Model Waiver
2025 Waiver Renewal - Model Waiver
The Agency for Health Care Administration (Agency) is announcing the start of a 30-day public notice and comment period. The Agency is seeking to renew Florida’s 1915(c) Model Waiver (FL.40166), which operates under the authority of Section 1915(c) of the Social Security Act.
This renewal request does not propose any significant changes. This renewal will make the following changes to the waiver.
• Renewing the waiver period for an additional five years.
• Updating the waiver frequency of services. Monthly monitoring of individuals when services are furnished on a less than monthly basis.
• Updating agency representative contact information.
• Addition of State plan program monitoring processes & remediation activities that are in compliance with the HCBS Settings Rule
• Revising the methodology for determining the G factor.
• Cost Neutrality Demonstration updated within appendix J.
The Agency will conduct a 30-day public notice and comment period prior to the submission of the proposed amendment requests to Centers for Medicare and Medicaid Services (CMS). The Agency will consider all public comments received regarding the proposed renewal request. The 30-day public notice and public comment period is from February 26, 2025, through March 27, 2025. This public notice and public comment period is being held to solicit public input from recipients, providers, and all stakeholders and interested parties.
When submitting comments, please include “Proposed Renewal to 1915(c) Model Waiver” in the subject line:
• Submit email comments to [email protected].
• Submit comments by mail to Bureau of Medicaid Policy, Agency for Health Care Administration, 2727 Mahan Drive, MS 20, Tallahassee, Florida 32308.
2025 Model Renewal
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4 MB
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Purpose
The purpose of the Medicaid Model Waiver is to provide services to eligible children 20 years of age or younger who are medically complex/medically fragile or diagnosed with degenerative spinocerebellar disease. The Model Waiver is designed to delay or prevent institutionalization and allow waiver recipients to maintain stable health while living at home in their community.
Eligibility Criteria
To qualify for the Model Waiver the applicant must:
- 20 years of age or younger,
- Determined disabled using criteria established by the Social Security Administration (SSA),
- Be at risk for hospitalization as determined by the Children’s Multidisciplinary Assessment Team (CMAT),
- Diagnosed as having degenerative spinocerebellar disease, or deemed medically fragile and have resided in a skilled nursing facility for at least 60 consecutive days prior to enrollment.
Covered Services
Waiver services include:
- Environmental Accessibility Adaptations
- Nursing Home Transition
- Respite Care
How to Apply
To be assessed for Model Waiver eligibility, contact the CMAT program at (850)245-4200. To apply for Medicaid, contact the Department of Children and Families at http://www.myflorida.com/accessflorida.
Approved Model Waiver Document
Model Waiver
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3.9 MB
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