Florida Florida is a state located in the Southeastern region of the United States. Florida is bordered to the west by the Gulf of Mexico, to the northwest by Alabama, to the north by Georgia, to the east by the Bahamas and Atlantic Ocean, and to ...

has several Medicaid Waiver Programs. Medicaid Waiver Programs allow recipients to 'waive' institutionalization and instead choose to direct services to assist them to live in the community. Waiver program services may offer additional supports and services than provided by traditional

Medicaid Medicaid in the United States is a federal and state program that helps with healthcare costs for some people with limited income and resources. Medicaid also offers benefits not normally covered by Medicare, including nursing home care and per ...

The HCBS/DD Waiver Program

The Home and Community Based Services Waiver, also called the HCBS/DD Waiver or "Big" Waiver, is one of Florida's Medicaid Waiver Programs that assists people who have disabilities. These disabilities include:

Cognitive impairments Cognitive deficit is an inclusive term to describe any characteristic that acts as a barrier to the cognition process. The term may describe * deficits in overall intelligence (as with intellectual disabilities), * specific and restricted defic ...

spina bifida Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, men ...

cerebral palsy Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sens ...

, Prader-Willi syndrome,

Down syndrome Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual dis ...

Phelan-McDermid syndrome 22q13 deletion syndrome, also known as Phelan–McDermid syndrome (PMS), is a genetic disorder caused by deletions or rearrangements on the q terminal end (long arm) of chromosome 22. Any abnormal genetic variation in the q13 region that present ...

, and Autism. The HCBS/DD medicaid waiver program helps cover the cost for things that regular medicaid does not pay for. The HCBS Waiver currently has 28 services and there is a spending cap based on the individuals needs. However, services must be "medically necessary". Individuals that meet the following criteria are eligible to receive services under the Home and Community Based Services Waiver: * Be under 65 years of age * Be a Florida resident * Be a U.S. citizen or qualified noncitizen * File for any other benefits to which they may be entitled * Disclose any rights to third party liability (i.e., health insurance) * Meet the income limit of $2,523 for an individual or $5,046 for a couple (as of January 2022) * Meet the asset limit of $2000 for an individual or $3000 for an eligible couple * If your monthly income exceeds $2,523/month you still can benefit from Medicaid Diversion by setting up a
income trust
This is a legal document and it must be done by an attorney In 2021 there was a waiting list of over 22,000 people for this waiver. Some of the people on the waiting list receive services from the FSL waiver.

The FSL Waiver Program

The Florida Supported Living Waiver, also called the FSL Waiver or "Little" Waiver is another Florida Medicaid Waiver Program. This Waiver currently has a spending cap of $14,792.00. There are eleven services on this waiver. Many people on the FSL Waiver are waiting to get on the HCBS Waiver. The FSL Waiver also assists people who have disabilities, and the requirements to receive services are the same as the HCBS Waiver.

Support Coordination

Support Coordinators for the HCBS and FSL Waiver Programs assist people who have disabilities in accessing supports and services. Natural resources are used whenever possible. Florida Medicaid is "The Payer of Last Resort". The rate for support coordination was reduced in 2011. The highest rate paid over the 18 years of the waiver was $161.60 per month, for each person served. In mid 2016 the rate was changed from the lowered $125.71 per month to $148.69, for adults and for children living in group homes, and from $62.86 to $74.35 for children living in family homes. Support Coordinators are on call

24/7 In commerce and industry, 24/7 or 24-7 service (usually pronounced "twenty-four seven") is service that is available at any time and usually, every day. An alternate orthography for the numerical part includes 24×7 (usually pronounced "twenty ...

. The average caseload size has changed. The high of 40 was reached in 1991; the low, 36. The maximum number of individuals served by a single support coordinator is 43 full-time recipients.Adults count as 1 full-time recipient and children a half time recipient. With the change in rates and caseload came changes as to the minimum frequency of visits. Adults in supported living must be seen at least once a month, and at least once every 3 months in their home. Adults in the family home must be seen at a minimum once every three months, at least once every 6 months in their home. Children in the family home must be seen at a minimum once every six months and at least once a year in the family home. Anyone in Residential Placement, group homes or foster homes, must be seen monthly. Several other services have been eliminated.

History

Prior to Medicaid Waiver Programs, many people who had disabilities were served in nursing homes or institutions. The HCBS and FSL Waivers help people to live in their communities by providing supports and services to people who live in the community. It is believed that it is less expensive for people to receive services in the community, rather than in a nursing home or an institution.

References

External links

The Agency For Persons With Disabilities

WaiverProvider.Com

Zar Database Solution

Support Coordinators.Com

OC Estate Lawyers
{{DEFAULTSORT:Florida Medicaid Waiver Medicare and Medicaid (United States) Government of Florida Healthcare in Florida