Home- and Community-Based Care (HCBS)

Diamond State Health Plan-Plus long-term services and supports (LTSS) gives members who are older or have disabilities benefits that let them live in their own home or community. These members might have needed care in a nursing facility or other place. This gives you more choices about how and where you get services. 

HCBS provided through the DSHP-Plus LTSS

Prior approval is required for:

• Adult day services.
• Attendant care services.
• Caregiver program offering education and supports.
• Cognitive services.
• Community-based residential alternatives that include assisted-living facilities.
• Day habilitation.
• Home-delivered meals.
• Independent activities of daily living (chore) services.
• Minor home modifications.
• Nursing facility services.
• Nutritional supplements for individuals with an HIV/AIDS diagnosis.
• Personal emergency response system.
• Respite care.
• Specialized medical equipment and supplies (not covered under the Medicaid state plan).
• Support for self-directed attendant care services. 
• Transition services for those moving from nursing facility to community.
• Workshops for those moving from a nursing facility to the community.

Your case manager

If you receive nursing facility care, your case manager will:

• Be part of the care planning process with the nursing facility where you live.
• Perform any additional needs assessment that may help manage your health.
• Add to the nursing facility’s care plan if there are things AmeriHealth Caritas Delaware can do to help manage health conditions or coordinate other kinds of physical and behavioral health care you need.
• Coordinate with the nursing facility when you need services the nursing facility isn’t responsible for providing.
• Conduct face-to-face visits at least every six months.
• Check at least one time a year to make sure that you continue to need the level of care provided in a nursing facility.

Do you have questions about these services? Call AmeriHealth Caritas Delaware Member Services, 24 hours a day, seven days a week, at:

• Diamond State Health Plan: 1-844-211-0966 (TTY 1-855-349-6281).
• Diamond State Health Plan-Plus: 1-855-777-6617 (TTY 1-855-362-5769).