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 Developmental 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.

Survey Field Tools

The QMB Developmental Disabilities Waiver Survey Field Tools are available to the public and case management agencies. The case management survey field tools identifies the criteria used to assess if an agency is in compliance with requirements. Case management agencies may find them helpful when conducting a self-test to measure their own performance to identify opportunities for quality improvement.

Report of Findings

Visit our Living Care Arrangements, Community Inclusion (Customized Community Supports & Employment Services) and Case Management Services pages for survey reports.