Regional Offices > Northeast Region

APD Northeast Region Office

3631 Hodges Boulevard
Jacksonville, FL 32224
Phone: 904-992-2433
Fax: 904-992-2442

Daytona Beach Field Office
Phone: 386-238-4607
Fax: 386-238-4753

Gainesville Field Office
Phone: 352-955-6061
Fax: 352-955-5787


   Leslie Richards - Northeast Region Director
   Leslie Richards
   Northeast Region Manager


Northeast Region Staff

Field 3 Office, Gainesville- Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Madison, Putnam, Suwannee, Taylor, and Union counties

Field 4 Office, Jacksonville- Baker, Clay, Duval, Nassau, and St. Johns counties

Field 12 Office, Daytona Beach- Flagler and Volusia counties

Apply for Services in the Northeast Region

Contact: Michelle Bucalos

Call Toll Free: 1-844-865-1172
If you reach the voicemail service, please leave a message with your name & number. Calls are returned in the order they are received.

Additional information can be found on the Applying for Services webpage.

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.

Northeast Region APD Enrollment Process for Prospective Waiver Providers

Agency Policies and Procedures Checklist

EFFECTIVE IMMEDITELY: Pursuant to the iBudget Waiver program, authorized under 1915 (c) of the Social Security Act, and because of critical needs for some specific provider types, APD will no longer operate two open enrollment periods each year for provider applicants of services furnished under the iBudget waiver.  Effective immediately, Regional offices will accept provider applications at all times.

Although APD will accept provider applications at all times, please keep in mind that certain critical needs exist for specific provider types in each APD Region. Each Region will identify critical service needs as defined below. 

Northeast Region critical services include: Transportation, Private Duty Nursing, Residential Nursing Services, Skilled Nursing, Behavior Analysis Service, and Behavior Focus (BF) & Intensive Behavior (IB) Residential Habilitation (Res-Hab) Service.

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 Northeast Region; please email the completed Letter of Intent form to

Zoning Requirements for applications seeking initial licensure through APD:

Page 12 of the Facility Application form.

Chapter 419, Florida Statutes require that persons seeking to establish APD-licensed foster care facilities* or group home facilities (meeting the definition of a “community residential homes” within the law) must provide local zoning officials with certain information as part of the license application process. 
*Note: Foster care facilities (with a maximum capacity of three residents) which intend to utilize live-in caregivers do not meet the statutory definition of “community residential home” as that term is defined in Chapter 419, F.S. and are therefore exempt from the local zoning notification requirements of the law.

Step 1: Obtain a list of community residential homes in your area which are licensed by the Agency for Health Care Administration. This information can be found on the Internet via the following link: 
Once you reach that website:

1. Choose “Search by Proximity”. 
2. Enter the address of the proposed facility and search for each of the following provider types (with 14 or fewer beds) within one mile: 
Assisted Living Facilities 
Adult Family Care Homes 
Residential Treatment Facilities 
Intermediate Care Facilities for the Developmentally Disabled 
3. Print out the search results for each of the above categories

Step 2: Obtain a list of community residential homes in your area which are licensed by Department of Children and Families (DCF). On the Internet, visit: for the telephone number and address of your local DCF office. Contact the appropriate DCF office to request a list of their currently licensed community residential homes within the vicinity of the proposed facility.

For a list of DCF Licensed facilities in the NE Region, please contact:

Kendra Bradley 
Licensing Specialist 
5920 Arlington Expressway 
Jacksonville Florida 32211 
United States

Step 3: Contact your local APD office to request a current list of APD-licensed community residential homes in your area.

Incident Reporting Form Instructions

Northeast Region Critical Incident Report and Emergency Phone Line numbers are listed below for each regional office. This includes Business Hours (Weekdays 8 am - 5 pm), and After Hours numbers (5 PM to 8 AM in the morning, on weekends, and/or on State of Florida recognized holidays). 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

Incident Reporting


All Incident Reports for the Northeast Region should be submitted via encrypted email to the following address: This includes all Incident Reporting forms, Follow-up Incident reports (due within 5 business days), and information needed for reports of Death.

All Medication Error Reports, along with corrective action plans, should be submitted to:

Northeast Region Business Hours Critical Incident (only) Numbers

  • Field Office 3 Gainesville (352) 955-6061

    Counties: Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy,
                    Madison, Putnam, Suwannee, Taylor, and Union

  • Field Office 4 Jacksonville (904) 992-2433

    Counties: Baker, Clay, Duval, Nassau, and St. Johns

  • Field Office 12 Daytona (386) 238-4607

    Counties: Flagler and Volusia

Northeast Region After Hours Critical Incident (only) On-call Numbers

  • Field Office 3 Gainesville (904) 567-4806

    Counties: Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy,
                    Madison, Putnam, Suwannee, Taylor, and Union

  • Field Office 4 Jacksonville (904) 567-4801

    Counties: Baker, Clay, Duval, Nassau, and St. Johns

  • Field Office 12 Daytona (904) 567-4805

    Counties: Flagler and Volusia

Note: The After Hours Critical Incident (only) On-call Number should only be used from 5 PM to 8 AM in the morning, on weekends, and/or on State of Florida recognized holidays, which result in office closure. During normal business hours (8 AM to 5 PM) Critical Incidents shall be called into your respective main Field Office phone number (see above).

Significant Additional Needs

As of July 1, 2016, Waiver Support Coordinators wishing to request additional funding for waiver services on behalf of APD waiver enrollees in the Northeast Region should submit their requests through the SAN process now located within the iBudget system. Any additional documentation that is requested as a result of their submission should be sent directly to the Waiver Liaison that is identified on the Notice of Intent.

For the Northeast Region, please direct any questions about the Significant Additional Needs request process to the following staff member:

Rebecca Scales - 386-238-4821 or email: .

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
  • Participant Information Update form
  • Direct Hire Employee [ name change/address change ]

  • 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

  • ICF or SNF to waiver transition referrals

  • 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 ]
  • Placement Referral Packets [ ICF ]

  • Licensed Home – census
  • Corrective Action Plan

  • Caseloads
  • Employment information

  • Caseloads
  • 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.

ZIP applications
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.