Delaware - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

Delaware funds pre-tenancy supports and community transition services primarily through the Diamond State Health Plan (DSHP) 1115 Demonstration Waiver and the Division of Developmental Disabilities Services (DDDS) Lifespan Waiver. Providers seeking to offer housing search, landlord mediation, and retention planning must first pass the DDDS Authorized Provider Committee interview and respond to a Request for Proposals (RFP) issued by the Division of Management Services (DMS) before they can enroll in the state's Medicaid system.

Because Delaware relies on a mandatory managed care delivery system for DSHP Plus members, final service authorization and reimbursement require active network contracts with the state's two designated Managed Care Organizations (MCOs). Applicants must complete a multi-phase approval sequence, beginning with a mandatory Requirements Summary Checklist and culminating in MCO credentialing, to actively bill for tenancy supports.

1. Service Definition and Scope

Delaware does not use the standalone term "Housing Stabilization" as a distinct waiver service category. Instead, tenancy support functions are covered under "Pre-Tenancy Supports" and "Community Transition Services" within the DSHP 1115 Waiver and the DDDS Lifespan Waiver.

These services assist Medicaid beneficiaries, particularly those transitioning from nursing facilities or institutional settings, in locating, securing, and maintaining independent community housing. The scope includes housing assessments, application assistance, landlord mediation, and the development of housing retention plans.

• Pre-Tenancy Supports: Assisting members with housing searches, applications, and understanding lease obligations.
• Community Transition Services: Funding for essential household setup, utility deposits, and moving expenses.
• Target Population: DSHP Plus members transitioning from nursing facilities and DDDS Lifespan Waiver participants.
• Service Limitations: Transition services are typically capped at a specific dollar amount (e.g., $2,500) unless an MCO case manager authorizes an exception.

2. Regulatory and Oversight Agencies

Oversight of housing-related HCBS in Delaware is split between the division managing the overarching Medicaid program and the division operating the specific waivers for developmental disabilities.

Providers must interact with both state agencies and the contracted MCOs to maintain compliance and active enrollment status.

• Division of Medicaid and Medical Assistance (DMMA): Administers the DSHP 1115 Waiver and oversees MCOs [https://dhss.delaware.gov/dmma/].
• Division of Developmental Disabilities Services (DDDS): Manages the Lifespan Waiver and the Authorized Provider process [https://dhss.delaware.gov/ddds/].
• Division of Management Services (DMS): Handles the mandatory Request for Proposals (RFP) procurement process [https://dhss.delaware.gov/dms/].
• Gainwell Technologies: Operates the Delaware Medical Assistance Portal (DMAP) for Medicaid provider enrollment [https://medicaid.dhss.delaware.gov/].

3. Gatekeeping Prerequisites: Who Can Even Apply

Delaware strictly controls entry into its HCBS provider network through a procurement and committee-review gate. A provider cannot simply submit a Medicaid enrollment application for tenancy supports without prior state authorization.

The state requires applicants to pass a formal interview and respond to an active procurement vehicle before Medicaid enrollment is permitted.

• RFP Requirement: Applicants must respond to the "Home and Community Based Services for Individuals with Intellectual and Developmental Disabilities" RFP through DMS.
• Authorized Provider Committee: Applicants must present a 15-minute presentation and pass a 45-minute interview with the DDDS Authorized Provider Committee.
• MCO Contracting: DSHP Plus services require active network contracts with Highmark Health Options or AmeriHealth Caritas Delaware.
• Existing Provider Threshold: Existing providers applying to add services must score 86% or higher on the Provider Compliance Checklist to proceed.

4. Licensure and Certification Requirements

Delaware does not issue a specific "Housing Stabilization" or "Tenancy Support" facility or agency license. Providers are certified through the DDDS authorization process rather than a traditional Department of Health licensure track.

To achieve certification, agencies must demonstrate adherence to comprehensive state standards governing HCBS delivery.

• DDDS Provider Standards: Agencies must attest to and comply with the official DDDS Provider Standards for all services.
• Community Settings Final Rule: Providers must demonstrate full compliance with CMS HCBS settings requirements.
• Business Registration: Applicants must hold a valid Delaware business license.
• Initial Authorization Letter: The formal certification document issued by DDDS that allows the provider to proceed to Medicaid enrollment.

5. Medicaid Provider Enrollment

Once authorized by DDDS, providers must enroll in the Delaware Medical Assistance Program (DMAP) using the state's MMIS portal operated by Gainwell Technologies.

