Delaware's Department of Health and Social Services (DHSS) put a $2.62 million "HCBS Phase I Rate Increase" on its list of new spending requests for fiscal 2028, the year that starts July 1, 2027. The figure is in the slides Cabinet Secretary Christen Linke Young presented at the state's Nov. 10 public budget hearing in Dover, posted by the Office of Management and Budget. At the same hearing, home care providers asked for about ten times that much, WMDT reported.
What DHSS asked for
DHSS is asking for $2.02 billion in general funds for fiscal 2028, up 3.8% from $1.95 billion this year, according to the presentation. Its slides split the new money into two lists.
The first is "door opener" requests, the cost of keeping current programs running as more people enroll. Two of the largest cover services for people with developmental disabilities:
| Door opener request | Amount |
|---|---|
| Medicaid growth | $15.4 million |
| Residential habilitation, 54 new clients | $13.67 million |
| Community-based services, 366 new clients | $4.90 million |
| Purchase of Care (child care) growth | $7.69 million |
The second list is discretionary requests. Under the heading "Care Economy," DHSS listed four rate items:
| Care economy request | Amount |
|---|---|
| McNesby Phase II rate increase | $2.79 million |
| PROMISE Phase II rate increase, Medicaid | $1.38 million |
| PROMISE Phase II rate increase, state funded | $0.97 million |
| HCBS Phase I rate increase | $2.62 million |
The McNesby name refers to the Michael McNesby Full Funding for Adults with I/DD Act, a 2018 law that tells the Division of Developmental Disabilities Services (DDDS) to phase in I/DD service rates up to benchmarked levels, subject to available funding. The slides do not say which services each phase covers or how the HCBS item would be split among providers.
The presentation also says fiscal 2027 investments raised pay for direct support professionals, and that a "recently completed rate study" will help "right-size" DSP rates. The governor's recommended fiscal 2027 budget, as DHSS presented it to the Joint Finance Committee in February, included $10.58 million for a DDDS rate increase for Direct Service Professionals. DHSS says it serves 6,701 people with developmental disabilities.
DHSS also proposed $19.49 million in cuts across its divisions, including contracts, fleet use and supplies, and a change to how Medicaid pays hospitals that it expects to save $12 million to $15 million in state money.
What home care providers asked for
The Delaware Association for Home and Community Care asked for a 25.5% increase in private-duty nursing rates and a 10% increase in personal care service rates. Executive Director Sue Getman told WMDT the two would cost the state about $7.3 million and $19.3 million. Those are the association's estimates, Delaware LIVE News noted, and the DHSS presentation does not say how its HCBS item relates to the request.
Parents, nurses and people who use in-home care told the hearing that turnover forces families to start over with new staff. "Knowing that there is a potential that even our current nurses could leave is terrifying for him because then we're starting over," Heather Holveck, the grandmother and guardian of a child with disabilities, told WMDT.
Federal changes in the background
The same slides list the effects of H.R. 1, the 2025 federal budget law: 14,712 Delawareans have lost SNAP food benefits under its work rules, and the state is preparing new Medicaid checks that start Jan. 1, 2027, including work requirements and eligibility reviews every six months for adults who are not disabled.
What this means for providers and DSPs
- These are requests, not a budget. Governor Matt Meyer's recommended budget comes out in January, the Joint Finance Committee holds hearings in the spring, and the final budget passes in June. Any rate phase can grow, shrink or disappear along the way.
- I/DD providers should watch the McNesby line. It is the item tied to the DDDS rate system. Providers may want to ask DDDS how the Phase II figure was built and which services it reaches.
- Growth money is also capacity money. The 54 new residential clients and 366 new community-based clients need staff. If those slots are funded without rate increases, the provider agencies that serve them will be hiring from the same tight DSP pool.
- Delaware's waiver is changing too. DDDS has separately proposed adding two new Lifespan Waiver services, with comments due Dec. 15.