Florida has several Medicaid Waiver Programs. Medicaid Waiver Programs cover supports and services not typically covered by Medicaid.
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The Home and Community Based Services Waiver, also called the HCBS/DD Waiver or "Big" Waiver, is one of Florida's Medicaid Waiver Programs that assists people who have disabilities. These disabilities include: Cognitive Impairments, Spina Bifida, Cerebral Palsy, Prader-Willi syndrome, Down Syndrome, and Autism. The HCBS/DD medicaid waiver program helps cover the cost for things that regular medicaid does not pay for. The HCBS Waiver currently has 28 services[1] and there is no spending cap. However, services must be "medically necessary".
In 2008 there was a waiting list of over 15,000 people for this waiver.[2] Some of the people on the waiting list receive services from the FSL waiver.
The Florida Supported Living Waiver, also called the FSL Waiver or "Little" Waiver is another Florida Medicaid Waiver Program. This Waiver currently has a spending cap of $14,792.00.[3] There are eleven services on this waiver. Many people on the FSL Waiver are waiting to get on the HCBS Waiver. The FSL Waiver also assists people who have disabilities, and the requirements to receive services are the same as the HCBS Waiver.
Support Coordinators for the HCBS and FSL Waiver Programs assist people who have disabilities in accessing supports and services. Natural resources are used whenever possible. Florida Medicaid is "The Payer of Last Resort".
The rate for support coordination was reduced in 2011. The highest rate paid over the 18 years of the waiver was $161.60 per month, for each person served. The current rate is $125.71 per month for adults and for children living in group homes, and $62.86 for children living in family homes. Support Coordinators are on call 24/7. The average caseload size has changed. The high of 40 was reached in 1991; the low, 36.
The maximum number of individuals served by a single support coordinator is 43 full time recipients.Adults count as 1 full time recipient and children a half time recipient.
With the change in rates and caseload came changes as to the minimum frequency of visits. Adults in supported living must be seen at least once a month, and at least once every 3 months in their home. Adults in the family home must be seen at a minimum once every three months, at least once every 6 months in their home. Children in the family home must be seen at a minimum once every six months and at least once a year in the family home. Anyone in Residential Placement, group homes or foster homes, must be seen monthly. [4] Several other services have been eliminated.
Prior to Medicaid Waiver Programs,{1991} many people who had disabilities were served in nursing homes or institutions. The HCBS and FSL Waivers help people to live in their communities by proving supports and services to people who live in the community. It is believed that it is less expensive for people to receive services in the community, rather than in a nursing home or an institution.