Respite services are direct services that are provided to supervise/support individuals on a short-term basis due to the absence or need for relief of those persons normally providing care. Respite services do not cover the care provided to a minor child when the primary caregiver or legally responsible individual is absent due to work. Services are limited to individuals residing in private homes (their own home or the home of a relative or friend).
Individuals can receive two categories of respite services: 24-hour respite and 15-minute respite. 24-hour Respite is provided for periods of more than 16 hours and is limited to 30 units (days) per individual per fiscal year, except when extended by the ODP Regional Office based on individual needs. 15-Minute Respite is provided for periods of 16 hours or less and is limited to 480 (15 minute) units per individual per fiscal year, except when extended by the ODP Regional Office based on individual needs.
Federal and State financial participation through the waivers is limited to:
- Services provided for individuals residing in their own unlicensed home or the unlicensed home of a relative, friend, or other family relations. Respite services are not available for individuals who reside in agency owned, leased/rented, or operated (i.e. licensed and unlicensed Family Living homes) homes.
- Respite services that are provided by providers or individuals who meet the qualification criteria outlined in the Consolidated and P/FDS Waivers. This requirement extends to all types of respite, including Respite – Camp.
- Room and board costs associated with respite care services that are provided in a facility approved (licensed or accredited) by the State that is not a private residence.
- Thirty units (days) of 24-hour respite per individual in a period of one fiscal year except when extended by the ODP Regional Office. This requirement is applicable to In-Home Respite – 24 Hours; Respite – Unlicensed Out of Home, 24 Hours; Respite – Licensed Out of Home, 24 Hours; and Respite – Camp, 24 Hours.
- 480 (15 minute) units of 15-minute respite per individual in a period of one fiscal year except when extended by the ODP Regional Office. This requirement is applicable to In-Home Respite – 15 Minutes; Respite – Unlicensed Out of Home, 15 Minutes; Respite – Licensed Out of Home, 15 Minutes; and Respite – Camp, 15 minutes.
- The provision of respite services does not prohibit supporting individuals’ participation in activities in the community during the period of respite. The provision of 24-hour respite services does not prohibit individuals’ participation in day and employment services.
Respite services may only be provided in the following location(s):
- Individual’s home or place of residence located in Pennsylvania.
- Licensed or approved foster family home located in Pennsylvania.
- Licensed community (55 Pa. Code Chapter 6400) or family living (55 Pa. Code Chapter 6500) home located in Pennsylvania with an approved program capacity of ten or fewer unrelated individuals if established prior to January 1, 1996 and with an approved program capacity of four or fewer unrelated individuals if established on or after January 1, 1996. The size limitations may be waived by ODP based on individual circumstances and needs.
- Unlicensed home of a provider or individual meeting the qualifications.
- Other community settings such as summer camp where the setting meets applicable state or local codes and the provider of service meets the provider qualifications established by the Department.
This service is not available for people residing in agency-owned, rented/leased, or operated (i.e. licensed and unlicensed Family Living homes) homes.
Respite billed under the following codes can only be funded through waiver dollars. These services may not be provided in Nursing Homes, Hospitals, or ICFs/MR. Respite may be provided in hospitals and nursing homes through base funding under Base-Funded Respite Care.