Medicaid waiver information

TALLAHASSEE — The Agency for Persons with Disabilities (APD) will implement the legislatively-mandated Medicaid waiver tiers on October 1.  Earlier this month, a challenge to APD’s authority to implement the required changes to the Medicaid waiver was resolved.

The challenge delayed the agency’s implementation from the original July 1 date. Now the agency is moving forward with notifying APD customers and their waiver support coordinators of the new start date. Letters will be mailed within the week to notify each customer of the waiver for which they qualify.

In 2007, the Florida Legislature required APD to create four new Medicaid developmental disability waivers called tiers.  The Legislature established criteria for each of the four waiver tiers. The criteria cover the individual’s needed level of service, along with other important characteristics, and the person’s current living situation. The new tier system establishes financial limits for three of the tiers.

Tier One      No cap
Tier Two      Cap of $55,000
Tier Three    Cap of $35,000
Tier Four     Cap of $14,792

Director of the Agency for Persons with Disabilities Jim DeBeaugrine said, “Most people will not see any service reductions when the new tiers begin on October 1.  However, for those who will need to reduce services, we understand this may be a difficult time. We urge them to immediately contact their waiver support coordinator to begin the process. Those individuals will need additional support from the agency, their families, and the community to make adjustments.”

Those APD customers affected by a cap will select the services that are most important to them, then work with their waiver support coordinator to update their service plan by September 10.

The agency annually serves about 35,000 Floridians with developmental disabilities of mental retardation, autism, cerebral palsy, spina bifida, and Prader-Willi syndrome. For more information on the agency, call 1-866-APD-CARES or visit www.apd.myflorida.com.