Regional Offices > Suncoast Region

APD Suncoast Region Office

1313 North Tampa Street
Suite 515
Tampa, FL 33602
Phone: 1-800-615-8720
Fax: (813) 233-4302

    Michael Taylor - Interim Suncoast Region Director

    Michael Taylor
    Suncoast Region Manager

Suncoast Region Staff

Suncoast Field Office (Field 23), Tampa- De Soto, Hillsborough, Manatee, Pasco, Pinellas, and Sarasota counties

Field 8 Office, Fort Myers- Charlotte, Collier, Glades, Hendry, and Lee 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.

EFFECTIVE IMMEDIATELY: 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. 

Suncoast Region currently has a critical service need for Behavior Analysts as well as Behavior Focused and Intensive Behavior Residential Habilitation providers in both the Tampa and Fort Myers field offices. Please Email if you require additional information on eligibility criteria.

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 Request for the Background Screening Clearinghouse to the Suncoast Region; please email the completed Request for the Background Screening Clearinghouse form to

For Official Transcripts for WSC applicants must be sent to the following address:
Attn: Linda Henderson/Jasmine Shotts
1313 N. Tampa St. Suite 515
Tampa, FL 33602

Interested in applying to license a new foster or group home with APD?

  • Complete the Application Request linked below.
  • Please attach a copy of a valid photo identification card with your request.

Once you complete and submit this request form, you will be contacted by APD regional staff to complete an interview to discuss the licensing process.

  • It is important to know, all APD providers and direct service professionals are required to pass a Level II Background Screening in accordance with Section 435.12 and 393.0655 Florida Statutes.

If you have any questions, please contact the Suncoast Region at

Be sure to check out the APD Group Homes video.

Room and Board Reimbursement Form 65G-13.008 A

Incident Reporting Form Instructions

Suncoast Region Critical Incident Reporting:

All providers must report critical incidents and other reportable incidents on the APD Incident Report form, incorporated by reference in Rule 65G-2.010, F.A.C.

Critical Incidents must be reported to the APD Regional/Field Office within one hour of becoming aware of the incident. Note: 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.

Providers reporting Critical Incidents after hours (Monday through Friday 5pm-8am; Holidays, and Saturday and Sundays), please call the Emergency Phone Line: 727-639-1668.

Providers reporting Critical Incidents during normal business hours (Monday through Friday, 8am-5pm, excluding Holidays, please call:
Ginger Morgan 813-255-4679 or Aletha Jones 813-255-4551.

All Incident Reports and follow-up reports should be sent in via email to

Please refer to for Incident Reporting Form, rule, and Instructions.

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 more information on upcoming 65G-7 trainings and annual updates or to register for a class

  • 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 pre-enrollment crisis enrollment
  • Not for use in SFR submissions

  • Intake and Eligibility applicant documentation for APD pre-enrollment eligibility

  • Competency evaluations
  • Court Orders

  • Regional Hearing Requests

  • Habilitation Plans
  • Continued Stay Reviews
  • All other related documents (i.e. 3033b's, self-assessment tool for physical and nutritional management, etc.)

  • Initial report and follow up reports
  • Death report

  • Medication Error reports
  • Corrective Action Plan

  • Suncoast Region is currently accepting provider enrollment applications for the following Critical Need: Waiver Support Coordination
  • 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 )

  • Completed plans of remediations (POR)
  • Request for technical assistance related to remediation and Qlarant issues.

Please submit QSI requests for the following purposes:

  • Requested documentation for QSI Assessment
  • SAN Request (Be certain the SAN request has been submitted to the ~iBudget along with all supporting documentation)
  • QSI Errors (Please refer to rule 65G-4.0124(1)(c), F.A.C.)
  • Expired QSI (Greater than three years old)

Please include the purpose of your request in the subject line (i.e. SAN request, QSI Error, Expired QSI, etc.).
(This email address is for WSC’s use only)

  • Placement Referral Packets [ APD licensed homes ]
  • Placement Referral Packets [ ICF ]

  • 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 )

  • Supported Employment Inquiries
  • Technical Assistance
  • Employment Enhancement Program (EEP) Referrals
  • Employment Enhancement Program (EEP) Billing Submissions

  • Disaster/Emergency Staff and Customer Spreadsheets
  • Technical Assistance
  • Start-Up and Subsidy Requests

  • Annual or Updated support plan
  • ( include all supporting documentation for services requested )

  • Waiver Support Coordination selection ballots

The link is for the following meetings:

  • Provider quarterly meetings
  • New Provider orientations

Please include the following information when you register:
Meeting location:
Name of your organization:
Name of person(s) attending from your organization

Please note: Space is limited at each of the locations. Please register early.  You will receive confirmation once you are registered for the meeting or orientation.

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.