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Service Descriptions

Below is a brief description of the services offered to individuals enrolled in Medicaid Home and Community-Based Services DD Waivers, including the CDC+ Program. Please refer to the Medicaid Handbook for a more detailed description of these services.

Note: Services with an (*) in front of the service title are services reviewed by Qlarant as part of the Provider Discovery Review process.

To access the Developmental Disabilities Individual Budgeting Waiver Services Handbook click here:

https://ahca.myflorida.com/content/download/5933/file/59G-13.070_DD_iBudget_Waiver_Services_2023rev.pdf

iBudget Services

Adult Dental Services
Coverage for dental treatments and procedures not otherwise covered by Medicaid State Plan services for adults 21 and older. These could include services such as diagnostic, preventive and restorative treatment, extractions, endodontic, and periodontal and surgical procedures.

*Behavior Analysis Services
Behavior Analysis Services are provided to assist individuals receiving services to learn new or increase existing functionally equivalent replacement skills for identified challenging behaviors or to learn other behaviors that are directly related to existing challenging behaviors.

*Behavior Assistant Services
Provides support in implementing the behavior analysis services plan created by the waiver behavior analyst service provider. Unlike other services, the behavior assistant provider’s focus is more on working with the caregivers to provide them with the skills to execute the procedures as detailed in the behavior analysis services plan, rather than the provision of intervention directly with the individual receiving services. Behavior Assistant Services are to be time limited.

Consumable Medical Supplies
Consumable Medical Supplies (CMS) are non-durable supplies and items to enable individuals receiving services to increase their ability to perform activities of daily living. CMS could include items such as diapers, gloves, feeding tubes, food supplements and hearing aids. These supplies should not duplicate supplies provided by the Medicaid Sate Plan.

*Consumer Directed Care +
CDC+ is a long-term care program alternative to the Medicaid Home and Community-Based Services (HCBS) Medicaid Waiver. The program provides the opportunity for individuals to improve the quality of their lives by being empowered to make choices about the supports and services that will meet their long-term care needs and to help them reach their goals.

Dietitian Services
Dietitian Services are those services prescribed by a physician, ARNP, or physician assistant that are necessary to maintain or improve the overall physical health. The services include annually assessing the nutritional status and needs; recommending an appropriate dietary regimen, nutritional support and nutrient intake; and providing counseling and education to the individual receiving services, family, direct service staff, and food service staff.

Durable Medical Equipment and Supplies
Durable Medical Equipment (DME) includes specified, prescriptive equipment required by the individual receiving services that can withstand repeated use, primarily serves a medical purpose, is appropriate for use in the home, and is prescribed for an individual who has a disability. The equipment could include van adaptations, lifts, wheelchairs, strollers, adaptive eating devices, and picture communication boards.

Environmental Accessibility Adaptations
Physical adaptations to the home, which are medically necessary to enable the individual receiving services to function with greater independence in the home. These adaptations could include installation of ramps and grab-bars, widening of doorways, modification of bathroom facilities or installation of specialized electric and plumbing systems required to accommodate the medical equipment and supplies.

*Life Skills Development Level 1 (Companion)
Services provided to adults age 21 and older that include supervision and socialization activities. The service provides access to community-based activities that cannot be provided by natural or other unpaid supports, and should be defined as activities most likely to result in increased ability to access community resources without paid support. These services are typically provided in a community setting.

*Life Skills Development Level 2 (Supported Employment)
Training and assistance to support the individual receiving services in sustaining paid employment at or above minimum wage unless the individual receiving services is operating a small business. Activities could include training to assist the person to learn, retain or improve specific job skills, and to successfully adapt and adjust to a particular work environment.

*Life Skills Development Level 3 (Adult Day Training)
Daytime supervision and individual training programs for adults age 22 or older offered during hours of the “work week”. The training, activities, and routine established by the ADT shall be meaningful to the individual receiving services and provide an appropriate level of variation and interest. These training programs occur at a facility or in a work-like setting.

*Life Skills Development Level 4 (Prevocational Services)
Service provides learning and work experiences, including volunteer work, where the individual can develop general, non-job-task-specific strengths and skills that contribute to employability in paid employment in integrated community settings. Services must be provided in community-integrated settings or designated locations.

Occupational Therapy
Occupational therapy is a one on one service prescribed by a physician, ARNP or physician assistant that is necessary to produce specific functional outcomes in self-help, adaptive, and sensory motor skill areas, and assist with control and maneuver within the environment.

