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

Tier 1 Service

Page posted: 10/01/03

Page reviewed: 8/22/11

Page updated: 5/12/15

Legal authority

Federally approved BI, CAC, CADI and DD Waiver plans, Minn. Stat. §245D.03


Respite: Short-term care services provided due to the absence or need for relief of the family member(s) or primary caregiver normally providing the care.

Covered services

In-home or out-of-home respite settings must meet necessary provider licensure and qualifications. Respite may be provided in the participant's home or place of residence, or one of the following out of home settings:

  • • Foster care
  • • Medicaid certified hospital
  • • Medicaid certified nursing facility
  • • Unlicensed setting (agency or individual must have a 245D service license).
  • Respite care is only provided for a primary caregiver meeting the following criteria:

  • • Responsible for the care and supervision of the person and
  • • Maintain his/her primary residence at the same address as the person and
  • • Named as an owner or leaser of the primary residence.
  • BI/CAC/CADI Waiver only

    Respite care is limited to 30 consecutive days per respite stay in accordance with the plan of care.

    Non-covered services

    With the exception of a community emergency or disaster, respite care is not available for people residing in:

    Respite care provided in the person’s home or other private residence will not include room and board payments.

    The DD Waiver does not reimburse respite care for:

  • Short term admission to an ICF/DD or
  • • More than four people in one home or setting at the same time.
  • Community emergency / Disaster

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

  • • May or may not reside at the same address as the participant, and
  • • May be paid or unpaid.
  • DHS:

    1. Must approve the request as a necessary expenditure related to the emergency or disaster.
    2. May waive other limitations on this service as needed to ensure DHS reimburses necessary expenditures related to protecting the health and safety of recipients.
    3. May approve the provision of respite services by unlicensed providers on a short-term, temporary basis.

    Community emergency/Disaster respite 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.

    If waiver residential providers need to relocate participants to ensure their health and safety, the providers or lead agencies should contact the DSD Regional Resource Specialist assigned to that county for information on:

  • • Funding mechanisms available for reimbursement of eligible costs associated with the relocation of participants
  • • 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 facilities) licensing in accordance with Minn. Stat. chapter 144A and defined under Minn. R. 9505.0175, subp. 23. (Respite can only be provided in a nursing facility for participants on the BI, CAC or CADI waivers)
    3. Chapter 245D licensing requirements (unless excluded) in one of the following sites:

  • • Adult foster care licensed under Minn. R 9555.5050 to 9555.6265
  • • Child foster care licensed under Minn. R 2960.3000 to 2960.3340
  • • Unlicensed site when the case manager has determined the site 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 can use an individual provider who meets requirements for exclusion from 245D licensure. For more information, see CBSM – Exclusions from 245D licensure.

    Email questions about exclusion from DHS licensure to the DHS Licensing Division HCBS Unit.


    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.

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