State IssuesPlanning & Executing
The Adequacy of Funding
Delaware’s Medicaid rates do not fully cover the costs of providing services and supports. Information about the shortfall in rates paid by the Division of Developmental Disabilities Services (DDDS) for HCBS-funded programs was updated in February 2016. It showed that the deficit had grown to $39 million, despite increases granted by the Joint Finance Committee in fiscal years 2015 and 2016. The original direct support professional rate study was published in January 2014, which you can read here. Behavioral health providers face similar problems with inadequate Medicaid rates for mental health and substance use disorder treatment and time-consuming pre-authorizations required by the state’s managed care organizations (United Healthcare and Highmark).
Delaware Statewide Transition Plan
The Division of Medicaid and Medical Assistance (DMMA) in the Delaware Department of Health and Social Services (DHSS) has submitted several versions of its statewide transition plan to The Center for Medicare and Medicaid Services (CMS), which include comments from stakeholders in Delaware’s Medicaid Long-Term Services and Supports (LTSS) system and DMMA’s response to them. Concerns expressed by A.N.D.’s membership have included how increased expectations for delivering services in the most integrated setting appropriate for each person will be funded, given the size of the deficit in the DSP rate paid to providers. Members also are concerned about the person-centered planning process during which people with disabilities and their guardians or families choose the services and supports they need.