Mariella is 27 years old. She lives in her family home with her parents. Her younger sister Gracie recently graduated from college and lives about two hours away. Mariella has been receiving Medicaid waiver services through Tier 3. She attends adult day training (ADT) three days a week and has a companion on a couple of other days. She also has some behavior analysis services as well as transportation and respite care. She has Full Support Coordination.
Under iBudget Florida, the process begins when her waiver support coordinator (WSC) meets with Mariella and her friend, Sarah. The WSC brings information about the services. Under iBudget Florida, Mariella is preapproved for Life Skills Development Levels 1 and 3, Personal Supports, Transportation, Behavior Analysis, and Full Support Coordination. Her new budget is about the same as her previous one.
Together, Mariella, Sarah, and her WSC make a few decisions. One is whether to apply for other services. They decide to apply for Behavior Assistant Services. The main decision is how to allocate the funding for waiver services. They decide to get similar amounts of services as she does now, but she slightly reduces the amount of Life Skills Development Level 1 (Companion), Level 3 (ADT), and Transportation to allow funding for the Behavior Assistant Services. The WSC logs on to the iBudget Florida application and inputs the proposed cost plan. The WSC hits the Submit button, and the plan is sent electronically to the area office.
Since this is Mariella's first plan under iBudget Florida, it must be reviewed and approved by a “live” person. After this plan is approved, the online system can automatically approve many types of changes. The area staff receives and reviews the proposed cost plan. Since Mariella meets the handbook requirements for receiving Behavior Assistant Services, she is approved to receive it. Since Mariella's plan addresses her health and safety needs and meets all the requirements, it is approved.
Service authorizations are generated through iBudget Florida, and waiver support coordinators can send these to providers using encrypted email.
Mariella attends Life Skills Development Level 3 (ADT), goes into the community and receives respite from her Personal Supports provider, and receives Full Support Coordination, Transportation, Behavior Analysis, and Behavior Assistant services.
A few months later, Mariella's behaviors intensify somewhat. Mariella, Sarah, and the WSC review her service use and cost plan to see how to address it. They see that Mariella, as is often the case, missed a few sessions of her Life Skills Development Level 3 services. They rebudget that funding for additional Behavior Assistant Services. They also decide to see if Mariella's sister Gracie can provide additional respite as a natural support, and they rebudget funding from future Personal Supports (used for respite) to Behavior Analysis. The WSC enters the plan into the iBudget Florida website and submits it. Since the plan is still within acceptable parameters and they are not requesting new types of services, the system automatically approves the revised cost plan and generates revised service authorizations. The waiver support coordinator can send the new service authorization to the provider using secure email.
As Mariella's needs change, her waiver support coordinator goes online to adjust her services while staying within her budget. For Mariella and her family, flexibility is what iBudget Florida is all about!