How does the iBudget Waiver operate, in a nutshell?

iBudget is administered directly by the Agency for Persons with Disabilities (APD). When a person enrolls, APD will send someone to do an in-person assessment (the QSI) with questions about functional, behavioral and physical needs. Some questions on the QSI are variables in an algorithm to come up with a baseline for funding. However, most enrollees need more help than the baseline amount will allow.

To get more services approved, the enrollee’s selected case manager, known as the Waiver Support Coordinator (WSC), will put together a request for APD to consider. The WSC is also responsible for developing a Support Plan to describe the enrollee’s strengths, needs, and goals.

APD must give written notice of its decisions on service requests. Once services have been approved, the enrollee, with the help of their WSC, will select service providers.

What is the goal of the iBudget Waiver?

According to the Florida rule that governs service coverage for the iBudget Waiver, the purpose of the waiver is to:

• Promote and maintain the health and welfare of enrollees

• Provide medically necessary supports and services to delay or prevent institutionalization.

• Foster the principles of self-determination as a foundation for services in the support.

Rule 59G-13.070, Fl. Admin. Code, adopting the Developmental Disabilities Individual Budgeting Waiver Services Coverage and Limitations Handbook.

Is iBudget a substitute for care in an Intermediate Care Facility (ICF)?

Yes. Like ALL HCBS Waiver, enrollees must meet an institutional level of care (in this case, the institution is an Intermediate Care Facility for people with Intellectual and Developmental Disabilities or ICF.) When someone is enrolled in the iBudget Waiver, they choose to have care provided in the home or in a community setting, like a group home, rather than enter an ICF.

Unlike the iBudget Waiver, which has a cap on enrollment and a long waiting list, an ICF is a service offered under Basic Medicaid and must be provided with reasonable promptness to anyone who clinically meets the need for that level of care.

What kind of services does iBudget offer?

All enrollees have a case manager known as a Waiver Support Coordinator. WSCs are NOT employees of APD but are independent providers, like other service providers. An enrollee chooses a WSC from a list of WSCs with openings. The WSC will work with the enrollee (and the enrollee’s legal representative or caregivers) to come up with an array of services that will allow the enrollee to meet his or her goals and live as independently as possible.

Services are grouped into Service Families: Life Skills Development (Companion, Supported Employment and Adult Day Training); Supplies and Equipment; Personal Supports; Residential Services (Standard, Behavior Focused, Intensive Behavior), Wellness and Therapeutic (Behavioral Services, Dietician, Nursing, Therapies, Counseling); Transportation; and Adult Dental Services.

Is there a limit on the amount of services?

There is no set cap on most covered services. Generally, the only limit is that the service must be medically necessary.