Medicaid HCBS Waiver programs and you decide you want to participate in Mi Via, you need to fill out a Waiver Change Form (WCF). You will receive this form upon request from the state program that you are currently enrolled in. Once this form is completed and returned, you will be contacted by a Consultant to enroll and develop your Mi Via Service and Support Plan and budget.
- If you are not yet in a Waiver program, you must register for services with the appropriate state program. Upon allocation for services, you will be able to choose to participate in Mi Via, New Mexico’s Self-Directed Waiver Program, by filling out a Primary Freedom of Choice form.
- Once Mi Via is selected, you will receive the appropriate paperwork to determine medical and financial eligibility from either the Aging and Long Term Services Department (ALTSD) or the Department of Health (DOH). This paperwork consists of the Human Services Department Income Support Division financial paperwork, ISD 381 (the blue form), Long Term Care Assessment Abstract (LOC), History and Physical (also known as an H&P) and instructions for completion and submission of forms. An ICD-9 form, in addition to the above forms, is also needed for brain injury participants only.
- One of Molina Healthcare TPA’s contracted home care agencies will contact you shortly after your selection to set up an appointment to conduct a face-to-face assessment.
- Once Molina Healthcare TPA receives all of your paperwork, your Level of Care (LOC) can be determined.
- Once your LOC is determined you will receive a letter in the mail from Molina Healthcare TPA. Your Consultant will also receive this letter and will contact you for next steps.
Mi Via Forms
Long Term Care Assessment Abstract (For AIDS, BI and CCW/D&E participants only)
Long Term Care Assessment Abstract (For DD participants only)
Medically Fragile Waiver Long Term Care Abstract (DOH 378)
History and Physical (H&P)
ICD-9 (Brain Injury participant only)
Confirmation of ICD9 Code
Other Useful Information:
Coordination of Long-Term Services (CoLTS) Program
CoLTS is a Medicaid managed care program that provides and coordinates services to certain Medicaid recipients. This includes all physical health and/or long-term care services, such as: doctor visits, hospital services, home and community-based services and long-term services (i.e. nursing facility services). Individuals enrolled in CoLTS receive their services under a managed care setting.
Individuals can choose from two CoLTS Managed Care Organizations (MCO) to receive services. Persons who get services under this managed care setting include: CoLTS c Waiver (CCW) (formerly the Disabled & Elderly Waiver) recipients, Personal Care Option (PCO) consumers, nursing home residents, people who have Medicare and Medicaid and are not getting long-term services, and people approved for the Mi Via Waiver who were approved through the CoLTS c Waiver (formerly Disabled & Elderly Waiver) or brain injury category of eligibility. People in Mi Via who are enrolled in CoLTS get their Mi Via services as they did before CoLTS, but now get their physical health services under CoLTS.
The two CoLTS MCOs are AMERIGROUP Community Care and Evercare of New Mexico. Contact information is as follows:
- AMERIGROUP - Phone number (505) 875-4320 (Albuquerque local) or (877) 269-5660 (toll-free)
- Evercare: Phone number (877) 236-0826 (toll-free)
New Mexico Aging and Long-Term Service Department (ALTSD) Resource Center Toll–free phone number: (800) 432-2080
The ALTSD is responsible for day-to-day management of certain home and community-based programs including PCO, Traumatic Brain Injury, CoLTS c waiver (formerly known as the Disabled and Elderly waiver), Mi Via self-directed waiver, for elderly and disabled persons on Medicaid and individuals with brain injury eligible for home and community-based services.
New Mexico Department of Health (DOH), Developmental Disabilities Supports Division (DDSD) Toll-free phone number: (800) 283-5548 (Albuquerque) or (877) 696-1472 (Santa Fe)
The DDSD is responsible for day-to-day management of the Medicaid Developmental Disabilities, Medically Fragile, and Mi Via waiver programs, for persons with developmental disabilities and for persons who are medically fragile and have or are at risk for developmental disability.
New Mexico Department of Health (DOH), Public Health Division (PHD), AIDS Waiver Manager: (505) 476-3618 (Santa Fe)
The PHD is responsible for day-to-day management of the AIDS and Mi Via Waiver Programs for persons living with AIDS.
New Mexico Human Services Department/Income Support Division (HSD/ISD) Toll-free phone number: (888) 473-3676
The HSD/ISD is the state agency that determines financial eligibility for HSD programs including Medicaid, Insure New Mexico!, food stamps, Temporary Assistance for Needy Families, and other programs.
New Mexico HSD/Medical Assistance Division (MAD) Toll-free phone number: (888) 997-2583
The HSD/MAD is the administering agency for the New Mexico Medicaid and Insure New Mexico! programs. Within the HSD/MAD Long-Term Services and Support Bureau, this includes oversight of Institutional Care Medicaid services (nursing facilities, intermediate care facilities for the mentally retarded, and hospital swing beds), the Coordination of Long-Term Services (CoLTS) program, the Program of All-Inclusive Care for the Elderly (PACE) program, Home and Community-Based Services (HCBS) waivers, and the utilization review/third-party assessor contract.
Mi Via Ombudsman
Molina Healthcare of New Mexico Inc. (Molina Healthcare), is pleased to announce that a Mi Via Ombudsman, Sharon Baca, has been hired to work directly with Participant issues. Sharon has full knowledge of the Mi Via Self-Directed Waiver Program and has previously worked as a consultant for Mi Via Participants. The Mi Via Ombudsman duties include working together with the Participant, their consultants and others who may be helping the Participant with their medical eligibility or budget, to get the answers needed to solve issues. She can also connect you directly to the person most able to help with your question. Sharon is currently accepting calls at a Mi Via Ombudsman phone number to assist you: (505) 999-0787. Participants may also call Molina Healthcare’s toll-free phone number at: (866) 916-3250 and ask to be connected with the Mi Via Ombudsman. Please note that if you have a specific question about your submitted budget or medical eligibility paperwork, you can also use the current process to contact your Mi Via care coordinator to discuss your question.