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RESPITE

Service Description

This service provides short-term care and supervision consistent with the health needs of the consumer
to
supplement care to provide a safe living environment and/or support or relieve caregivers for the benefit
of the consumer.

Service Setting

1.        This service may be provided in the following settings:
1.1        The consumer’s home;
1.2        The home of the Qualified Vendor or direct service staff that has been inspected and approved by
the Department of Health or the Department of Economic Security;
1.3        A group home or developmental home (child or adult) licensed by the Department of Economic
Security;
1.4        A Medicare/Medicaid certified nursing facility; or
1.5        A certified ICF/MR.

2.        When services occur in any building other than the consumer’s home, the building must meet the
requirements of building inspection for Fire, Health/Safety.

3.        If out-of-home respite is provided in a licensed facility, the facility shall not provide services to more
individuals than its license allows.

4.        This service shall not be provided when the consumer is hospitalized.

5.        This service shall not be provided to consumers living in group homes, vendor supported
developmental homes (child or adult), skilled nursing facilities, non-state operated ICFs/MR, or Level I or
Level II behavioral health facilities, or to consumers living independently.

Service Goals and Objectives

Service Goals

1.        To provide relief to a family member or person caring for a consumer.

2.        To provide supervision either in or outside of the home, as well as supporting the emotional,
physical and mental well being of the consumer.

Service Objectives

The Qualified Vendor shall ensure that the following objectives are met:

1.        Determine the consumer’s routine plan of care from the consumer’s caregiver.

2.        As identified in the consumer’s ISP and/or routine plan of care, provide respite care and service to
the consumer.
2.1        Provide for the social, emotional and physical needs of the consumer.
2.2        Ensure that the consumer receives medication as prescribed.
2.3        Provide first aid and appropriate attention to injury and illness.
2.4        Ensure provision of food to meet daily dietary needs. Therapeutic diets requiring specialized
ingredients or food supplements will be supplied by the family.
2.5        Assist the consumer in utilizing transportation to support the consumer in all daily living activities,
e.
g., day treatment and training, employment situation, medical appointments, visits with family and friends,
and other activities.
2.6        Carry out any programs identified in the consumer’s ISP and/or routine plan of care.

Service Utilization Guidelines

1.        The amount of respite is determined on a yearly basis through the ISP process not to exceed the
amount set by Federal or State Medicaid rules.

2.        The ISP team shall decide, prior to the delivery of services, who and how service delivery will be
monitored.

3.        When families have more than one consumer eligible for respite from the Division and all will be
receiving respite at the same time, the hours will be deducted from the authorized level of respite for each
consumer.

4.        Families receiving respite for consumers who wish other non-eligible individuals to receive care
will
be responsible for the costs of serving the non-eligible individual. The Division will only pay for services
delivered to consumers authorized to receive such service.

5.        The Qualified Vendor shall not serve, at one time, more individuals than can safely be provided for,
and not more than three people, giving considerations to compatibility (e.g., age, diagnoses, behavior,
sex,
etc.).

6.        Consumers shall be in the care of a certified/contracted respite provider at all times while in respite
service. The consumer will not be transferred to another certified/contracted respite provider without the
consent of the parent/consumer’s representative.

Rate

Published.

Unit of Service

1.        The basis of payment for Respite, Short-Term is an hourly unit of direct service time. Direct service
time is the period of time spent with or on behalf of the consumer and verified by the consumer. When
billing, the Qualified Vendor should round its direct service time to the nearest 15-minute increment, as
illustrated in the examples below:
        If services were provided for 65 minutes, bill for 1 hour.
        If services were provided for 68 minutes, bill for 1.25 hour.
        If services were provided for 50 minutes, bill for .75 hour.

2.        If the Qualified Vendor provides respite for more than 13 hours in one day, this is considered to be
Respite, Continuous. One unit of Respite, Continuous equals one day (13 or more hours in a 24-hour
period) of direct service time. A Qualified Vendor billing for Respite, Continuous will bill for the
appropriate
number of days of service and will include the actual cumulative hours of service provided on the billing
document as required by the Division.

3.        If the Qualified Vendor provides this service with a single direct service staff person to multiple
consumers at the same time, the basis of payment for each consumer will be the total direct service time
multiplied by the appropriate multiple client rate for the same unit of service. In no event will more than
three consumers receive this service with a single direct service staff person at the same time.

Direct Service Staff Qualifications

1.        All direct service staff must have at least three months experience in providing assistance to an
individual to meet essential personal physical needs as described in R6-6-1529 (“such as showering,
bathing, toileting, and eating”).

2.        Direct service staff must have the ability to provide assistance to a consumer to meet essential
personal, physical and homemaking needs. This ability includes social, physical and emotional fitness.

Record keeping and Reporting Requirements

The Qualified Vendor must maintain on file proof of hours worked by their direct service staff, e.g., staff
time sheets. Each document must be signed by the consumer/family/consumer’s representative as
verification of hours served.