A Safer Home is Within Reach: Using Delaware Medicaid's DSHP-Plus Program
Your guide to using Delaware Medicaid (DSHP-Plus) to fund wheelchair ramps, stair lifts, and accessible bathrooms in Kent and Sussex County. Learn how to apply.
A Safer Home is Within Reach: Using Delaware Medicaid’s DSHP-Plus Program to Fund Your Home Modifications
For residents of Delaware, particularly in Sussex and Kent counties, living independently at home is a cherished goal. But for seniors and individuals with disabilities, the physical environment of a home can pose challenges to safety and autonomy. Fortunately, Delaware provides a pathway to address these challenges through its Medicaid program. The Diamond State Health Plan Plus (DSHP-Plus) program offers significant support for home modifications, helping to create safer, more accessible living spaces.
This guide will provide a clear and comprehensive overview of how to leverage the DSHP-Plus program to pay for vital home modifications. We will explore who is eligible, what modifications are covered, the step-by-step application process, and the importance of selecting a qualified, Medicaid-approved contractor in Delaware.
Understanding the DSHP-Plus Program
The DSHP-Plus program is Delaware’s Medicaid managed care program designed to provide long-term services and supports (LTSS) to eligible individuals. Its primary objective is to empower people who might otherwise require institutional care to live safely and independently in their own homes and communities. A critical benefit offered under DSHP-Plus is funding for home modifications.
These are not cosmetic upgrades; they are essential changes to a person’s residence aimed at removing physical barriers and enhancing their ability to function independently. The program recognizes that a safe home environment is a cornerstone of community-based care.
Key Insight: If you are a Delaware resident on Medicaid and require assistance with daily activities, the DSHP-Plus program is your most direct route to securing funding for necessary home accessibility improvements.
Covered Home Modifications Under DSHP-Plus
While specific approvals are based on an individual’s assessed needs, DSHP-Plus can cover a wide array of modifications. The focus is always on what is reasonable and necessary to ensure the individual’s health and safety. Common examples include:
| Category | Common Modifications Covered |
|---|---|
| Home Entry & Egress | Installation of Wheelchair Ramps, Stair Lifts, and Handrails |
| Bathroom Accessibility | Conversion to a Roll-in or Barrier-Free Shower, Installation of Grab Bars and Walk-in Tubs |
| General Home Safety | Widening of Doorways for Wheelchair Access, Installation of Accessible Sinks or Counters |
It is important to note that all modifications must be included in the member’s person-centered service plan and be directly related to their functional needs. For example, a wheelchair ramp would be approved for an individual who uses a wheelchair for mobility.
Your Step-by-Step Guide to Accessing DSHP-Plus Home Modification Benefits
The process for obtaining home modifications through DSHP-Plus involves several key steps, from establishing eligibility to final project completion. Working with a contractor who is familiar with this process, like Accessibility Solutions LLC, can make it significantly smoother.
Step 1: Confirm Your Eligibility
To qualify for DSHP-Plus, you must be a Delaware resident and meet the specific financial and functional eligibility criteria for Delaware Medicaid’s long-term care services.
- Financial Eligibility: You must meet the income and asset limitations set by the Delaware Division of Medicaid and Medical Assistance (DMMA).
- Functional Eligibility: A functional assessment must determine that you require a level of care typically provided in a nursing facility.
Step 2: Enroll in a Managed Care Organization (MCO)
Delaware administers its DSHP-Plus benefits through two contracted MCOs. Once deemed eligible, you will enroll with one of these organizations:
- Highmark Health Options
- Delaware First Health
After enrolling, a Care Coordinator from your chosen MCO will be assigned to you. This person will be your primary point of contact and guide through the process.
Step 3: Develop Your Person-Centered Service Plan
Your Care Coordinator will work with you, your family, and your healthcare providers to create a service plan tailored to your unique needs. This will typically involve a home visit from an occupational or physical therapist who will assess your home for safety risks and accessibility barriers. Their recommendations will form the basis for the home modifications requested in your plan.
Step 4: Select a Qualified, Enrolled Provider
This is a crucial step. To use your DSHP-Plus benefits, you must use a home modification contractor who is enrolled as a provider with both Delaware Medicaid and your specific MCO (Highmark or Delaware First Health). Using a non-enrolled provider will result in your claim being denied.
When searching for a contractor in Sussex or Kent County, you should always verify:
- Their enrollment status with the Delaware Medicaid program.
- Their credentialing status with your MCO.
- Their experience with projects funded through DSHP-Plus.
Step 5: The Approval and Construction Process
Your chosen contractor will submit a detailed bid and scope of work to your MCO for approval. Your Care Coordinator will review the proposal to ensure it aligns with your assessed needs and service plan. Once the MCO provides authorization, the contractor can schedule and complete the work. The MCO pays the contractor directly, meaning there are no out-of-pocket costs for you for the approved services.
The Advantage of an Experienced Delaware Medicaid Contractor
Partnering with a contractor who has a deep understanding of the DSHP-Plus program is invaluable.
- Navigational Expertise: They know the specific documentation, submission, and approval workflows for both Highmark Health Options and Delaware First Health.
- Efficient Process: Their familiarity with the system helps prevent common errors that can lead to delays or denials.
- Trusted Partner: As an enrolled provider, they have a direct line of communication with the MCOs, ensuring a coordinated effort.
Accessibility Solutions LLC is a proud and experienced provider for the Delaware Medicaid DSHP-Plus program. We are committed to helping our neighbors in Kent and Sussex counties build the safe and accessible homes they deserve.
Frequently Asked Questions (FAQs)
Q: What is the Delaware Lifespan Waiver, and how is it different from DSHP-Plus?
A: The Delaware Lifespan Waiver is another program that can fund home modifications, but it is specifically for individuals with intellectual and developmental disabilities and is administered by the Division of Developmental Disabilities Services (DDDS). DSHP-Plus is for Medicaid-eligible adults who meet a nursing facility level of care.
Q: Is there a dollar limit to the modifications I can receive?
A: While there isn’t a single, fixed lifetime limit like in some other states, all modifications must be deemed reasonable and necessary. The scope and cost of the project are reviewed by the MCO based on your individual needs. The goal is to provide what is essential for your health and safety at home.
Take the Next Step
If you or a loved one are a Delaware resident and find that your home is no longer meeting your needs, the DSHP-Plus program may be the key to a safer future. Don’t let uncertainty about the process or cost prevent you from exploring your options.
Contact Accessibility Solutions LLC for a free consultation. Our team can help you understand the DSHP-Plus program, evaluate your needs, and start the journey toward a more independent and accessible life in your own home.
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