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Fair Hearing Rights

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If you are concerned that you have not been treated fairly or that the DOH has not followed procedures, you have an opportunity to request and participate in an administrative Fair Hearing.

You will receive information about Fair Hearing rights when you receive your DDW Planning Package that includes your SIS results, NM DDW Group assignment and service package options. You will also receive Fair Hearing rights notification when you receive outcomes of any prior approval or prior authorization processes related to your budget and any services you have requested. At any of these times, you may exercise your right to request a Fair Hearing.

If you request a Fair Hearing, you may also want to engage in an agency conference. The agency conference may be scheduled at any point by you or the Developmental Disabilities Supports Division (DDSD) to discuss issues with your support services. The purpose of the agency conference is to informally decide whether the issue can be resolved by mutual agreement and for DDSD to provide technical support, or guidance for planning.

DDSD encourages you to work with your case manager and your team to determine whether or not the assigned NM DDW Group adequately meets your health and safety needs. Example of steps that teams should take:

  • Using the SIS to determine the type and amount of paid services needed;
  • Look at the amount of services utilized in the last ISP year;
  • Identify community and other natural supports;
  • Develop a budget based on the services determined necessary that fall within the assigned NM DDW Group; and
  • Contact the DDSD Regional Office for help in understanding the new waiver system

Read the Fair Hearing FACT Sheet

For more information, contact the Fair Hearings Bureau

37 Plaza La Prensa
P.O. Box 2348
Santa Fe, NM 87507
1-800-432-6217 (6)
(505) 476-6213
505) 476-6215 Fax

Read the New Mexico Administrative Code on Fair Hearings

Notice of Right to Appeal

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