The QSI — Questionnaire for Situational Information (Version 4.0) is APD's approved needs assessment. A trained APD assessor administers it as a structured interview with the person and the people who know their daily life, and the resulting scores do two jobs: they inform the support plan, and specific items feed the iBudget algorithm that sets the person's individual budget — alongside age and living setting. The requirement is in statute: section 393.0662, F.S., directs APD to use an assessment instrument including the QSI, and Rule 65G-4.0214, F.A.C., spells out the allocation algorithm that turns specific QSI items into a dollar amount.
The four areas
Most items are rated on a 0–4 scale, from 0 (no help or no concern) to 4 (constant help, total dependence, or the most serious level). Eating, for example, runs from “eats independently” (0) to “receives all nutrition through a tube” (4).
Life changes and community inclusion
Recent life changes and the help the person needs to adjust to them while living, working, filling valued roles and taking part in the community. It frames the rest of the interview.
Functional status
How much help the person needs through a routine day: vision, hearing, eating, walking, transfers, toileting, hygiene, dressing, communication, self-protection and evacuating the home. These items feed the budget algorithm's functional score.
Behavioral status
Behavior in the past 12 months that hurt the person, hurt others, destroyed property, was sexually inappropriate, involved running away, or could lead to separation from others — and the supports in place for it. Behavioral scores are among the strongest drivers of the budget.
Physical status
Health over the past year: injuries, psychotropic and seizure medications, gastrointestinal problems, seizures, skin breakdown, nutrition, treatments, chronic care needs, physician and nursing visits, ER visits, hospital admissions and days missed due to illness.
How the interview works, and how to prepare
A certified assessor holds a face-to-face interview, in the language the person understands, with the person, their guardian and their family — and anyone else the person wants there. The form also calls for the assessor to observe the person, talk to caregivers or health care staff as needed, and review records: recent assessments, medical and school progress notes, previous support plans and other sources.
Many items ask about the past 12 months — how many times the person was injured, went to the ER, was admitted to a hospital, or hurt themselves or someone else. Memory is a poor source for a count over a year. Before the interview, gather:
- Incident reports from the past year — injuries, ER visits, hospitalizations, behavioral incidents
- The current medication list and MAR, including psychotropic and seizure medications and any changes
- Recent progress notes, quarterly summaries and nursing summaries that describe the help the person needs
- Behavior plans and data, if the person has them
- A short list of the hardest days: what happens, how often, and what support it takes
Why providers should care about an assessment they don't administer
The QSI is APD's to conduct — but its consequences land on providers. The scores shape the budget, the budget becomes the cost plan, and the cost plan becomes the service authorizations you bill against. And when a person's needs genuinely increase, the path to a reassessment runs through documentation: service logs and progress notes that record new behaviors, declining skills, or rising medical needs are the evidence a WSC uses to justify redoing the QSI early. The form itself names provider records as sources: for many physical items, the “suggested sources of information” are the MAR and quarterly or annual nursing summaries, and injuries, ER visits and hospital admissions are counted over the past year — the same events your incident reports and quarterly summaries record. An agency whose notes are vague can watch a consumer stay under-budgeted for years.
The three-year cycle, and the exception
The QSI is required at waiver eligibility and at least every three years after, and the form calls for it to be reviewed for changes each year when the support plan is written. The exception matters more than the rule: a significant change in circumstances — a health event, new high-risk behavior, loss of a family caregiver, a move — justifies an earlier reassessment, requested through the person's waiver support coordinator. Families preparing for a QSI interview should answer for the person's hardest days, not their best ones; the algorithm can only fund the needs the assessment captures. For what happens after the budget is set, see the iBudget services menu — or, for households considering self-direction, how CDC+ works.
Frequently asked questions
What is the QSI?
The Questionnaire for Situational Information (Version 4.0) — APD's approved functional needs assessment. A trained APD assessor observes and interviews the person and the people who know them well, then rates each item from 0 (no help needed) to 4 (the most help). It covers life changes, functional, behavioral and physical status, and it informs both the support plan and the iBudget amount.
How often is the QSI done?
At eligibility determination for waiver services, then at least once every three years — and again when a major life change may have altered the person's support needs. The QSI form also calls for it to be reviewed for changes each year when the support plan is developed. Between assessments, the scores on file are the scores that count.
How does the QSI affect the iBudget amount?
The iBudget algorithm sets each person's budget from factors including age, living setting, and specific QSI item scores (the functional and behavioral items). A QSI that understates needs can produce a budget that won't cover them, which is why families are told to prepare for the interview honestly and thoroughly.
Can a QSI be redone if needs change?
Yes. A significant change in the person's situation — health decline, new behaviors, a change in living setting — is grounds to request a reassessment through the WSC rather than waiting out the three-year cycle. Provider documentation of the change is often what substantiates the request.
Who should be at the QSI interview?
The person, their family or guardian, and anyone else they want there. The support coordinator doesn't have to attend. The assessor may also talk to caregivers, nurses and providers, and reads the person's records.
Do providers fill out the QSI?
No — only certified assessors administer it. Providers come in through their records: the assessor reviews recent assessments, progress notes, the support plan, nursing summaries, the MAR and incident history, and may interview the caregivers who know the person day to day.