It has been almost four months since the settlement of Wheaton, et al v. APD, Case No. 4:13-cv-00179-MW-CAS. That settlement created some powerful tools to ensure that Florida Medicaid Developmental Disability Waiver recipients can receive a decision regarding supplemental funding necessary to cope with increased service needs and other changing circumstances with reasonable promptness.
However, Disability Rights Florida is aware that some waiver clients are still struggling to request and obtain supplemental funding. To help anyone having trouble submitting service requests, here are a few things that waiver clients and their support coordinators ought to keep in mind:
- APD staff cannot refuse to accept a waiver client’s request for supplemental funding. While APD may still deny that request under the standards set out in the iBudget rule, it must consider and make a decision on any request in a timely manner. If there is any confusion as to who you ought to send the request to, ask for the regional office’s specified email address for supplemental funding requests.
- It is imperative you submit supplemental funding requests as soon as possible, even if you do not have all of the supporting documentation prepared. If APD feels additional documentation is necessary, they can request it after you submit your request. In the meantime, if services are immediately necessary, a request for emergency funding can be submitted to the regional office. This ensures that APD is held to the timelines established in the iBudget rule and the Wheaton settlement. Do not let anyone talk you out of submitting a request if you believe it is truly necessary.
- Keep in mind that APD now has strict timetables on processing requests for new or increased services. Once they receive a request for supplemental funding they have 30 days to either approve the funding, deny the funding, or request additional documents. If APD requests additional documents they have a total of 60 days from when they initially received your request to either approve or deny it. If APD requests additional documents, the client or their support coordinator have 10 days to supply the documents or tell APD to proceed with the documents they already have. Once 60 days have passed from the day that APD received the initial request for supplemental funding, if APD has neither approved nor denied the request, the client or their support coordinator must notify APD in writing that they have not responded. At that point APD has 20 more days before the service is automatically approved.
- If you have any questions regarding the process of submitting a request for supplemental funding, have any questions about the Wheaton Settlement and reasonable promptness, or feel uncertain about something that APD staff has told you, do not hesitate to contact Disability Rights Florida. You can contact us at 1-800-342-0823 or use our online intake.