Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Delaware program

Nurses and carers at home (Delaware Medicaid)

Help with nursing and personal care at home after your child’s Medicaid plan reviews their needs.

What it is

Help with nursing and personal care at home after your child’s Medicaid plan reviews their needs.

Delaware Medicaid can cover nursing and personal care when the child’s needs meet the plan’s rules. The oncology team describes those needs. A separate option lets a family direct personal care and hire a family member.

Eligibility rules
  • Your child needs Medicaid first. The plan assesses skilled nursing and personal care separately and sets the hours from what the team documents.
  • Medical complexity, an intellectual or developmental disability, or a behavioral health condition can support the care assessment.
  • Private duty nursing is continuous care from a licensed nurse. A parent paid for personal care is not thereby a nurse; the two are separate approvals.
What you get
  • Approved nursing or personal care hours at home.
  • Pay for an eligible legally responsible family carer, up to 40 hours a week.
What the help includes
  • The plan assesses skilled nursing, personal care and pediatric respite separately. Delaware’s demonstration also provides respite for eligible children with specified complex needs; it is not routine before- or after-school care or supervision of a sibling.
  • Delaware also pays for respite (a trained carer so you can rest) for children with complex needs: usually up to 15 days or 285 hours a year, and up to 72 hours at a time in an emergency without prior approval. It is not babysitting for a sibling.
If you decide to apply
  1. Ask the oncology team whether home nursing or personal care could help. If you decide to pursue it, the team supplies an order for the plan’s review.
  2. Have the Medicaid number, plan name and a description of a typical day and night ready.
  3. Ask the care manager how the option to direct personal care works for your family.

Child’s Medicaid health-plan care manager; Central Intake · 1-866-940-8963 · Official page ↗

What happens next
  • The oncology team supplies the order and daily-care description. The health plan reviews the request.
  • The plan must decide within seven days, or 72 hours when urgent. Ask for the approved hours, the pay rate for a family carer and the worker requirements in writing. A decision deadline does not guarantee a nurse is available.
Good to know

A paid carer who is legally responsible for the child cannot also direct that care and sign the time sheets.

Other details
  • Someone else must direct care and sign time sheets when a legally responsible family member is paid.
Official sources
Ask your social worker

“Could nursing or personal care help us at home? What are the benefits and drawbacks of paid family care, and could you help request an assessment if it fits?”

Why I’m asking: I want to understand which care can be covered and what paid family care would require.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask for the care manager by name, keep the authorisation reference, and say plainly what a night at home looks like.

Your social worker

The care manager opens prior authorisation and explains the self-directed option and its time-sheet rule.

The care team

The oncologist writes the order and the description of the daily care.

Who decides
The child’s Medicaid health plan, on the oncology team’s order.
Ask your social worker
“Can the health plan authorise nursing hours at home, and can you explain the self-directed personal care option and who would sign the time sheets?”

How to apply

First step: Ask the oncology team for the home nursing order, then call the health plan’s care management line and ask to open the authorisation.

  1. Ask the oncologist for the order describing the nursing your child needs at home.
  2. Ask the health plan’s care manager to open prior authorisation and to explain the self-directed personal care option.
  3. Ask who will sign the time sheets before a family member is hired.

Official application / program page ↗

Where it starts: Ask the oncology team for the order, then ask the health plan’s care manager to open the authorisation and the self-directed option.

What to gather

  • The oncologist’s order
  • A written description of a typical day and night at home
  • The Medicaid identity number and the health plan name

How long: Not published for Delaware. Ask the plan for its own deadline and write down the date you asked.

What a yes looks like

An authorisation with a number of hours and a date range, and an agency or a carer to arrange.

What a no looks like, and the next move

Usually not enough written detail about the daily care. Ask for the denial in writing and appeal with the oncologist’s description.

Watch out

  • Medicaid comes first. Nursing hours are a plan service, not a separate application.
  • A paid family member who is legally responsible for the child must have someone else direct the care and sign time sheets, and is capped at 40 hours a week.
  • Home health care needs prior authorisation. Ask the plan for its decision deadline in writing, because Delaware’s own clock was not published.

Dates that change this

2024-07-01: The paid family carer route sits in the federal approval that runs from July 2024 to December 2028. It is not a pandemic leftover, and it is not permanent beyond that approval period.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Nursing and personal care hours at home, with a legally responsible family member able to be paid for up to 40 hours a week.

  • $40/week — Paid hours a week for a legally responsible family member
  • $21 — Age ceiling for the self-directed personal care option

Covers: Private duty nursing, listed as covered in the state-approved plan handbook · Personal care and home health, subject to the plan’s prior authorisation · Self-directed personal care, where the parent hires the carer · Care coordination through the health plan

Legal protection: The health plans must meet the state’s obligations for the child health benefit: coverage, outreach and help getting it

What it costs the family: None beyond the plan.

The eligibility facts, as published

Coverage
the child must be on Delaware Medicaid
Age
up to 21 for the self-directed personal care option
Condition
medical complexity, an intellectual or developmental disability, or a behavioural health condition
Authorisation
home health care requires prior authorisation in the published plan table; a Delaware-wide decision deadline was not found

Expect friction on: Home health care needs prior authorisation from the health plan · Whether nursing hours can actually be staffed was not established in the research

The trap: A paid family member who is legally responsible for the child cannot also sign their own time sheets. Another family member or representative must direct the care and sign, and the paid hours stop at 40 a week.

Where I read this

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