DD Waiver vs. Mi Via: Which New Mexico Waiver Fits Your Family?
A plain-English comparison of New Mexico's two iDD Medicaid waivers — agency-directed DD Waiver vs. self-directed Mi Via — covering pay, paperwork, flexibility, and who each fits best.
Updated July 30, 2026
New Mexico gives iDD waiver families a real choice: the DD Waiver (agency-directed) or Mi Via (self-directed). Both fund care at home instead of an institution, both can pay family caregivers, and you can switch between them. The difference is who runs the show — an agency, or you.
The short answer
- The DD Waiver gives you the most support with the least on your plate: the agency employs the caregivers and carries the administrative load — hiring, training, compliance, nursing oversight, and paperwork — and other services (therapies, day programs) are funded by the state on top of the residential rate.
- Mi Via trades some of that support for control: you manage a fixed annual budget and take on the employer role. It tends to work best when support needs are lighter and predictable — and it's currently the clearer path when the caregiver would be a parent of a minor or a spouse.
Side-by-side comparison
| DD Waiver | Mi Via | |
|---|---|---|
| Model | Agency-directed — provider agencies deliver services | Self-directed — you manage a budget and direct services |
| Who employs caregivers | The agency hires, trains, and employs them | You hire employees or select vendors; a financial management agency runs payroll |
| Your guide | Case manager (case management agency) | Consultant (consultant agency) |
| Budget | Services approved in your plan; no fixed personal cap | Individual budget by age and level of care — currently $85,767/yr for adults 21+, $80,468 for ages 18–20 using In-Home Living Supports |
| State reimbursement rate | Family Living: flat $191.71/day to the agency (eff. 7/1/2024) | In-Home Living Supports: negotiated $26.33–$191.48/day (eff. 10/1/2024) |
| Primary caregiver pay at Lift | Up to $144/day (over $4,380/mo), paid daily | Up to $191/day, negotiated, paid daily |
| Parent of an adult as paid caregiver | Yes — Family Living provider | Yes — most services |
| Parent of a minor / spouse as paid caregiver | Limited — some services (not Family Living), 40 hr/week cap | Yes — nearly all services since the 2026 policy, 40 hr/week cap |
| Caregiver relief | Up to 750 hrs/yr substitute care in Family Living | Respite and other supports budgeted within your plan |
| Paperwork burden on family | Low — agency handles it | Higher — you approve timesheets, manage the budget, and plan services (with consultant + FMA support) |
How the DD Waiver works day to day
On the DD Waiver, a provider agency like Lift employs your caregivers. The most common arrangement for families is Family Living: the participant lives with their caregiver — often a parent of an adult child — who is paid a daily rate. The agency is responsible for training, background checks, nursing oversight, compliance, and arranging up to 750 hours a year of substitute care so the primary caregiver can take time off. Other services (therapies, community supports, day programs) are funded by the state on top of the residential rate.
How Mi Via works day to day
On Mi Via, the participant (or their representative) is in charge — which means both the freedom and the responsibility sit with the family. The state's third-party assessor sets an individual budget based on age and level of care; a consultant helps you build a service plan; and a financial management agency pays your caregivers and handles employment taxes. Daily-rate residential support — In-Home Living Supports — is provided through vendor agencies like Lift: you negotiate the rate, we handle payroll, compliance, and daily pay. In fiscal year 2024, In-Home Living Supports was Mi Via's biggest service — about $135 million supporting 2,288 people, frequently provided by family members.
One thing to weigh carefully: the budget is a hard ceiling, and caregiver pay, respite, and most other services all draw from the same pot. Per the Legislative Finance Committee, about two-thirds of Mi Via participants exceeded their budget allotment in fiscal year 2024 — a sign of how quickly real-world needs can outgrow the cap. Families managing significant medical or behavioral needs often find the DD Waiver's structure — where residential care is funded at its own rate and other services are added on top — holds up better as needs grow.
Which should your family choose?
The choice isn't permanent, so don't agonize. If you're unsure, the DD Waiver is the easier place to start: trained, agency-employed caregivers, nursing oversight, guaranteed substitute-care coverage, no budget ceiling to manage, and other services funded on top rather than out of the same pot. That structure earns its keep as medical or behavioral needs grow — and needs have a way of growing.
Mi Via is worth a serious look when the pieces line up: the participant's needs are relatively light, the family genuinely wants to run the show, and the fixed budget comfortably covers everything — or the caregiver would be a parent of a minor child or a spouse, whom the 2026 rules allow to be paid on Mi Via but not for the DD Waiver's Family Living service.
Whichever waiver you land on, our stance is the same: the best caregivers are the ones the participant and family choose — relatives, friends, whoever you trust. And if family isn't available or preferred, we'll help you find and train additional caregivers and supports.
Not sure? See our step-by-step guide to getting paid as a family caregiver in New Mexico, or just call us — we work with both waivers every day and will tell you honestly which fits.
Frequently asked questions
Can I switch between the DD Waiver and Mi Via?
Yes. Participants can move between the traditional DD Waiver and Mi Via using a Waiver Change Form without losing their allocation.
Which waiver pays family caregivers more?
The headline numbers can be misleading. At Lift, DD Waiver Family Living providers earn up to $144/day with the agency handling all compliance — and other services are state-funded on top. Mi Via In-Home Living Supports caregivers can earn up to $191/day, but that rate is negotiated within a capped budget that also has to fund most other services, so the practical number is often lower. Which nets out better depends on the participant's needs — we're happy to run your specific numbers.
Do I lose agency support on Mi Via?
You keep some, but the responsibility shifts to you. Mi Via requires a consultant agency for planning, a financial management agency for payroll, and vendor agencies for daily-rate services like In-Home Living Supports — but the family approves timesheets, manages the budget, and owns the decisions. A vendor like Lift Family Care softens that load with payroll, compliance, and daily pay, though it remains a bigger lift than the DD Waiver's full-agency model.
How many people use each waiver?
As of March 2026, about 4,849 New Mexicans were on the traditional DD Waiver and 3,949 on Mi Via, per the Developmental Disabilities Supports Division — nearly 8,900 people across the state's iDD waivers.
Sources
- NMAC 8.314.6 — Mi Via HCBS Waiver (amended effective July 1, 2024).
- NM Health Care Authority — Mi Via program, including the Mi Via Waiver FAQ (January 2026) with current individual budget amounts and the DDSD policy on payment to legally responsible individuals (February 2026).
- NM DDSD — DD Waiver Service Standards (effective July 1, 2024): Family Living and substitute care provisions.
- NM Legislative Finance Committee — DD and Mi Via Waivers progress report (November 18, 2024): FY24 enrollment and spending figures.
- NM Health Care Authority — waiver fee schedules: DD Waiver Fee Schedule (effective July 1, 2024) and Mi Via Waiver Fee Schedule (effective October 1, 2024).
This guide summarizes state rules for families and isn't legal or benefits advice. Program rules change — confirm current details with DDSD or with us before making decisions.