Why Florida Families Must Apply to the Medicaid Waiver NOW — Waiting Isn’t an Option!

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If your child or loved one has developmental, intellectual, or complex medical needs, you may be tempted to “wait until things get more stable” before applying for Medicaid waiver services—or to begin exploring group homes. You may even think, "Well, my child or family member is young and is years from needing services... so I'll get around to it." But in Florida, waiting often means years of delay. With thousands of people already in the queue, families who delay may inadvertently forfeit both care and peace of mind.

The Reality of the Wait: Numbers & Impact

As of early 2023, 22,372 Floridians with developmental disabilities (DD) were on the iBudget Waiver waitlist — people who qualify for services but are not yet receiving them. According to more recent reporting, over 21,000 individuals are approved and awaiting services for this Florida Medicaid Waiver. The average wait time has been 8½ years, and many people wait well over 10 years. What does that mean in practice? Families may be coping with increasing medical complexity, care needs rising, emergencies happening, or caregivers burning out—all while waiting for access to foundational support.

This is a difficult process.

Why “Planning Later” Becomes Your Adversary

Most people underestimate how long the application, assessment, funding, and placement process takes. The system involves state agencies, medical necessity determinations, evaluations, navigating licensure & oversight, etc. Delays in submitting thorough documentation or securing necessary physician/therapist input can further set families back. Strong funding packets with medical necessity documentation often make the difference. Waiting often means missing windows where early intervention could reduce complications, hospitalizations, or prevent decline in health. Once a condition worsens, care becomes more intensive; health outcomes often degrade.

Florida Medicaid Waiver: Data-Backed Supports & Legal/Policy Context

Florida law, through iBudget, offers a “Significant Additional Needs” process for clients whose requirements exceed the standard algorithm. This allows for additional funding opportunities when supported by medical documentation. The Home Health Aide for Medically Fragile Children Program (HHAMFC / FHHA) (established by HB 391, 2023) enables parent/family caregivers to be compensated as aides, provided they undergo training/licensure, to decrease the risks of institutionalization. However, participation has been limited due to concerns about how caregiver income might impact Medicaid eligibility.

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What Audubon Gardens Group Offers

In our video, we share case studies: medically fragile clients who entered with severe health deficits and, through strategic funding packets and executed care plans, saw measurable improvements — weight gain, better medical stability, fewer hospital or ER visits. These are not theoretical outcomes; they are real results from documented plans and oversight.

What You Should Do TODAY

1. Start your Medicaid waiver application immediately—even if you feel "not ready.”

2. Work with physicians, nurses, and therapists to gather documentation of medical necessity (diagnoses, prior hospitalizations, equipment needs, physician letters).

3. Find or assign a Waiver Support Coordinator who knows how to build strong packets.

4. Ask whether you qualify for programs like FHHA (Family Home Health Aide) or additional “significant needs” funding.

5. Monitor for deadlines, eligibility changes, and be proactive—it might take many months to move through the system.

Conclusion

Time plays a critical role in this situation. Each month of delay extends the period during which your loved one's care, safety, and quality of life might be at risk. With waitlists often extending to 8–10 years or more, taking action is not just a choice; it's imperative.

Sources & References

• Florida Developmental Disabilities Waitlist Campaign: ~22,372 waitlist count (2023)

• APD Quarterly Reports: number waiting, services provided, etc.

• Florida Statutes on iBudget Significant Additional Needs

• HB 391 / FHHA Program documentation