Developmental Disabilities ibudget Medicaid Waiver

The purpose of the Medicaid iBudget Waiver is to provide home and community-based supports and services to eligible persons with developmental disabilities living at home or in a home-like setting, utilize an individual budgeting approach, and provide enhanced opportunities for self-determination. The iBudget Waiver is designed to promote and maintain the health of eligible individuals with developmental disabilities, to provide medically necessary supports and services to delay or prevent institutionalization, and to foster the principles and appreciation of self-determination.
Behavior Analysis is to assist individuals to learn new or increase existing functionally equivalent replacement skills for identified challenging behaviors or to learn other behaviors that are directly related to existing challenging behaviors. Behavior analysis services include the use of behavior programming and behavioral programs. Behavior analysis includes the design, implementation, and evaluation of systematic environmental modifications to understand a recipient’s behavior and strives to positively change the recipient’s behavior in socially significant ways.
 Behavior analysis uses direct observation and measurement of a recipient’s behavior and environment. Behavioral services include procedures to insure generalization and maintenance of positive behaviors. 
This service is designed to facilitate ongoing changes in the recipient’s environment, the interactional styles of caregivers and the contingencies for the recipient’s behavior provided by other people in order to make lasting improvements in the recipient’s behavior. Training for parents, caregivers, and staff is integral to the implementation of a behavior analysis services plan and to the monitoring of its effectiveness.

The primary purpose of the behavior assistant services (BAS) is to provide support in implementing the behavior analysis services plan created by the waiver behavior analyst or provider licensed under Chapter 490 or 491, F.S. The assistant must maintain a copy of the plan. 

This includes assisting the certified behavior analyst in assessing the recipient, assisting in implementing new procedures in the presence of the behavior analyst, acting as a model for correct implementation for the recipient or the caregivers, or coaching caregivers to implement the behavior program. Unlike other services, the behavior assistant provider’s focus is more on working with the caregivers to provide them with the skills to execute the procedures as detailed in the behavior analysis services plan, rather than the provision of intervention directly with the recipient. Behavior assistant services are to be time limited. Once paid or unpaid supports gain skills and abilities to assist the recipient to function more independently and in less challenging ways, the behavior assistant services should be faded out and discontinued. 
This time period for use of this service is limited to 6 months; however, depending on varied complexities of the behavior, effectiveness of treatment and procedures implemented, exceptions may be granted by the Regional Office Operations Manager or designee in consultation with Regional Behavior Analyst.

In order to determine when and in what situations challenging behavior of the person occurs, the individual’s behavior is assessed to identify the functional relationships between a particular behavior and the recipient’s environment. A variety of techniques including positive reinforcement are used in order to produce practical behavior change.

This service provides training and assistance, in a variety of activities, to recipients who live in their own homes or apartments. These services are provided by a qualified supported living coach to a recipient residing in a living setting meeting the requirements set forth in Rule 65G-5.004, F.A.C., and can include assistance with locating appropriate housing; the acquisition, retention, or improvement of skills related to activities of daily living, such as personal hygiene and grooming; household chores; meal preparation; shopping; personal finances; and the social and adaptive skills necessary to enable recipients to reside on their own

This service is for customers 21 and older who live in their own home or family home. It also applies to those at least 18 but under 21 who live in their own home.

 It combines the services formerly known as respite care, companion, in-home supports, and personal care assistance. This service provides assistance and training in activities of daily living such as eating, bathing, dressing, personal hygiene, and preparation of meals.

 If specified in the support plan, this service may provide housekeeping chores. 

This service also includes non-medical care and socialization, and may provide access to community-based activities that have therapeutic benefits.

This service was formerly known as “companion” services.  It includes non-medical care and socialization activities provided to an adult on a one-to-one basis or in groups of up to three recipients.

This service provides supportive care and supervision to individuals under age 21, living in the family home, when the primary caregiver is unavailable due to a brief planned or emergency absence, or when the primary caregiver is temporarily physically unable to provide care.