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The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Developmental Disabilities Waiver Survey Unit
QMB provides regulatory oversight of DDW provider agencies of Case Management Services and Living Supports, Community Supports and Employment Services. DDW survey teams conducts unannounced on-site, systems-based surveys and other quality improvement activities related to the health, welfare and safety of individuals receiving supports through case management services, living supports, community supports and employment services in compliance with the Centers for Medicare and Medicaid Services waiver assurances, DDSD standards and other rules and regulations.
Case Management Services play a critical role in supporting individuals to obtain their desired outcomes through the development of person center service planning.
Living Care Arrangements, Community Inclusion (Customized Community Supports & Employment Services) provide and deliver the day to day services necessary to support individuals to enjoy the highest quality of life possible and achieve their desired personal outcomes.
For more information on case management services, community supports, and employment services, visit the Developemental Disabilities section of our website or contact the DDSD case management coordinators in the regional offices.
Conditions of Participation
Case management services primarily focus of the following Centers for Medicare and Medicaid Services waiver assurance service domains: service plans; (ISP) development & monitoring); level of care; qualified providers; health, safety and welfare. Identified within each service domain there are fundamental core regulations and standards identified as Conditions of Participation (COPS) essential compliance with COPS is necessary in order to ensure the health and welfare of individuals served.
Plan of Correction Process
Upon completion of a QMB survey the case management agency receives a report of findings. Upon receipt of the report of findings the case management agency must submit a Plan of Correction (POC) to address all identified deficiencies in the Report of findings within 10 working days. For instructions on how to complete the initial plan of correction see QMB Plan of Correction Process (Attachment A).
The submitted POC is then approved by QMB. The agency has 45 days from the date of receiving the Report of Findings to implement their Plan of Correction.
On rare occasions, it may be necessary to request a time extension to complete a component of a POC. A written request for a time extension must be submitted to the POC coordinator with an explanation as to why the addition time is needed and when it will be completed. QMB will review the request for the extension and notify the provider if approved or not approved.
Requests for technical assistance must be requested through your regional DDSD Office.
Report of Findings
Visit our Living Care Arrangements, Community Inclusion (Customized Community Supports & Employment Services) and Case Management Services pages for survey reports.
Survey Field Tools
This section provides two different set of field tools. One is for Case Management and the other is for Living Supports, Community Supports and Employment Services. Please select the correct field tools for your specific purposes from below.
Case Management Survey
QMB utilizes multiple field tools when conducting compliance surveys of Case Management Agencies. These field tools are provided to the public for their use. Agencies may use the field tools as a quality assurance tool to conduct a self-test of their performance.
Disclaimer
These tools are provided as a sample of the QMB survey process and is not a complete tool set. They are not an all-inclusive of the DDSD standards and regulations, nor do they include all requirements for compliance. For a complete set of DDSD standards and rules please refer back to the actual DDSD standards, rules, regulations or policies.
QMB has the potential to cite any deficiency that we find on-site even if it is not on the tool, but there is a regulation, standard or policy to uphold it, including the providers own policy.
QMB reviews and updates the survey field tools on a regular basis to ensure their effectiveness in monitoring current requirements.
Case Management Tools
Living Care Arrangements and Community Inclusion
The QMB living supports, community supports and employment services survey field tools are available to the public and living supports, community supports and employment services agencies. The living supports, community supports and employment services Survey Field tools identifies the criteria used to assess if an agency is in compliance with requirements. Living supports, community supports and employment services agencies my find them helpful when conducting a self-test to measure their own performance to identify opportunities for quality improvement.