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Calls to Action

Florida Housing and Community Living

Florida operates Medicaid home and community-based (HCBS) waivers to serve people with developmental disabilities, including autism. These HCBS programs along with affordable housing services help Florida residents with autism live fulfilling lives in the community.
March 26, 2015

Read below for recent news and updates about Florida's housing and community living programs...

NEW! Support Senate Version of Budget to Increase Access to Services for over 2000 Floridians with Disabilities and their Families!

What is this about?

The availability of housing and community supports – including housing vouchers and developmental disability waiver slots – is directly tied to the amount of money budgeted by the legislature for each fiscal year (FY). The amount of money for these programs also determines whether or not service budgets are capped and how much providers can be reimbursed.

The legislature will decide how much is budgeted – or appropriated – for all of the programs serving people with autism, including the iBudget waiver. Both the House and the Senate will adopt different budgets and must reconcile their differences before finalizing the budget bill in May.

What is the problem?

The Florida House and Senate presented two very different bills, with $4.3 billion less in the House budget, including over $30 million less for moving individuals with disabilities off of the iBudget waiver waiting list. The Senate budget – SB 2500 – includes $40 million to move people off of the waiting list and into the iBudget waiver services. The Senate budget also includes rate increases for support coordinators and personal support which is critically needed to ensure people can hire and retain high-quality caregivers for their loved ones with autism. An additional $3 million is also included in the senate budget to provide supported employment services to individuals on the waitlist.

The Florida Senate Budget bill, SB 2500 makes inroads to providing needed to services to those on the waiting list. The budget includes additional iBudget waiver services for 2000+ individuals. The additional funds for supported employment for those who remain on the waiting list will assist those Florida citizens with disabilities to find employment in the community and lead more independent lives while they await their iBudget waiver services.

Specifically, the Senate’s FY 2015-2016 budget includes:

  • $16.1 million to serve approximately 2,000 transition-age individuals who are waiting for iBudget waiver services;
  • $1.2 million to increase Support Coordinator rates by 6.5%;  
  • $0.6 million to increase Personal Day Supports rates by 2.5%; and
  • $0.3 million to provide Supported Employment Services for Waitlist Individuals

How can you get involved?

Contact your local Senator or Representative and tell them to support the Senate Budget, SB 2500

Take Action Now!

Be sure to sign up to receive action alerts to advocate for additional funding and supports for individuals with autism through the Housing and Community Living Initiative that Autism Speaks is piloting in Florida. 

Past Updates

New! Autism Speaks held a Lunch and Learn webinar on Thursday, February 26th to discuss our Housing and Community Living initiative in Florida. Read the slides here!

Florida has proposed changing its Medicaid waiver program for Home- and Community-Based Services (HCBS) in order to comply with a federal directive that prohibits services that "isolate" participants from the general community, and is inviting public reaction. The new rules will affect group homes, adult residential facilities, congregate living health facilities, and other settings.

This is a positive announcement as it forces states to make sure services are developed in a person-directed manner.

According to the state Agency for Healthcare Administration, "The draft transition plan for the Developmental Disabilities Individual Budgeting (iBudget) Waiver is designed to ensure individuals receiving home and community based services authorized under the iBudget Waiver are integrated in, and have access to, supports in the community, including: opportunities to seek employment, engage in community life and control personal resources."

Individuals with autism and their caregivers who receive or want Medicaid waiver funding can comment on the new proposal through March 14. Further information is available at the Florida Agency for Healthcare Administration website HERE.

The 30-day public notice and public comment period for the draft transition plan is being held to solicit meaningful public input from recipients, providers and all stakeholders on the development of the draft transition plan. The public comment period begins February 3, 2015 and ends March 14, 2015.

Comments and suggestions can be mailed to:

Agency for Health Care Administration
Attention: HCBS Waivers
2727 Mahan Drive, MS #20
Tallahassee, Florida 32308

Comments and suggestions can be emailed to FLMedicaidWaivers@ahca.myflorida.com. Please reference "Statewide Transition Plan" in the subject line.

What’s the issue?

Early this year, the federal government issued new guidelines that may affect how you as an individual with autism or a caregiver will receive services through Medicaid. Florida has proposed revising its Medicaid program to comply with the new regulations, which can affect services such as in-home or out-of-home residential support, day activities like supported employment or day habilitation, and other services like respite and family support. For more information about these rules, check out this replay from Autism Speaks’ live chat.

What can you do about it?

Florida is now required to seek public input. This is your opportunity as an individual with autism or a caregiver to affect how these changes take place in your state.

The new rules were published in early 2014 by the Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administering the Medicaid program. The regulations outlined criteria for certain HCBS programs operated under specific Medicaid waiver programs.

Medicaid HCBS programs provide a variety of services and supports that individuals with autism need to live in the community. These programs offer an alternative to institutional services for people with disabilities who need ongoing support to meet their functional needs. All states operate HCBS programs that serve individuals with developmental disabilities, like autism, but these programs vary widely from state to state in terms of eligibility requirements and available services. More information about Medicaid HCBS is available online.

What do the new rules mean?

The rules require all Medicaid HCBS programs to allow individuals to be able to choose their services and have access to the community. In particular, states are prohibited from using HCBS funding for settings that isolate individuals from the broader community. This is an important new protection that could help individuals with autism live in settings that are more integrated with the community.

However, in implementing this new requirement, each state Medicaid office has significant discretion in determining whether a given setting results in “isolation.” As a result of the rules, states are beginning to 1) identify the type of settings that may no longer be in compliance with the new rules, and 2) develop plans on how they will change their HCBS programs.

CMS developed these rules over a number of years, and Autism Speaks has long been involved in helping ensure that the needs of the autism community were represented in the development of these new standards. Now that the rules are final, states are beginning to implement the necessary changes to their programs including identifying the type of settings that may no longer be in compliance with the new rule, and to develop plans that outline any changes they will make to their HCBS programs as a result.

What is Autism Speaks doing and what can autism families do?

During this process, states are required to obtain input from advocates and Autism Speaks urges each state to seek and incorporate stakeholders’ views on what constitutes isolating settings and how best to integrate individuals into the broader community. For more information on Autism Speaks’ position on Housing and Residential supports, view our position statement here. Individuals with autism and their family know firsthand the barriers to true community integration and are the most appropriate individuals to help define isolating settings.

Not sure what to say?

  • Medicaid policy can be very confusing and the state documents that describe programs aren’t written in a way that most people can understand. But that shouldn’t stop advocates from expressing their opinion. CMS has published two sets of exploratory questions to assist states in assessment of residential settings and non-residential HCBS settings, that advocates can use to help them think about their experiences and create their message to state officials.

If you are in a waiver program already, use these questions to tell about your experience. For example:

  • What was your experience planning your waiver services? Were you able to choose the services you wanted and get them where and how often you wanted?
  • Does the place where you get your services reflect your needs and preferences? Did you have options to choose from?

If you are not yet receiving waiver services (because you are on a waitlist or otherwise) but expect to be using waiver services in the future, use these questions to talk about what services will be important to you in the future. For example:

  • Do you want to be able to work? If not, what type of meaningful non-work activities would you like to be involved in?
  • Would you like to have roommates or live on your own? How often would you like to have visitors? What types of supports are necessary for you to live as independently as possible?