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MFW Families and Providers


The Developmental Disabilities Supports Division (DDSD) is moving to the Health Care Authority (HCA). Our current webpages have moved to the Official HCA Website. Please go there for all future DDSD updates.

The Medically Fragile Waiver (MFW) serves individuals who have been diagnosed with a medically fragile condition before reaching age 22, and who either have a developmental disability or delay or who are at risk for developmental delay.  A medically fragile condition is defined as a chronic physical condition which results in a prolonged dependency on medical care for which daily skilled nursing intervention is medically necessary.

Services provided through the MFW are case management, home health care, respite care, private duty nursing, physical, occupational and speech therapies, behavior support consultation, nutritional counseling and specialized medical equipment and supplies. The New Mexico Department of Health, Developmental Disability Services Division administers the MFW.

The Medically Fragile Waiver Standards July, 2022 address each service covered by the Medically Fragile Waiver as approved in October, 2021 effective July 1, 2021. There are many services available including respite Individuals should expect to receive services that meet these standards.


In order to receive services on the Medically Fragile Waiver, individuals must meet the requirements for financial and medical eligibility for the program. Individuals must maintain eligibility to continue receiving waiver services.

Central Registry/ Allocation

The Medically Fragile Waiver Program receives a copy of the waiver registration form (MAD 325) from the ISD office and the referral is registered on the Central Registry by the date stamped on the MAD 325 form. The referral on the Central Registry is based upon a first come, first served basis. The appropriated funds by the New Mexico Legislature determine the number of allocated slots for the Medically Fragile Waiver Program statewide.


Application for the Medically Fragile Waiver is made with the Income Support Division (ISD) office in the county where the applicant resides.

To be considered financially eligible, the applicant must meet the Medicaid income guidelines specific to Category 95/Medically Fragile Waiver.  The financial eligibility for the Medically Fragile Waiver applicants is determined by the Medicaid Income Support Division at the Human Services Department (HSD).

The medical eligibility for the Medically Fragile Waiver applicants is determined by the contracted Medicaid Utilization Review Agent with the HSD Medical Assistance Division (MAD). The applicant for the Medically Fragile Waiver must meet both the financial and medical eligibility set forth by Medicaid. The medically fragile individuals must meet the same medical level of care criteria required for Intermediate Care Facility (ICF) for the Intellectually/Developmentally Disabled (IDD).

Case Management Services

The Medically Fragile Waiver Program works with a state-wide contracted Case Management (Registered Nurses only) Program to coordinate the necessary services the waiver recipient needs with the contracted direct service providers (i.e., home health agencies) throughout the state.

Each case manager lives and serves in the community and provides services in the surrounding rural areas. The Case Management Program comprises a model of family-centered service coordination for individuals who are medically fragile and their families in a culturally diverse state.

The case manager, combined with direct services providers and/or family, develops an Individual Service Plan (ISP) with the recipient's primary care physician. This plan defines the services the medically fragile recipient will receive, including the cost of services.

The rate of fees charged for services and a schedule for when the services will be delivered are controlled by agreements established with DDSD and the providers of those services throughout New Mexico. These programs provide in-home services that support the family decision to care for their medically fragile family member at home instead of in an institution.

Learn more about the Case Management Program coordination of services by visiting Medically Fragile Case Management Program section of the University of New Mexico Center for Development and Disability website.

Choosing Providers

You have a choice of Medically Fragile Waiver Providers in your service area.  Your choice will be documented on the Secondary Freedom of Choice form provided by your MFW case manager.  You may use the How to Select a Home Health Agency learn about things to consider when choosing a provider.

Provider Enrollment

To Learn how to become a Medically Fragile Waiver Provider, please visit Provider Enrollment

Get Involved

Please visit the Advisory Council on Quality and the Family Advisory Board sections of our website to get involved with the Medically Fragile Waiver program.

Learn More

Visit the following website resources to learn more.

Emergency Preparedness Resources

New Mexico Evacuation Workbook