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Home and Community Based Services (HCBS)

HCBS Services


Lifespan Waiver

The Lifespan Waiver provides eligible Delawareans access to Medicaid-approved services through the 1915(c) Home and Community Based Services Waiver. Individuals on the waiver are supported to live more independently in their homes and communities through services that promote and support community living.

Current Waiver

Determine Eligibility

Services Offered (click on title to see definition of service)

This service is designed to assist with increasing and maintaining independence with adaptive skills, socialization, activities of community living or daily living. Activities should include community engagement.

This is a highly individualized service designed to help in specific goal attainment or personal interests in one's own community. This service can only be delivered in a ratio of 1 staff to 1 service recipient (1:1) and no more than 1 staff to 2 service recipients (1:2) to ensure personal goals and interests are actively pursued. This service must be delivered in the community. It is designed to pair with other services or part-time, not as a stand-alone service.

This service is intended for those that have an interest in competitive employment in the community that need to increase or develop general "soft" skills that contribute to sustained employability. This may include learning non-job-specific skills including volunteer work opportunities or internships.

This service is designed for those that want to work and/or are employed but need continued support or skills training in order to obtain employment or maintain their employment or increase their employment status, whether additional hours or higher level positions. This service can either be delivered as Individual Group Supported Employment (1 staff to 1 service recipient) or Small Group Supported Employment (1 staff to a range of service recipients that work together as a "crew").

This service can be self-directed, where the service-recipient and/or family identify who will provide the care or a PASA or Home Health Agency may be selected to provide the care, which can include activities of daily living such as bathing, household chores, shopping, etc., or transportation to community activities or appointments, etc.

This service is designed to give the primary caregiver(s) a break. This service can be self-directed, where the service recipient and/or family identify who will provide the care or Camp may be selected as an option; otherwise a PASA or Home Health Agency may be selected to provide this service.

This service can provide up to 40 hours per week of personal care to an individual in their own home or apartment, who has relatively minimal support needs but who still requires assistance to enable them to live as independently as possible in the community.

This service is designed to assist individuals in acquiring skills related to activities of daily living, such as personal grooming and hygiene, bed making and household chores, eating and food preparation, community inclusion and social and adaptive skills necessary to enable individuals to live in the community. This service can either be provided by an agency in a neighborhood group home or apartment or by a Shared Living Provider, a single primary caregiver in their private home.

This service is the overall coordination and monitoring of the health care needs of the service recipient. This may include assessments, oversight and monitoring of medication records, medical appointment records, etc.

This service provides an individually designed behavior plan and strategies to support service recipients that have significant behavioral issues. The plan is developed through a functional behavioral assessment and necessary training of the support team in order to properly implement the plan.

This service is available for service recipients that are either transitioning from an institutional setting to a community setting or from a provider-managed setting to their own private resident in the community. It covers an exhaustive list of one-time expenses and services in order to establish a domicile (home) in the community.

An item, piece of equipment, or product system that is used to increase, maintain, or improve functional capabilities for service recipients. Also included in this service is an evaluation of technology need, training, custom fitting, maintenance, repair, etc. This service can only cover assistive technology that is not otherwise covered by traditional State Plan Medicaid.

This service covers medical equipment and supplies which may include devices, controls, or appliances that enable the service recipient to increase their level of independence in the completion of activities of daily living that are not otherwise covered by State Plan Medicaid.

Include physical adaptations to the private residence of the service recipient or the service recipients family (the service recipient must live with them full time to be eligible) that are necessary to ensure the health, welfare and safety of the service recipient and/or increase their level of independence in their home. This may include grab bars, widening of doors, etc.

Include adaptations or alterations to the automobile that is the service recipients primary means of transportation. Alterations or adaptations that are of general utility or maintenance are excluded from both services.

Additional Resources

Pathways to Employment Information

HCBS Service Provider Information

HCBS Settings Rule published in Federal Register

CMS Guidance Materials

Delaware Statewide Transition Plan

Regional Community Services Contact


Previous versions of the Lifespan Waiver can be found below:

Approved 2019 to 2024 Waiver Renewal

Approved 2015-2019 Waiver Renewal