Florida Community Cares: A New Alternative to the iBudget Waiver?

Families of individuals with intellectual and developmental disabilities in Florida know all too well the challenges of accessing services. With the iBudget Waiver waitlist exceeding 20,000 people and average waits stretching well past 8 years, many wonder: Is there another path?

Florida Community Cares, also known as the Intellectual & Developmental Disabilities Comprehensive Managed Care program (ICMC), now offers a promising alternative. As of October 1, 2025, the program is rolling out statewide — giving eligible individuals across Florida access to more responsive, coordinated care. As of today, September 26th, 2025, APD representatives have confirmed they anticipate presenting the FCC enrollment option to over 12,000 consumers on the iBudget Waiver waitlist, with a considerable number of them being located in the Central Region (Greater Orlando MCA).

This post explains what Florida Community Cares / ICMC is, how it differs from iBudget, its benefits and risks, and what to consider before switching or enrolling.

What is Florida Community Cares / ICMC?

Florida Community Cares (ICMC) is a statewide Medicaid managed care program administered by the Agency for Health Care Administration (AHCA) in partnership with the Agency for Persons with Disabilities (APD). It provides home and community-based services (HCBS) for persons with intellectual and developmental disabilities, along with regular Medicaid services, under a more flexible and person-centered model.

Key eligibility details:

• Must be 18 or older.

• Must have an intellectual or developmental disability diagnosis.

• Must be eligible for Medicaid or already on Medicaid.

• Must live in Florida.

As of October 1, 2025, the ICMC program is available across all Florida counties. The rollout makes this managed care alternative accessible to individuals statewide who are in pre-enrollment for iBudget. 

How It Differs from the iBudget Waiver

Feature	iBudget Waiver	Florida Community Cares (ICMC)
Administrative approval steps	Requires local medical case management reviews, state-level Significant Additional Needs (SAN) requests, and APD oversight.	Case managers under Florida Community Cares have more direct authority; fewer layers of review in many cases.
Flexibility of funding for services	Funding is allocated annually via the iBudget allotment; going above that often requires SAN or other special approval.	Case managers / waiver support coordinators have more leeway to allocate funding to services based on changing needs without going through SAN or MCM for every change.
Provider documentation & reporting	Providers must be licensed through APD, use iConnect for documentation, submit implementation plans and sometimes quarterly reports.	Providers still must meet APD licensing standards; but under ICMC some reporting requirements (e.g. quarterly reports, iConnect usage for certain things) are reduced or simplified.
Waitlist status	Individuals on the iBudget pre-enrollment / waiver waitlist typically wait many years for services.	With ICMC now statewide, eligible individuals may access services faster, bypassing some of the delays inherent in the iBudget process.
Program oversight	APD has major oversight, state and local reviews.	Administered via managed care through FCC (Florida Community Care), under contract and oversight by AHCA, with APD licensing standards intact.
Care Coordinator Client Ratios	Waiver Support Coordinators can have 30+ Clients	Care Coordinators have 10-20 Clients.

Benefits of Statewide ICMC

• Access across the entire state as of October 1, 2025, means families no longer need to worry whether their county participates. 

• Faster enrollment and more responsive service delivery, since many of the prior steps in review are streamlined.

• Greater ability to adjust the level of services as needs change.

• Reduced administrative burden for providers, enabling them to focus more on care than paperwork.

• Additional benefits beyond standard Medicaid, such as caregiver supports, over-the-counter supplies, community integration, etc. 

Risks and Things to Consider

Even though the program is available statewide, there might be a limited number of spots. Depending on where you are and how many people are interested, you could face some delays or waiting times. The program has funding for several years, but like any new policy, it's important to keep an eye on any changes in laws or regulations. Joining ICMC means you're taken off the iBudget pre-enrollment list. If you decide to leave ICMC later, there are rules about getting back on the list, so make sure you know how your waitlist spot is handled. We've talked to agency leaders, and they "say" you won't lose your waitlist spot if you want to switch back, but they haven't provided any clear guidelines or processes to back this up. Some services under iBudget might be a bit different from those under ICMC, so families should compare both to make sure all their needs are met.

What to Do If You’re Considering ICMC

Here are the steps families and providers should follow to make an informed decision:

1. Confirm eligibility: check that your loved one meets the criteria (age, Medicaid status, diagnosis). Since the program is statewide, this is now less of a geographic concern.

2. Talk with potential providers: ensure the home or provider is licensed under APD and participates with Florida Community Care.

3. Gather documentation: medical records, therapy evaluations, assessments that show current needs (especially those for any SAN-like needs).

4. Understand the implications: what happens if ICMC is not a good fit, for example, being removed from the pre-enrollment list.

5. Use support: waiver support coordinators, case managers, and trusted providers can help guide through the choice between staying with iBudget or switching to ICMC.

Guidance for Providers

Providers who serve individuals with developmental disabilities should take note:

• Licensing requirements under APD remain in force.

• Reporting requirements may be lighter under ICMC vs iBudget in certain respects.

• Providers will need to align with Florida Community Care’s network and contractual obligations.

• Being part of ICMC may allow for more flexibility in service delivery, but providers must ensure documentation meets the standard for services rendered.

Conclusion

With the statewide expansion of Florida Community Cares / ICMC effective October 1, 2025, many families across Florida now have access to a managed-care alternative that may deliver services more quickly and responsively than the traditional iBudget Waiver.

While no program is perfect, the reduced bureaucracy, broader eligibility, and enhanced service coordination make ICMC a compelling option. Families should carefully compare both paths, weigh risks, and choose what best meets their loved one’s needs.

At Audubon Gardens Group, we can help you understand both pathways, prepare your documentation, and decide which option will best support quality of life and health outcomes. If you’re exploring ICMC or iBudget, reach out for guidance.

References

• AHCA: ICMC Program information, eligibility, and services. 

• AHCA Waiver Amendment Status Report, August 2025, including expansion of eligibility and statewide availability. 

• “New law brings managed care to people with intellectual disabilities,” Florida Phoenix, June 10, 2025. 

• Ask Medicaid Florida: article announcing statewide launch of ICMC effective October 1, 2025. 

• In-person community meeting by AHCA and Florida Community Cares at Primrose Center, Orlando Florida