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Home & Community-Based Services: State-Only Funded Programs in Delaware

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Community Living Respite¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Physically disabled adults (18-59years)

Annual Expenditure: N/A

Funding Source: General revenue

Number of People Served: N/A

Eligibility Criteria: Adult residents of Sussex County with physical disabilities age 18-59 living independently but requiring the assistance of a full-time caregiver.

Further Information: Other information Limited to Sussex County.

Program Name: Attendant Services¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Physically disabled adults (18+)

Annual Expenditure: Up to $680,000/yr

Funding Source: General revenue + federal funds

Number of People Served: N/A

Eligibility Criteria: Adults (18+) with specific social, financial & physical criteria.

Further Information: Other information This program was authorized by the state's Medicaid Community Attendant Supports and Services Act (MiCASSA)

Program Name: Assistive Devices¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Physically disabled adults.

Annual Expenditure: N/A

Funding Source: General revenue

Number of People Served: N/A

Eligibility Criteria: Devices must directly promote independent action/communication, adults must have an assessed need & money is provided only when no other funds are available.

Further Information: Cost control per purchase cap ($10,000). Lifetime cap $25,000.

Program Name: Alzheimer's Respite¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Adults (45+) with Alzheimer's Disease

Annual Expenditure: N/A

Funding Source: General revenue

Number of People Served: N/A

Eligibility Criteria: Adults (45+) with Alzheimer's Disease

Further Information: Cost control length of care not to exceed 8hrs/visit.

Program Name: Home Modification¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Physically disabled adults 18+

Annual Expenditure: N/A

Funding Source: General revenue

Number of People Served: N/A

Eligibility Criteria: Adults (18+) with a permanent or long-term disability when no other funding source is available.

Further Information: Cost control $10,000 lifetime cap.

Program Name: Emergency Response System⁴,¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Elderly & Physically disabled

Annual Expenditure: $49,288 FY02 Appropriation

Funding Source: General revenue

Number of People Served: 120 FY02

Eligibility Criteria: At-risk elderly or adults with physical disability who live alone or who are alone a large portion of the day. No income or asset limit

Further Information:

Program Name: Statewide Respite Services⁴,¹⁰

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Elderly

Annual Expenditure: $124,557 FY02 Appropriation

Funding Source: General revenue, clients contribute

Number of People Served: 67 FY02

Eligibility Criteria: No income or asset limit.

Further Information: Cost control Co-pay on sliding scale

Program Name: Alzheimer's Adult Day Services⁴

Administrative Agency: Health & Social Services, Division of Services for Aging & Adults with Physical Disabilities

Population Served: Adults with dementia or related disorders

Annual Expenditure: $452,220 FY02 Appropriation

Funding Source: General revenue

Number of People Served: 37 FY02

Eligibility Criteria: No income or asset limit.

Further Information:

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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