Board clarifies adult and child respite rules, adds group respite option for some child waivers

The Medical Services Board approved revisions to adult and child respite rules across several waivers to improve clarity and consistency with federal waiver approvals.

Corinna Barak and Karina Barrick of the Office of Community Living said the rule changes remove in-home respite from the Community Mental Health Supports (CMHS) waiver where there is no federal authority, add a 30-day cap on respite days per plan year for Supported Living Services (SLS) — consistent with waiver language — and clarify that legal guardians, primary caregivers or legally responsible persons may not provide respite. The department added objective criteria for "over-the-cap" exceptions to be based on documented increases in medical or behavioral needs.

For child waivers (CES, CW CHN and CHIRP), the department proposed a new group-respite service delivery model under CHIRP to allow families with more than one child on a waiver to use a single provider for group respite, reducing administrative burden. Karina Barrick said these changes reflect waiver requirements and that CDHS foster-home standards will be referenced rather than copied into rule text.

Board members asked for clarifications on behavioral-health cases, foster-care standards and how respite differs across waivers; the department answered that skilled and therapeutic respite options exist for higher-need children and that exceptions processes remain.

Ending: The board adopted document 4 and moved it to the consent agenda for next month; the department said the changes are budget-neutral and would benefit a modest share of waiver members.