Delaware Medicaid Waivers & Home and Community Based Programs Overview

Delaware, known as The First State, has a well-coordinated Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the Delaware Division of Medicaid and Medical Assistance (DMMA) under the Delaware Health and Social Services (DHSS), the state’s Medicaid program operates through Diamond State Health Plan-Plus (DSHP-Plus), a managed long-term services and supports (MLTSS) program that consolidates waiver services under managed care.

Key waiver programs include the Elderly and Disabled (E&D) Waiver, which provides in-home support, skilled nursing, and respite care for individuals at risk of institutionalization, and the Lifespan Waiver, which serves individuals with intellectual and developmental disabilities (IDD) through habilitative and employment support services.

Delaware also offers Self-Directed Services, allowing waiver participants to have more control over their care planning and provider selection.

Regulatory oversight in Delaware is managed through DMMA and DHSS, with additional licensing and compliance requirements enforced by the Delaware Division of Health Care Quality (DHCQ). The Managed Care Organizations (MCOs) contracted under DSHP-Plus are responsible for service coordination, eligibility assessments, and provider oversight, ensuring that participants receive high-quality, cost-effective care in community settings. The state has also implemented Electronic Visit Verification (EVV) for personal care services, reinforcing accountability in Medicaid-funded home care programs.

Delaware emphasizes integrated care models, value-based purchasing, and person-centered planning to ensure that waiver participants receive comprehensive, high-quality services while maintaining independence and community engagement. Providers in Delaware must navigate stringent Medicaid provider enrollment, compliance reporting, and managed care coordination to successfully participate in the state's HCBS system.

---

Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

Browse Policy & Procedure Manual for This State's Programs and Services