Department of Health & Human Services s7

Department of Health & Human Services Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-14-26 Baltimore, Maryland 21244-1850

Center for Medicaid and State Operations Division of Community and Institutional Services

March 4, 2011

Roberta K. Bradford, Deputy Secretary for Medicaid Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308

Dear Ms. Bradford,

I am pleased to inform you that your request to implement Florida’s Home and Community Based “Developmental Disabilities Individual Budgeting Waiver” for individuals with Developmental Disabilities living in the community has been approved. This waiver (control number 0867) will be effective March 15, 2011.

This waiver will provide recipients the opportunity for greater choice among services within the limits of an individual budget. The State has indicated that it has developed a phased transition plan for all recipients who will be enrolled in this new waiver from the other Florida Tiered waivers. The State is attesting that no loss of services will be experienced by waiver recipients by their transition to this waiver from the other Florida Tiered waivers.

Specifically, this waiver will provide; Residential Habilitation; Respite; Support Coordination; Adult Dental Services; Occupational Therapy; Physical Therapy; Private Duty Nursing; Respiratory Therapy; Skilled Nursing; Specialized Medical Equipment & Supplies; Specialized Mental Health Counseling; Speech Therapy; Transportation; Behavior Analysis Services; Behavior Assistant Services; Dietitian Services; Environmental Accessibility Adaptations; Family & Guardian Training; Life Skills Development; Person-Centered Planning; Personal Emergency Response System; Personal Supports; Residential Nursing; Special Medical Home Care; and Supported Living Coaching.

The following estimates of unduplicated recipients and average per capita costs of waiver services have been approved:

Waiver Unduplicated Waiver Institutional Year Recipients Expenditures Expenditures 1 2,000 $23,606 $98,275 2 15,750 $31,280 $98,275 3 30,045 $31,241 $98,275 This approval is subject to your agreement to serve up to the number of individuals indicated above for each waiver year. If Florida chooses to make alterations to this waiver, you must submit an amendment to CMS for review and approval. The waiver can be renewed at the end of the three year period by providing documentation of satisfactory performance and oversight.

We appreciate the cooperation provided by you and your staff in the development of this home and community-based services waiver program. If there are any questions, you may contact Arun Natarajan at (410)-786-7455 or Kimberly Adkins-McCoy in the Atlanta Regional Office at (404)652-7159.

Sincerely,

Mary Sowers Director

cc: Shantrina Roberts Atlanta Regional Office Kimberly Adkins-McCoy Atlanta Regional Office