How New Mexico pays for disability services

Waiver inventory

The Supports Waiver has effectively wound down: it was created to serve people stuck on the wait list, and after New Mexico cleared the list in FY2023 only three people remained enrolled in FY2024.

State-only funded programs

• State General Funded (SGF) Services. Administered by the Developmental Disabilities Supports Division within the New Mexico Health Care Authority. SGF provides a limited set of services and supports to people who have completed DD Waiver eligibility determination and are on the Central Registry wait list, and is explicitly named on the state's own allocation page as an option available while waiting. Services covered include respite, adult services, and Community Integrated Employment; SGF Service Standards require competitive integrated wages and prohibit use of SGF funds for subminimum-wage positions. The program has a dedicated SGF Program Manager and regional SGF liaisons. Approximate annual appropriation: not found in any document I retrieved. hca.nm.gov and hca.nm.gov
• SGF Service Standards correction memo dated July 10, 2026 confirming the program's current operating status: api.realfile.rtsclients.com
• The Brain Injury Services Fund Program is listed on the Health Care Authority's assistance menu as a separate state program, but it targets traumatic brain injury rather than IDD and I did not verify its appropriation. hca.nm.gov

County / regional / local funding

None identified. New Mexico administers DD waiver services through DDSD regional offices (which are state offices, not independently funded regional centers) and through statewide Medicaid fee schedules that apply uniformly with no geographic differential. The DDSD Payment Disclosure Report states explicitly that "all services are available statewide for both children and adults, and the cost is the same regardless of age." Sources checked: hca.nm.gov hca.nm.gov and the 2025 DDSD Payment Disclosure Report.

Funding scale

• Total DD Waiver plus Mi Via plus Supports Waiver cost, FY2024 actual: $773.4 million (reported as "nearly $800 million"). FY2025 projected increase of 27 percent to approximately $907 million. nmlegis.gov
• Total DDSD budget FY2024: $1.2 billion. nmlegis.gov
• State general fund appropriation for rate increases, FY2024: $20.5 million, matched with federal Medicaid for roughly $91 million total. nmlegis.gov
• FMAP: 71.66 percent (FY2026), the highest of the three states in this set. kff.org
• Spending per participant, FY2024: traditional DD Waiver $115,832; Mi Via $74,148. Per-client costs grew 46 percent from FY2014 to FY2024. nmlegis.gov
• People served in DD waivers: 7,849 total in FY2024 (DD Waiver 4,598, Mi Via 3,248, Supports Waiver 3). More than 8,700 across the DD, Mi Via, and Medically Fragile waivers per testimony to the Legislative Finance Committee in September 2025. nmlegis.gov and thecandlepublishing.com (secondary)
• Waiting list: New Mexico effectively cleared its waiver waiting list in FY2023, using $211.4 million in federal ARPA funds across FY2022 to FY2024. The list peaked above 4,100 people in FY2022 and stood at roughly 200 people in FY2024. A Central Registry wait list still exists structurally: everyone found eligible is placed on it and allocated when funding becomes available. nmlegis.gov and hca.nm.gov
• Average hourly rates actually paid, calendar 2025 claims (Access Rule disclosure): Habilitation Group $19.06 across 14,399,792 hours and 1,539 beneficiaries; Habilitation Individual $52.25 across 3,001,328 hours and 3,110 beneficiaries; Home Health Aide $45.23; Personal Care (Customized In-Home Supports) $33.68 across 419 beneficiaries. Family Living and Job Maintenance were excluded because they cannot be converted to hourly units. hca.nm.gov (2025 Payment Disclosure Report)

Residential funding detail

What is funded. New Mexico's DD Waiver funds residential support through the "Living Supports" service group plus Customized In-Home Supports:

1. Family Living (T2033 HB), a host-family / shared-living model in which the person lives with a contracted family or individual provider. Paid as a flat statewide daily rate, $191.71 effective July 1, 2026. Notably, the separate "Family Living, Jackson Class Only" premium rate that existed in the 2021 fee schedule no longer appears in the July 2026 schedule.
2. Supported Living (T2016 HB), the state's provider-operated residential model, paid as an acuity-tiered daily rate across four categories: Category 1 Basic Support, Category 2 Moderate Support, Category 3 Extensive Support, and Category 4 which splits into Extraordinary Medical (U7) and Behavioral Support (U8) at the same dollar amount. A Non-Ambulatory Stipend (H2022 HB TG) of $65.22 per day layers on top.
3. Intensive Medical Living Services (T2033 HB TG), the highest-intensity residential tier, $492.90 per day effective July 1, 2026.
4. Customized In-Home Supports (S5125 HB), paid at a 15-minute unit for people living with family or natural supports and for people living independently, at the same rate for both.
5. Crisis Support (Alternative Residential Setting) (T2034 HB), a temporary residential placement at $490.25 per day.
6. Mi Via In-Home Living Supports (T2033), a self-directed daily residential support with a negotiated rate range of $26.33 to $191.48 per day, plus Homemaker/Direct Support at $7.90 to $15.38 per hour.
7. ICF/IID, paid at provider-specific floor rates with three acuity levels. SFY27 floor rates effective July 1, 2026 range roughly from $283.74 (Santa Maria el Mirador Chacoma II, Level III) to $1,218.53 (Santa Maria el Mirador Camino Espuela, Level I).

Payment structure. Daily per diem with categorical acuity tiers for Supported Living and a flat daily rate for Family Living; 15-minute units for in-home supports, respite, community supports, and most employment services; monthly rates for Case Management ($370.80) and Community Integrated Employment Job Maintenance ($1,363.11); per-mile for non-medical transportation ($0.66).

