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Documentation Needed When Requesting a Crisis Review at the Time of Applying for Services

For APD to begin the crisis review process, an individual must have been determined eligible for APD services pursuant to section 393.065, F.S., and must meet the level of care requirement for an intermediate care facility for individuals with intellectual disabilities pursuant to federal regulations. Please submit the necessary crisis documentation listed within the Quick Guide. Please note that the Quick Guide: Applying for APD Services and Requesting Crisis Review is a reference only and not an exhaustive list. If necessary, APD may request additional information or documentation in order to complete the crisis review.

Caregiver Unable to Give Care

Examples of Documents That May Be Needed

The client is living with a caregiver who is in extreme duress and no longer able to provide for the applicant’s health and safety because of illness, injury, or advanced age, and the applicant requires a caregiver. Such as:

  • without immediate provision of waiver services, the applicant’s health and safety are at imminent risk,
  • without immediate provision of waiver services, the applicant cannot remain living with the caregiver,
  • other potential caregivers, such as another parent, stepparent, brother, sister or other relative or person, are unavailable or are unable to provide care,
  • the caregiver’s physical or mental condition prevents the provision of adequate care, or
  • the caregiver’s age impairs the caregiver’s ability to provide sufficient care to the applicant, or
  • the caregiver cannot provide sufficient care because of the age or size of the applicant, or the physical, functional, or behavioral demands of the applicant, or
  • other circumstances prevent the caregiver from providing sufficient care.
  • One or more of the following documents may be needed:
    • Medical records
      • If the condition or circumstance is due to a medical condition, a physician’s statement must be provided to explain why the current caregiver cannot continue.
      • Circumstances that are not medical in nature must be described and signed by the caregiver.
    • Medicaid State Plan approval / authorization / prior service authorization approval forms (if under age 21)
    • Work schedule
    • Eviction notice/foreclosure notice
    • Medication lists
    • Letter from Social Security Disability 
    • More than one child with a disability/caregiving to others
    • Driver’s license/legal ID
    • Law enforcement reports
    • Client’s high school diploma (if a need for supports/supervision is a basis for crisis application, ex: Adult Day Training (ADT), Personal Supports, etc.)
    • Dismissal letter from employer
    • Unemployment benefits statements
    • Denial of services from private health insurance
    • Written statement from caregiver describing reasons for not being able to obtain employment or support the client
    • Credible evidence from either the caregiver, law enforcement, DCF protective service investigations, hospitals, court documents, or other professionals aware of the client’s dangerous behaviors that place their health and safety at imminent risk.

*Note: documents should be current within the last 12 months.

See Chapter 393, Florida Statutes; Rule 65G-1.046-047, Florida Administrative Code for further details.

Additional information can be found at Apply for Services.


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