SUPPORTING SUCCESSFUL MOVEMENT FROM INSTITUTIONAL SETTINGS TO COMMUNITY-BASED INDEPENDENT LIVING

Transition Services in Florida help individuals with disabilities, chronic illnesses, or other long-term care needs move safely and successfully from institutional settings such as nursing homes, hospitals, or intermediate care facilities into homes or community-based living arrangements. These services are authorized under Florida’s Medicaid Home and Community-Based Services (HCBS) waiver programs, promoting independence, dignity, and person-centered living.

1. GOVERNING AGENCIES

Agency: Florida Agency for Health Care Administration (AHCA)
Role: Oversees Medicaid enrollment, transition funding, and compliance with HCBS rules

Agency: Florida Agency for Persons with Disabilities (APD) (for individuals with developmental disabilities)
Role: Coordinates transition planning and service delivery for APD waiver participants

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Transition Services meet Medicaid HCBS settings and person-centered standards

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2. TRANSITION SERVICE OVERVIEW

Transition Services provide essential supports to assist individuals in relocating from institutional or group settings to private homes, family residences, or other community-based environments.

Approved providers may deliver:

• Assessment and transition planning
• Coordination of housing arrangements and securing leases
• Purchase of essential household items (furniture, cookware, bedding)
• Moving expenses and utility setup fees
• One-time security deposits and connection fees (electric, water)
• Education on independent living skills and community resource access
• Short-term transition case management and support

Transition services must align with the participant’s person-centered service plan and must be one-time, non-recurring expenses necessary to establish a basic household.

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Florida Division of Corporations (Sunbiz)
• Obtain EIN from the IRS and NPI (Type 2)
• Complete APD Qualified Provider Application or Medicaid waiver application (depending on the population served)
• Maintain general liability insurance
• Develop procedures for assessment, transition planning, purchasing, and financial tracking

Staff must meet competency standards related to case management, community resource navigation, and Medicaid compliance

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4. APD/AHCA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Request Transition Services provider application packet from APD or AHCA
• Attend Medicaid HCBS or APD provider orientation sessions (recommended)

Application and Documentation Submission:

• Submit Articles of Incorporation, business registration, insurance coverage, staffing plan, and financial management policies
• Provide participant intake forms, transition needs assessment templates, and purchase tracking procedures
• Submit background screening results for all staff involved in participant support or financial transactions

Program Readiness Review:

• AHCA and/or APD review provider documentation for compliance with Medicaid transition service rules
• Review may include audits of financial processes and participant tracking systems

Approval & Medicaid Enrollment:

• Upon approval, complete enrollment with Florida Medicaid Provider Enrollment Portal
• Configure billing codes for Transition Services under the appropriate HCBS waiver programs

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Sunbiz)
• IRS EIN confirmation
• NPI confirmation
• Liability insurance coverage

APD/AHCA-Compliant Policy & Procedure Manual including:

• Participant intake and transition assessment protocols
• Financial management, purchasing, and receipt tracking systems
• Emergency preparedness and relocation support planning
• Incident reporting, confidentiality, and participant rights policies
• Staff credentialing, background screening, and training documentation
• Medicaid billing and service documentation tracking

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6. STAFFING REQUIREMENTS

Role: Transition Coordinator / Case Manager
Requirements: Bachelor's degree in social work, human services, rehabilitation, or related field preferred; experience in case management or housing transition; background screening clearance

Role: Transition Support Specialist (optional, for larger programs)
Requirements: High school diploma or GED required; training in community living support; background screening clearance

All staff must complete:

• Training on person-centered planning and transition procedures
• Financial accountability and purchasing compliance training
• HIPAA confidentiality and abuse prevention training
• Emergency preparedness and participant safety protocols

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7. MEDICAID WAIVER SERVICES

The following Florida Medicaid Waivers authorize Transition Services:

• Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) Program
• iBudget Florida Waiver (for individuals with intellectual and developmental disabilities transitioning into independent living)
• Traumatic Brain Injury/Spinal Cord Injury (TBI/SCI) Waiver (for eligible individuals)

Approved providers may deliver:

• Pre-transition planning, housing support, and independent living readiness
• Procurement of basic household furnishings and utilities setup
• Short-term case management to stabilize transitions

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8. TIMELINE TO LAUNCH

Phase: Business Formation and Initial Documentation Setup
Timeline: 1–2 weeks

Phase: APD/AHCA Provider Application and Readiness Review
Timeline: 60–90 days

Phase: Staff Hiring, Training, and System Finalization
Timeline: 30–45 days

Phase: Medicaid Enrollment and Claims Configuration
Timeline: 45–60 days

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9. CONTACT INFORMATION

Florida Agency for Health Care Administration (AHCA)
Website: https://ahca.myflorida.com/

Florida Agency for Persons with Disabilities (APD)
Website: https://apd.myflorida.com/

Florida Medicaid Provider Enrollment Portal
Website: https://home.flmedicaidmanagedcare.com/

10. SCOPE OF WORK

• Business registration and EIN/NPI setup
• APD/AHCA provider enrollment and Medicaid documentation support
• Development of Transition Services Policy & Procedure Manual
• Staff credentialing templates and participant intake forms
• Medicaid billing system setup and service authorization tracking
• Website, domain, and email setup
• Financial management and purchase tracking systems
• Participant transition planning templates and emergency relocation procedures
• Incident reporting, quality assurance, and compliance systems
• Community outreach, housing resource development, and referral networking

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — FLORIDA TRANSITION SERVICES PROVIDER

We help community agencies and entrepreneurs launch Medicaid-compliant Transition Services under Florida’s HCBS Waiver programs.