In 2014, New Mexico replaced the state’s waiver programs with a Medicaid managed care program called Centennial Care. Under Centennial Care, participants can still receive care services in their homes and communities as an alternative to nursing home care. Under Centennial Care, this is called the Community Benefit.
The CoLTS C Medicaid Waiver is no longer an option for state residents.
New Mexico’s CoLTS C Medicaid Waiver is a program targeting low income, elderly individuals who might require nursing home care were it not for the services provided under this program. This program offers care services and non-care support to enable older adults and individuals with disabilities remain living in their own homes and / or assisted living communities instead of being placed in a nursing home. It also helps nursing home residents to return to their homes if they choose to do so.
The program is managed by the state’s Human Services Department (HSD). CoLTS is an acronym for Coordination of Long Term Services. The waiver was formerly referred to as the Disabled and Elderly Waiver and one may still find some literature which uses this dated name.
Self-direction of care is available through an associated program called Mi Via. Mi Via allows CoLTS C Waiver program participants to choose their own care providers to meet their functional, medical, and social needs.
The CoLTS C Waiver has eligibility criteria related to the applicant’s age, level of impairment and finances.
Age – applicants must be at least 65 years of age.
Level of Impairment – applicants are assessed as having a need for nursing home level care
Finances – CoLTS C has the same financial criteria as New Mexico Institutional Medicaid. In 2014, the monthly income limit is $2,163. Note that this is significantly higher than the limit for Aged, Blind and Disabled (ABD) Medicaid at approximately $721 / month. The countable resource limit is $2,000 for both ABD and Institutional Medicaid / Medicaid Waivers.
Exceptions to the Financial Limits – there are several exceptions to these limits. Married couples with only one of the two partners applying for CoLTS or Medicaid can structure their finances to provide the non-applicant with the majority of income and assets. This enables them to continue living independently concurrently lowering the applicant’s income and assets to the eligibility limit. Non-applicant spouses can have up to $117,240 in assets and $2,931 in monthly income. Also worth noting is that one’s house and car are not counted towards the asset limit.
A second exception exists when the applicant uses income trusts and asset conversions. Applicants can allocate their income which exceeds the limit into a Pooled Income Trust effectively lowering their income. They can also convert assets over the limit into exempt assets. For example, final expense insurance and burial plots may be considered exempt. Pre-planning for these expenses can lower one’s countable resources to the appropriate level.
– These asset and income conversion techniques are complicated and easy to structure incorrectly. New Mexico Medicaid does a thorough review of each applicant’s finances, therefore it is advised that persons wishing to use these techniques find assistance.
Benefits and Services
Each applicant receives a customized care plan. Possible benefits for CoLTS C Waiver participants include the following:
- Adult Day Health
- Assisted Living
- Case Management
- Emergency Response System
- Environmental Modifications
- Homemaker Services
- In Home Respite
- Occupational Therapy
- Personal Care Services
- Physical Therapy
- Private Duty Nursing (RN/LPN)
- Speech Therapy
How to Apply / Learn More
CoLTS C is available statewide in all counties, but it has a limit on total participation and therefore waiting lists may exist. To learn more about the program, check wait list status or apply, one can contact their local Aging & Disability Resource Center (ADRC), call 800-432-2080 or visit the CoLTS website.