Comprehensive Intellectual and Developmental Disabilities Managed Care (IDD Pilot) Waiver
Summary
The IDD Pilot Waiver is a voluntary, comprehensive program consisting of Managed Medical Assistance (MMA) services, Long-Term Care (LTC) Waiver services, and Florida Developmental Disabilities Individual Budgeting (iBudget) Waiver services.
Eligibility Criteria
To qualify for the IDD Pilot Waiver the applicant must:
- Be 18 years of age or older
- Meet the eligibility requirements in any of Categories 1 through 6 in s. 393.0659(5) 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 60-70 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 60-70 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.
- Reside in one of two pilot regions: Region D (Hardee, Highlands, Hillsborough, Manatee, and Polk counties) and Region I (Miami-Date and Monroe counties)
Covered Services
Home and Community Based Settings (HCBS) services promote the health and functioning of individuals diagnosed with a developmental disability to prevent hospitalization or institutionalization. The goal of the Pilot Program is to enable recipients to receive services in their home or in the community.
The following HCBS services are included in the Pilot Program:
- Adult Day Health Care
- Adult Dental Services
- Assisted Living
- Behavior Analysis Services
- Behavior Assistant Services
- Care Coordination
- Dietitian Services
- Environmental Accessibility Adaptations
- Equipment and Supplies*
- Home Delivered Meals
- Life Skills Development Level 1 – Companion
- Life Skills Development Level 2 – Supported Employment
- Life Skills Development Level 3 – Adult Day Training
- Life Skills Development Level 4 – Prevocational Services
- Medical Services*
- Medication Administration
- Medication Management
- Occupational Therapy
- Personal Emergency Response Systems (PERS)
- Personal Supports
- Physical Therapy
- Private Duty Nursing
- Professional and Home Care Services*
- Residential Habilitation
- Residential Nursing
- Respiratory Therapy
- Respite
- Skilled Nursing
- Specialized Medical Equipment and Supplies
- Specialized Medical Home Care
- Specialized Mental Health Counseling
- Speech Therapy
- Supported Living Coaching
- Therapy Services*
- Transportation*
- Unpaid Caregiver Training
- Vaccines*
* Expanded benefits for the IDD Pilot are extra services provided by the managed care plan to recipients in the Pilot Program. The Pilot Program offers expanded benefits tailored to the IDD population. Members in the Pilot Program also receive the Managed Medical Assistance (MMA), Long-Term Care (LTC) Waiver, Home and Community-Based Services (HCBS), and Dental Plan expanded benefits.
How to Apply
For information on how to apply for the IDD Pilot 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
2024 IDD Pilot Waiver Document
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