Home and Community Based Waiver -- "Med-Waiver"

What is Med-Waiver?

Med-Waiver (also called the Home and Community Based Waiver) is not a program, but a funding source.  It is designed to provide the  Developmental Disabilities Program (DDP))  clients who need institutional level care, adequate support to be able to remain in the home.  If your child qualifies for institutional level care, then they are eligible for med-waiver funding; however, you must begin by becoming a client of the DDP.  All DDP clients who are eligible are referred to the med-waiver.  One prerequisite for receiving funds through med-waiver is that the DDP client have Medicaid.  Your state support coordinator can help you qualify for Medicaid even if your family does not meet low income guidelines.  Family income is not used to determine eligibility for med-waiver.  As with becoming a DDP client, you do not have to disclose your income.  Eligibility is determined only by the applicant's income and assets.  

Choosing a Med-Waiver Support Coordinator 

Once you are determined eligible for the Medicaid waiver, the Agency for Persons with Disabilities (APD) will provide you with information on choosing a Med-waiver Support Coordinator.  This is a case manager who works independently from the state, but whose work is overseen by APD.  

You and your Med-waiver Support Coordinator will write up a "support plan" and a "cost plan" (a budget) that gets submitted to APD for funding.  Your support coordinator will help you locate service providers and negotiate their rates.

Med-waiver Support Coordinators either work for an agency (like Adept and People Systems) or work alone as "sole providers".  In either case they are paid through Medicaid.  They are considered service providers themselves; their service being case management or support coordination.  Currently, they receive $137.00/month per case and are allowed up to 38 cases.  They are required to contact you every month.  If they bill Medicaid and fail to contact you monthly, it is considered Medicaid Fraud.

 There are some things to keep in mind when choosing between an agency and a sole provider.  First of all, support coordinators are required to have backup should they become ill or take time off.  The agencies have an on-call system to cover for people who are out.  The sole provider must make arrangements, so it's important to find out who will be the backup in case of emergency.  Secondly, the agencies typically cover the entire district, whereas a sole provider may only know the resources offered in the town in which he or she works.  If you choose a sole provider, make sure they know the resources in your area.  Finally, and in defense of the sole provider; since they work alone, they must meet more stringent job specifications (equivalent to the agency's supervisor level).

The important thing to remember is that YOU ARE THE BOSS; and if you are not happy with the job they are doing, you can change to another support coordinator.  Never stay with someone with whom you are unhappy.

What about Service Providers?

Finally, a note on providers.  There is a shortage of people qualified to provide services, especially those people who act as companions, respite care providers and personal care attendants.  If you currently have someone that you use, they can get   certified to be paid by med-waiver.  Even family members can become med-waiver providers.  To qualify as a med-waiver service provider contact the Agency for Persons with Disabilities in your area. 

Remember, that to become a med-waiver recipient, you must first apply.  Being a Medicaid recipient does not automatically qualify you for Med-waiver. 

While the waiting list seems endless, it is important that  you contact your local office and make an appointment to complete an application.

Contact your local district office.  

In Marion County:

        Agency for Persons with Disabilities

        Developmental Disabilities Program

District 13

3001 W. Silver Springs Boulevard

Ocala, FL 34473

(352) 732-1441

What about those on the waiting list?

It is important to contact your local office periodically to find out the status of your application.  Some important questions to ask are:

- How many people are on the list state wide?

- How many people are on the district's list?

- How many slots are available?

- Where do I stand on the list?

What about complaints?

The Family Care Counsel (FCC) is an advisory board made up of parents and consumers that oversees DDP.  Parents can call for information and are welcome to attend FCC meetings.  The FCC reports directly to the governor's office.  Parents are urged to report complaints concerning DDP to the FCC:

District 13: (352) 489-6279

Click below to see a copy:

 APD Family and Supported Living Waiver Services Directory (9/05)

     Useful Link

Click for information on finalized 2007 budget