How Florida pays for disability services

Waiver inventory

Florida has not adopted 1915(k) Community First Choice or a 1915(i) state plan HCBS benefit for this population in any source retrieved.

State-only funded programs

• APD Statewide Dental Program. Directed by the Legislature in 2022 with an $8.5 million appropriation to provide dental care to people with intellectual and developmental disabilities. Administering agency: Agency for Persons with Disabilities. Source: apd.myflorida.com
• Developmental Disabilities Defendant Program (forensic facilities). APD operates two forensic facilities for people with developmental disabilities involved in the criminal justice system, outside the ICF/IID benefit. The FY2026-27 budget carries $5 million for forensic facility design and construction and $2 million fixed capital outlay for institutional services. Administering agency: APD. Sources: apd.myflorida.com and fddc.org
• Personal needs allowance. The FY2026-27 budget raised the monthly personal needs allowance for residents of licensed facilities from $174.06 to $178.92, a state-funded pass-through rather than a service. Source: fddc.org

I checked apd.myflorida.com program pages, the AHCA federal waivers page, and FDDC's budget summary. I could not retrieve a discrete "Individual and Family Supports" general revenue line item; Florida's Long Range Program Plan and the General Appropriations Act were not retrievable (floridafiscalportal.state.fl.us fails TLS hostname verification). Treat the state-only inventory as incomplete.

County / regional / local funding

• Children's Services Councils / Juvenile Welfare Boards. Independent special districts authorized by s. 125.901, Florida Statutes. Mechanism: voter-approved ad valorem property tax capped at 0.5 mills of county assessed valuation. Geography: individual counties that have voted them in. Permitted uses are "preventive, developmental, treatment, and rehabilitative services for children," which in practice includes children with developmental disabilities, though the statute does not name disability explicitly. Councils must supplement, not supplant, existing children's services funding. Official URL: leg.state.fl.us
• No county developmental disability boards, county DD levies, or regional center allocations exist in Florida. APD administers through six state regional offices, not local taxing bodies.

Funding scale

• iBudget waiver, FY2026-27: $2.3 billion all funds, including estimated federal Medicaid match. fddc.org
• FY2026-27 additions: $10 million iBudget expansion; $22.8 million for a uniform provider rate increase; $27.5 million transferred from iBudget waiver surplus for institutional salary payments; $33.5 million to procure and replace the iConnect system, $31.5 million of it initially in reserve. fddc.org
• ICMC managed care program, FY2026-27: $141.4 million, an increase of $28.8 million over the prior year. fddc.org
• Florida FMAP, FY2027: 55.43 percent federal, so roughly 44.57 percent state share on matched spending. kff.org
• People served in the DD waiver: 36,521 active iBudget enrollees as of 12/1/2025. flsenate.gov
• Spending per participant: approximately $63,000 all funds, derived by dividing the $2.3 billion FY2026-27 iBudget appropriation by 36,521 enrollees. This is a derived figure, not a published one.
• Waiting list (APD calls it the preenrollment list): 17,433 people as of 12/19/2025. flsenate.gov
• Waiting list composition, January 2023 snapshot (secondary, University of South Florida): 22,372 people; Category 6 (age 21 and over) 13,059 or 58.4 percent; Category 7 (under 21) 8,997 or 40.2 percent; Category 3 (intensive needs) 222; Category 4 (caregiver over 70) 81; Category 5 (school transition) 11. No published average wait; the site states many people have waited over ten years. ddwaitlist.cbcs.usf.edu
• Total IDD spending across all funds and all programs: not found as a single published figure. Florida did not complete the FY2022 or FY2023 RISP surveys. publications.ici.umn.edu
• ICF/IID: 428 people lived in Florida state IDD facilities of 16 or more residents in FY2023. publications.ici.umn.edu

Residential funding detail

Florida funds four distinct residential pathways under iBudget.

1. Residential Habilitation in licensed group homes and foster/family care homes. Paid as a per diem stratified by two axes: service intensity level and behavioral acuity track. Standard track runs Basic, Minimal, Moderate, Extensive 1, Extensive 2. A Behavior Focused track sits above it, and an Intensive Behavioral track (Levels 1 through 6) sits above that, with an Enhanced Intensive Behavioral tier named in the coverage policy. Solo and agency rates are identical across all Residential Habilitation lines in the October 1, 2025 table.

2. Live-In Residential Habilitation. Per diem priced by staff-to-resident ratio (1:1, 1:2, 1:3), with agency rates roughly 22 percent above solo-provider rates. This is Florida's host-home-adjacent model.

