OPPAGA text logo with graphic of FL historic capitol
OPPAGA text logo with graphic of FL historic capitol

Department of Elder Affairs

State-Funded Home and Community Services

What is the purpose of the state-funded home and community services programs?

The Alzheimer's Disease Initiative (ADI) was created by the Legislature in 1985 to provide a continuum of services to meet the changing needs of individuals with Alzheimer's disease.  The Community Care for the Elderly (CCE) and the Home Care for the Elderly (HCE) programs enable functionally impaired elders to live dignified and reasonably independent lives in their own homes or in the homes of relatives or caregivers.

Who is eligible for these programs?

  • Alzheimer's Disease Initiative.  Respite care is available for individuals who are diagnosed or suspected of having a memory loss and caregivers of adults who have been diagnosed with Alzheimer's Disease or a related disorderIndividuals of any age suspected of having a memory disorder may request diagnostic evaluations in a Memory Disorder Clinic.  Individuals of any age, with or without a diagnosed memory disorder, are eligible to sign up for the ADI Brain Bank.

  • Community Care for the Elderly. Individuals must be age 60 or older and functionally impaired, as determined by an initial comprehensive assessment and annual reassessments. Primary consideration for services is given to elders referred to Department of Children and Families’ Adult Protective Services (APS) and determined by APS to be victims of abuse, neglect, or exploitation and in need of immediate services to prevent further harm.

  • Home Care for the Elderly.  Individuals must be age 60 or older, meet the Medicaid Institutional Care Program (ICP) asset and income limitations, be at risk of nursing home placement, and have an approved adult caregiver living with them who is willing and able to provide or help arrange for care.

What services are provided by these programs?

Alzheimer's Disease Initiative. This initiative is a coordinated, comprehensive plan of care and, in conjunction with a 15-member advisory committee  appointed by the Governor, is made up of three program components. 

  • Respite Care Services provided in all 67 counties by Area Agencies on Aging offer caregiver relief or rest for a specified period of time. The service may be provided in a client's home or in a facility, such as an assisted living facility .  In addition, caregivers and consumers may receive supportive services essential to maintaining persons with Alzheimer's disease or related dementia in their own homes.  The supportive services may include caregiver training and support groups, counseling, consumable medical supplies, and nutritional supplements.
  • Memory Disorder Clinics provide comprehensive assessment, diagnostic, and referral services for persons with memory problems. The clinics also conduct research and develop training materials for caregivers and health care professionals. There are 16 memory disorder clinics in the state.
  • The Florida Brain Bank is a service, education, and research-oriented network of statewide regional sites.  The intent of the Brain Bank is to find a cure for Alzheimer's disease by collecting and studying the brains of deceased patients who were clinically diagnosed with dementia. 

Community Care for the Elderly. This program provides a wide variety of home and community-based services for elders, including adult day care, case management, chore assistance, counseling, home-delivered meals, home health aide, legal assistance, personal care, respite, and transportation.

Home Care for the Elderly.  This program provides a basic subsidy for most program participants.  Some participants receive special subsidies that can be used for incontinence supplies, medications, medical supplies, wheelchairs, assistive devices, ramps and home accessibility modifications, nutritional supplements, home health aide, home nursing, and other services to help maintain the individual at home.  The program provides formal case management when necessary.

For more information about services provided by the ADI, CCE, and HCE programs, please see the department's Summary of Programs and Services

How many clients received state-funded home and community services?

The department provided state-funded home and community-based services to the following numbers of seniors.
 Seniors Served 
Service 

Fiscal Year

2017-18

   Fiscal Year

2018-19

ADI- Respite and Supportive Services5,2288,480
ADI- Memory Disorder Clinic Services9,753 13,105
ADI- Registered With the Brain Bank60 70
Community Care for the Elderly Program44,086 44,245
Home Care for the Elderly Program3,0242,750
 

 

What is the average time a client spent in the CCE program before enrolling in the Medicaid long-term care program?

In Fiscal Year 2018-2019, the average time a client received Community Care for the Elderly (CCE) services for an average of 3.6 months before becoming eligible for and enrolling in the Statewide Medicaid Managed Care Long-Term Care (SMMC LTC). This does not meet the department's performance standard of 2.8 months.

