Regional Offices > Northwest Region
APD Northwest Region Office
Northwest Region Manager
Northwest Region Staff
Field 1 Office, Pensacola- Escambia, Okaloosa, Santa Rosa, and Walton counties
Field 2 Office, Tallahassee- Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Wakulla, and Washington counties
Provider Enrollment Information - for both New Providers and Existing Providers
Provider Applications are for new Providers and Provider Expansion Request Forms are for Existing providers wishing to expand geographically, provide additional services, or to expand from solo to agency status.
Beginning immediately, APD will accept new provider applications and provider expansion applications only during “Open Enrollment Periods”.
Applications to provide services considered “Critical Service Needs” are currently being accepted. Refer to the information below on the Northwest Region critical provider needs.
Open Enrollment is as follows:
April 1 through May 31
August 1 through September 30
Applications received outside of these open enrollment periods will be returned to the applicant.
Northwest Region Critical Service Needs are as Follows for all counties:
- Waiver Support Coordination
- Behavior Focused Residential Habilitation (APD licensed group home setting*)
- Intensive Behavior Residential Habilitation (APD licensed group home setting*)
- Environmental Accessibility Adaptations
- Standard Residential Habilitation (APD licensed group home setting*)
- Behavior Analysis (all levels)
- Personal Support (only for Walton and Okaloosa counties)
- Supported Living Coaching
The enrollment for only these specific services will be open for qualified applicants until the need is satisfied. Applicants for Support Coordination services cannot apply to enroll in any other service. Contact Briana Golar (Briana.Golar@apdcares.org) at the 850-922-9963, for more information on eligibility criteria.
*Licensing of Group Homes is a separate process, please, contact Joanne David (Joanne.David@apdcares.org) at the 850-595-8347, for more details.
Provider applicants who do not currently have an “APD General” line item eligibility determination in the AHCA Background Screening Clearinghouse and need to submit their Letter of Intent to the Northwest Region; please email the completed Letter of Intent form to Northwest.Intent@apdcares.org
Incident Reporting Form Instructions
Northwest Region Critical Incident Report and After Hours Emergency Phone Line: Primary 850-519-2401 or Secondary 850-445-6539 Critical Incidents must be reported to the APD Regional/Field Office within one hour of becoming aware of the incident. The initial report may be made via telephone, however, an Incident Reporting Form must be filled out and submitted to the Regional Office no later than one business day after initial reporting. Incident Reports, follow-up reports and reports of death should be sent in via email to Northwest.firstname.lastname@example.org.
The CMS self-assessment is currently being implemented with APD licensed group and foster homes and Adult Day Training Programs (ADT) only. To find the CMS self-assessment tool go to: https://ahca.myflorida.com/medicaid/hcbs_waivers/index.shtml
If you are a group/foster home or ADT provider who has completed the CMS self-assessment you need to follow these steps:
- After completing the CMS self-assessment, the group/foster home or ADT must keep it until such time APD staff visits the facility and requests it for validation;
- If the CMS self-assessment yielded any standards as “presumptively institutional”, then the provider must submit a copy of the CMS self-assessment to AHCA and maintain the original for APD review.
For more information refer to the CMS frequently asked questions at:
You may also send your questions to AHCA at:FLMedicaidWaivers@ahca.myflorida.com
Standard APD Regional Office E-mail Addresses
As you are aware, there are several workflow processes at APD such as submitting cost plans, support plans, significant additional needs, etc. Therefore, APD has created the following standard e-mail addresses you can use to send these types of information to APD. Please use these e-mail addresses to send encrypted confidential information to APD.
Also, keep in mind that you may still contact Regional staff members via telephone if you have questions, concerns, or issues which require immediate attention.