Room and board. Medicaid HCBS may not pay room and board in these settings, and the DD Waiver fee schedule contains no room-and-board line item. Residential providers are reimbursed for services only; the person's own income, typically SSI, covers room and board. I did not find a published New Mexico state supplemental payment or state-funded room-and-board subsidy specific to DD Waiver residential settings.

Rate structure link: hca.nm.gov (select "Developmental Disabilities (DD) Waiver Fee Schedule")

Comparable service rates

All DD Waiver rates below are from the Developmental Disabilities Waiver Fee Schedule effective July 1, 2026. Mi Via rates are from the Mi Via Waiver Fee Schedule effective October 1, 2024.

For reference, HMA's proposed rate models dated December 3, 2025 (with a January 2027 implementation midpoint) recommended substantially higher amounts than the July 2026 schedule now in effect, for example Supported Living Category 1 at $311.79/day versus the current $229.60, Family Living at $202.39/day versus $191.71, and Case Management at $380.69/month versus $370.80. These are recommendations, not adopted rates. healthmanagement.com

Official rate schedule links

• New Mexico Medicaid fee schedules index (contains the Developmental Disabilities (DD) Waiver Fee Schedule, Mi Via Waiver Fee Schedule, Medically Fragile Waiver Fee Schedule, and ICF-IID Rates Effective 07.01.2026; the files load through a JavaScript file widget): hca.nm.gov
• Direct PDF, DD Waiver Fee Schedule effective July 1, 2026: api.realfile.rtsclients.com
• Direct PDF, Mi Via Waiver Fee Schedule effective October 1, 2024: api.realfile.rtsclients.com
• Direct PDF, SFY27 ICF-IID floor rates effective July 1, 2026: api.realfile.rtsclients.com
• HCA Director's Office rate studies page (final HMA rate study report, proposed rate models, provider capacity assessment, payment disclosure reports): hca.nm.gov
• HMA proposed HCBS rate models, December 3, 2025: healthmanagement.com
• DD Waiver Service Standards: api.realfile.rtsclients.com
• Historical DD Waiver fee schedule, MAD Supplement 22-05, effective July 1, 2021 (useful for rate trend comparison): hsd.state.nm.us

Notable features and flags

• Jackson lawsuit legacy. Jackson v. Los Lunas was dismissed in 2022 after 35 years, and the state continues to operate under revised procedures ensuring participant service needs are met. The legacy remains embedded in the payment system: the July 1, 2026 fee schedule still carries a distinct "Customized Community Supports, Group, Jackson Class Only" code (T2021 HB U5) at $6.29 per 15 minutes, more than double the Category 1 group rate of $2.96. The parallel "Family Living, Jackson Class Only" code that existed in the 2021 schedule has been dropped, and the 2024 DD Waiver Service Standards changed the reference to "Former Jackson Class Member." nmlegis.gov and api.realfile.rtsclients.com
• July 1, 2026: the DD Waiver and Medically Fragile Waiver were reauthorized by CMS for a new five-year period; the Mi Via Waiver was approved for five years in October 2025. thecandlepublishing.com (secondary)
• February 2026 legislative session: DDSD received no appropriation tied to the 2025 HMA rate study, and only a fraction of the $47 million in additional appropriations the agency requested. The gap between the current July 2026 fee schedule and HMA's proposed models is therefore unfunded. thecandlepublishing.com (secondary)
• January 9, 2025: CMS approved rate increases across the DD, Mi Via, and Medically Fragile waivers, retroactive to July 1, 2024 for DD and Medically Fragile and to October 1, 2024 for Mi Via, based on the 2023 rate study. hca.nm.gov
• Waiting list cleared then structurally retained. New Mexico cleared a 4,100-person list in FY2023 with $211.4 million in ARPA funds, but the Central Registry allocation mechanism remains: people found eligible go on the registry and are offered services by application date "when there is funding available," with State General Funds and Turquoise Care Community Benefits offered as interim supports. This means the system can regenerate a list quickly if appropriations lag enrollment growth, and FY2025 waiver costs were already projected to grow 27 percent. hca.nm.gov
• Self-direction is unusually large. Mi Via carried 3,248 participants in FY2024, about 41 percent of all waiver participants, at $74,148 per person versus $115,832 in the traditional DD Waiver. Mi Via rates are published as negotiated ranges rather than fixed amounts for most services. nmlegis.gov
• Provider capacity. DDSD's Provider Capacity Assessment (September 2023) documented providers on moratorium and unable to accept new participants, with participants and case managers identifying eight services as unavailable in the authorized amount or quality. api.realfile.rtsclients.com

Confidence

Solid: the current DD Waiver fee schedule with every service code, unit, and dollar amount effective July 1, 2026; the Mi Via fee schedule; the SFY27 ICF/IID floor rates; the average hourly rates actually paid in 2025 from the Access Rule payment disclosure; the FMAP; and the residential service architecture. Also solid: the FY2024 enrollment, spending, and per-participant figures and the waiting list history, all from a Legislative Finance Committee progress report. Estimated or dated: the FY2025 cost projection of $907 million is an estimate, not an actual; enrollment counts are FY2024 and I could not obtain an FY2025 or FY2026 count from a primary state document, so the "more than 8,700" figure comes from a secondary report of September 2025 LFC testimony. Could not find: the annual appropriation for State General Funded Services; a current published Central Registry count; a per-waiver enrollment figure for the Medically Fragile Waiver; and any New Mexico state supplemental payment covering room and board in residential settings. Both search-engine access and the WebFetch proxy were heavily rate-limited during this research, which limited follow-up on those items.