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Delaware - Home Modification Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Delaware Division of Developmental Disabilities Services (DDDS) funds Minor Home Modification services through the HCBS Lifespan Waiver and the Diamond State Health Plan Plus 1115 Demonstration Waiver. Providers must secure an active contract by responding to the open and continuous Request for Proposals (RFP) managed by the Division of Management Services (DMS) Procurement Office via the Bonfire Hub.

Approval requires passing the DDDS Authorized Provider Committee review, enrolling through the Gainwell-operated Delaware Medical Assistance Portal (DMAP), and holding appropriate state business and contractor licenses. Projects are capped at $6,000 per modification, $10,000 annually, and $20,000 over the beneficiary's lifetime.

1. Service Definition and Scope

In Delaware, Minor Home Modification provides assessed, permitted, and inspected structural changes to a beneficiary's private residence to ensure safety and accessibility. This service is funded primarily under the DDDS Lifespan Waiver and the Diamond State Health Plan Plus (DSHP-Plus) program.

The scope is strictly limited to modifications that address a specific assessed need, such as ramps, widened doorways, and accessible bathroom fixtures. It explicitly excludes general home maintenance, roof repair, or square-footage additions.

2. Regulatory and Oversight Agencies

Home modification providers are overseen by a combination of state divisions managing the waivers and the procurement process. The Division of Developmental Disabilities Services (DDDS) manages the programmatic approval for the Lifespan Waiver.

The Division of Medicaid and Medical Assistance (DMMA) oversees the Medicaid enrollment, while the Division of Management Services (DMS) handles the mandatory contracting process.

3. Gatekeeping Prerequisites: Who Can Even Apply

Delaware requires prospective HCBS providers to pass a strict procurement and committee review process before Medicaid enrollment is permitted. The state utilizes an open and continuous Request for Proposals (RFP) titled 'Home and Community Based Services for Individuals with Intellectual and Developmental Disabilities'.

Applicants must submit their proposals electronically through the Bonfire Hub. The DMS Procurement Office and DDDS review these proposals only once per quarter, and the DDDS must award the RFP before a service contract is issued.

4. Licensure and Certification Requirements

Delaware does not issue a distinct 'healthcare' or 'Medicaid' license for home modification providers. Instead, providers must comply with standard state and local business and construction regulations.

Providers must hold a valid Delaware Division of Revenue business license and ensure that all personnel or subcontractors hold the appropriate trade licenses (e.g., plumbing, electrical) required by local county or municipal building departments.

5. Medicaid Provider Enrollment

Once a provider receives a Qualified Provider Authorization Letter from DDDS, they must enroll as a Delaware Medicaid provider. This is completed through the Delaware Medical Assistance Portal operated by Gainwell Technologies.

Providers must submit their authorization letter, professional licensing, and business information through the portal. Enrollment cannot proceed without the initial authorization from DDDS.

6. Staffing, Training and Background Checks

While home modification contractors do not provide direct personal care, they interact with vulnerable populations and must adhere to state background check and orientation requirements.

Agency owners and key personnel must complete the DDDS New Provider Orientation as part of the approval process.

7. Documentation, Policies and Records

Providers must maintain comprehensive records for every modification project to justify Medicaid billing and ensure compliance with the approved scope of work.

This includes maintaining copies of the initial written bids, before-and-after photographs, and official sign-offs from local building inspectors.

8. Billing, Rates and Claims

Minor Home Modification is not billed on a fee-schedule basis; it is reimbursed based on the specific, prior-authorized bid amount approved by DDDS or the managed care organization.

Claims are submitted through the Gainwell DMAP system only after the work is completed, inspected, and signed off by the beneficiary or their representative.

9. Approval Sequence and Timeline

The Delaware DDDS outlines a strict four-phase process for becoming an authorized provider. Phase 1 involves information gathering and reviewing the Provider Application Manual.

Phase 2 requires submitting the application and passing the Authorized Provider Committee Interview. Phase 3 involves Medicaid enrollment via Gainwell and responding to the DMS RFP. Phase 4 is final contracting with the DDDS Office of Business Supports and Services.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied at the DDDS committee stage due to incomplete submissions or failure to demonstrate financial stability.

For active providers, claim denials typically stem from proceeding with work before prior authorization is fully approved or failing to secure required local building permits.

11. Key Contacts and Resources

Prospective providers must utilize the specific DDDS resource mailboxes and the Gainwell call center for application and enrollment assistance.

The Bonfire Hub is the mandatory portal for the RFP submission process.

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