Ramah Care Services, Inc.
Customized Community Supports (CCS)
Customized Community Supports (CCS) for adults is designed to assist a person to increase his/her
independence and potentially reduce the amount of paid supports, to establish or strengthen
interpersonal relationships, to join social networks and to participate in typical community life.

Ramah Care Services, Inc. offers Customized Community Supports (CCS), which refers to non-work
activities.  CCS services are mandated to be provided in the community to the fullest extent possible.

CCS are based upon the preference and choices of each person and are designed to measure progress
toward Desired Outcomes specified in the ISP.  Activities include adaptive skill development, adult
educational supports, citizenship skills, communication, social skills, self-advocacy, informed choice,
community integration and relationship building.

Outcomes from this service may include an enhanced capacity for self-determination, development of
social networks that allow the person to experience valued social roles while contributing to his or her
community and in establishing lasting community connections.

When planning CCS, the Interdisciplinary Team (IDT) members shall recognize the person's right to
make life choices that may include risk.  The IDT members shall assess risk on an individual basis and
develop or enhance risk mitigation strategies as needed.  The assumption of risk shall be balanced with
the person's ability to assume responsibility for that risk and a reasonable assurance of health and
safety while maintaining compliance with DDSD Service Standards and the NM Nurse Practice Act for
those with health-related supports.

Individuals who have health related support needs that require nursing services during the provision of
CCS have access to nursing supports in various ways.  Nursing supports at various levels are bundled
into the CCS Group Services and are available for other CCS models of service (CCS-I, CCS-Small 
Group, CCS_IIBS) through coordination with the person's Living Supports provider.

Types of CCS
  • Individual Customized Community Supports (CCS-I)
CCS-I are age appropriate and provided on a one-to-one (1:1) basis.  Activities listed in the scope of
work are delivered in a manner consistent with the person's ISP and are provided exclusively in the
community.

  • Small Group Customized Community Support (CCS Small Group)
CCS-Small Group is provided in groups of three (3) or less.  Activities listed in the scope of work are
delivered in a manner consistent with the person's ISP and are provided exclusively in the
community, not in an agency-operated building.

  • Customized Community Supports-Group (CCS-Group)
Within the CCS Group model, there are three categories of service: 
  • CCS Group Category 1
  • CCS Group Category 2 (Extensive Support)
  • CCS Group Jackson
The three categories are based on intensity and nature of individual support needs.

  • Individual Intensive Behavior Supports Customized Community Supports (CCS-IIBS)
CCS-IIBS are designed to meet the needs of individuals with extraordinary behavioral needs.
Individuals in this service exhibit extraordinary behavioral support needs such as aggressive
behavior, property destruction, stealing, self-injury, pica, sexual inappropriateness, frequent
emotional outbursts, wandering, and/or substance abuse.  If behavioral needs are left unsupported,
this could expose the person to risk of doing significant harm to him/herself or others.  Services are
provided on a one-to-one (1:1) basis, only at times when this level of support is needed.

Meaningful Day
The objective of implementing a Meaningful Day is to plan and provide supports to implement the
person's definition of his/her own meaningful day, contained in the Individual Service Plan (ISP).

  • Meaningful Day includes:
    • purposeful and meaningful work;
    • substantial and sustained opportunity for optimal health;
    • self-empowerment;
    • personalized relationships;
    • skill development and/or maintenance; and
    • social, educational and community inclusion activities that are directly linked to the vision.
Desired Outcomes and Action Plans as stated in the person's ISP.

  • Community Life Engagement (CLE) is also sometimes used to refer to "Meaningful Day" or "Adult
Habilitation" activities.  CLE refers to supporting people in their communities in non-work activities.
Examples of CLE activities may include participating in clubs, classes or recreational activities in the
community, learning new skills to become more independent, volunteering, or retirement activities.
Meaningful Day activities should be developed with the four guideposts of CLE in mind.
    • Individualized supports for each person;
    • Promotion of community membership and contribution;
    • Use of Human and social capital to decrease dependence on paid supports; and
    • Provision of supports that are outcome-oriented and regularly monitored.

  • The term "day" does not mean activities between 9:00 am and 5:00 pm on weekdays.

  • Community inclusion is not limited to specific hours or days of the week.

Centennial Care
Centennial Care is a New Mexico Medicaid program.  Services are provided by four managed care
organizations (MCOs).  These services include physical health, behavioral health, long-term care and
community benefits.

For more information, visit the Centennial Care page with the NM Human Services Department.

To apply for Centennial Care, visit the YesNM Online Portal, create an account and follow the
instructions.