DDSD MI VIA Waiver Applications

The Provider Enrollment Application for Mi Via Consultant Agency is available for interested providers to download. Be sure that all paperwork in the application is filled out completely and accurately.

Please review the DDSD Waiver Standards for services about which you are inquiring, and review the other links that are provided under the Important Links portion below. Include all requested documentation with the application to avoid delay or denial of your application. If you have any questions about the application, please feel free to email us.If the email does not function, just cut and paste this email address (cpb.peu@state.nm.us) to your email program.

Provider Enrollment Application for Mi Via Consultant Agency Packet

You may obtain these forms below (note: download times may vary):

Provider Application Packet for Mi Via - effective April 30, 2011 (updated Dec-2011)

SUBCONTRACT APPROVAL FORM for MI VIA WAIVER

Mi Via Consultant Standards and Regulations

NMAC 8.314.6 regulations

Mi Via Consultant Service Standards - effective April 1, 2011

 

Mi Via Consultant Guide

The Mi Via Consultant Guide is a training tool for providing consultant services that is usable for new consultants and as a helpful reference for all consultants.  Click here for the consultant guide - (Revised 4/20/2012; posted 5/16/2012)

Important Links for Provider Enrollment Application Packet
DDSD Policy and Procedures
DDSD Regional Office Contacts
DHI Incident Management
DHI Incident Management Guide

NMAC TITLE 7 CHAPTER 1 PART 9 Caregivers Criminal History Screening Program (CCHSP)

NM Taxation and Revenue Department

Mi Via Website (www.mivianm.org/)

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