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Minnesota Department of Human Services Community-Based Services Manual (CBSM)
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Respite

Page posted: 10/1/03

Page reviewed: 5/22/18

Page updated: 5/22/18

Legal authority

Federally approved BI, CAC, CADI, DD and EW waiver plans, Alternative Care (AC) program (Minn. Stat. §256B.0913), Minn. Stat. §245D.03

Definitions

Respite: Short-term care services provided to a person when his/her primary caregiver is absent or needs relief.

Primary caregiver(s): Person or people principally responsible for the care and supervision of the person who receives services.

In-home respite: Respite provided in the person’s home or place of residence.

Out-of-home respite: Respite provided outside of the person’s home or place of residence.

Primary caregiver

A person is eligible to receive respite if the primary caregiver is absent or needs relief from his/her caregiver duties. See the following sections for additional program-specific primary caregiver requirements.

AC and EW

Under the AC program and EW, the primary caregiver must either:

  • • Not be paid at all
  • Be paid only for a portion of the time he/she provides care/supervision to the person.
  • The primary caregiver does not need to live in the same house as the person who receives services.

    BI, CAC, CADI and DD

    Under the BI, CAC, CADI and DD waivers, the primary caregiver must both:

  • • Maintain his/her primary residence at the same address as the person.
  • • Be the owner or leaser of the primary residence.
  • Settings

    If the person lives in a setting where he/she receives customized living, residential care or shift-staff foster care, he/she cannot receive respite unless there is a community emergency or disaster.

    See the following sections for program-specific setting requirements. All respite settings must meet provider standards and qualifications, including licensing requirements (see provider standards and qualifications section).

    AC and EW

    Under the AC program and EW, the person can receive respite in the following settings:

  • • Building registered as a housing with services establishment where a licensed home care provider delivers services
  • • Camps
  • • Foster care (family or corporate/community residential)
  • • His/her home or place of residence
  • • Medicare-certified hospital
  • • Medicare-certified nursing facility
  • • Unlicensed setting if certain requirements are met (see provider standards and qualifications section).
  • BI, CAC and CADI

    Under the BI, CAC and CADI waivers, a person may receive respite in the following settings:

  • • Camps
  • • Foster care (family or corporate/community residential; see foster care settings section)
  • • His/her home or place of residence
  • • Medicaid-certified hospital
  • • Medicaid-certified nursing facility
  • • Residential hospice facility (see residential hospice facilities section)
  • • Unlicensed setting if certain requirements are met (see provider standards and qualifications section).
  • DD

    Under the DD Waiver, a person may receive respite in the following settings:

  • • Camps
  • • Foster care (family or corporate/community residential; see foster care settings section)
  • • His/her home or place of residence
  • • Medicaid-certified hospital
  • • Residential hospice facilities (see residential hospice facilities section)
  • • Unlicensed setting if certain requirements are met (see provider standards and qualifications section).
  • Foster care settings that serve people on BI, CAC, CADI or DD

    If a foster care or community residential setting serves people who receive waiver/AC services, it may serve no more than four people, including the people who receive respite. To serve more than four people, the license holder may request a permanent fifth bed license or a temporary fifth bed variance. For more information, see CBSM – Changes to size of setting – 5th bed.

    Residential hospice facilities that serve people on BI, CAC, CADI or DD

    Residential hospice facilities may provide respite services to:

  • • Hospice patients who are 21 years of age or younger and on BI, CAC, CADI or DD
  • • A maximum of eight people.
  • Covered services

    Respite covers room and board when it is provided in a licensed facility.

    Non-covered services

    Respite does not cover room and board when it is provided in the person’s home or an unlicensed setting.

    DD Waiver only

    Under the DD Waiver, respite does not cover a person’s short-term admission to an intermediate care facility for persons with developmental disabilities (ICF/DD) or nursing home.

    Service amount

    When a person receives respite 24-hours a day, he/she can receive up to 30 consecutive days per respite occurrence. The length of the person’s stay must be documented in his/her support plan.

