Service Descriptions

Below is a brief description of the services offered to individuals enrolled in the iBudget Waiver, including the CDC+ Program. Please refer to the current iBudget Handbook for a more detailed description of these services.

Note: Not all waiver services are reviewed by Qlarant. Services with an (*) in front of the service title are services reviewed as part of the Qlarant Provider Discovery Review process.

To access the current iBudget Handbook click here:

https://ahca.myflorida.com/medicaid/rules/adopted-rules-service-specific-policies

iBudget Services

Adult Dental Services
Adult Dental Services cover 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
Behavior Assistant Services provide support in implementing the Behavior Analysis Services Plan (BASP) developed by the iBudget Waiver Behavior Analyst. 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 BASP, 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 + Representative
A CDC+ Representative is an uncompensated individual designated by the person to assist in managing the person’s budget allowance and needed services. The CDC+ Representative advocates for and acts on behalf of the person in his or her CDC+ matters. The Representative is trained and provided with materials to assist the person in implementing self-direction of budget allowance and approved CDC+ services.

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 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
Environmental Accessibility Adaptations are 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)
Life Skills Development Level 1 services are available 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)
Life Skills Development Level 2 provides 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)
Life Skills Development Level 3 provides 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)
Life Skills Development Level 4 provides learning and work experience, 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
Personal Emergency Response Systems are electronic communication systems that enable an individual receiving services to secure help in the event of an emergency. This service is limited to individuals who live alone or who are alone for significant parts of the day and have no regular caregiver for extended periods of time and otherwise require extensive routine supervision.

*Personal Supports
Personal Supports services provide assistance and training to individuals 21 or older living in their own home or family home. This service provides assistance and training in activities of daily living, including the areas of eating, bathing, dressing, personal hygiene, and preparation of meals. Personal supports are designed to encourage community integration. Personal supports provided in supported living are also designated to teach the individual about home-related responsibilities.

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
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 provided primarily in the individual’s own home, family home or when the individual who lives in those settings is engaged in a community activity. This service is limited to individuals age 21 years or older who are eligible for active nursing interventions on a continuous basis for over two consecutive hours per episode.

*Residential Habilitation Standard
Residential Habilitation Standard services are available to individuals living in a licensed residential facility. This service provides supervision and specific training activities to assist the individual to acquire, maintain, or improve skills related to activities of daily living to include personal hygiene skills, such as bathing and oral hygiene; homemaking skills such as food preparation, vacuuming, and laundry; and social and adaptive skills that enable the person to reside in the community.

*Residential Habilitation Behavior Focused
Residential Habilitation Behavior Focused services can only be provided to individuals living in APD licensed facilities, which have been designated as Behavior Focused. This service is appropriate for individuals exhibiting at least one specified behavioral characteristic within the past six months. The goal of Behavior Focused Residential Habilitation services is to prepare the individual for full or partial re-integration into the community, with established behavioral skills, such as developing a healthy lifestyle, filled with engaging and productive activities.

*Residential Habilitation Intensive Behavior
Residential Habilitation Intensive Behavior services can only be provided to individuals living in APD licensed facilities, which have been designated as Intensive Behavior. This service 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 Focused or Standard Residential Habilitation setting. The goal of Intensive Behavior Residential Habilitation services is to prepare the individual for full or partial reintegration into the community, with an expanded set of skills and behaviors, with a focus on independent adaptive functioning, and developing a healthy lifestyle, while participating in engaging and productive activities.

*Residential Habilitation Enhanced Intensive Behavior
Residential Habilitation Enhanced Intensive Behavior services can only be provided to individuals living in APD licensed facilities, which have been designated as Residential Habilitation Enhanced Intensive Behavior. This service is for individuals who present behavioral challenges that are exceptional in intensity, duration, and frequency, whose needs cannot be met in an intensive, behavior focused, or standard residential habilitation setting. The goal of Enhanced Intensive Behavior Residential Habilitation services is to prepare the individual for full or partial reintegration into less restrictive community settings by teaching an expanded set of skills and behaviors. The focus is on independent adaptive functioning and developing a healthy lifestyle, while participating in engaging and productive activities.

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 to individuals who resident in a licensed residential facility, or when an individual residing in a licensed residential facility is engaged in a community activity.

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 provide nursing care to individuals with complex medical conditions, requiring an intensive level of nursing care. This service must be provided in an APD licensed foster or group home that has been approved by the APD state office to provide this level of care.

Specialized Mental Health Counseling
Specialized Mental Health Counseling provides mental health services that focus on the unique treatment of psychiatric disorders and rehabilitation for impairments for individuals with developmental disabilities and 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/CDC+ Consultant
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.