Florida Adult Care Food Program (ACFP) Monthly Certification of Title XIX Eligibility For Profit Pro

Form Template

Each private for-profit Adult Day Care Center (and other adult long-term care facilities) must receive compensation from amounts granted to the state under Title XIX of the Social Security Act, for at least 25 percent of its enrolled adults, or the license capacity for each facility.

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Users can certify on the Florida Adult Care Food Program (ACFP) Monthly Certification of Title XIX Eligibility For Profit Providers app that the Monthly Reimbursement Voucher does not include any meals or food assistance in any for-profit center for which the center received such compensation for less than 25 percent of its enrolled adults or license capacity during this reporting month. Center(s) approved for split shifts must have 25 percent of enrolled adults eligible for Title XIX benefits.

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