    Community emergency or disaster

    If a community emergency or disaster requires a person to relocate from a current residence, a licensed and qualified provider may provide out-of-home respite for the primary caregiver. The primary caregiver:

  • • May or may not reside at the same address as the person
  • • May be paid or unpaid.
  • DHS must approve the request as a necessary expenditure related to the emergency or disaster. DHS also may:

  • • Waive other service limitations as needed to ensure DHS reimburses necessary expenditures related to protecting the person’s health and safety
  • • Approve unlicensed providers to provide respite services on a short-term, temporary basis.
  • Process

    When a community emergency or natural disaster affects Minnesota, DHS works closely with the State Emergency Operations Center (SEOC) to monitor the situation. As part of DHS’ emergency preparedness activities, protocols are in place to ensure each DHS business area is in communication with lead agencies and providers who may be affected by a disaster.

    AC and EW

    If there is a need to relocate a person on EW or AC to ensure his/her health and safety due to a community emergency or disaster, the provider or lead agency should contact the DHS Aging and Adult Services Division to request approval for related expenditures. Email dhs.aasd.hcbs@state.mn.us, or call 651-431-2600 and ask to speak to someone from the policy integration unit.

    BI, CAC, CADI and DD

    If there is a need to relocate a person on BI, CAC, CADI or DD to ensure his/her health and safety due to a community emergency or disaster, the provider or lead agency should contact the applicable DSD Regional Resource Specialist (RRS) for information on:

  • • Funding available to reimburse eligible costs associated with people’s relocation
  • • Whom to contact at DHS for additional disaster-related assistance.
  • Provider standards and qualifications

    Respite care is a DHS enrollment-required service. For more information, see CBSM – Waiver/AC service provider overview.

    In-home respite care

    Unless excluded, a respite provider must meet one of the following requirements:

  • • Have a license under Minnesota Statutes, Chapter 245D as a basic support service provider
  • • Have a license under Minnesota Statutes, Chapter 144A with a home and community-based services designation.
  • Out-of-home respite care

    An out-of-home respite provider must meet one of the following requirements:

    1. Hospital licensing standards under Minn. Stat. §144.50 to 144.56.
    2. Nursing facility (long-term care facility) licensing in accordance with Minn. Stat. Chapter 144A and defined under Minn. R. 9505.0175, subp. 23 (BI, CAC, CADI, EW and AC only)
    3. Residential hospice facilities as defined under Minn. Stat. §144A.75, subd. 13(a)(1) (BI, CAC, CADI and DD only)
    4. Chapter 245D licensing requirements (unless excluded) in one of the following settings:

  • • Adult foster care licensed under Minn. R. 9555.5050 to 9555.6265
  • • Child foster care licensed under Minn. R 2960.3000 to 2960.3340
  • • Camp certified by the American Camp Association
  • • Unlicensed setting when the case manager has determined the setting will meet the assessed needs of the person.
  • 245D exclusion

    In some cases, a person who receives in-home respite or out-of-home respite in a foster care setting or unlicensed setting can use an individual provider who meets the requirements for exclusion from 245D licensure. For more information, see CBSM – Exclusions from 245D licensure.

    For questions about exclusion from DHS licensure, call the DHS Licensing Division HCBS Unit at 651-431-6624.

    Reporting

    Providers licensed under 245D must report all uses of controlled procedures, emergency use of manual restraint and prohibited procedures according to Minn. Stat. §245D.06, subd. 5 to DHS via the Behavioral Intervention Report Form, DHS-5148.

    Authorization, rates and billing

    See sections below for program-specific authorization, rate and billing information for respite. For more information, see Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

    AC and EW

    Under the AC program and EW, the lead agency authorizes respite at the state-established rate. Use the daily rate when respite is provided for 12 or more hours, or overnight. Otherwise, use the 15-minute rate.

    BI, CAC, CADI and DD

    Under the BI, CAC, CADI and DD waivers, respite authorized in 15-minute units is a framework service. Respite authorized in daily units is a market rate service. The lead agency uses the Rate Management System (RMS) to determine rates. For more information, see CBSM – Rate Management System.

    Additional resources

    CBSM – Changes to size of setting – 5th bed
    CBSM – Exclusions from Chapter 245D licensure

    CBSM – Waiver general process and procedures (BI, CAC, CADI, DD)

    CBSM – Waiver programs overview

    CBSM – Waiver/AC service provider overview
    Rate Management System (RMS) User Manual

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