Resources for Families, Providers, and Others Involved in the Care
of Children with Medical Complexity

The purpose of Delaware’s Children with Medical Complexity Advisory Committee (CMCAC) is to strengthen the system of care, increase collaboration across agencies, encourage community involvement, and ultimately ensure that every child with medical complexity has the opportunity to receive the adequate and appropriate health care services they need and deserve.  One of the priorities identified by this group is to develop new and strengthen existing resources for parents/caregivers, providers, and the larger community involved in the care of children with medical complexity. As a result, this page has been developed as a repository of these resources.  This page will continue to evolve as the work of the CMCAC and its workgroups continue.

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Delaware CMCAC Private Duty Nursing (PDN) Toolkit

One of the goals of the Children with Medical Complexity Advisory Committee was to review and make transparent the prior authorization process for Private Duty Nursing (PDN).    As a result, the workgroup developed a toolkit for navigating the PDN prior authorization.

• DE CMC PDN Emergent Care Decision Tree
• DE CMC Highmark Health Options Process for Urgent PA PDN Requests
• DE CMC Highmark Health Options PDN Letter of Medical Necessity Checklist
• DE CMC Highmark Health Options PDN Letter of Medical Necessity
• DE CMC AmeriHealth Caritas Delaware Policy for Urgent PA PDN Requests
• DE CMC AmeriHealth Caritas Letter of Medical Necessity Template
• DE CLASI Temporary Custodian Healthcare Authorization
• AmeriHealth Caritas PDN Welcome Letter
• Amerihealth Caritas PDN What to Expect Letter
• Highmark Health Options PDN Welcome Letter
• Highmark Health Options PDN What to Expect Letter
• Delaware First Health PDN Welcome Letter
• Delaware First Health PDN What to Expect Letter
• Delaware First Health PDN Letter of Medical Necessity
• Delaware First Health PDN Emergent Care Process

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Delaware CMCAC Durable Medical
Equipment (DME), Supplies, and Pharmacy Resources

• What to Expect DME and Supplies Brochure
• Updated Joint Care Coordinator Training on DME and Supplies
• Joint MCO DME and Supplies Training for Care Coordinators
• CMC DME and Supplies Information Sheet
• CMC Pharmacy Products and Services Information Sheet

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Family-Centered Training Materials

One of the goals of the Children with Medical Complexity Advisory Committee was to develop competency/family-centered training for the community involved in the care of children with medical complexity. This area is continuously evolving, but some materials are provided below.

• Parenting a Child with Special Needs Roundtable Recorded Webinar
• From the Foundation: Current Issues Facing CSHCN and Their Families

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Self-Directed Attendant Care (SDAC) for
Children and Pediatric Medicaid Respite

Effective January 1, 2023, the Delaware Health and Social Services (DHSS), through the Medicaid program, began providing coverage of a self-directed option for parents on behalf of children receiving personal care services.

Self-direction allows a parent/guardian or other representative designated by the parent/guardian to direct this service on behalf of their child.  Effective January 1, 2023, DHSS also began providing coverage of Pediatric Respite Services targeted to children with special needs.  DHSS conducted virtual information sessions in 2023 to share information about these new services with families and providers.  DMMA also conducted a Town Hall in March 2024 to share information and answer questions related to these new services.  Materials from the information sessions these events can be found below.

• New Medicaid Pediatric Respite Services Presentation: Family Session - May 2023
• Family Stakeholder Session - Q&A
• Provider Stakeholder Session - Q&A
• DMMA SDAC Respite Town Hall Presentation March 2024

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