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iBudget Florida The Waiver of the Future

iBudget Florida is a home and community-based services waiver that offers individual budgets and flexibility to meet the unique needs of individuals. It replaces the old tier waiver system and streamlines the service review and approval process. This system promotes equity, sustainability, and self-direction, giving individuals more control over their services.

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iBudget Florida The Waiver of the Future

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  1. iBudget Florida - Family Cafe

  2. iBudget Florida The Waiver of the Future Rick Scott, Governor Michael P. Hansen, Director iBudget Florida - Family Cafe

  3. iBudget Overview • A home and community-based services waiver that provides services in the community iBudget Florida - Family Cafe

  4. iBudget Overview • Focuses on individual budgets with flexibility to move service funds to meet needs • Replaces the current tier waiver system: Tier 1, Tier 2, Tier 3, Tier 4 iBudget Florida - Family Cafe

  5. iBudget Background • 2009 General Appropriations Act (GAA) required a plan by February 2010 • Agency for Persons with Disabilities (APD) researched other states’ systems and best practices • APD worked with iBudget Florida stakeholders group to design a plan iBudget Florida - Family Cafe

  6. iBudget Background • iBudget implementation was authorized in s. 393.0662, F.S., in 2010 • APD Rule 65G-4.0210 to 65G-4.0218 describes the iBudget algorithm and budget approval process • iBudget Medicaid Coverage and Limitations Handbook (Rule # 59G-13.070 – provider handbook) iBudget Florida - Family Cafe

  7. Simplify the System • Streamlines the service review and approval process • Service reviews are more limited, focused, and streamlined, focusing on health and safety issues iBudget Florida - Family Cafe

  8. Simplify the System • Organizes services into service families based on similarity of purpose of the services • Business process efficiencies using technology iBudget Florida - Family Cafe

  9. Flexibility and Self Direction • Individual decision making on the services needed • Service array is revised to increase flexibility • Flexibility to make changes within the iBudget allocation iBudget Florida - Family Cafe

  10. Flexibility and Self Direction • Limited approval process • Individual iBudget maximum amount • Combines four services into one to simplify service delivery iBudget Florida - Family Cafe

  11. Equity • Allocates funding based on the individual’s age, living setting, characteristics, and circumstances • By law, no cost plan can be reduced by more than 50% • Summary of cost plan reductions to date iBudget Florida - Family Cafe

  12. Sustainability • Provides a predictable estimate of future funding needs • Creates an efficient customer budgeting process with the waiver system used as the payor of last resort iBudget Florida - Family Cafe

  13. Sustainability • Maximizes use of nonwaiver resources iBudget Florida - Family Cafe

  14. So What Is New? • Much will stay the same, day-to-day • Providers • Majority of services and rates • Waiver support coordinators’ important roles • Residential options iBudget Florida - Family Cafe

  15. So What Is New? • Equitable budgets while staying within our funding, as required by the Legislature • Uses new method to decide budget amounts iBudget Florida - Family Cafe

  16. So What Is New? • Funding is assigned at the beginning of the year • Expectation: expenditure of services statewide will not exceed the agency’s funding iBudget Florida - Family Cafe

  17. So What Is New? • The individual decides how much to spend on specific services within the overall iBudget • The individual can move funds around to meet changing needs—even funds that were unspent in previous months iBudget Florida - Family Cafe

  18. So What Is New? • Streamlines or eliminates prior service authorization (PSA) process • Services changes may often be made quickly • Online system can often review and approve automatically • If online system can’t approve, APD staff will review iBudget Florida - Family Cafe

  19. So What Is New? • New iBudget electronic system will help individuals and their WSCs plan and manage services • Unique reporting features • Claims report • Service authorizations • Monitor service use iBudget Florida - Family Cafe

  20. So What Is New? • Receive iBudget amount • Review support plan needs and goals • Approve cost plans • Create service authorizations quarterly iBudget Florida - Family Cafe

