DE DDDS Lifespan Waiver Explained

The Delaware Division of Developmental Disabilities (DDDS) Home and Community-Based 1915(c) Lifespan Waiver Amendment is a vital program in healthcare, particularly for family caregivers, in Delaware. This initiative offers Medicaid-approved services to eligible individuals, enabling them to live more independently within their homes and communities. This program serves as a lifeline for the underpaid and often overlooked workforce of family caregivers, recognizing and supporting their crucial role in the healthcare system. In this article, we will explore the significance of the Lifespan Waiver and shed light on the financial support it provides to family caregivers.

Overview of the Lifespan Waiver

The Lifespan Waiver, operating under the 1915(c) Home and Community-Based Services Waiver, is a crucial Medicaid program in Delaware that provides essential services to eligible individuals who require long-term care and support. The primary purpose of this waiver is to enable participants to remain in their homes and communities while receiving necessary care instead of being institutionalized in nursing homes or other facilities.

The program is designed to assist individuals with disabilities, chronic illnesses, age-related conditions, and those needing significant support for daily living activities. The Lifespan Waiver aims to enhance its participants' quality of life and independence by offering a range of Medicaid-approved services.

The waiver's goals and objectives involve promoting community living, individual choice, and self-direction. It seeks to empower care recipients by providing access to comprehensive supportive services tailored to their unique needs. By doing so, the Lifespan Waiver acknowledges family caregivers' value and dedication to assisting their loved ones, ultimately striving to foster a more inclusive and compassionate healthcare system.

Eligibility Requirements

To be eligible for the Lifespan Waiver under the 16 DE Admin. Code 2100, applicants must meet specific criteria to receive support and services from the Division of Developmental Disabilities Services (DDS). The following eligibility requirements must be met, except when explicitly stated otherwise:

1. Residency: The applicant must be a resident of the State of Delaware and a U.S. citizen or a qualified alien as per DE Medicaid requirements. The five-year bar applies to Medicaid eligibility but does not apply to non-Medicaid DS services.
2. Age: The applicant must be at least three years old and have documented evidence that their disability originated before age 22. In some cases, DDDS may consider a comprehensive assessment and diagnosis of a qualifying condition completed after age 22 if attempts to obtain evaluations from the developmental period were unsuccessful.
3. Clinical Requirements: The applicant must have a disabling condition that meets at least one of the following criteria:
   > Intellectual Disability (ID): Characterized by significantly below-average general intellectual functioning, with an IQ score of approximately 70 or below on a standardized assessment.
   > Autism Spectrum Disorder (ASD): Determined through a comprehensive evaluation based on the current version of the American Psychiatric Association's DSM.
   > Prader-Willi Syndrome: Diagnosed by a licensed practitioner.
   > Additionally, the applicant must exhibit significant limitations in adaptive behavior functioning, as indicated by a score of approximately 70 or below on a standardized adaptive behavior functioning assessment or consistent scores below 70 across different raters.‍
4. Assessment Requirements: Assessments must be conducted by a licensed practitioner or school psychologist using the most recent editions of standardized assessments accepted by the Division. For ASD assessments, a detailed developmental history indicating behavioral characteristics of ASD during the developmental period is necessary.‍
5. Exception for Applicants Aged Three Through Eight: Provisional eligibility may be granted if the clinical requirements cannot be fully met for applicants aged three through eight. Provisional eligibility can be supported by clinical documentation indicating the possibility of a qualifying condition or a minimum of two developmental delays in various domains.‍
6. Eligibility Determined Without All Documentation: DDDS may determine eligibility without some required documentation in extraordinary or challenging circumstances. However, DDDS reserves the right to redetermine eligibility if the necessary documentation becomes available later.‍
7. Review of Updated Assessments and Redetermination of Eligibility: DS retains the right to review updated assessments and redetermine eligibility until the individual reaches the age of 22, including requiring additional testing before that age.

Services and Support

Under the Lifespan Waiver, a comprehensive range of services and supports are provided to eligible individuals, enabling them to live more independently in their homes and communities. These services are supposed to meet the unique needs of individuals with disabilities, chronic illnesses, or age-related conditions. The waiver offers the following services and supports:

1. Day Services: Engaging in activities and programs that promote community participation and skill development.
2. Community Participation: Activities and support to enable participation in community life and social integration.
3. Prevocational Services: Training to develop employment-related skills and abilities.
4. Supported Employment: Assistance finding and maintaining competitive employment in integrated community settings.
5. Personal Care: Assistance with activities of daily living, such as bathing, dressing, and eating.
6. Respite: Temporary relief for family caregivers by providing short-term personal care for the individual.
7. Supported Living: Services to foster independent living within the person's home or family home.
8. Residential Habilitation: Supportive services for individuals living in a community-based residential setting.
9. Nurse Consultation: Professional nursing consultation and guidance for healthcare needs.
10. Behavioral Consultation: Expert advice and support for managing behavioral challenges.
11. Community Transition: Assistance in transitioning from institutional settings to community-based living.
12. Assistive Technology: Devices and equipment to enhance independence and quality of life.
13. Specialized Medical Equipment: Medical equipment tailored to the individual's specific needs.
14. Home Modifications: Adaptations to the home environment to improve accessibility and safety.
15. Vehicle Modifications: Adaptations to vehicles for individuals with mobility challenges.

The Lifespan Waiver goes beyond conventional healthcare services, focusing on home and community-based services (HCBS) and assistive technologies to empower participants to lead fulfilling lives. These specialized supports acknowledge the value of community living and provide participants with opportunities to engage in society while receiving necessary care and assistance actively.

Compensation for Family Caregivers

The Lifespan Waiver does offer compensation for unpaid family caregivers through a self-directed option. This means that eligible participants have the flexibility to choose their caregivers, and in many cases, they can select a family member to provide the needed care and support. Through the self-directed option, family caregivers can receive financial compensation for the services they provide to their loved ones. This approach recognizes family caregivers' valuable role in the well-being of the individuals they support. By compensating family caregivers, the Lifespan Waiver acknowledges their dedication and hard work and helps alleviate the financial burden often associated with caregiving responsibilities.

A Note from Givers

If you are a family caregiver in Delaware, take a moment to see if you qualify for compensation under this compassionate initiative. Fill out this form today to determine your eligibility and claim the rightful support you deserve.