I/DD Waivers in Florida

All states: Medicaid disability services map

Florida I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Florida?

Two state agencies share the work. The Agency for Health Care Administration (AHCA) is Florida's Medicaid agency. The Agency for Persons with Disabilities (APD) runs the iBudget Florida waiver day to day under an agreement with AHCA, decides who has a developmental disability, and handles applications and the waiting list. AHCA itself runs the smaller ICMC managed care waiver.

• Agency for Health Care Administration (AHCA): the state Medicaid agency. It oversees the iBudget waiver and adopts the provider fee schedule by rule. It also operates the ICMC waiver.
• Agency for Persons with Disabilities (APD): operates iBudget Florida, licenses group homes, foster homes and Adult Day Training programs, enrolls iBudget providers, and runs the iConnect system that providers use for electronic visit verification (EVV).
• Front door: people apply to a local APD regional office. Children under 3 are served by Early Steps at the Department of Health instead.
• Case management: every iBudget enrollee chooses a Waiver Support Coordinator from a support coordination agency, a private agency that must be a qualified organization under s. 393.0663, F.S. People who self-direct work with a CDC+ consultant instead. ICMC members get a case manager from the health plan.

What Medicaid waivers and programs serve people with I/DD in Florida?

Florida has one I/DD waiver run by APD, the Developmental Disabilities Individual Budgeting (iBudget) Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. iBudget enrollees can self-direct through Consumer-Directed Care Plus (CDC+). AHCA runs a second, voluntary I/DD waiver called ICMC that delivers similar services through a health plan.

• iBudget Florida (1915(c), control number FL.0867): serves people age 3 and older with a developmental disability as Florida law defines it (intellectual disability, autism, cerebral palsy, spina bifida, Down syndrome, Prader-Willi syndrome or Phelan-McDermid syndrome) who meet the level of care for an intermediate care facility and are eligible for Medicaid. Services include support coordination, four Life Skills Development levels (Companion, Supported Employment, Adult Day Training and Prevocational Services), residential habilitation, supported living coaching, personal supports, respite, behavior analysis and behavior assistant services, nursing and therapies, transportation and home accessibility changes. Each person has an individual budget. The waiver plans for 40,742 participants in its first year, rising to 46,137 in year 5.
• Consumer-Directed Care Plus (CDC+): a self-direction option for iBudget enrollees under a separate federal authority, 1915(j). The person or family buys iBudget services within a monthly budget, with help from a CDC+ consultant. APD acts as the fiscal and employer agent, handling payroll for the workers they hire.
• Intellectual and Developmental Disabilities Comprehensive Managed Care (ICMC) Program (1915(c), control number FL.2346): formerly called the IDD Pilot Program. It is open to adults 18 and older who are on the iBudget pre-enrollment list, meet the same level of care and choose to enroll. One health plan, Florida Community Care, provides all regular Medicaid and long-term care services plus iBudget-type supports such as the Life Skills Development levels, residential habilitation, supported living coaching, personal supports, respite and behavior analysis. It plans for 2,108 participants in its second and third years. Because AHCA, not APD, operates it, it is counted here as a related program rather than an APD waiver.

Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) are the institutional option, and both waivers measure eligibility against the ICF/IID level of care.

Does Florida pay for I/DD services through managed care?

Mostly no. AHCA states that the iBudget waiver is fee-for-service, meaning the state pays enrolled providers directly for each service, and it is not offered by health plans. The one exception is the voluntary ICMC program, where a single health plan, Florida Community Care, coordinates and pays for services.

• iBudget: APD authorizes services within each person's budget, and providers bill through the state's fee-for-service system. Waiver Support Coordinators from private agencies help plan and arrange services.
• ICMC: APD describes it as a statewide program in which a Florida Community Care case manager coordinates medical care and home and community services. The enrollment line is 1-877-711-3662, option 4.

Is there a waiting list for I/DD services in Florida?

Yes. People APD finds eligible who cannot be enrolled in iBudget right away are placed in one of seven pre-enrollment priority categories set in state law, s. 393.065(5), F.S. APD reported 15,399 people in pre-enrollment as of August 4, 2026. Nearly all of them are in the two lowest-priority groups, Category 6 (age 21 and older) and Category 7 (under age 21).

• Count by category (August 4, 2026): according to APD's pre-enrollment report, Category 3 had 50 people, Category 4 had 272, Category 5 had 10, Category 6 had 7,171 and Category 7 had 7,896. Categories 1 and 2 had none.
• Trend: APD reported 15,495 people in pre-enrollment as of June 5, 2026.
• While waiting: APD's pre-enrollment page says APD helps develop a support plan within 60 days of the eligibility decision.
• ICMC: adults in any pre-enrollment category can choose to enroll in ICMC instead of waiting for an iBudget opening.

We did not find a plain-language description of each priority category on the sources we checked. For a person's category or place on the list, families can call APD at 1-866-APD-CARES (1-866-273-2273) or ask their APD regional office.

How do people apply for I/DD services in Florida, and how are budgets set?

People apply to APD through a regional office, by mail, in person or online at ApplyNow.APD.MyFlorida.com. People in crisis can also call 1-866-APD-CARES (1-866-273-2273). Once a person is enrolled, APD staff complete the Questionnaire for Situational Information (QSI), and a formula in state rule turns the results into the person's iBudget amount.

• Eligibility for APD services: APD decides whether the person has a developmental disability under s. 393.063, F.S., that began before age 18. Children age 3 to 5 who are at high risk can also qualify.
• Eligibility for the waiver: the person must also meet ICF/IID level of care, be eligible for Medicaid (the Department of Children and Families, DCF, decides this) and have funding available. People who meet the rules but have no funded opening go into a pre-enrollment category.
• Assessment: the QSI is completed by trained and certified APD staff and done again every three years.
• Budgets: an algorithm in Rule 65G-4.0214, F.A.C., uses the person's age, living setting and QSI results to set the individual budget. CDC+ participants get a monthly budget under Rule 59G-13.088, F.A.C.

