When people search for the self-directed iBudget program, the program they mean is Consumer-Directed Care Plus (CDC+) — APD's self-direction option inside the iBudget waiver. Instead of receiving services through enrolled provider agencies, an eligible person exchanges their approved cost plan for a monthly budget they direct themselves: hiring their own workers, setting schedules, and purchasing approved supports.
How self-direction actually works
The budget starts in iBudget
CDC+ is not a separate waiver. The person's allocation is determined through the iBudget system first — the same algorithm, QSI, and cost-plan process — and then exchanged for a monthly CDC+ budget they direct themselves.
A fiscal employer agent holds the money
The participant never receives the funds directly. Payments run through the fiscal/employer agent (APD acts in that role) at the participant's direction — payroll and tax withholding for hired workers, invoices for vendors and approved purchases.
The participant (or their representative) becomes the employer
They recruit, hire, train, schedule, and pay their own workers — including many relatives — instead of receiving those services through an enrolled agency. That employer role, with its paperwork, is the trade for the flexibility.
Program rules still apply
Spending must follow the CDC+ Coverage, Limitations and Reimbursement Handbook, purchases tie back to needs in the support plan, and the WSC (as CDC+ consultant) stays in the picture. Self-direction changes who delivers — not whether the plan governs.
iBudget vs. CDC+: the key difference
The one-line answer: in CDC+ the participant is the employer. Under the regular iBudget waiver, services come from Medicaid-enrolled providers who bill against authorizations. Under CDC+ the person (or their representative) hires, schedules, and pays their own workers from a monthly budget — and can hire people who aren't Medicaid providers at all. The budget amount itself still comes from iBudget.
| iBudget (agency model) | CDC+ (self-directed) | |
|---|---|---|
| Who employs the worker | An enrolled provider agency or solo provider | The participant (or representative) is the employer of record |
| Who can be hired | Medicaid-enrolled iBudget providers only | Workers and vendors outside the Medicaid provider network, including some relatives |
| How the money moves | Providers bill Medicaid against service authorizations in the cost plan | A monthly budget allowance, paid out by the fiscal/employer agent under a purchasing plan |
| Paying parents of minors, spouses, guardians | Not allowed | Allowed |
| Support coordinator | Waiver support coordinator (WSC) | A WSC who is also a trained CDC+ consultant |
| Governing rule and handbook | Rule 59G-13.070 — iBudget Handbook (May 2023) | Rule 59G-13.088 — CDC+ Handbook (October 2015) |
Agency model vs. self-direction: the honest trade
Self-direction buys flexibility and pays for it in administration. The participant's side takes on hiring, payroll paperwork, scheduling, and budget management that an agency otherwise absorbs. The agency model buys professional management — trained, credentialed staff, backup coverage when a worker no-shows, and quality oversight — at the cost of less family control over who walks in the door. Many households land in between: CDC+ for daily personal supports delivered by a relative, with specific services still purchased from agencies. For an agency owner, that middle ground is the reason to understand CDC+ rather than treat it as pure attrition.
Where to start
For families weighing the switch, the conversation starts with the person's waiver support coordinator, and APD's CDC+ pages carry the enrollment steps, the participant training, and the program handbook. For a refresher on the waiver mechanics underneath it all — the allocation, the cost plan, and the services menu — see iBudget waiver services, explained and the QSI assessment that feeds the budget algorithm.
Frequently asked questions
What is one key difference between the iBudget waiver and CDC+?
Who is the employer. Under the regular iBudget waiver, services come from Medicaid-enrolled provider agencies that bill Medicaid. Under CDC+, the participant (or their representative) becomes the employer — hiring their own workers, including people outside the Medicaid provider network, and paying them from a monthly budget through a fiscal/employer agent.
What is the self-directed option under Florida's iBudget waiver?
Consumer-Directed Care Plus (CDC+). An eligible iBudget enrollee exchanges their approved cost plan for a monthly budget they control, held by a fiscal employer agent, and uses it to hire their own workers and buy approved services and supports instead of receiving them through enrolled agencies.
Can CDC+ participants pay family members as caregivers?
In many cases, yes — hiring and paying their own workers, including relatives, is the program's core appeal. The worker is employed by the participant (or representative) under CDC+ rules, not by a provider agency, and program rules govern which relatives may be paid for which supports.
Is CDC+ a different waiver from iBudget?
Not in practice. APD describes CDC+ as an offering within the iBudget waiver, and a person must be an iBudget recipient before enrolling. (Technically it runs under a separate federal authority — a 1915(j) State Plan option, while iBudget is a 1915(c) waiver.) Eligibility and the budget amount come through iBudget; CDC+ changes how the budget is spent.
Who can choose CDC+?
Per the CDC+ Handbook, the person must already be an iBudget waiver recipient, live in their own home or the family home, not have been disenrolled from CDC+ before for mismanaging funds, and pass the program's readiness review. The WSC starts the conversation.
What does CDC+ mean for provider agencies?
Two things: some consumers will leave agency services for self-direction, and some CDC+ participants still purchase specific services from agencies as vendors. Agencies that understand the program can serve both models instead of losing the household entirely.