Families of individuals with intellectual and developmental disabilities in Florida know all too well the challenges of accessing services. With the iBudget Waiver waitlist exceeding 20,000 people and average waits stretching well past 8 years, many wonder: Is there another path?
Florida Community Cares, also known as the Intellectual & Developmental Disabilities Comprehensive Managed Care program (ICMC), now offers a promising alternative. As of October 1, 2025, the program rolled out statewide — giving eligible individuals across Florida access to more responsive, coordinated care. APD representatives have confirmed they anticipate presenting the FCC enrollment option to over 12,000 consumers on the iBudget Waiver waitlist, with a considerable number located in the Central Region (Greater Orlando).
Florida Community Cares (ICMC) is a statewide Medicaid managed care program administered by AHCA in partnership with APD. It provides home and community-based services (HCBS) for persons with intellectual and developmental disabilities, along with regular Medicaid services, under a more flexible and person-centered model.
Eligibility requirements: must be 18 or older, have an intellectual or developmental disability diagnosis, be eligible for or already on Medicaid, and live in Florida.
Administrative layers: iBudget requires local MCM reviews, state-level SAN requests, and APD oversight. Under ICMC, case managers have more direct authority with fewer layers of review in many cases.
Funding flexibility: iBudget allocates funding annually; going above requires SAN or special approval. Under ICMC, case managers have more leeway to allocate funding based on changing needs without going through SAN or MCM for every change.
Care coordinator ratios: Waiver Support Coordinators can have 30+ clients under iBudget. Care Coordinators under ICMC have 10–20 clients — meaning more attention per person.
Waitlist access: Individuals on the iBudget pre-enrollment waitlist may access services faster under ICMC, bypassing some of the delays inherent in the iBudget process.
Even with statewide availability, there might be a limited number of spots initially. Joining ICMC means you are taken off the iBudget pre-enrollment list. If you decide to leave ICMC later, there are rules about getting back on the list. Agency leaders say you won't lose your waitlist spot if you want to switch back — but as of this writing, they haven't provided clear documented guidelines to back this up.
Some services under iBudget might differ from those under ICMC, so families should compare both carefully to ensure all needs are met.
Confirm eligibility. Talk with potential providers to ensure they are APD-licensed and participate with Florida Community Care. Gather documentation — medical records, therapy evaluations, assessments showing current needs. Understand the implications of leaving the pre-enrollment list. Use your waiver support coordinator, case manager, and trusted providers to help guide the decision between iBudget and ICMC.
At Audubon Gardens Group, we can help you understand both pathways, prepare your documentation, and decide which option will best support quality of life and health outcomes. Reach out through our contact form if you're exploring ICMC or iBudget.
Florida Community Cares is a statewide Medicaid managed care program administered by AHCA in partnership with APD. It provides home and community-based services for persons with IDD under a more flexible, person-centered model.
MCOs will manage service coordination and provider networks, aiming for greater efficiency. Care coordinators under ICMC have 10-20 clients versus 30+ for iBudget WSCs, meaning more attention per person.
The intention is not for individuals to lose their current services, but for those services to be overseen by a managed care organization. There may be changes in delivery processes, but core services remain available.