Removing applicants from the waitlist and enrolling them in the SMMC LTC program is based on budget availability and priority ranking, with the highest priority individuals being released first. Applicants who are not in the CCE program may have higher priority for SMMC LTC than those who are in CCE. Therefore, some clients may remain in CCE for longer than the standard of 2.8 months. The department has requested a new performance standard for Fiscal Year 2020-21. 

How are these activities funded?

Home and community service programs are funded as part of the Home and Community Services budget entity.
Fiscal Year: 2020-21
Fund Salary Rate/ Position General Revenue Trust Funds
SALARY RATE
POSITIONS
SALARIES AND BENEFITS
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
OTHER PERSONAL SERVICES
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
EXPENSES
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
OPERATING CAPITAL OUTLAY
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
AGING AND ADULT SERVICES TRAINING AND EDUCATION
FROM FEDERAL GRANTS TRUST FUND
SPECIAL CATEGORIES
GRANTS AND AIDS - ALZHEIMER'S DISEASE INITIATIVE
FROM GENERAL REVENUE FUND
SPECIAL CATEGORIES
GRANTS AND AIDS - COMMUNITY CARE FOR THE ELDERLY
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
GRANTS AND AIDS - HOME ENERGY ASSISTANCE
FROM FEDERAL GRANTS TRUST FUND
SPECIAL CATEGORIES
GRANTS AND AIDS - OLDER AMERICANS ACT PROGRAM
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
SPECIAL CATEGORIES
CONTRACTED SERVICES
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM GRANTS AND DONATIONS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
GRANTS AND AIDS - CONTRACTED SERVICES
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
RISK MANAGEMENT INSURANCE
FROM GENERAL REVENUE FUND
SPECIAL CATEGORIES
CORONAVIRUS (COVID-19) - PUBLIC ASSISTANCE - STATE OPERATIONS
FROM FEDERAL GRANTS TRUST FUND
SPECIAL CATEGORIES
LEASE OR LEASE-PURCHASE OF EQUIPMENT
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
TRANSFER TO DEPARTMENT OF MANAGEMENT SERVICES - HUMAN RESOURCES SERVICES PURCHASED PER STATEWIDE CONTRACT
FROM GENERAL REVENUE FUND
FROM FEDERAL GRANTS TRUST FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
SPECIAL CATEGORIES
PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)
FROM GENERAL REVENUE FUND
FROM OPERATIONS AND MAINTENANCE TRUST FUND
GRANTS AND AIDS TO LOCAL GOVERNMENTS AND NONSTATE ENTITIES - FIXED CAPITAL OUTLAY
GRANTS AND AIDS - EASTER SEALS CAPITAL IMPROVEMENT
FROM GENERAL REVENUE FUND
GRANTS AND AIDS TO LOCAL GOVERNMENTS AND NONSTATE ENTITIES - FIXED CAPITAL OUTLAY
GRANTS AND AIDS - SENIOR CITIZEN CENTERS
FROM GENERAL REVENUE FUND
TOTAL
150,548,339
197,295,778

Updates

Waitlist Funding. The 2020 Legislature appropriated  $4.8 million to serve elders on the Community Care for the Elderly Program and Home Care for the Elderly Program waitlists, as well as $2.8 million for Alzheimer's respite care services. 

Where can I find related OPPAGA reports?

A complete list of related OPPAGA reports is available on our website.

Where can I get more information?

Other Reports
Education Manual Understanding and Dealing with Alzheimer's Disease & Related Disorders, Florida Alzheimer's Disease Initiative, Revised May 2016.
Reports, Department of Elder Affairs.
Websites of Interest
Alzheimer's Research Forum
Alzheimer's Disease Education and Referral Center
Caregiver Action Network
Personal Assistance Services
Home and Community Based Services Clearinghouse
Performance Information
Performance measures and standards for the department may be found in its Long Range Program Plan.

What are the applicable statutes?

Title 42, U.S. Code, s. 1396n; Title 42, Code of Federal Regulations, s. 441.302; and ss. 430.201 through 430.207, 430.501 through 430.504, and 409.906(13), Florida Statutes.

Whom do I contact for help?

Florida Department of Elder Affairs, Bureau of Community and Support Services, 850-414-2184
Elder Helpline, 1-800-963-5337 or 1-800-955-8771 for TDD or 1-800-955-8770 for voice

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