Legal authority

Federally approved BI, CAC, CADI, DD and EW waiver plans, Minn. Stat. §256B.0913, Minn. Stat. §245D.03

Definitions

Respite: Short-term care services provided to a person when their 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 to a person in their home. This can include time spent in community locations used by the general public (e.g., malls, parks, libraries) while the person continues to stay in their home.

Out-of-home respite: Respite provided to a person in a licensed setting or unlicensed setting that is not the person’s home. This can include time spent in community locations used by the general public (e.g., malls, parks, libraries) while the person stays in a licensed or unlicensed setting that is not their home.

Relative: For the purposes of this page, a relative is one of the following people who is related by blood, marriage or adoption:

Eligibility

A person is eligible to receive respite if their primary caregiver(s) are absent or need relief from caregiver duties. Refer to the primary caregiver(s) section for additional information.

A person is not eligible to receive respite when they receive any of the services listed in the non-covered services section.

Primary caregiver(s)

Alternative Care (AC) and Elderly Waiver (EW)

Under AC and EW, the primary caregiver(s) must be principally responsible for the care and supervision of the person who receives services and either:

The primary caregiver(s) do not need to live in the same house as the person who receives services.

Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI) and Developmental Disabilities (DD) waivers

Under BI, CAC, CADI and DD, the primary caregiver(s) must:

Covered services

Respite covers:

Non-covered services

Not covered within the service

Respite does not cover:

Under the DD Waiver, respite does not cover a person’s short-term admission to a nursing facility.

Services that cannot be authorized with respite

Respite does not cover services for a person who receives the following services (unless there is a community emergency or disaster; refer to the community emergency or disaster section for more information):

Remote support

Respite – in-home 15-minute units can be delivered through remote support when the person receives respite in their home. Services delivered through remote support must meet all the requirements listed on CBSM – Remote support.

Secondary information

Services under all waiver/AC programs must meet the requirements listed on the services section of CBSM – Waiver and Alternative Care programs overview.

DD Waiver only

If a person chooses to have parent(s) or unpaid caregiver(s) provide habilitation, the lead agency must:

Respite is not a habilitation service. For more information, refer to CBSM – Habilitation.

Settings

Respite can be provided in a person’s own home, family home or in settings as outlined in the provider standards and qualifications section.

Community emergency or disaster

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

DHS must approve the request as a necessary expenditure related to the community emergency or disaster. DHS also may:

Process

When a community emergency or 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 AC or EW to ensure their health and safety due to a community emergency or disaster, the provider or lead agency should contact the DHS Aging and Adult Services Division at dhs.aasd.hcbs@state.mn.us to request approval for related expenditures.

BI, CAC, CADI and DD

If there is a need to relocate a person on BI, CAC, CADI or DD to ensure their health and safety due to a community emergency or disaster, the provider or lead agency should contact the applicable DHS Disability Services Division regional resource specialist (RRS) for information about:

Provider standards and qualifications

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

In-home respite

Unless excluded, an in-home respite provider must meet one of the following requirements to serve people in their home or place of residence:

Out-of-home respite

The following sections explain the age, setting license and service license requirements for out-of-home respite.

Hospital

A person can receive out-of-home respite in a hospital when all the following requirements are met:

Nursing facility

A person can receive out-of-home respite in a nursing facility when all the following requirements are met:

Residential hospice facility

A person can receive out-of-home respite in a residential hospice facility when all the following requirements are met:

A residential hospice facility cannot serve more than eight people.

Assisted living facility

A person can receive out-of-home respite in an assisted living facility when all the following requirements are met:

Adult family foster care

A person can receive out-of-home respite in an adult family foster care setting when all the following requirements are met:

For BI, CAC, CADI and DD, an adult family foster care setting cannot serve 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, refer to CBSM – Changes to size of setting by waiver service.

For EW, adult foster care providers may be licensed to serve up to five adults per home if all people who receive foster care are age 55 or older and do not have a serious and persistent mental illness or a developmental disability.

Community residential setting

A person can receive out-of-home respite in a community residential setting when all the following requirements are met:

A community residential setting cannot serve 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, refer to CBSM – Changes to size of setting by waiver service.

Child foster care (family or corporate/shift staff)

A person can receive out-of-home respite in a child foster care setting when all the following requirements are met:

Intermediate care facility for persons with developmental disabilities (ICF/DD)

A person can receive out-of-home respite in an ICF/DD when all the following requirements are met:

Respite must be provided in a distinct, separate space that is not currently certified as part of the ICF/DD, per State Operations Manual, section 2134 (PDF).

For each shift, ICF/DD staff must be assigned to either respite or ICF/DD services. Staff cannot provide both respite and ICF/DD services during a single shift. Providers must ensure respite services are operating in ways that do not interfere with the care for people who live in the ICF/DD.

Camp

A person can receive out-of-home respite in a camp when all the following requirements are met:

Unlicensed setting for adults

An adult can receive out-of-home respite in an unlicensed setting when all the following requirements are met:

Respite providers in unlicensed settings for adults age 18 or older are limited to serving a maximum of six people.

Unlicensed setting for children

A child can receive out-of-home respite in an unlicensed setting when provided by a relative and all the following requirements are met:

245D exclusion

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

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.

Service amount

Out-of-home 24-hour respite is limited to a maximum of 30 consecutive days per respite occurrence. The length of the person’s stay must be documented in the support plan.

Authorization, rates and billing

The following sections include program-specific authorization, rate and billing information for respite.

AC and EW

Under AC and EW, the lead agency authorizes respite at the state-established rate. The lead agency uses the daily rate when respite is provided for 12 or more hours or overnight. Otherwise, the lead agency uses the 15-minute rate. For more information, refer to Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

BI, CAC, CADI and DD

15-minute units

Under BI, CAC, CADI and DD, 15-minute respite is a market rate service. For more information, refer to CBSM – Market rate services and Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

Daily units

Under BI, CAC, CADI and DD, daily respite is a market rate service. The lead agency must use a daily rate when respite is provided for 10 or more hours per day. For more information, refer to CBSM – Market rate services and Long-Term Services and Supports (LTSS) Service Rate Limits, DHS-3945 (PDF).

CBSM – Changes to size of setting by waiver service
CBSM – Exclusions from Chapter 245D licensure
CBSM – Habilitation
CBSM – Market rate services
CBSM – Rate methodologies for AC, ECS and EW service authorization
CBSM – Remote support
CBSM – Waiver, AC and ECS general process and procedures
CBSM – Waiver/AC programs overview
CBSM – Waiver/AC service provider overview
HCBS Safety Checklist for Out-of-Home Respite Services in an Unlicensed Setting, DHS-7759E (PDF)
RMS User Manual