IMPLEMENTATION OF DIAMOND STATE HEALTH PLAN PLUS

Most of the Medicaid-eligible population in Delaware is currently enrolled in the Diamond State Health Plan (DSHP) for health care services.  DSHP is a managed care model of service delivery with two managed care organizations responsible for managing health care needs (either Delaware Physicians Care or UnitedHealthcare Community Plan). 

Delaware’s Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) and the Division of Medicaid and Medical Assistance (DMMA) are collaborating on the development and implementation of an integrated Long Term Care Initiative, Diamond State Health Plan Plus (DSHP Plus).  This new delivery system of long-term care services is scheduled for implementation in April 2012.  Clients in the existing programs will be transitioned to DSHP Plus.

Individuals enrolled in the new DSHP Plus will have access to the current benefit package in the DSHP (e.g., acute care services, in-patient hospitalization, out-patient visits, behavioral health services, etc.), as well as an expanded package of long-term care services.  The extended package will include services currently provided by the Elderly and Disabled (E&D) Waiver and the Aids Waiver, at a minimum. DSHP Plus will include the following populations:

• Medicaid eligible individuals residing in nursing homes
• Individuals enrolled in Medicaid’s Elderly and Disabled (E&D) Waiver
• Individuals enrolled in Medicaid’s Aids Waiver
• Individuals in the community who are dually eligible for Medicaid and Medicare
• Money Follows the Person
• Medicaid for Workers with Disabilities

Two separate client letters  are being mailed on December 1 and December 5. Spanish versions of the information is being mailed to Spanish speaking clients. You can access the information being sent to Medicaid clients here. DMMA will provide updates as the planning work continues and encourages visiting their website at http://dhss.delaware.gov/dhss/dmma/dshpplus.html.