- For AIM submittals (Allocation Implementation Meeting)
- For LRC
- As requested by Region and/or LRC Chairperson
- Reactive Strategies
- WSC caseload submittals
- Purchasing Plans
- Quick Updates
- Participant Information Update form
- Direct Hire Employee [ name change/address change ]
- All Other CDC related documents ( such as: background screening )
- Includes complaints made by or against APD Providers, Waiver Support Coordinators, or APD staff members
- Documentation for waitlist crisis enrollment
- Not for use in SFR submissions
- Intake and Eligibility applicant documentation for APD waitlist eligibility
- Competency evaluations
- Court Orders
- Regional Hearing Requests
- Placement Referral Packets [ ICF ]
- Initial report and follow up reports
- Death report
- Medication Error reports
- Corrective Action Plan
- Enrollment ( Solo or Agency Provider Checklist; Provider Application; Provider Reference Form; Background Screening Results – include Exemptions to a Disqualifying Offense; Employment History check; Local Criminal Records check; APD affidavit of Good Moral Character; Proof of Completion of Required Training; Copy of AHCA Medicaid Provider welcome letter; Applicant Signed Medicaid Waiver Services Agreement; Regional iBudget Enrollment Application – Waiver Support Coordinator (WSC ), or, Regional iBudget Provider Enrollment Application – non WSC )
- Updates to Provider Demographics ( change of address, phone and email changes )
- Provider Expansion Request Forms ( service array and/or expansion within region or additional regions )
- [ Not for Plan of Remediation ]
- Request for technical assistance related to remediation and/or QIO reviews
- Requested documentation for QSI Assessment
- Placement Referral Packets [ APD licensed homes ]
- ICF transitions into APD licensed home
- Licensed Home – census
- Room and Board Payment Requests
- Corrective Action Plan
- Significant Additional Needs – increase in funding
( be certain to include all supporting documentation )
- Employment information
- Disaster/Emergency plan
- Stipend/Start-Up request
- Annual or Updated support plan ( include all supporting documentation for services requested )
DSM secure email will no longer be accessible to APD after June 30, 2014. Effective July 1, 2014 APD will implement the following email addresses mailboxes for use by Waiver Support Coordinators, providers, and others when sending client-related information to APD. This group of mailboxes replaces secure mailboxes previously used when providing APD staff with information on a broad range of topics intended for evaluation, review and action by APD staff.
APD’s IT office identifies acceptable encryption methods, as follows:
Microsoft Office applications (for example, Word and Excel)
This is the preferred method. If you already have Word and Excel version 2007 or higher, this option is already available at no cost. As long as all the confidential APD consumer information is contained within the encrypted document, it can be sent as an attachment to a regular, unencrypted e-mail. If you do this, please remember to not include any information about APD consumers in the body or subject line of the e-mail except the iBudget PIN number which is only known internally to APD staff and APD providers. Below are links to instructions on how to encrypt using Word and Excel.
Word 2013 encryption instructions:
Excel 2013 encryption instructions:
Encrypted web e-mail
Similar to the DSM web-based e-mail system, there are other free (e.g., SendInc) or paid (e.g., ZixMail) options to send secure, encrypted e-mails to APD. This method encrypts the entire e-mail, including any file attachments, but some still display the subject line so please remember to not include any information about APD consumers in the subject line. While this is an acceptable method of sending confidential consumer information to APD, this requires APD staff to create and maintain separate accounts (user names and passwords) for each different system.
There are several free and paid “ZIP” type applications (e.g., WinZip) available that can compress one or more files into one ZIP file, some but not all of which can also encrypt the file(s). These ZIP applications that can also encrypt will encrypt any type(s) of file(s) you ZIP. You can then send the encrypted ZIP file which contains the confidential APD consumer information in a regular, unencrypted e-mail to APD. If you do this, please remember to not include any information about APD consumers in the body or subject line of the e-mail except the iBudget PIN number which is only known internally to APD staff and APD providers.
NOTE: Some methods of encryption use a particular type (algorithm) by default. If you are given options, the best encryption type to select is AES 128-bit or higher. If AES is not available, the next best type is 3DES (also known as Triple DES). It is recommended you do not choose regular DES as it has been proven to be a weak encryption method.
Guidance on Setting Encryption Passwords
Whenever you encrypt a file, you must set a password needed to open the document. To make this process easier for you and APD staff, please use your Medicaid Provider Number as the password to encrypt. If you do not have a Medicaid Provider Number, please contact your local field office to let them know what password you will be using.