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Consultant Services

Consultant-Support Guide services on the Mi Via Waiver are person-centered and are intended to educate, guide and assist participants to make informed planning decisions about services and supports. This leads to the development of a Service and Support Plan (SSP), based on the participant’s assessed needs. The consultant assists the participants with implementation and quality assurance related to the SSP and Authorized Annual Budget (AAB). Consultant services provide support to participants to maximize their ability to self-direct their Mi Via Services.

In general, consultant services include:

  • Assisting with activities and information needed to complete the pre-eligibility/enrollment services process and to provide information, support and assistance during the annual recertification for medical and financial eligibility.
  • Assisting the participant in utilizing all program assessments to develop the SSP.
  • Educating the participant regarding Mi Via covered and non-covered supports, services and goods and assisting participants in identifying resources outside the Mi Via Program that may assist in meeting their needs.
  • Reviewing the Mi Via Service Standards, processes and paperwork with the participants.
  • Assisting participants how to navigate the Mi Via program, assistance with supporting communication with the TPA and FMA.
  • Assisting the participant to assure that their chosen service providers are adhering to the Mi Via Service Standards as applicable.
  • Assisting the participant to identify and resolve issues related to the implementation of the SSP.
  • Assisting the participant with required quality assurance activities to ensure implementation of the participant’s SSP and utilization of the authorized budget.
  • Assisting participants to identify measures to help them assess the quality of their services/supports/good and self-direct their quality improvement process.
  • Serving as an advocate for participate, as needed, to enhance his or her opportunity to be successful with self-direction.
  • Providing training to participants related to recognizing and reporting critical incidents.
  • Providing support guide services which are more intensive supports that help. participants more effectively self-direct services based upon their needs. The amount and type of support needed must be specified in the SSP and reviewed quarterly.
  • Assisting the participant with reconsiderations of goods or services denied by the Third-Party Assessor (TPA), submit documentation as required, and participant in Fair Hearings as requested by the participant or state.

Qualified Consultant Providers

Mi Via Consultant Agencies are located throughout the state. Consultants are required to meet minimum training requirements, have experience working with individuals with intellectual and/or developmental disabilities and medically fragile conditions. As Consultants provide an essential role of support and direction for participants, they are expected to work collaboratively with NMDOH, HSD and HSD’s contractors (TPA and FMA) and to follow the rules of the Mi Via Waiver program.


Learn More

Consultants must stay informed and rely on many forms, instructions, and resources to do their job. Below are quick links to documents and updates for important information for consultants.

Guide

Effective October 1, 2018. At this time, the Consultant Guide is under construction. Please refer to the most current Mi Via Waiver Standards, Appendices and New Mexico Administrative Code (NMAC) for information about the Mi Via Waiver program and consultant services.

Procedures

Forms

Other