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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.
Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)
The primary purpose of the ICF/IID is to provide health or rehabilitative services to a person with Intellectual Disability and/or related conditions.
An Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) provides, in a residential setting, ongoing evaluation, planning, supervision, treatment to help individuals with intellectual disabilities function at his or her greatest ability.
ICF/IID is an alternative Medicaid benefit to home and community-based services waiver (HCBS) programs for individuals at the ICF/IID level of care. 42 C.F.R. § 441.303(d)
In New Mexico, there are ICF/IID providers throughout the state and each one has a variety of facilities which are individually licensed and certified by the New Mexico Health Care Authority. ICF/IIDs are located within the community and range from one bed to up to sixteen beds with an average of six beds in a facility.
For Individuals
How to find out if I am eligible to live in an ICF/IID?
Individuals with intellectual and developmental disabilities who meet the definition of developmental disability in accordance with New Mexico Administrative Code NMAC 8.290.4 are eligible for admission to an ICF/IID. In general, to match the definition of a developmental disability the individual must:
- Have an Intellectual Disability, onset by age 18 or
- A specific related condition (Cerebral Palsy, Autistic Disorder, Down Syndrome, Epilepsy, etc.) and
- Have significant limitations in at least 3 areas of major life activity that began prior to age 22
How do I apply for admission to an ICF/IID?
You must complete the Home and Community Based Services Application and follow the directions for submission: Pre-Service Intake Bureau
After the regional DDSD office receives the application packet, a Pre-Service Intake Specialist will contact you if additional information is needed. All individuals applying have 60 days to return the application packet and supporting documentation.
Once the Pre-Service Intake Specialist has determined the individual has met criteria and is eligible, the individual will receive a Yes Match letter via mail. This approval letter is required for ICF/IID admissions.
Who should I contact if I receive a letter stating I am a Yes Match and I am interested in ICF/IID?
Your “Yes Match” letter will have contact information for ICF/IID questions. A listing of ICF/IID’s in New Mexico can be requested from the Health Care Authority, Developmental Disabilities Supports Division – ICF/IID Program Coordinator.
Learn More
Services
- Personal Assistance services 24-hours a day, 7 days a week
- Nursing Services
- Dental Services
- Medical Services
- Psychological Services
- Speech Pathology and Audiology
- Physical and Occupational Therapy
- Social Services
- Pharmacy Services
- Dietetic Services
- Medicaid Aid Services
For Providers
- Where Can I find the Level of Care MAD 378 Abstract?
If you are an ICF/IID provider, you can find the guide to completing the Level of Care MAD 378 abstract here: Admission Criteria.
You can access the current abstract by visiting the New Mexico Medicaid Portal website and navigating to providers section, selecting “view” under public information for the MAD 378 under HSC/MAD Forms.
- Who do I need to contact for billing inquiries?
For billing issues concerning denied claims, please contact the ICF/IID Program Coordinator with the Transaction Control Number (TCN). The ICF/IID Program Coordinator will research the claim and assist with troubleshooting the errors.
All other billing errors should be directed to Conduent.
- I want to become a licensed ICF/IID Provider in the state of New Mexico, where do I get more information?
For information and instructions on how to apply for a health facility license, please visit the Division of Health Improvement, Health Facility Licensing and Certification Program Operations Bureau page at: Programs Operations Bureau
Contact Information
Statewide ICF/IID Program Coordinator
Jessica T. Trujillo
505-623-1916
Statewide ICF/IID Program Manager
Vacant