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iBudget waiver services, explained

The Florida iBudget waiver covers about thirty services — from Personal Supports and Adult Day Training to behavior analysis, therapies, and home modifications. Here's the full list in plain language: what each service is, and what providers should know about delivering it.

Updated July 2026

The Developmental Disabilities Individual Budgeting (iBudget) waiver is Florida's Medicaid waiver for home and community-based services, administered by APD. Every consumer has an individual budget, a support plan, and a waiver support coordinator — and every service a provider delivers must trace back to an authorization inside that budget. The iBudget Handbook defines each service, who can deliver it, and how it must be documented. This page is the plain-language map of that service menu.

In-home and daily-living support

  • Personal Supports

    Hands-on assistance and training with activities of daily living for adults (21+) living in their own home or the family home — the waiver's highest-volume in-home service.

  • Respite Care

    Temporary care for a consumer under 21 when the primary caregiver needs relief or is unavailable — delivered in the home or community.

  • Supported Living Coaching

    Training and assistance that helps an adult live independently in their own home or apartment — from budgeting and cooking to landlord and community relationships.

  • Special Medical Home Care

    Intensive nursing-level care for consumers with complex medical conditions, provided in specific licensed homes approved for it.

Life Skills Development (all four levels)

  • Life Skills Development 1 — Companion

    Non-medical supervision and community-based socialization, one-to-one or in very small groups. Formerly called companion services.

  • Life Skills Development 2 — Supported Employment

    Job coaching that helps a consumer find and keep community employment at or above minimum wage — or build a small business — in individual or group models.

  • Life Skills Development 3 — Adult Day Training (ADT)

    Structured daytime programs teaching daily-living, social, and pre-work skills, typically in a facility setting.

  • Life Skills Development 4 — Prevocational Services

    Learning and volunteer-work experiences that build general employability skills as a path toward paid employment.

Residential services

  • Residential Habilitation (Standard)

    Supervision and daily-living skills training for consumers living in licensed residential facilities — billed per day or per month depending on the model.

  • Residential Habilitation (Behavior Focused)

    The same core service for residents whose behavioral needs meet defined criteria, delivered by staff with additional behavioral training.

  • Residential Habilitation (Intensive Behavior / Enhanced)

    The highest tiers — for residents with significant behavioral intensity, in designated facilities with specialized oversight (including the enhanced level for the most severe needs).

  • Residential Nursing Services

    Continuous nursing care for consumers who live in licensed facilities and need it.

Behavioral and mental health

  • Behavior Analysis Services

    Assessment and behavior-plan development by certified behavior analysts — building replacement skills for challenging behaviors.

  • Behavior Assistant Services

    Trained assistants who help implement an approved behavior plan day-to-day, supporting the analyst's program and the caregivers.

  • Specialized Mental Health Counseling

    Counseling for consumers with co-occurring psychiatric needs, oriented to rehabilitation goals.

Nursing, therapies, and nutrition

  • Skilled Nursing

    Part-time or intermittent nursing visits (as opposed to continuous care).

  • Private Duty Nursing

    Continuous one-on-one nursing for adults (21+) in home or community settings.

  • Occupational, Physical, Respiratory & Speech Therapy

    Physician-prescribed, one-on-one therapies targeting functional outcomes — self-help and adaptive skills, mobility and posture, respiratory function, and communication or swallowing.

  • Dietitian Services

    Nutritional assessment, meal-plan recommendations, and counseling, prescribed by a physician.

Equipment, supplies, and the home

  • Consumable Medical Supplies

    Non-durable items used daily — briefs, feeding-tube supplies, and similar.

  • Durable Medical Equipment & Supplies

    Prescribed equipment built for repeated use — wheelchairs, lifts, and the like.

  • Environmental Accessibility Adaptations

    Physical home modifications — ramps, grab bars, widened doorways — that make the home safe and usable.

  • Personal Emergency Response Systems (PERS)

    Electronic units that let a consumer summon emergency help, including installation and monitoring.

Getting around, dental, and coordination

  • Transportation

    Rides between home and waiver services in the community — often documented per trip.

  • Adult Dental Services

    Dental treatment for adults 21+ that the Medicaid State Plan doesn't otherwise cover.

  • Support Coordination / CDC+ Consultant

    The waiver support coordinator (WSC) every consumer has — locating, selecting, and coordinating services and monitoring health and safety. Consumers in CDC+ also have a representative managing their budget.

Service definitions, limits, and provider qualifications live in the iBudget Handbook and Rule 65G-4, F.A.C., and change through handbook updates and provider advisories — treat this page as orientation and the current handbook as the authority. Rates and unit limits are set per service and per authorization.

What this means for your agency

Each service you're enrolled to deliver brings its own trio of obligations: staff who meet that service's qualifications and training requirements, documentation entered in APD iConnect to that service's rules, and agency records that prove both — the consumer record and personnel files a Provider Discovery Review examines. APDHQ is the EHR for Florida APD iBudget agencies that keeps that second half organized: per-service checklists, expiration tracking on every certificate, and one-click audit packets when the review letter arrives.

Frequently asked questions

What services does the iBudget waiver cover?

Roughly thirty distinct services across eight families: in-home supports (Personal Supports, Respite, Supported Living Coaching), Life Skills Development levels 1–4, Residential Habilitation tiers, behavior analysis and behavior assistant services, nursing and therapies, dietitian services, consumable supplies and durable equipment, environmental adaptations, personal emergency response systems, transportation, adult dental, and support coordination.

Who decides which services a consumer receives?

Services flow from the consumer's person-centered support plan and iBudget cost plan, coordinated by their waiver support coordinator (WSC) and authorized within the consumer's iBudget allocation. Providers deliver against service authorizations — never beyond them.

Do different services have different documentation rules?

Yes. Each service carries its own documentation requirements in the iBudget Handbook — service logs, progress notes, monthly summaries, or trip logs — and its own unit type (15-minute units, hourly, daily, monthly, or per-trip). Staff qualifications and training also differ by service.

Are there age restrictions on iBudget services?

Several services carry them — for example Personal Supports and Adult Dental are for adults 21 and over, while Respite Care is for consumers under 21. The iBudget Handbook and the consumer's authorization govern in every case.

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