Region Northwest | APD - Agency for People with Disabilities (2023)

APD Northwest Regional Office

4030 Esplanade Road
Suite 280
Tallahassee, FL 32399-2949
Phone: (850) 487-1992
Fax: (850) 488-3763

Office in Panama City
Direct phone number: (850) 747-5638

Region Northwest | APD - Agency for People with Disabilities (1)
Linda Doner
Area Manager Northwest

Employees of the Northwest Region

Box 1 Office, Pensacola- Escambia, Okaloosa, Santa Rosa and Walton counties

Field 2 Office, Tallahassee- Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Wakulla and Washington counties

Vendor registration information – for both new and existing vendors

Due to the COVID-19 outbreak, most APD regional employees are working remotely. To avoid delays in processing vendor applications, please email applications
Applications for Waiver Support Coordinators will be given priority.

provider applicationsare for new providers andVendor Extension Request Formsare for existing providers looking to expand geographically, add additional services, or expand from solo to agency status.

EFFECTIVE IMMEDIATELY:Pursuant to the iBudget Waiver Program authorized under 1915(c) of the Social Security Act,and due to critical requirements for some specific vendor types, APD will no longer offer two open registration periods per year for vendors applying for services provided under the iBudget Waiver. From now on, regional offices will accept applications from providers at any time.

While APD accepts vendor applications at all times, please remember that certain vendor types in each APD region meet certain critical requirements. Each region identifies critical service requirements as defined below.

The critical service needs of the Northwest region for all districts are as follows:

  1. Waiver Support Coordination
  2. Behavior-oriented living habilitation (APD-licensed living group*)
  3. Intensive Behavior Residential Habilitation (APD-licensed residential group*)
  4. dentists
  5. Adjustments to environmental accessibility
  6. Standard residence habilitation (APD-licensed residential group*)
  7. Behavior analysis (all levels)
  8. Personal care
  9. Supported residential coaching

*Group living licensing is a separate process, please contact ( for more details.

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Provider applicants who do not currently have and are required to submit an “APD General” line item eligibility determination in the AHCA Background Screening ClearinghouseRequest for the Background Screening Clearinghouseto the Northwest region; Please email the completed formRequest for the Background Screening Clearinghouseshape

Official transcripts for WSC applicants must be sent to the following address:
Latoya Kelso
Agency for people with disabilities
3309 Frankford Avenue, Suite C
Panama City, FL 32405

Incident Reporting Form Instructions

Northwest Region Critical Incident Report and After Hours Emergency Number: Primary 850-519-2401 or Secondary 850-445-6539 Critical incidents must be reported to the APD Regional/Field Office within one hour of the incident becoming known. Initial reporting can be done by telephone, but an incident reporting form must be completed and submitted to the Regional Office no later than one business day after the initial report. Incident reports, follow-up reports and death reports should be emailed

CMS self-assessment

CMS Self-Assessment is currently only implemented with APD-licensed group and nursing homes and adult day training (ADT) programs. The CMS self-assessment tool can be found at:

If you are a group/nursing home or ADT provider who has completed the CMS self-assessment, you must follow the steps below:

  1. Upon completion of the CMS self-assessment, the group/nursing home or ADT must retain it until APD staff visit the facility and request it for validation;
  2. If the CMS self-assessment has identified standards as “believed to be institutional”, the provider must aCopyof the CMS self-assessment to AHCA and retain the original for APD review.

For more information, see the CMS FAQ at: based-Setting-Requirements.pdf

If you have any questions please contact Eunice Leckey

You can also send your questions to AHCA at:

Standard email addresses for APD regional offices

As you know, APD has various workflow processes such as submitting expense plans, support plans, significant additional requirements, etc. Therefore, APD has created the following standard email addresses that you can use to send these types of information to to send APD . Please use these email addresses to send encrypted confidential information to APD.

Also, remember that you can still contact regional staff by phone if you have any questions, concerns, or issues that require immediate attention.

