Mi Via: New Mexico’s Medicaid Cash and Counseling Program

Page Reviewed / Updated - Mar. 2014

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers" which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.

Waiver Description

Under Mi Via, friends and relatives can be compensated for providing personal care assistance.

Mi Via is a state Medicaid program for the elderly and disabled that provides a very wide range of services to enable individuals to self-direct their care and increase their ability to live independently. It is based on the Cash and Counseling demonstration project in which program participants determine their care requirements and select and manage their care providers instead of relying on the state to perform these activities on their behalf. This model of program is also referred to as consumer direction. It is becoming increasingly popular because it both decreases administrative costs for the state and increases the flexibility and control for the participant.

A second factor that contributes to the popularity of the Mi Via program is that under certain circumstances family members and friends can be hired to provide personal / attendant care services; even spouses and adult children can be paid to be caregivers. The program works by making the participant an “employer” and uses a 3rd party, fiscal intermediary to manage payments to the “employees” or care providers. The hourly rate which caregivers are paid is determined by the state and is well less than state average of $19 / hr.   An unconfirmed estimate would be between $10 - $13 / hr. 

 

Eligibility Guidelines

To be eligible for the Mi Via program, New Mexico residents must be eligible for Medicaid and one of the HCBS waivers, most relevantly the CoLTS C Waiver. To read the full eligibility criteria for CoLTS C, click here. A brief summary follows.

Applicants for Mi Via must be 65 or older, legal New Mexican residents, require nursing home level care and be financially qualified for New Mexico Institutional Medicaid.  In short in 2014, single applicants must have monthly income less than $2,163 and countable resources less than $2,000. These limits are somewhat flexible and there are numerous exceptions and workarounds. Persons unsure if they are eligible financially should strongly consider finding assistance applying for Medicaid in advance of filing the paperwork. Learn more about assistance.

 

Benefits and Services

Many states have similar programs which strictly limit the services that can be self-directed to only personal care services. New Mexico has gone in the opposite direction and allows a very wide range of supports to be self-directed under the Mi Via program. For example, most states disallow individuals that reside in assisted living communities from participating in the program, New Mexico does not. Instead they just limit some of the services for which individuals living in assisted living are eligible.   Many state disallow spouses from receiving payment, New Mexico, on the other hand, permits this option. 

  • Personal care attendant to assist individuals with activities of daily living such as bathing, grooming and toileting
  • Assistance with instrumental activities of daily living such as meal preparation, shopping for groceries and other essentials
  • Companion services and transportation escorts
  • Medication oversight
  • Personal emergency response and 24 hr monitoring
  • Home health aide
  • Private duty nursing
  • Respite care
  • Alternative therapies including acupuncture and massage therapy
  • Home modifications
  • Assistive technologies to increase independence
  • Nutritional counseling services

 

How to Apply / Learn More

The application process depends on one’s current Medicaid status. If one is currently enrolled in a New Mexico Medicaid waiver program, contact the administrator for a Waiver Change Form. If one is not yet a Medicaid enrollee, one should contact their local New Mexico Public Health Office.  More information can be found on the Mi Via website and a complete Participant Manual is available for download.