Home & Community-Based Services: State-Only Funded Programs in Florida
States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).
Program Name: Community Care for the Elderly4,11
Administrative Agency: Dept of Elder Affairs
Population Served: Elderly 60+
Annual Expenditure: $42,364,370 FY02-03 (may include federally funds)
Funding Source: 80% general revenue, 20% tobacco settlement funds (FY00)
Number of People Served: 34,476 FY02-03 (may include federally funded clients)
Eligibility Criteria: Individuals who are financially &/or functionally ineligible for Medicaid, individuals waiting Medicaid HCBS placement or nursing home placement, individuals receiving Medicaid HCBS. No income or asset limit.
Further Information: Cost control: No cost caps. Waiting list. Co-pay on sliding scale (3% of program costs in FY98) some clients exempt (e.g. if they receive waiver services). 10% match required from service providers. Quality control: contacts with case managers, client satisfaction surveys. Other information A Community Care Programs for the Elderly program was funded by General Revenue in FY02-03 ($5.9 million) but it is not funded in FY03-04.
Program Name: Homecare for the Elderly3,4,12
Administrative Agency: Dept of Elder Affairs
Population Served: Elderly 60+
Annual Expenditure: $9,529,461 FY02-03
Funding Source: General revenue
Number of People Served: 5,599 FY02-03
Eligibility Criteria: Individuals who are financially &/or functionally ineligible for Medicaid, individuals waiting Medicaid HCBS placement or nursing home placement, individuals receiving Medicaid HCBS. Income limit FY02 $1,635 (300%SSI), asset limit FY02 $2,000 (individual)
Further Information: Cost control: No cost caps. No service limits applied. A subsidy payment for caregivers to help them maintain low-income elders in their own home. Subsidy intended to fund food, housing, clothing, medical care. There is a specialized subsidy for health care. Quality control: contacts with case managers, client satisfaction surveys. Consumer direction Can be consumer directed.
Program Name: Alzheimer's Disease Initiative3,4,12
Administrative Agency: Dept of Elder Affairs
Population Served: Caregivers of adults 18+ with dementia or related disorder
Annual Expenditure: $11,394,025 FY03
Funding Source: General revenue, tobacco settlement funds
Number of People Served: 8,880 FY02
Eligibility Criteria: Diagnosis of dementia or related disorder. Individuals who are financially &/or functionally ineligible for Medicaid, individuals waiting Medicaid HCBS placement or nursing home placement, individuals receiving Medicaid HCBS. No income or asset limit
Further Information: Cost control: No cost caps. No service limits applied. Co-pay on sliding fee scale (although some clients are exempt, e.g. if they are waiver clients). Quality control: contacts with case manager, client satisfaction surveys. Other information Statewide.
Program Name: Contracted Services11,12
Administrative Agency: Dept of Elder Affairs
Population Served: Elderly 60+
Annual Expenditure: $648,424 FY02-03
Funding Source: General Revenue
Number of People Served: 937 FY02-03
Eligibility Criteria: N/A
Further Information: Cost control: no co-pay required. Other information 3 counties only.
Program Name: Respite for Elders Living In Everyday Families (RELIEF)3
Administrative Agency: Dept of Elder Affairs
Population Served: Elderly 60+ & adults with dementia or related disorders
Annual Expenditure: $1,294,530 FY02-03
Funding Source: General revenue
Number of People Served: 369 02-03
Eligibility Criteria: Homebound people when traditional assistance not available.
Further Information: Cost control limit of 4hrs/wk respite Other information Multi-county.
Abbreviations:
AAAs - Area Agencies on Aging.
ADL - Activities of Daily Living.
AT - Assistive Technology. Dept - Department.
FY - Financial Year.
HCBS - Home & Community-Based Services.
LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.
Mth - month.
Rehab - Rehabilitation.
SCI - Spinal Cord Injury.
SSBG - Soical Services Block Grant.
TBI - Traumatic Brain Injury.
Wk - week.
Yr - year.
Footnotes:
(a) Note that some figures listed are the yearly appropriation, not expenditure.
(b) Sources of funding are listed in the language with which they are reported.
(c) The figures for number of participants are not necessarily figures for unduplicated participants.
Notes:
(1) The definitions of the services provided in programs may differ between states.
(2) Unless otherwise stated, programs are statewide.
(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.
(4) The table does not include Mental Health Services programs.
(5) All information is the most up-to-date found from secondary sources noted in the references.
(6) N/A means the information has not been found (not available).
(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.
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