What day and residential services can I/DD providers offer in Florida?

iBudget pays for day and employment services as four Life Skills Development levels, and for residential services in licensed group homes and foster homes, assisted living facilities and supported living. APD licenses group homes, foster homes and Adult Day Training programs under Rule 65G-2, F.A.C., which was revised effective March 26, 2026. The same services are also offered in ICMC.

Day and employment services

• Life Skills Development Level 3, Adult Day Training (ADT): scheduled activities in a non-residential setting that build self-help, social and community living skills. ADT programs must be licensed by APD and designated by the APD regional office. Facility-based programs may have no more than 10 people per direct service staff member. APD's 2026 billing advisory describes an hourly rate plus a monthly rate for people who attend 80 or more hours in a month, under the rate table effective October 1, 2025.
• Life Skills Development Level 4, Prevocational Services: time-limited learning and work experiences, including volunteer work, that build skills for paid jobs in the community. Providers must be designated by the APD regional office. Billed hourly, with the same monthly rate for 80 or more hours. The research did not find a published ratio.
• Life Skills Development Level 2, Supported Employment: help finding and keeping a paid job in the community. The waiver cost estimate shows both quarter-hour and hourly units. The research did not find a published ratio or a separate license.
• Life Skills Development Level 1, Companion: non-medical companionship and support to take part in the community. The research did not find a published ratio or billing unit.

Residential services

• Residential habilitation in group homes and foster homes: supervision and training to help a person build and keep skills, offered at standard, behavior focused, intensive behavior and enhanced intensive behavior levels and paid by the day or month. Homes are licensed by APD under Chapter 393, F.S., and Rule 65G-2, F.A.C., and designated by the APD regional office.
• Residential habilitation in assisted living facilities: the same service in an assisted living facility licensed under Chapters 408 and 429, F.S., with separate day and month rates.
• Supported living: adults live in their own home or apartment with Supported Living Coaching, Personal Supports or both. Supported living coaches must complete APD's pre-service training. The research did not find a license requirement for the home.
• ICF/IID: the institutional option, paid under the Medicaid state plan rather than the waiver.

How are I/DD provider rates set and how do agencies enroll in Florida?

iBudget rates come from a statewide fee schedule that AHCA adopts by rule (Rule 59G-13.081, F.A.C.). The rates are built from actuarial models of direct care wages, employment costs, program costs and administrative costs, with geographic adjustments, and they depend on what the Legislature funds. The latest change is a uniform rate increase retroactive to July 1, 2026. Agencies enroll as iBudget providers through APD.

• 2026 rate increase: APD's Provider Advisory 2026-019 describes a uniform iBudget rate increase authorized by Chapter 2026-232, Laws of Florida, retroactive to July 1, 2026. The new rates were applied in iConnect on September 1, 2026, and AHCA reprocessed earlier claims for the 2026-27 fiscal year in September 2026. We did not confirm the size of the increase; check APD's rate change table.
• Wage basis: in 2022 APD had an actuarial firm review personal care related services so rates would support a $15 an hour minimum wage for direct care staff.
• Becoming a provider: APD's apply to be a provider page explains the steps. Applicants for a licensed foster home, group home or Adult Day Training program must already have a facility and show they can operate for up to 60 days without state payment. Licensed settings must also enroll as iBudget providers. Support coordination agencies must be qualified organizations under s. 393.0663, F.S.
• EVV: APD requires EVV in its iConnect system for in-home Personal Supports and Respite. Services by live-in caregivers and services in licensed residential facilities are exempt, according to APD's March 2021 advisory. Since September 2022, skilled respite, skilled nursing, private duty nursing and nursing assessments in non-licensed settings also use EVV in iConnect, per APD's September 2022 advisory. In June 2026 APD announced automated EVV scheduling in iConnect (Provider Advisory 2026-013).

What is changing next for I/DD services in Florida?

AHCA has amendments pending for both I/DD waivers. The iBudget amendment has a proposed effective date of November 1, 2026, and the ICMC amendment a proposed effective date of December 1, 2026. As of October 28, 2026, we did not confirm that CMS, the federal Medicaid agency, has approved either one, so the dates may change.

• iBudget amendment (FL.0867.R03.02): adds Tatton-Brown-Rahman syndrome to the state's definition of developmental disability and clarifies background screening rules, following HB 565 (2026). The amendment is posted on AHCA's iBudget waiver page.
• ICMC amendment (FL.2346.R00.02): revises the developmental disability definition in the same way. Its public comment period ran from July 30 to August 28, 2026.

Several changes from 2026 are already in place: the uniform rate increase retroactive to July 1, 2026, the revised licensing rule for residential facilities and Adult Day Training programs (effective March 26, 2026), and automated EVV scheduling in iConnect. For the status of the amendments, providers can ask AHCA at FLMedicaidWaivers@ahca.myflorida.com.

Florida I/DD sources

• AHCA: Developmental Disabilities iBudget Waiver
• AHCA: iBudget waiver 2026 amendment (FL.0867.R03.02)
• AHCA: Intellectual and Developmental Disabilities Comprehensive Managed Care (ICMC) Waiver
• AHCA: ICMC waiver 2026 amendment (FL.2346.R00.02)
• APD: iBudget Florida
• APD: Pre-enrollment report (August 4, 2026)
• APD: Apply for services
• APD: Apply to be a provider
• APD: Provider Advisory 2026-019, upcoming rate increase
• APD: iConnect EVV

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Florida EVV requirements

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.