  21. So What Is New? • The individual has more choice over what services and how much of each service the individual receives! • Individuals will be pre-approved for types of services (but not quantity, frequency, etc.) iBudget Florida - Family Cafe

  22. So What Is New? • Must ensure health and safety • Equitable budgets while staying within our funding, as required by the Legislature iBudget Florida - Family Cafe

  23. So What Is New? • How the person plans for services • the budget is provided up front • How to distribute the funds for the services needed • Service authorizations will be quarterly and not annually iBudget Florida - Family Cafe

  24. What Services Have Changed? Day activities renamed: Life Skills Development Services • Companion = Life Skills Development Level 1 • Supported Employment = Life Skills Development Level 2 • Adult Day Training = Life Skills Development Level 3 iBudget Florida - Family Cafe

  25. What Services Have Changed? • Personal Supports service family • Respite Care for children is still a separate service • Combines the services of Personal Care Assistance, Respite for adults, Companion and In-Home Supports into one service—Personal Supports iBudget Florida - Family Cafe

  26. What Services Have Changed? • Provider of Personal Supports is a broad provider type that can perform many different tasks needed by an individual • The rate for Personal Supports is a blending of the rates from the four separate services iBudget Florida - Family Cafe

  27. CDC+ and iBudget Florida • CDC+ option will continue (July 1, 2013 for iBudget) • CDC+ participants will have funding determined through their iBudgets • CDC+ participants will “spend” iBudgets according to CDC+ policies iBudget Florida - Family Cafe

  28. Consumer Flexibility in Spending LEAST FLEXIBLE: • Residential Services • Therapeutic Supports and Wellness • Life Skills Development • Supplies and Equipment • Personal Supports • Support Coordination • Transportation • Dental Services MOST FLEXIBLE: Individual Budgets iBudget Florida - Family Cafe

  29. Individual Budgets iBudget Allocation Methodology to Determine Individual Budgets iBudget Florida - Family Cafe

  30. iBudget Allocation Formula AGE QSI ASSESSMENT 1) Functional score 2) Behavioral score 3) Ability to transfer, self-protect, and maintain hygiene LIVING SETTING Determine Individual Budgets iBudget Florida - Family Cafe

  31. Individual Budgets • If the existing cost plan is lower than the algorithm, the cost plan amount remains in effect • No cost plan can be reduced by more than 50% iBudget Florida - Family Cafe

  32. Individual Budgets • If the cost plan is higher than the algorithm amount, the iBudget algorithm will be individually reviewed to consider the individual’s living setting, natural supports, family circumstances, and other factors affecting the level of service needed iBudget Florida - Family Cafe

  33. Individual Budgets • No cost plan can be reduced by more than 50% - very few will receive this amount of reduction • Notice will be sent with the final iBudget allocation iBudget Florida - Family Cafe

  34. Individual Budgets • Statewide, approximately 60 percent of individuals may receive no reduction; their cost plans will remain the same • Reductions will be based on individual reviews iBudget Florida - Family Cafe

  35. Individual Budgets • Individual reviews will be conducted by the WSC and the area office and will be completed for all individuals who have a reduction to ensure needs are met and to avoid institutionalization iBudget Florida - Family Cafe

  36. Individual BudgetsExample 1 iBudget Florida - Family Cafe

  37. Individual BudgetsExample 2 iBudget Florida - Family Cafe

  38. Individual BudgetsExample 3 iBudget Florida - Family Cafe

  39. 2009 iBudget Timeline 2009 • Concept of individualized • budgets begins at APD 5 Years 2010 2010 • Individual budgets for delivery of home and community-based services; iBudget system established 2011 2011 • May - Proof of concept; 4 families and 14 providers • October - Areas 1 & 2 pilot the iBudget application 2012 2012 • April – Areas 1 & 2 implement full iBudget program • CDC+ will start July 2013 2013 • Implement statewide • 2012-2013 fiscal year iBudget Florida - Family Cafe

  40. Questions? Thank You! Contact us online at iBudgetFlorida.org iBudget Florida – Family Cafe

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