Below is brief description of the services offered to individuals enrolled in Medicaid Home and Community-Based Services DD Waivers, including the CDC+ Program. Please refer to the Medicaid Handbook for a more detailed description of these services.
Note: Services with an (*) in front of the service title are services reviewed by the Delmarva Foundation as part of the Provider Discovery Review process.
To access the Medicaid Handbook go to:
- Under Provider Services Section heading, select Support
- Under Support Section heading, select Handbook
- Select Developmental Disabilities Individual Budgeting Waiver Services effective 9/3/2015
*Life Skills Development Level 1- (Companion) (September 2015 page 2-14)
Services provided to adults age 21 and older that include supervision and socialization activities. The service provides access to community-based activities that cannot be provided by natural or other unpaid supports, and should be defined as activities most likely to result in increased ability to access community resources without paid support. These services are typically provided in a community setting.
*Life Skills Development Level 2- (Supported Employment – SE) (September 2015 page 2-15)
Training and assistance to support the individual receiving services in sustaining paid employment at or above minimum wage unless the individual receiving services is operating a small business. Activities could include training to assist the person to learn, retain or improve specific job skills, and to successfully adapt and adjust to a particular work environment.
*Life Skills Development Level 3 - (Adult Day Training – ADT) (September 2015 page 2-21)
Day-time supervision and individual training programs for adults age 22 or older offered during hours of the “work week”. The training, activities, and routine established by the ADT shall be meaningful to the individual receiving services and provide an appropriate level of variation and interest. These training programs occur at a facility or in a work-like setting.
Consumable Medical Supplies (September 2015 page 2-25)
Consumable Medical Supplies (CMS) are non-durable supplies and items to enable individuals receiving services to increase their ability to perform activities of daily living. CMS could include items such as diapers, gloves, feeding tubes, food supplements and hearing aids. These supplies should not duplicate supplies provided by the Medicaid State Plan.
Durable Medical Equipment and Supplies (September 2015 page 2-29)
Durable Medical Equipment (DME) includes specified, prescriptive equipment required by the individual receiving services that can withstand repeated use, primarily serves a medical purpose, is appropriate for use in the home, and is prescribed for an individual who has a disability. The equipment could include van adaptations, lifts, wheelchairs, strollers, and adaptive eating devices, and picture communication boards.
Environmental Accessibility Adaptations (September 2015 page 2-36)
Physical adaptations to the home which are medically necessary to enable the individual receiving services to function with greater independence in the home. These adaptations could include installation of ramps and grab-bars, widening of doorways, modification of bathroom facilities or installation of specialized electric and plumbing systems required to accommodate the medical equipment and supplies.
Personal Emergency Response Systems (September 2015 page 2-39)
An electronic communication system that enables an individual receiving services to secure help in the event of an emergency.
*Personal Supports (September 2015 page 2-40)
Personal Supports services provide assistance and training to an adult (21 or older) individual receiving services in activities of daily living, including the areas of eating, bathing, dressing, personal hygiene, and preparation of meals. This service can also provide respite services to an individual receiving services age 21 and older living in their family home.
*Respite Care (September 2015 page 2-43)
Respite care is a service that provides supportive care and supervision to individual receiving services under the age of 21 when the primary caregiver is unable to perform the duties of a caregiver. This service is generally used due to a brief planned or emergency absence, or when the primary caregiver is available, but temporarily physically unable to care for or supervise the individual receiving services for a brief period of time.
*Residential Habilitation Standard (September 2015 page 2-47)
Residential Habilitation service provide supervision and specific training activities to assist the individual receiving services to acquire, maintain, or improve skills related to activities of daily living.
*Residential Habilitation Behavior Focus (September 2015 page 2-50)
Residential Habilitation services with a behavior focus are appropriate for individuals receiving services exhibiting at least specified behavioral issues within the past six months.
*Residential Habilitation Intensive Behavior (September 2015 page 2-54)
Intensive behavior (IB) Residential Habilitation is for individuals receiving services who present issues with behavior that are exceptional in intensity, duration, and frequency, that meet additional conditions and whose needs cannot be met in a behavior focus or standard Residential Habilitation setting.
*Special Medical Home Care (September 2015 page 2-60)
Special Medical Home Care Services are provided in APD licensed foster or group homes for individual receiving services with complex medical conditions, requiring an intensive level of nursing care.
*Supported Living Coaching - SLC (September 2015 page 2-61)
Supported Living Coaching services provide training and assistance, in a variety of activities, to individuals receiving services who live in their own homes or apartments. Services can include assistance with locating appropriate housing; the acquisition, retention, or improvement of skills related to activities of daily living, such as personal hygiene and grooming; household chores; meal preparation; shopping; personal finances; and the social and adaptive skills necessary to enable ability to reside on their own.
