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Developmental Disabilities Individual Budgeting (iBudget) Waiver

Purpose

The purpose of the Medicaid iBudget Waiver is to provide home and community-based supports and services to eligible persons with developmental disabilities living at home or in a home-like setting, utilize an individual budgeting approach, and provide enhanced opportunities for self-determination.  The iBudget Waiver is designed to promote and maintain the health of eligible individuals with developmental disabilities, to provide medically necessary supports and services to delay or prevent institutionalization, and to foster the principles and appreciation of self-determination.

Eligibility Criteria

To qualify for the iBudget Waiver the applicant must:

  • Meet the eligibility requirements in accordance with Chapter 393, F.S.
  • Meet the Level of Care criteria for placement in an ICF/IID
  • Be eligible for Medicaid under one of a variety of categories described in the Florida Medicaid Provider General Handbook
  • Be diagnosed with one or more of the following qualifying disabilities:
    • The individual’s intelligence quotient (IQ) is 59 or less; or
    • The individual’s IQ is 60-69 inclusive and the individual has a secondary handicapping condition that includes: Down syndrome; Cerebral palsy; Prader-Willi Syndrome; Spina bifida; Epilepsy; Autism; or ambulation, sensory, chronic health, and behavioral problems; or has an IQ of 60-69 inclusive and the individual has severe functional limitations in at least three major life activities including self-care, learning, mobility, self-direction, understanding and use of language, and capacity for independent living; or
    • The individual is eligible under the category of Autism, Cerebral Palsy, Down Syndrome, Prader-Willi Syndrome or Spina bifida and the individual has severe functional limitations in at least three major life activities including self-care, learning, mobility, self-direction, understanding and use of language, and capacity for independent living.

Covered Services

Waiver services include:

  • Adult Day Training
  • Adult Dental Services
  • Behavior Analysis Services
  • Behavior Assistant Services
  • Companion
  • Consumable Medical Supplies
  • Dietitian Services
  • Durable Medical Equipment and Supplies
  • Environmental Accessibility Adaptations
  • Occupational Therapy
  • Personal Emergency Response Systems
  • Personal Supports
  • Physical Therapy
  • Private Duty Nursing
  • Residential Habilitation
  • Residential Nursing Services
  • Respiratory Therapy
  • Respite Care
  • Skilled Nursing
  • Specialized Medical Home Care
  • Specialized Mental Health Counseling
  • Speech Therapy
  • Support Coordination
  • Supported Employment
  • Supported Living Coaching
  • Transportation

How to Apply

For information on how to apply for the iBudget Waiver, contact the Agency for Persons with Disabilities by phone, toll-free at 1-866-273-2273, or by mail at: Agency for Persons with Disabilities, 4030 Esplanade Way, Suite 380 Tallahassee, FL 32399-0950.

Waiver Document

Effective 07/01/2021: iBudget Waiver [10.03MB PDF]

Amendment

The Agency for Health Care Administration will conduct a 30-day public notice and comment period prior to the submission of the proposed amendment request to federal Centers for Medicare and Medicaid Services (CMS). The 30-day public notice and public comment period is from June 1, 2022 through June 30, 2022. The Agency will consider all public comments received regarding the amendment request prior to submission to CMS.

The main purpose of this amendment is to update the service definition of adult day training and add prevocational services as a new waiver service. Additional updates are being made to performance measure language and critical incident reporting information. Florida is requesting an effective date of October 1, 2022 for this amendment.

When submitting comments, please include “Proposed Amendment to the 1915(c) iBudget Waiver” in the subject line:
  • Submit email comments to FLMedicaidWaivers@ahca.myflorida.com
  • Submit comments by mail to Bureau of Medicaid Policy, Agency for Health Care Administration, 2727 Mahan Drive, MS 20, Tallahassee, FL 32308
  • If you are hearing or speech impaired, please contact the Agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800) 955-8770 (Voice).
  • iBudget Waiver Amendment [3.27MB PDF]

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