Letter from the acting director of APD Bryan Vaughan

A Host Home is a Non-Waiver service open to persons on the waiting list and all persons receiving assistance from Developmental Disabilities Medicaid Waivers. A Host Home will provide a homelike (non-treatment oriented) environment for those not in need of residential habilitation services, close continuous supervision, or for those who are not suited for supported living services.

The provision of any in-home waiver services ( such as: behavioral, in-home support, personal care, nursing, residential habilitation, and like ) is prohibited unless approved in emergency situations by the Area Administrator. This is not a shift work model or in-home staff model.

These homes are licensed “by APD” as three bed foster homes and the payment is made by the adult consumer in accordance with the currently established Room and Board rates for foster care placements. This rate is currently $543.42, or the federal SSI monthly benefit amount minus the personal needs allowance.

The Room and Board of $543.42 for children will be paid from Area room and board allocations, due to the limitations of Jenkins v. State. In some cases adults may not have sufficient SSI income to pay the entire rate. In those cases Areas will supplement the payment. Parental, trust fund and personal payment is allowed and encouraged. Partial months of residence will be prorated to the daily rate. The Areas will visit each home monthly unless exempted by future policy changes.

Normal background check requirements remain in place as do the non-waiver specific training requirements. The Areas will give priority to Host Home Family applicants for access to background screening and training. The Host Home Family will keep a monthly attendance log, facilitate persons to access school and work and provide assistance tracking and accessing medical and dental appointments. Each resident and host family will sign an agreement to be approved by the Area Administrator that details the boarding agreement. Persons will be carefully matched by the Areas to host homes in accordance with consumer and host family needs and desires. This matching process is critical to predicting the future success of the relationship.

The consumer is expected to have made clear arrangements for two weeks of respite annually. The area must ensure that the host parents have a back-up plan in place concerning personal emergencies. As indicated above, both children and adults are potential Host Home Program participants.

The program is particularly suited to:

  • Persons on the waitlist who need a place to live.
  • Persons who reside in residential habilitation facilities who are determined by assessment to have received maximum benefit from training. (Special note: Persons assessed to have maximized the benefit of training may be allowed to remain in the residential habilitation facility on a room and board only basis.)
  • Persons Considering living in an ALF.
  • Persons stepping down from more restrictive facilities.
  • Children currently in, or exiting foster care.

This program does not apply to:

  • Private homes of families providing care to a relative with a developmental disability.
  • Any home already licensed as a group home.
  • Foster homes, or adult family care homes licensed by DCF or AHCA.

The Agency will continue to develop additional
lower cost residential options in the near future.

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Developmental Disabilities
Legislative Session Report #9

By Kingsley Ross

For people interested in developmental disabilities (DD), the final week of this year�s legislative session focused on appropriations and Medicaid reform as the House and Senate finished the session early Saturday morning. Action during week 9: House and Senate reconciled the differences in their budgets. The results are shown below for the Agency for Persons with Disabilities (APD). The conferees were unable to agree on whether to fund APD�s deficit for next fiscal year and bumped that issue up to the presiding officers. The budget passed on the final evening of the session. 

Major Budget Issues
for the Agency for Persons with Disabilities (APD)
as of sine die
in millions
in millions
Budget Conference
Agreement in millions
*Across the board Waiver provider rate cut � Conference agreed to a 4% cut.
*Cut South FL geographic rate differential � by 50% for Palm Beach, Broward & Dade; Monroe by more than 80% – Conference agreed to take no cut
*Reduce service rates to �individual rates� vs. corporate rates. Affects companion & several other services – Conference agreed to take no cut
*Freeze cost plans � Conference agreed to freeze
*Cover Waiver deficit � Conference FY 2010-11 $169.2 mil and FY 2011-12: $54.5 million
*Reduce private Intermediate Care Facilities for the DD (ICF/DD) – Conference agreed to a 3% cut.

Medicaid reform also passed on the last day of the session. It does not require that APD services be administered through a managed care organization. Before it passed, the tort reform provisions that would have limited the liability for providers were removed the bills. Tort reform will have to wait until next spring to be considered again.

Action Needed. Thank Rep. Grimsley and Hudson for advocating for our programs. These two individuals carrie d the banner for our programs in conference and worked hard on behalf of programs for people with DD.

Rep. Denise Grimsley (863) 385-5251 denise.grimsley@myfloridahouse.gov

Rep. Matt Hudson (239) 417-6270

The struggle over the Health and Human Services (HHS) appropriations continued virtually to the last minute and was finally settled when the Senate agreed to fund several outstanding HHS is sues including partially funding next year�s APD deficit. These issues were, in reality, a priority mainly for the House and in the end, the House had to use some of their reserves to pay for them.

As it relates to APD, key members of the Senate leadership felt that they were rewarding an agency for not living within its budget.

In a way, you can understand the frustration that some legislators must feel about this issue. Legislators are the charged with appropriating funds and rightfully or wrongfully, they have been trying to reduce APD�s budget for several years. In the face of these reductions, APD has continued to over spend its budget which, from their point of a view, could be perceived as a statement of defiance. Much of the over spending can be tied to adding about 5,000 people to the waiver several years ago and not having the funds for those new consumers annualized in the following fiscal year. Federal regulations, giving consumers the right to appeal decisions about their cost plans, has also thwarted efforts to reduce costs. Unfortunately, there is no way to punish those who were responsible for the over annualization. Those leaders have left and the argument that reducing the amount available for services, only impacts consumers and providers has fallen on deaf ears.

There are a number of proposals being examined about how to reduce services beyond the 4% provider rate cut. One of those proposals is to use the iBudget algorithm to achieve the reduction. Others consider that priority should be given to individuals who, for instance, are in residential care since many no longer have their parents to help out. Decisions will need to be reached rapidly in order to have the full 12 months of the fiscal year to absorb the cuts. Waiting will just mean the cuts will need to be larger since there will be less time for them to be applied.

Given this, next fiscal year is going to be difficult and we are very likely to be facing another year of cuts in 2012 session. We must begin now to change the perception that everything turned out ok and that you can punish an agency by cutting its services. To do this we must thank those who have helped us and show that we appreciate what they have done. We must also cultivate new champions by educating legislators on what we do and how people are affected as a result of the cuts.


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