Providers must also complete the MCO-Only Provider Enrollment Application if they are exclusively contracting with the managed care plans for DSHP Plus services.

• Enrollment Portal: Applications are submitted via the DMAP Provider Portal [https://medicaid.dhss.delaware.gov/].
• Required Documentation: Providers must upload their Qualified Provider Authorization Letter issued by DDDS.
• NPI Requirement: A valid National Provider Identifier (NPI) is required for the agency.
• Application Type: Providers select the "MCO-Only Provider Enrollment Application" for DSHP managed care participation.

6. Staffing, Training and Background Checks

Direct support professionals and case managers providing tenancy supports must meet baseline state qualifications for HCBS personnel.

Agencies are responsible for maintaining training records in the state's Electronic Training System or their own compliant learning management system.

• Age Requirement: Direct service staff must be at least 18 years of age.
• Background Checks: Mandatory state and federal criminal background checks are required for all public-facing staff.
• Basic Certifications: Staff must hold current First Aid and CPR certifications.
• Driver License: A valid driver's license is required if staff are transporting members during housing searches.

7. Documentation, Policies and Records

Delaware requires HCBS providers to maintain robust internal policies and utilize state-mandated electronic systems for client tracking.

Agencies must submit specific policy frameworks during the Phase 1 application process.

• Compliance Plan: Submission of an "Essential Elements to a Medicaid Compliance Plan" document.
• Requirements Summary Checklist: A mandatory Word document checklist that must accompany the initial application.
• Electronic Client Data: Providers must utilize the state's Electronic Client Data Management System for DDDS members.
• Transition Plans: Detailed documentation of housing assessments, identified barriers, and step-by-step retention strategies.

8. Billing, Rates and Claims

Reimbursement for tenancy supports is handled primarily through the MCOs for DSHP Plus members, utilizing specific HCPCS codes designated in the provider's contract.

Community transition services have hard caps, and providers must secure prior authorization before incurring expenses on behalf of a member.

• MCO Claims: Claims are submitted directly to Highmark Health Options or AmeriHealth Caritas Delaware, not straight-to-state.
• Transition Cap: Community transition services are generally limited to $2,500 per transition.
• Exception Process: MCO case managers can authorize service request exceptions above the $2,500 limit based on documented need.
• Room and Board: Federal financial participation (Medicaid) cannot be billed for ongoing rent or room and board costs.

9. Approval Sequence and Timeline

The Delaware HCBS provider approval process is divided into distinct phases, starting with information gathering and ending with MCO contracting.

The state reviews proposals quarterly, meaning timelines are dictated by the RFP submission windows.

• Phase 1 (Information Gathering): Reviewing the Provider Application Manual and completing 12 mandatory overview sessions.
• Phase 2 (Application & Interview): Submitting the application as a .ZIP file and completing the Authorized Provider Committee interview.
• Phase 3 (Medicaid & RFP): Enrolling in the Gainwell portal and responding to the DMS RFP.
• Phase 4 (Contracting): Finalizing network agreements with the DSHP MCOs.

10. Common Denials and Survey Findings

DDDS strictly enforces application formatting and completeness. Applications that do not follow the exact submission instructions are rejected before substantive review.

During the interview phase, failure to articulate how the agency will specifically meet Delaware's regulations results in denial.

• Incomplete Submissions: DDDS will immediately return applications missing the Requirements Summary Checklist or improperly formatted .ZIP files.
• Zero-Point Rule: DDDS reserves the right to reject any application that scores 0 points on any single interview question.
• Compliance Failure: Existing providers failing to meet the 86% threshold on the Provider Compliance Checklist are denied expansion.
• Reapplication Lockout: Providers denied by the Committee must wait six (6) months before submitting a new application.

11. Key Contacts and Resources

Prospective providers should direct initial inquiries to the DDDS Provider Authorization Committee and utilize the state's official manuals.

Technical assistance for the Medicaid enrollment portal is handled separately by Gainwell Technologies.

• DDDS Provider Auth Committee: [email protected]
• Gainwell Provider Call Center: 1-800-999-3371 (8:00am - 4:30pm EST)
• DMAP Provider Portal: [https://medicaid.dhss.delaware.gov/]
• Provider Application Manual: [https://dhss.delaware.gov/wp-content/uploads/sites/6/ddds/pdf/ProviderApplicationManualFinal07012024.pdf]

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