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  • For LRC
  • As required by region and/or LRC officer
  • Reactive Strategies

  • WSC Caseload Submissions

  • shopping plans
  • Participant information update form
  • Direct Hire Employee [Name Change/Address Change]

  • Includes complaints from or against APD Providers, Waiver Support Coordinators, or APD employees

  • Documentation for crisis enrollment on the waiting list
  • Not for use in SFR transmissions

  • Application documents for admission and eligibility for APD waiting list eligibility

  • competency assessments
  • court orders

  • Regional Hearing Requests

  • First report and follow-up reports
  • Todes message

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  • Medication Error Reports
  • corrective action plan

  • Registration (Checklist for Solo or Agency Providers; Provider Application; Provider Reference Form; Background Check Results – including exceptions to a disqualifying misdemeanor; Employment History Check; Local Criminal Record Check; APD affidavit of good conduct; Proof of completion of required Training; Copy of AHCA Medicaid Provider Welcome Letter; Applicant signs Medicaid Services Waiver; Regional iBudget Registration Application - Regional iBudget Provider Registration Application - non-WSC )
  • Provider demographic updates (change of address, phone and email changes)
  • Application forms for provider expansion (service offering and/or expansion within a region or additional regions)

  • [ Not for recovery plan ]
  • Request for technical support related to fixes and/or QIO reviews

  • For admission, expansion and change of treating care coordinators and care coordination qualified organizations (agencies)

  • Required documentation for the QSI assessment

  • Placement Referral Packages [APD Licensed Households]
  • Placement Recommendation Packages [ ICF ]

  • ICF moves to an APD licensed home
  • Licensed Home - Census
  • Payment requirements for room and board
  • corrective action plan

  • Significant additional needs - increase in funds

(Make sure to include all supporting documentation)

  • case loads
  • Employment Information

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  • case loads
  • Disaster/Emergency Plan
  • Grant/start-up request

  • Annual or updated support plan
  • (attach any supporting documentation for the requested services)

  • Ballot for waiver support coordination

APD will no longer be able to access DSM secure emails after June 30, 2014.Effective July 1, 2014, APD will implement the following email mailboxes for use by Waiver Support Coordinators, vendors and others when sending customer-related information to APD. This group of mailboxes replaces secure mailboxes previously used to provide APD employees with information on a wide range of topics intended for APD employees to evaluate, review and take action.

APD's IT office identifiedacceptable encryption methods, as follows:

Microsoft Office applications (e.g. Word and Excel)
This is the preferred method. If you already have Word and Excel version 2007 or higher, this option is already available for free. As long as all sensitive APD consumer information is included in the encrypted document, it can be sent as an attachment to a regular, unencrypted email. If you do so, please remember not to include any information about APD consumers in the body or subject line of the email, with the exception of the iBudget PIN number, which is only known internally to APD employees and APD providers. Below are links to instructions on how to encrypt with Word and Excel.

Word 2013 Encryption Instructions:

Encryption instructions for Excel 2013:

Encrypted web email
Similar to the web-based email system DSM, there are other free (e.g. SendInc) or paid (e.g. ZixMail) options to send secure, encrypted emails to APD. This method encrypts the entire email, including all file attachments, but some still display the subject line, so please remember not to include information about APD consumers in the subject line. While this is an acceptable method of sending confidential consumer information to APD, it requires APD employees to create and maintain separate accounts (usernames and passwords) for each different system.

ZIP applications
There are several free and paid "ZIP" type applications (e.g. WinZip) that can compress one or more files into a ZIP file, some but not all of which can also encrypt the file(s). These ZIP applications, which can also encrypt, encrypt all types of files that you zip. You can then send the encrypted ZIP file containing the APD confidential consumer information to APD in a standard, unencrypted email. If you do so, please remember not to include any information about APD consumers in the body or subject line of the email, with the exception of the iBudget PIN number, which is only known internally to APD employees and APD providers.

NOTE: Some encryption methods use a specific type (algorithm) by default. If you have options, the best encryption type is to choose fromAES 128-bit or higher. If AES is not available, the next best type is 3DES (aka Triple DES). It is recommended to youdo notChoose regular DES as it has proven to be a weak encryption method.

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Instructions for setting encryption passwords
Whenever you encrypt a file, you must set a password that is required to open the document. To simplify this process for you and the APD staff,Please use your Medicaid provider number as the password to encrypt. If you do not have a Medicaid provider number, please contact your local office to let them know what password you will be using.


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