One-Time Home and Community-Based Services
Delaware’s Medicaid program is claiming Delaware’s enhanced federal match ($52+ million) and is listening to the community for the best ways to use that funding to support home and community-based services (HCBS). States must develop and submit a detailed spending plan to the Centers for Medicare and Medicaid Services (CMS) that uses the dollars to enhance, expand or strengthen HCBS, and do it in a way that is sustainable after the enhanced funding ends. The funding cannot be used for housing or housing supports, or any other building projects. So far, Delaware has allotted more than $13 million.
Delaware's Spending Plan
Recruitment/Retention Bonuses ($4.6 million): In support of Delawareans with intellectual and developmental disabilities living in the community, $1,000 retention or recruitment bonuses are being paid to more than 4,000 Direct Support Professionals (DSPs).
- Rate Study for DSPs ($400,000): The current reimbursement rate for personal care attendants, home health aides, and other direct support professionals, who provide services in the Diamond State Health Plan (DSHP) and DSHP Plus programs, will be assessed for adequacy.
- Critical Incident Management System Upgrade ($140,000): In order to integrate incident management for vulnerable Delawareans across DHSS’ divisions, this first phase will begin with a review and update of existing policies and procedures across Medicaid’s partner agencies. The goal: an integrated Incident Management System that can spot patterns, isolate similar incidents early and inform prevention measures.(Please note this dollar amount does not include costs related to the procurement of an IT system to facilitate an integrated management system.)
Under Review (estimates in development)
- Respite for Caregivers of Children with Complex Medical Conditions and Behavioral Health Needs: This service would provide respite for caregivers of children with complex medical conditions, severe emotional disorders and dual diagnoses of mental health and intellectual or developmental disabilities.
- Children and Adults with Complex Medical Needs: Because the support of individuals can include services from many of DHSS’ divisions, this activity would support the development of an interdepartmental team to review, analyze and determine the course of possible action for complex cases.
- Long-Term Services and Supports (LTSS) Strategic Planning Study: In order to better understand the needs of Delawareans who want to receive their long-term services and supports in the setting of their choice, Delaware’s Medicaid program would conduct a study to assess how LTSS are delivered currently and develop recommendations for short-term and long-term changes.
- Retention/Recruitment Bonuses for Personal Care Attendants ($7.4 million): In support of Delawareans with significant physical disabilities living in the community, $1,000 retention or recruitment bonuses would be paid to more than 6,450 personal care attendants, home health aides and other direct support professionals within Diamond State Health Plan (DSHP), DSHP Plus and Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) programs.
- Aging and Disability Resource Center Upgrade ($250,000): Enhancements to Delaware’s Aging and Disability Resource Center (1-800-223-9074 or www.DelawareADRC.com) would create a No Wrong Door information technology infrastructure.
- Support for Centers for Independent Living ($400,000): For Delawareans who wish to return to the community following an institutional stay, operations would be strengthened and additional staff or contractual help hired at Delaware’s two Centers for Independent Living.
- Marketing/Outreach for No Wrong Door ($200,000): To help Delawareans learn about home and community-based services available to them or their loved ones, a one-time investment would be made in an education, marketing and outreach campaign.
To review Delaware’s plan: Initial spending plan
To submit additional feedback, comments or questions about activities proposed as part of the HCBS Spending Plan or to propose additional activities you would like to see supported: MedicaidInfo@delaware.gov
Virtual public forums with stakeholders targeted at behavioral health are scheduled for:
To read stakeholders’ comments, review spending plans from other states, and for updates on Delaware’s Home and Community-Based Services Federal Match Increase Spending Plan:
To read the U.S. Department of Health and Human Services’ announcement: