Is working for consumer directed care plus a government employee

Agency for Persons with Disabilities

What is the purpose of the agency?

• increasing access to community-based services, treatment, and residential options;
• increasing the number of individuals with developmental disabilities in the workforce; and
• improving management of the agency and oversight of providers.

What activities are performed by the department?

Who is eligible to receive services?

The agency serves Floridians with developmental disabilities as defined in Ch. 393, Florida Statutes. This includes individuals with the following disabilities.

• Intellectual disabilities (Full Scale IQ of 70 or below)
• Severe forms of autism
• Spina bifida cystica or myelomeningocele
• Cerebral palsy
• Prader-Willi syndrome
• Down syndrome
• Phelan-McDermid syndrome
• Individuals between the ages of 3 to 5 at high risk for a developmental disability

What services are provided?

The Agency for Persons with Disabilities (APD) works with local communities and private providers to support people who have developmental disabilities and their families in living, learning, and working in their communities; provides assistance in identifying the service needs of people with developmental disabilities; and educates the public on disability issues while focusing attention on employment for people with disabilities.

• Home and Community-BasedServices (HCBS). The HCBS waiver is the agency's largest program, providing Floridians who are eligible for Medicaid services an alternative to institutional-based care. Known as the iBudget Florida waiver, the program provides social, medical, behavioral, and therapeutic services and living arrangements in the community. For Fiscal Year 2021-22, there was a total of 35,413 individuals in the community who were active on the iBudget waiver. Some clients enroll in a self-directed program called Consumer-Directed Care Plus (CDC+). Individuals enrolled in CDC+ have maximum budget flexibility because they have fewer restrictions on who is hired to deliver services and can negotiate how much to pay for those services. People in CDC+ must have a CDC+ Consultant, who is similar to a Waiver Support Coordinator. As of July 1, 2022, 4,167 people in the HCBS program were managing their own services through the CDC+ program.
  
• Developmental Disability Centers (DDCs). The agency operates two Medicaid-funded DDCs for people who need structured residential care 24-hours a day. Tacachale in Gainesville and Sunland in Marianna are communities that offer residents opportunities to enhance their quality of life and maximize individual potential. The full-service residential facilities provide medical care, therapy, and a variety of recreation opportunities. The residents participate in social outings, team sports, community events, learning a trade, and working onsite. During Fiscal Year 2021-22 , the centers provided services to an average daily population of 435 individuals.
  
• Developmental Disabilities Defendant Program (DDDP). Individuals with developmental disabilities charged with committing a felony crime may be court-ordered into the agency’s DDDP. DDDP is a 146-bed secure facility located in Chattahoochee for defendants with developmental disabilities who are deemed incompetent to participate in their own defense or stand trial. In this program, residents with a secure court order receive competency training and other services in accordance with their needs. This is not a voluntary residential setting. The agency also has 34 secure beds on the Sunland campus in Marianna. During Fiscal Year 2020-21, the average daily population to whom the DDDP provided services was 140 individuals.
  
• Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). Intermediate care facilities provide health and rehabilitative services to individuals with developmental disabilities in a protected residential setting. ICF/IIDs provide active treatment that is the continuous, aggressive, and consistent implementation of a program of specialized and generic training, and health or related services, directed toward helping the individual function with as much self-determination and independence as possible.

How do people apply for services?

People who have or might have a developmental disability may apply for services by completing an application for services (available on the agency's website in English , Spanish, and Haitian Creole) and hand delivering or mailing the application to the agency's local area office where the applicant lives.

What limits apply to program services?

The iBudget system allows the state to receive federal Medicaid matching payments for services provided to developmentally disabled persons in the community. Because there are not enough home and community-based services waiver slots to serve all eligible persons, the agency maintains a waitlist of individuals who have requested services. The agency reported that, as of June 30, 2022, there were 22,578 individuals on the iBudget waitlist, and that 1,552 individuals had been moved from the waitlist to the iBudget waiver. Between 2017 and 2022, the average number of agency clients on the waiting list is about 22,000. The current trend indicates that the number of clients on the waiting list has slightly declined the past three years.

How does the agency track performance?

The agency tracks key performance measures in its Long Range Program Plan . In Fiscal Year 2021-22, the agency reported that 88.8% of people receiving services met key health, safety, and quality of life measures, a slight decrease from the previous fiscal year (89.4%) and below the approved standard of 92%. The agency also reported serving 4,476 clients via supported living, a decrease from the previous fiscal year (4,684). However, the number of clients supported exceeded the agency's approved standard of serving 4,000 individuals. In addition, the agency reported that 53% of clients were employed in integrated settings, an increase from the previous fiscal year (45%). The clients employed in integrated settings exceeded the approved standard of 30%.