Delaware CCADP Katie Beckett Medicaid

Delaware families with household incomes too high for standard Medicaid often assume their child with a disability has no pathway to coverage. The Children's Community Alternative Disability Program (CCADP) — Delaware's version of the Katie Beckett/TEFRA option — exists specifically for this situation. It evaluates only the child's personal income and assets, not the family's.

How CCADP Works

Under regular Medicaid rules, a child living at home has their parents' income counted toward eligibility. CCADP bypasses this by using an institutional-level evaluation: if the child meets the medical criteria for care in an Intermediate Care Facility (ICF) but can be safely cared for at home, Delaware covers them under Medicaid without counting parental income.

The program name — Children's Community Alternative Disability Program — describes its logic exactly. The state saves money by keeping the child in the community rather than in an institution, and in exchange, it provides Medicaid coverage regardless of family wealth.

CCADP is available to children under 19 who meet these criteria:

• Delaware residency
• A disability that meets the institutional level of care standard (ICF/IID or nursing facility level)
• The child's own income and resources fall within Medicaid limits ($2,000 resource cap applies to the child individually)
• The child can be safely cared for at home or in a community setting

Family income is not evaluated. A family earning $200,000 per year can qualify for CCADP if the child meets the clinical criteria and the child's own income and resource limits.

CCADP and 12-Month Continuous Eligibility

Effective January 1, 2024, all children under 19 enrolled in Delaware Medicaid — including CCADP — are guaranteed 12 months of continuous, uninterrupted coverage. Mid-year fluctuations in family income or changes in family circumstances do not affect coverage until the annual renewal.

This protection is especially important for families of teenagers approaching 18. The child maintains coverage through the full enrollment year, even if their income picture changes as they begin receiving SSI or start part-time employment.

What CCADP Covers

CCADP provides full Delaware Medicaid coverage — the same benefit package as any other Medicaid category. This includes physician visits, hospital care, prescription drugs, behavioral health services, therapies (OT, PT, speech), durable medical equipment, and home health services.

CCADP provides the Medicaid coverage that may be needed for DDDS Lifespan Waiver services, but CCADP by itself does not establish DDDS or waiver eligibility. Separate DDDS clinical and ICF/IID level-of-care determinations, along with waiver enrollment and funding, still apply.

The Transition at 18

CCADP covers children under 19. When the young adult turns 19 (not 18 — the program extends through the year), they must transition to an adult Medicaid pathway. The two most common routes:

SSI-linked Medicaid. If the young adult qualifies for SSI, Delaware's 1634 status automatically enrolls them in Medicaid. No separate application needed.

Long-term care Medicaid. If the young adult does not qualify for SSI but needs Lifespan Waiver services, they must apply for Medicaid through the long-term care pathway. This requires meeting the $2,000 individual resource limit and the $2,485/month income cap (250% of the SSI federal benefit rate). If income exceeds the cap, a Miller Trust (Qualified Income Trust) must be established.

The transition from CCADP to adult Medicaid is the single most common coverage gap for Delaware families. The automatic 12-month continuous eligibility helps bridge the gap — but only if the family files for adult Medicaid before the CCADP enrollment year ends.

Applying for CCADP

Applications go through the Delaware Division of Medicaid and Medical Assistance (DMMA) via the ASSIST online portal or by contacting the local Division of Social Services office. The application requires:

• Clinical documentation of the child's disability (psychological evaluation, physician statement)
• Evidence of institutional level of care need
• The child's personal financial information (not the parents')
• Delaware residency documentation

Processing for a disability-based CCADP determination has a 90-day standard. If the child is already clinically eligible for DDDS, share that documentation with DMMA as supporting material, but DMMA still makes its own institutional level-of-care determination.

The Delaware SSI at 18 & Adult Disability Benefits Guide maps the CCADP-to-adult Medicaid transition alongside the SSI redetermination and DDDS enrollment timelines, so families can coordinate all three applications without gaps.

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