3. Supported Living Coaching. Hourly-equivalent, billed in quarter-hour units, capped at 24 units per day and 8,760 units per year. This funds coaching for people who hold their own lease or own home. It buys support, not housing.

4. Assisted Living Facility Residential Habilitation. A separate rate set exists, last posted effective July 1, 2022, per the APD rates and billing page.

Room and board. Room and board is not a waiver-payable cost. The iBudget rate table prices habilitation services only, and the FY2026-27 budget action raising the personal needs allowance from $174.06 to $178.92 per month confirms the structure: a person in a licensed residential setting assigns SSI or other benefit income toward room and board and retains the personal needs allowance. There is no separate state room-and-board subsidy identified in the sources retrieved for iBudget residential settings.

Institutional residential. Two state Developmental Disabilities Centers operate as ICF/IID facilities: Tacachale in Gainesville and Sunland Center in Marianna. Payment methodology for publicly owned and operated ICF/IID facilities is set by rule 59G-6.040. apd.myflorida.com and ahca.myflorida.com

In-home and family settings. Funded through Personal Supports (quarter-hour, ratios 1:1 through 1:3), In-Home Support, Companion (Life Skills Development Level 1), and Respite, which is limited to people under 21.

Rate structure link: ahca.myflorida.com

Comparable service rates

All rates below are agency rates from the adopted rule rate table effective October 1, 2025.

ICF/IID per diem rates and ALF Residential Habilitation rates are not published in the iBudget rate table. See the ICF reimbursement rule and the APD rates and billing page listed below.

Official rate schedule links

• ahca.myflorida.com
• ahca.myflorida.com
• ahca.myflorida.com
• ahca.myflorida.com
• ahca.myflorida.com
• ahca.myflorida.com
• ahca.myflorida.com
• apd.myflorida.com
• apd.myflorida.com

Notable features and flags

• October 1, 2025: New adopted iBudget provider rate table took effect, replacing the July 1, 2024 table. It is the current authority for all waiver service pricing. ahca.myflorida.com
• October 1, 2025: ICMC expanded from a two-region pilot (Regions D and I: Hardee, Highlands, Hillsborough, Manatee, Polk, Miami-Dade, Monroe) to all SMMC regions statewide. A waiver amendment was submitted August 13, 2025 for that effective date. Enrollment was still small at the time of the status report: 91 Group One enrollees as of August 20, 2025. ahca.myflorida.com
• July 1, 2026: People enrolled in the iBudget Waiver or SMMC Long-Term Care became able to transfer into ICMC, a significant managed care carve-in for a population historically served fee-for-service. ahca.myflorida.com
• FY2026-27 budget: $22.8 million for a uniform provider rate increase, $10 million for iBudget expansion, and a new monthly reimbursement structure for Life Skills Development programs based on attendance hours, a material change in how day services are paid. fddc.org
• December 2025: Preenrollment list stood at 17,433 against 36,521 active enrollees, meaning roughly one person waits for every two served. AHCA has identified about 14,000 people ages 18 and older on the preenrollment list as an outreach target for ICMC, which is the state's current strategy for the waiting list. flsenate.gov and ahca.myflorida.com
• Data gap flag: Florida did not complete the FY2022 or FY2023 RISP surveys, so national comparative residential data for Florida is stale. publications.ici.umn.edu

Confidence

Solid: the full October 1, 2025 rate schedule, because it comes from the adopted-rule PDF hosted by AHCA and I extracted the line items directly. Also solid: enrollment (36,521) and preenrollment (17,433), both from a 2026 House staff bill analysis; the ICMC authority, timeline, and region list from the AHCA status report; and the FMAP from KFF. Estimated: the $63,000 per-participant figure, which I derived by dividing the FY2026-27 appropriation by December 2025 enrollment and which mixes fiscal periods. Also estimated: the FY2026-27 appropriation figures themselves, which come from FDDC's budget summary rather than the General Appropriations Act, and which FDDC noted were pending gubernatorial action. Could not find: a single published all-funds total for Florida IDD spending; the state-versus-federal split of actual iBudget expenditures; enrollment or rate detail for the Model Waiver and Familial Dysautonomia Waiver; ICF/IID per diems; ALF Residential Habilitation rates; a verified inventory of APD general-revenue-only service lines. The Florida Fiscal Portal, which hosts APD's Long Range Program Plan, fails TLS hostname verification and could not be retrieved. apd.myflorida.com served robots.txt inconsistently, blocking several page fetches.

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