Panel tells NCD Florida study finds most iBudget waiver denials upheld; due-process and definition problems cited
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Summary
A research coalition told the National Council on Disability that, in a review of 100 Florida iBudget waiver final orders (Mar 2024'May 2025), only two denials were reversed; they attributed the results to procedural barriers (lack of counsel, limited expert evidence, hearing delays) and state definitions that diverge from DSM-5-TR/ICD-11 clinical standards.
A multi-year research project presented to the National Council on Disability found that Florida's iBudget waiver eligibility process frequently upholds denials and uses eligibility definitions and evidentiary practices that may exclude otherwise qualifying people with developmental disabilities.
Robert Latham, associate director at the University of Miami Children and Youth Law Clinic, reported the coalition systematically reviewed 100 administrative final orders filed between March 26, 2024 and May 22, 2025 and found just two reversals of agency eligibility determinations. "Out of the 100 orders that we reviewed, only 2 reversed an eligibility determination by the agency," he said.
Disability Rights Florida attorney Jason Khan summarized due-process findings: petitioners seldom had legal counsel (only 1 of 100 orders indicated counsel), petitioners rarely presented clinical expert testimony (only 14 had clinically qualified witnesses; only three were accepted as experts in the orders), and APD rarely referred applicants for needed external evaluations even when reviewers judged such referrals were warranted (about 60% of sampled orders).
Clinical expert Dr. Musser told the council that Florida's eligibility definitions are narrower and outdated compared with current clinical practice and diagnostic guidance. She said APD relies on criteria that over-emphasize a hard IQ cutoff of 70, older DSM-IV-style autism criteria, and age-of-onset rules that exclude many individuals diagnosed in clinical practice. "APD's definition is more narrow and outdated than the clinical definitions," she said, noting DSM-5-TR (2022) and ICD-11 standards as the clinical reference points.
Panelists urged NCD to document the statewide findings, hear from affected families, and recommend statutory or administrative updates so state definitions align with contemporary clinical standards. Latham also highlighted portability concerns: families who receive waivers in other states may lose eligibility upon moving to Florida because of differing state standards.
Next steps: Panelists recommended NCD collect family testimony and consider outreach to Florida officials and Congress; council members suggested preparing briefings timed to WHO/clinical updates to press for change.