*Support Coordination - Full (September 2015 page 2-69)
Full Support Coordination provides significant support to an individual receiving services to ensure health, safety, and well-being. The WSC can share tasks with the other support persons as the individual receiving services desire, but ultimately the WSC shall be responsible for performing all tasks required to locate, select, and coordinate services and supports, whether paid with waiver funds or through other resources.
*Support Coordination – Limited (September 2015 page 2-70)
Limited Support Coordination services are services intended to be less intense than Full Support Coordination. In the event an individual receiving services experiences emergencies requiring a more intensive level of support coordination, a change would need to be requested.
*Support Coordination - Enhanced (September 2015 page 2-71)
Enhanced Support Coordination services consist of activities to assist the individual receiving services in transitioning from a nursing facility or intermediate care facilities for the developmentally disabled (ICF/DD) to the community or for assisting individuals receiving services who have a circumstance which necessitates a more intensive level of support coordination.
*Behavior Analysis Services - (September 2015 page 2-91)
Behavior Analysis Services are provided to assist individuals receiving services to learn new or increase existing functionally equivalent replacement skills for identified challenging behaviors or to learn other behaviors that are directly related to existing challenging behaviors.
*Behavior Assistant Services (September 2015 page 2-94)
Provides support in implementing the behavior analysis services plan created by the waiver behavior analyst service provider. Unlike other services, the behavior assistant provider’s focus is more on working with the caregivers to provide them with the skills to execute the procedures as detailed in the behavior analysis services plan, rather than the provision of intervention directly with the individual receiving services. Behavior Assistant Services are to be time limited.
Dietitian Services (September 2015 page 2-96)
Dietitian Services are those services prescribed by a physician, ARNP, or physician assistant that are necessary to maintain or improve the overall physical health. The services include annually assessing the nutritional status and needs; recommending an appropriate dietary regimen, nutritional support and nutrient intake; and providing counseling and education to the individual receiving services, family, direct service staff, and food service staff.
Occupational Therapy - OT (September 2015 page 2-100)
Occupational therapy is a one on one service prescribed by a physician, ARNP or physician assistant that is necessary to produce specific functional outcomes in self-help, adaptive, and sensory motor skill areas, and assist with control and maneuver within the environment.
Physical Therapy - PT (September 2015 page 2-101)
Physical Therapy is a one on one service prescribed by a physician, ARNP or physician assistant that is necessary to produce specific functional outcomes in ambulation, muscle control, and postural development and to prevent or reduce further physical disability.
Private Duty Nursing (September 2015 page 2-97)
Continuous nursing care prescribed by a physician and rendered by licensed practical or registered nurses in the family home or the individual receiving services own home. Private Duty Nursing services are prescribed by a physician, ARNP, or physician assistant and consist of individual, continuous nursing care provided by registered or licensed practical nurses. This service is limited to recipients age 21 years or older who are eligible for active nursing interventions on a continuous basis for over two consecutive hours per episode. This service is normally provided on a one-to-one basis.
Residential Nursing Services (September 2015 page 2-98)
Residential Nursing services are services prescribed by a physician, ARNP, or physician assistant and consist of continuous nursing care provided by registered or licensed practical nurses. This service is provided in a licensed setting.
Respiratory Therapy (September 2015 page 2-102)
Respiratory therapy is a one on one service prescribed by a physician, ARNP, or physician assistant and relates to impairment of respiratory function and other deficiencies of the cardiopulmonary system.
Skilled Nursing (September 2015 page 2-99)
Skilled Nursing is a service prescribed by a physician, ARNP, or physician assistant and consists of part-time or intermittent nursing care visits provided by registered or licensed practical nurses provided on a daily basis.
Specialized Mental Health Counseling (September 2015 page 2-103)
Specialized mental health services for persons with developmental disabilities are services provided to maximize the reduction of mental illness and restoration to the best possible functional level.
Speech Therapy (September 2015 page 2-102)
Speech therapy is a one on one service prescribed by a physician, ARNP, or physician assistant and is necessary to produce specific functional outcomes in the communication skills of a individuals receiving services with a speech, hearing, or language disability, or service necessary to remediate swallowing disorders and oral motor functions.
Transportation (September 2015 page 2-104)
Transportation services are the provision of rides to and from the home of the individual receiving services and community-based waiver services, when such services cannot be accessed through natural (i.e., unpaid) supports.
Adult Dental Services (September 2015 page 2-106)
Coverage for dental treatments and procedures not otherwise covered by Medicaid State Plan services for adults 21 and older. These could include services such as diagnostic, preventive and restorative treatment, extractions, endodontic, and periodontal and surgical procedures.