Your Adult Child Has to Move: A Florida Family's First Steps

Someone called you, and now everything is different.

Maybe it was a letter. Maybe it was a meeting you thought was routine. However it arrived, the message was some version of the same thing: your child is turning 21, or already has, and the place that has cared for them cannot keep doing it.

If you are reading this within a few days of that call, we want to say something before anything else. The disorientation you are feeling is not a failure of preparation on your part. Almost no family sees this coming with enough time. You built your entire life around a set of arrangements that worked, and you were told, with very little warning, that those arrangements are ending.

That is a hard place to think clearly from. So let us try to make the next few weeks smaller and more ordered than they feel right now.

Why this happens at 21

It helps to understand that this is a structural feature of how care is funded, not a judgment about your loved one.

For most of your child's life, Medicaid's rules for children required coverage of medically necessary services. That framework is broad, and it is why so much was available without you having to fight for each piece of it separately.

At 21, that framework ends. Adult services in Florida run primarily through waiver programs, which have their own eligibility rules, their own funding levels, and their own limits. For many young adults, the amount of support that can be authorized changes considerably. Providers who built their operations around the higher pediatric structure often find that the adult numbers do not work for them, and they stop serving people at that age.

You are not being singled out. A whole cohort of families reaches this same cliff every year, and most of them are told about it far too late.

Knowing that will not fix your situation. But it changes the question in your head from "what did we do wrong" to "what do I do next," and that is a more useful question.

What to do next, in order

First, find out exactly how much time you have. Ask for the date in writing. Ask whether there is any flexibility in it. Some transitions have more room in them than the first conversation suggests, and you cannot plan around a deadline you are guessing at.

Second, find out which waiver your loved one is on, or is being moved to. In Florida this usually means the APD iBudget Waiver, or ICMC, or a move between the two. These are not interchangeable, and the answer determines which homes can accept your loved one at all. If nobody has told you clearly, ask directly and keep asking until you get a plain answer.

Third, get your waiver support coordinator on the phone this week. If you have one, they are the person who maps needs to providers and coordinates funding, and they should be doing that work with you right now rather than after you have found something. If you do not have one, or you have one you never hear from, that is a fixable problem and it is worth fixing immediately.

Fourth, gather the paperwork before you need it. The current care plan. Recent medical records. The medication list. Any assessment on file. Every home you talk to will ask for some version of this, and having it ready is the difference between a conversation that moves and one that stalls for two weeks.

Fifth, start calling homes now, not after the paperwork is perfect. This is the step families delay, usually out of a sense that they should have everything in order first. You do not need everything in order. You need to know what exists.

The questions to ask any home you talk to

Most families have never had to evaluate a residential home before. There is no reason you would know what to ask. These are the questions that actually separate one home from another.

What level of care do you specialize in? This is the first question and it matters more than any other. A home built for ambulatory, higher functioning adults is not equipped for someone who is medically fragile, and the reverse is also true. A good home will tell you plainly when your loved one is not a fit. Be cautious with anyone who says yes to everything.

How many people live here? Under Florida's licensing, group homes of this kind cap at six residents. Some homes run at that cap. Some run smaller. Ask, and ask why they chose the number they chose.

Who is here at two in the morning? Nights are when medically complex residents get into trouble, and nights are where the difference between homes is starkest. Ask who is awake, what their training is, and what happens when something changes.

How many people here know my loved one's baseline? This is the question almost nobody asks, and it is the one that predicts outcomes. Stability in a medically complex adult depends on somebody noticing that today is slightly different from yesterday. That only happens when the same staff see the same person consistently enough to know what ordinary looks like for them. Ask about turnover. Ask how long the current team has been in place.

Who calls me, and when? Ask what triggers a call to the family and who makes it. Ask what you will hear about routinely and what you will hear about immediately.

Reading this because you are trying to work something out for someone you love? You can tell us about them at the bottom of this page. A real person reads every inquiry.

Can I visit, and can I visit again? Any home worth considering will say yes to both.

Write the answers down. After the fourth tour they blur together, and the notes are what you will actually decide from.

The part we want to be honest about

Families who start this process before the deadline end up with better options than families who start after it. Not sometimes. Consistently.

That is not a sales point, and it does not help if you are already past that window. But if you are reading this because someone gave you a heads up and the deadline is still months away, please treat those months as the resource they are. Tour homes while nothing is urgent. Meet people while you can still walk away. The families who do that make their decision from a position of choice, and choice is most of what determines how these transitions go.

If you are already inside the window, you can still do this well. It just requires moving now rather than after you feel ready. You will not feel ready.

For support coordinators and discharge planners

If you are managing a client through this transition, the constraint you are working against is almost always time, and the families who reach you late are the ones who were told late. When you know a transition is coming, the most valuable thing you can do is start the conversation early enough that the family can tour more than one option. We are always willing to talk through whether a client is a fit for us, including when the answer is no. More detail is on our page for support coordinators.

Where we sit in this

The Garden at Bennett and The Garden at Ibis are small on purpose. Six residents each, which is the licensed maximum and also the number we chose. We provide 24 hour nursing care for medically complex adults, and we serve the age range that this whole article is about, because that is the range where families keep finding that nobody will take their loved one.

We have watched what consistency does for a medically complex adult over years, not months. It is the reason we are structured the way we are.

If you want to talk it through, call us at (689) 777-2892. Antoinette, our administrator, takes these calls herself. There is no intake script and no pressure. Most first conversations are just a parent describing their situation while we ask questions.

If we are not the right home for your loved one, we will tell you, and we will try to point you somewhere useful. You should walk away from any conversation with us better equipped than you were, whether or not it leads to us.

Related Articles

Explore More Resources