Turquoise Care (NMCC) Community Benefits (age 21+)

Agency Based Services/Self-Directed Services & Waiver Services:

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Agency Based Community Benefits:

Agency Based Community Benefits (ABCB) provides a more traditional type of service such as the community benefits that can be offered by a provider agency. Members receiving services through the Agency Based Community Benefits model must select an accredited & approved provider who is contracted with the member’s MCO. ABCB offers two models:

The Consumer-Directed model allows the member to “direct” the delivery of their own personal care services recruiting, selecting and even terminating their own care attendant. They have control of their personal care, supervise their attendant as well as have more flexibility over their caregiver(s) schedule. Inteli-Care works with the member and helps to coordinate all business-related responsibilities assuring the member is happy with all aspects of their personal care services.

The Consumer-Delegated model is designed for the member to “delegate” the delivery of services to Inteli-Care LLC as their approved personal care provider. Inteli-Care is responsible for recruiting, interviewing, hiring, supervising, training and terminating their personal care attendant. When the member elects the Delegated model he or she is giving up the control of being able to direct their own care, putting it in the hands of their provider agency. With this model the agency has a lot more responsibility and is required to do monthly supervised visits in the residence. Supervised visits may be scheduled or unscheduled as long as it is during the member’s normal scheduled hours.

Self-Directed Community Benefits:

Self-Directed Community Benefits (SDCB) provides a community-based alternative to institutional care that offers the member a more customized choice for directing his or her choice of services and benefits. The member can choose the direction of care and have control over the supports and services they feel they need. Self-Directed Community Benefits is an alternative to the more traditional type of services such as the community benefits that can be offered by a provider agency. Members receiving services through the Self-Directed Community Benefits model will have to select a Support Broker who is with a Support Broker Agency contracted with the member’s MCO.

Waiver:

The Acquired Immunodeficiency Syndrome Waiver (AIDS Waiver) serves individuals who are disabled due to a diagnosis of Acquired Immune Deficiency Syndrome. Services provided through the AIDS waiver are case management, homemaker/personal care and private duty nursing by registered nurses and licensed practical nurses. The New Mexico AIDS Waiver program is administered through a partnership between the New Mexico Human Services Department (HSD) and the New Mexico Department of Health/Public Health Division (DOH/POD).

Environmental Modifications:

Environmental Modifications, also known as E-Mods, are internal and external physical adaptations or alterations to a home which are necessary to ensure the health, welfare and safety of a member. These modifications allow the member to function with greater independence and allow the member to continue living in the comfort of their home.

The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit provides comprehensive and preventive health care services for children under age 21 enrolled in Medicaid. EPSDT ensures children and adolescents receive appropriate preventive, dental, mental health, and specialty services through: 

• Early: Assessing and identifying problems early
• Periodic: Checking children’s health at periodic, age-appropriate intervals
• Screening: Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
• Diagnostic: Performing diagnostic tests to follow up when a risk is identified 
• Treatment: Controlling, correcting, or reducing identified health problems