Delaware currently has two programs that are open to children. One is an HCBS 1915(c) Medicaid waiver, and one is a TEFRA or TEFRA-like program. Delaware also provides community-based services through an 1115 waiver program, DSHP-Plus. While most of these services are for adults, the program recently added pediatric respite and self-directed personal care services for children, including those provided by parents and guardians. The program also provides access to Medicaid for children at a slightly lower level of care than those eligible for TEFRA.

Delaware also offers some employment related and personal care home and community based services to those already enrolled in Medicaid, ages 14-25, through a 1915(i) program.

Delaware Advocacy Organizations:

Last updated 8/30/23

Programs in Delaware

  • Target Population: Children who would otherwise require care in an institution with any type of disability, including medical, developmental, intellectual, or psychiatric conditions. This program is restricted to those with a more severe level of need.
  • Ages: 0-18
  • Levels of Care: Intermediate Care Facility, Nursing Facility, Hospital
  • Income Waiver: Yes, the program is based on the child’s income only. Parent income is not counted.
  • Waiver Type: TEFRA-like
  • Spots: unlimited
  • Expiration Date: NA
  • Description: Provides Medicaid coverage only.
  • Online State Information: Children’s Community Alternative Disability Program
  • How to Apply: Contact your local Long Term Medicaid Program.
  • Waiting List: none

Also called Developmental Disabilities Home and Community Based Waiver

  • Target Population: Children and adults with developmental or intellectual disabilities, including autism.
  • Ages: 12+
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Yes, the waiver is based on the child’s income only, using TEFRA criteria. Parent income is not counted.
  • Waiver Type: 1915(c)
  • Spots: 3136
  • Expiration Date: 6/30/2024
  • Description from medicaid.gov: Provides day habilitation, personal care, prevocational services, residential habilitation, respite, supported employment – individual, supported employment – small group, assistive technology for individuals not otherwise covered by Medicaid, behavioral consultation, community transition, home or vehicle accessibility adaptations, nurse consultation, specialized medical equipment and supplies not otherwise covered by Medicaid, supported living for individuals with autism or ID, ages 12 – no max age.
  • Online State Information: DDS Home and Community Based Services
  • Official Federal Information
  • How to Apply: Contact DDS at 302-744-9700 or see the Applicant Services page.
  • Waiting List: none
  • Target Population: Primarily adults with disabilities, but some services for children with disabilities, including those who have a slightly lower level of need than the Children’s Community Alternative Disability Program.
  • Ages: all
  • Levels of Care: Intermediate Care Facility, Nursing Facility, Hospital, and children with a lower level of care
  • Income Waiver: Yes, the waiver is based on the child’s income only, using TEFRA criteria. Parent income is not counted.
  • Waiver Type: 1115
  • Spots: NA
  • Expiration Date: 12/31/2023
  • Description: While most services are for adults, this program does provide access to Medicaid similar to TEFRA for those who have a lower level of care than required by the Children’s Community Alternative Disability Program. This program also covers pediatric respite as a service and self-directed personal care services for children, including those provided by a parent or guardian, as of 6/2023. See pp. 26-9 of this document. Additional info is available here. Money Follows the Person has also been rolled into this program.
  • Online State Information: Delaware’s DSHP page
  • Official Federal Information
  • How to Apply: Apply for Medicaid either via the Children’s Community Alternative Disability Program or the traditional route.
  • Waiting List: none

Additional Information

  • Delaware’s Medicaid Demonstration Waiver allows parents, guardians, and other family members to be paid for providing personal care to children. Parents can work up to 40 hours per week, and another adult must be responsible for and sign paperwork. See pp. 27-29 of this document.