About the iBudget DD Waiver and Waitlist
What is the iBudget DD waiver?
The Florida Medicaid Developmental Disabilities Individual Budgeting (iBudget) Home and Community-Based services (HCBS) waiver is authorized under section 1915(c) of the Social Security Act and governed by Title 42, Code of Federal Regulations (CFR), Parts 440 and 441. The iBudget Waiver provides home and community-based supports and services to eligible persons with developmental disabilities (DD) living at home or in a home-like setting. The iBudget Waiver program is funded by both federal and matching state dollars.
Currently, people with the following developmental disabilities may be eligible for the iBudget waiver.
- Autism Spectrum Disorder
- Cerebral Palsy
- Spina Bifida
- Intellectual Disabilities
- Down Syndrome
- Prader-Willi Syndrome
- Phelan McDermid Syndrome
- Children age 3-5 who are at a high risk of a developmental disability
Visit the Agency for Persons with Disabilities (APD) website for more info on who is eligible.
People enrolled in the iBudget Waiver receive services that enable them to:
- Have a safe place to live.
- Have a meaningful day activity.
- Receive medically necessary medical and dental services.
- Receive medically necessary supplies and equipment.
- Receive transportation required to access necessary waiver services.
This waiver uses an individual budgeting approach and enhanced opportunities for self-determination. The purpose of this waiver is to:
- Promote and maintain the health and welfare of eligible individuals with developmental disabilities.
- Provide medically necessary supports and services to delay or prevent institutionalization.
- Foster the principles of self-determination as a foundation for services and supports.
Eligible recipients can choose from an array of services which allows them to live as independently as possible in their own home or in the community and achieve productive lives. Recipients can choose between the iBudget Waiver or an intermediate care facility for individuals with intellectual disabilities (ICF/IID).
For more information on the iBudget Waiver, visit APD's iBudget Florida webpage and the Florida Developmental Disabilities Council (FDDC) guide, “Making the Most of Your Florida Medicaid and iBudget Services.”
Why is there a DD waitlist?
Simply stated, the need for services far outpaces the current funding allocated by the Florida Legislature. However, the waitlist has been a longstanding problem. Indeed, many people with DD have been waiting for over ten years or more! There are 21,017 people (as of December 2017) on the waitlist until resources become available (i.e. 40% are waiting, while 60% are receiving services). The waitlist first reached over 20,000 in May, 2011. Approximately half of the individuals on the waiting list receive Medicaid State plan services.
The waitlist has 7 priority categories based on an evaluation of current circumstances and/or intensity of need. Progress has been made to address people in the top 5 categories—however categories 6 and 7 makes up nearly 93% of the current waitlist!
Individuals on the DD Waitlist by Priority Group
|Category 2||Children in Welfare System||0.0%|
|Category 3||Intensive Needs||856||4.1%|
|Category 4||Caregiver Over Age 70||190||0.9%|
|Category 5||Transition from School||235||1.1%|
|Category 6||Age 21 and Over||9,894||47.1%|
|Category 7||Age Under 21||9,624||45.8%|
|Priority Not Yet Assessed||218||1.0%|
Source: Agency for Persons with Disabilities (Dec. 2017)
There have been efforts to reduce the number of people waiting, and to ensure those with more support needs are prioritized. For example, additional funding was allocated in the 2016 legislative session to take 1500 individuals off the waitlist. However, such funding was reduced in 2017, to enable only 400 additional people to come off the waitlist. This figure is not enough to counter new additions to the waitlist from new applicants seeking services. Not surprisingly, the result is that the waitlist has increased from 20,476 in January 2017 to 21,017 in December 2017.