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Delaware - Integrated Employment — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

In Delaware, Integrated Employment services are funded through the Division of Developmental Disabilities Services (DDDS) under the 1915(i) Pathways to Employment State Plan Amendment and the 1915(c) Lifespan Waiver. The service is defined as job development, placement, and on-site coaching that leads to competitive work in a community setting at prevailing wage.

To become an approved provider, agencies must first pass the DDDS Authorized Provider Committee review by submitting a comprehensive application package. The most significant structural precondition is that after DDDS authorization and Medicaid enrollment, providers must respond to and be awarded a contract through an open and continuous Request for Proposals (RFP) managed by the Division of Management Services (DMS) before they can receive a service contract and accept referrals.

1. Service Definition and Scope

Integrated Employment in Delaware encompasses job development, placement, and on-site coaching designed to assist individuals with intellectual and developmental disabilities in securing and maintaining competitive employment in community settings at prevailing wages.

The service is individualized and focuses on matching the participant's skills and interests with employer needs, ensuring the participant is integrated into the typical workforce.

2. Regulatory and Oversight Agencies

The primary oversight agency for Integrated Employment services is the Delaware Department of Health and Social Services (DHSS), specifically through the Division of Developmental Disabilities Services (DDDS) and the Division of Medicaid and Medical Assistance (DMMA).

DDDS manages the provider authorization process, while DMMA oversees Medicaid enrollment and compliance.

3. Gatekeeping Prerequisites: Who Can Even Apply

Before a provider can accept referrals or bill for Integrated Employment services, they must navigate a multi-step authorization and procurement process. The most critical gatekeeping prerequisite is the requirement to respond to and be awarded a contract through the Division of Management Services (DMS) Request for Proposals (RFP).

This RFP, titled "Home and Community Based Services for Individuals with Intellectual and Developmental Disabilities," is open and continuous, but proposals are only reviewed once per quarter. A provider cannot receive a service contract from DDDS until DMS accepts the RFP bid and DDDS awards the RFP.

4. Licensure and Certification Requirements

Delaware does not issue a distinct facility or service license specifically for Integrated Employment providers. Instead, providers are approved through the DDDS Authorized Provider process.

Providers must possess a standard State Business License or 501(c)(3) status and comply with all DDDS Provider Standards and policies.

5. Medicaid Provider Enrollment

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

Providers must submit their authorization letter, professional licensing, and business information during the enrollment process.

6. Staffing, Training and Background Checks

Providers must ensure that all employees and contractors meet strict background check and training requirements. This includes criminal background investigations and screenings against the child and adult abuse registries.

Staff must also complete Department-required training, including training specific to the participant's service plan and unique needs.

7. Documentation, Policies and Records

Providers must maintain comprehensive documentation to demonstrate compliance with DDDS standards and Medicaid regulations. This includes maintaining an Essential Elements to a Medicaid Compliance Plan.

Providers are also expected to utilize the Electronic Client Data Management System and Electronic Health Record systems as outlined in the DDDS Provider Application Manual.

8. Billing, Rates and Claims

Billing rates for Integrated Employment are established during a mandatory meeting with the DDDS Office of Business Supports and Services (OBSS) after Medicaid enrollment and RFP award.

Claims are submitted through the Delaware Medical Assistance Portal for Providers, where providers can also inquire on claim status and patient eligibility.

9. Approval Sequence and Timeline

The approval process is multi-phased, beginning with Information Gathering and submitting an application to the DDDS Authorized Provider Committee. If the application is complete and passes review, the provider receives a Qualified Provider Authorization Letter.

Following this, the provider must enroll in Medicaid, respond to the quarterly RFP, attend DDDS New Provider Orientation, and finalize contracting and rates with DDDS OBSS before receiving an Authorization to Accept Referrals letter.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied if they are incomplete. DDDS explicitly states that they will not accept an incomplete application and will return it to the submitting agency.

Additionally, failure to properly format the application (e.g., submitting a Requirements Summary Checklist in Word format, creating separate .pdf documents for each question, and submitting as a .ZIP file) can result in rejection.

11. Key Contacts and Resources

Prospective providers should utilize the resources provided by DDDS and DMMA to navigate the application and enrollment process. The DDDS Provider Application Manual is the primary guide.

For specific questions regarding the application process, providers can contact the DDDS Provider Authorization Committee via their resource mailbox.

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