Delaware Medicaid Waiver

What Programs Are Available To Assist People With Disabilities in Delaware?

Is there a Medicaid waiver program? As of April 1, 2012, Delaware has one Home and Community Based Waiver: the DDDS Waiver. There are also two 1115 waivers.

The DDDS Waiver (1915(c) waiver)
Elderly and Disabled (E&D) Waiver (1115 waiver)
AIDS/HIV Related Diseases (AHW) (1115 waiver)

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What state department handles the Medicaid waiver program in Delaware? The Delaware Division of Developmental Disabilities Services assists persons with intellectual or developmental disabilities in Delaware. The Office of Applicant Services provides individuals and/or families with information about and assistance with applying for services from the Division of Developmental Disabilities Services. This unit provides individuals and/or families with service and application process information and also processes applications for Division services. Individuals who also wish to apply for the DDDS waiver are referred to another unit within DDDS that processes those applications and forwards them to the Medicaid agency.

What programs assist people who have developmental disabilities in Delaware? The Division of Services For Aging And Adults With Physical Disabilities assists persons with disabilities in Delaware.

What is the best number to call to get started? Call Applicant Services at : (302) 744-9700 or Toll Free - 1-866-552-5758

Is there a website? Delaware Website

Delaware also answers questions by email!
E-mail Delawareadrc@state.de.us, which is the Delaware Health and Social Services office.

Who Qualifies For Assistance?

What is considered a developmental disability in Delaware?

In order to qualify for DDDS services, the disability/disorder must be attributed to at least one of the following:

Mental Retardation; defined as a significant generalized limitation in intellectual functioning. Significant generalized limitation in intellectual functioning is defined as IQ scores approximately two standard deviations below the mean. (American Association on Intellectual and Developmental Disabilities; Classification Manual, 2002); and/or
Autistic Disorder (299.00; American Psychiatric Association; Diagnostic & Statistical Manual - IV, 1994); and/or
Asperger's Disorder (299.80; American Psychiatric Association; Diagnostic & Statistical Manual - IV, 1994); and/or
Prader-Willi Syndrome (documented medical diagnosis; World Health Organization; International Classification of Diseases - 9); and/or
Brain injury or neurological condition related to mental retardation that meets: a) a significant generalized impairment in intellectual functioning (defined in 1.3.1); b) significant limitations in adaptive behavior functioning (defined in 1.4); and c) originates before age 22 (defined in 1.5);

AND must have significant limitations in adaptive behavior functioning defined as performance that is at least two standard deviations below the mean of either:

Score on a standardized measure of conceptual, social, or practical skills; or
Overall score on a standardized measure of conceptual, social and practical skills And the disability must originate before age 22;

The same criteria is used as part of the eligibility process for the DDDS waiver. Applicants must also meet ICF/IID level of care, financial and other criteria.

Are there income limits to receive services? In addition to the Medicaid institutional criteria for ICF/IID for the DDDS waiver, those applying for community based long term care services must have incomes at or below 250 percent of the SSI standard benefit rate and must have less than $2,000 in resources.

How old do you have to be to start receiving services? The minimum age to be eligible for the Developmental Disabilities Waiver is 4.

Is There a Waiting List For Services in Delaware?

How long is the waiting list? There is no waiting list in Delaware for the DDDS HCBS Medicaid Waiver. Delaware is one of the few states that does not have a waiting list.

How many people are on the waiting list? Delaware does not currently have a waiting list for services.

What Services Are Offered & What Are The Service Limitations?

What services does the Medicaid waiver program in Delaware offer? The Delaware DDDS waiver provides case management, day habilitation, prevocational services, residential habilitation, supported employment, clinical consultation (behavioral and nursing). Services must be described in the Plan of Care and are limited only by medical necessity.

What services are available to people living in the family home? DDDS currently provides the following services to people living in the family home who are not recipients under the DDDS waiver: respite, home modifications or repairs, assistive technology/durable medical equipment, assistance with medical/dental bills, rental assistance, pest control service, etc..

Does Delaware offer community group homes? Yes, Delaware supports individuals with developmental disabilities who need residential habilitation in three settings: neighborhood group homes, staffed apartments and shared living arrangements (also referred to as Adult Foster Care).

Does Delaware offer supported living? DDDS provides drop in supports, also called supported living, to persons with DD who live independently but who may need occasional support.

Are there still state owned institutions? How many people are living in institutions? The Stockley Center in Georgetown, DE is certified as a Medicaid ICF/IID facility that provides institutional care for persons with various intellectual disabilities who require active treatment. The current licensed bed capacity is 70 but there are only 61 residents at present.

How Do You Select A Provider?

Do providers work for the state? DDDS services are mostly provided by contracted providers but there are a few services that are also provided by state employees.

About how many providers are there in the state? There are about 50 agencies that provide Medicaid waiver services in Delaware.

Do you have a choice in providers? Delaware has a robust provider network from which clients can choose. DDDS assists clients and families in selecting providers using various processes such as provider fairs.

How Do You Become A Provider?

Is There A Fee to become a provider? There is currently no fee to become a provider. Providers interested in becoming part of the DDDS Medicaid Provider network should visit the DDDS website. The contact information for providers who may have questions about enrollment is as follows: Director of Professional Services 302-744-9634

Selection of providers is based on choice, and the State of Delaware and its agents cannot guarantee that an authorized/enrolled provider will be selected. Therefore, the DDDS shall host “provider fairs” (at least twice annually) so that service recipients and their families can meet authorized providers in person. The DDDS also strongly encourages its authorized providers to market their businesses as much as possible to gain visibility in the community.

Additional Information

In April 2012, Delaware’s Elderly and Disabled Waiver and the AIDS/HIV waiver were terminated as 1915(c) waivers and the authority for operating these programs was subsumed under Delaware’s 1115 waiver. The operation of these programs was also transferred from the Delaware Division of Services for Aging and Adults with Physical Disabilities to the Medicaid Managed Care Organizations (MCO) in Delaware. All of the benefits formerly available under these two waivers are now part of the MCO benefit package and continue to be available to eligible Medicaid recipients. The DDDS HCBS Waiver continues to exist as a 1915(c) waiver and is currently the only 1915(c) waiver approved for the State of Delaware. This waiver continues to be operated by the Delaware Division of Developmental Disabilities Services.

* Delaware does not currently have a Family Support Waiver. The Family Support Waiver is a proposed waiver that was never actually implemented. Delaware has been asked to submit a plan for such a waiver to the legislature in the spring of 2015, so it's still a possibility.