Personal Emergency Response Systems
An electronic communication system that enables an individual receiving services to secure help in the event of an emergency.

*Personal Supports
Personal Supports services provide assistance and training to an adult (21 or older) individual receiving services in activities of daily living, including the areas of eating, bathing, dressing, personal hygiene, and preparation of meals. This service can also provide respite services to an individual receiving services age 21 and older living in their family home.

Physical Therapy
Physical Therapy is a one on one service prescribed by a physician, ARNP or physician assistant that is necessary to produce specific functional outcomes in ambulation, muscle control, and postural development and to prevent or reduce further physical disability.

Private Duty Nursing
Continuous nursing care prescribed by a physician and rendered by licensed practical or registered nurses in the family home or the individual receiving services own home. Private Duty Nursing services are prescribed by a physician, ARNP, or physician assistant and consist of individual, continuous nursing care provided by registered or licensed practical nurses. This service is limited to recipients age 21 years or older who are eligible for active nursing interventions on a continuous basis for over two consecutive hours per episode. This service is normally provided on a one-to-one basis.

*Residential Habilitation Standard
Residential Habilitation service provide supervision and specific training activities to assist the individual receiving services to acquire, maintain, or improve skills related to activities of daily living.

*Residential Habilitation Behavior Focus
Residential Habilitation services with a behavior focus are appropriate for individuals receiving services exhibiting at least specified behavioral issues within the past six months.

*Residential Habilitation Intensive Behavior
Intensive behavior Residential Habilitation is for individuals receiving services who present issues with behavior that are exceptional in intensity, duration, and frequency, that meet additional conditions and whose needs cannot be met in a behavior focus or standard Residential Habilitation setting.

*Residential Habilitation Enhanced Intensive Behavior
Residential Habilitation Enhanced Intensive Behavior services are for recipients who present behavioral challenges that are exceptional in intensity, duration, and frequency, whose needs cannot be met in an intensive, behavior focus, or standard residential habilitation setting.

Residential Nursing Services
Residential Nursing services are services prescribed by a physician, ARNP, or physician assistant and consist of continuous nursing care provided by registered or licensed practical nurses. This service is provided in a licensed setting.

Respiratory Therapy
Respiratory therapy is a one on one service prescribed by a physician, ARNP, or physician assistant and relates to impairment of respiratory function and other deficiencies of the cardiopulmonary system.

*Respite Care
Respite care is a service that provides supportive care and supervision to individual receiving services under the age of 21 when the primary caregiver is unable to perform the duties of a caregiver. This service is generally used due to a brief planned or emergency absence, or when the primary caregiver is available, but temporarily physically unable to care for or supervise the individual receiving services for a brief period of time.

Skilled Nursing
Skilled Nursing is a service prescribed by a physician, ARNP, or physician assistant and consists of part-time or intermittent nursing care visits provided by registered or licensed practical nurses provided on a daily basis.

*Special Medical Home Care
Special Medical Home Care Services are provided in APD licensed foster or group homes for individual receiving services with complex medical conditions, requiring an intensive level of nursing care.

Specialized Mental Health Counseling
Specialized mental health services for persons with developmental disabilities are services provided to maximize the reduction of mental illness and restoration to the best possible functional level.

Speech Therapy
Speech therapy is a one on one service prescribed by a physician, ARNP, or physician assistant and is necessary to produce specific functional outcomes in the communication skills of individuals receiving services with a speech, hearing, or language disability, or service necessary to remediate swallowing disorders and oral motor functions.

*Support Coordination
Full Support Coordination provides significant support to an individual receiving services to ensure health, safety, and well-being. The WSC can share tasks with the other support persons as the individual receiving services desire, but ultimately the WSC shall be responsible for performing all tasks required to locate, select, and coordinate services and supports, whether paid with waiver funds or through other resources.

*Supported Living Coaching
Supported Living Coaching services provide training and assistance, in a variety of activities, to individuals receiving services who live in their own homes or apartments. Services can include assistance with locating appropriate housing; the acquisition, retention, or improvement of skills related to activities of daily living, such as personal hygiene and grooming; household chores; meal preparation; shopping; personal finances; and the social and adaptive skills necessary to enable ability to reside on their own.

Transportation
Transportation services are the provision of rides to and from the home of the individual receiving services and community-based waiver services, when such services cannot be accessed through natural (i.e., unpaid) supports.