Florida Cash & Counseling: Consumer Directed Care Plus Waiver

Waiver Description

Florida’s Consumer Directed Care Plus Waiver, more commonly referred to as CDC Plus or CDC+, is a Medicaid Waiver program that allows participants to select their own care providers rather than have the state make those decisions on their behalf.   This long term care program offers a variety of supports to help person remain living in their homes or in the homes of caregivers.  Consumer directed or participant directed care gives the individual greater control and flexibility and generally leads to a higher level of consumer satisfaction with the care  they receive.  This model of program is also referred to as cash and counseling. Participating individuals are evaluated to determine their care needs and then a budget plan is developed.  Individuals are empowered to hire, train and manage their care providers.  They approve their care providers’ time sheets and submit them to a state fiscal agent who then makes payments to the care providers.  Friends, neighbors are even family members including the adult children can be hired as care providers.  Unlike in many states, in Florida even spouses can be paid caregivers.

Eligibility Guidelines

In addition to having a medical need for care, being 60+ years old, participants must be receiving services under Florida’s Aged and Disabled or the Traumatic Brain / Spinal Cord Injury Waivers and be financially qualified for Medicaid. In 2014, financial eligibility for Medicaid in Florida has the following requirements.  Countable resource limits of $2,000 for a single applicant or $3,000 for a married applicant if both parties are applying.  If married with only one spouse applying, the other spouse can have $117,240 in countable resources. The value of one’s home can be included or exempt depending on circumstances.  If the home is occupied by one or both spouses and the value of their home equity is less than $543,000, then their home is not considered a countable asset. However, if the home is not occupied by the owner and it is evident that for medical reasons they will not be returning to live in the home, then it can be considered a countable asset. There is a monthly income limit of $2,163 for a single applicant or $4,326 for a married couple applying.  Individuals with higher incomes may still qualify by allocating their excessive funds into financial trusts called pooled income or miller trusts.  These are special trusts established by professional Medicaid planners that can lower an applicant’s income to the necessary level but still provide a family with some limited access to the additional funds.  One should contact an eldercare financial planner or elder law attorney to learn more about this option.

Benefits and Services

The range of care services for which an individual is eligible is determined at the onset of their participation in the program.  Their care needs are reviewed periodically during their enrollment to accommodate for changing requirements.  A broad range of possible services can be paid for under the CDC+ program. And the consumer is given a great deal of flexibility in what services they retain individuals to perform on their behalf.  Follows are many common services.

• Assistance with meal preparation, grocery shopping and eating
• Assistance with household chores such as laundry, house cleaning and yardwork
• Assistance with personal care such as bathing, dressing and toileting
• Assistance with mobility in and around the home and transportation assistance outside the home
• Home modifications such as the addition of wheelchair ramps and grab bars.
• Durable medical equipment and assistive technology such as wheelchairs, communication aids and environmental accessibility adaptations
• Disposable medical supplies such as incontinence supplies or nutritional supplements
• Personal emergency response system

How to Apply / Learn More

This program is available statewide across Florida. Interested persons can learn more on the Consumer Directed Care Plus website or by calling their toll free number at 1-866-232-3733.