HCBS Waivers - Medicaid Paid Respite

Wilted Daughter

In another post I described the trials of seeking caregiver respite. I was notified today that 7-day respite is approved (Paid by Medicaid). I'm passing on what I learned/know...hopefully someone else may benefit.

The short version:

*Many states have Home & Community Based Services Waivers 1915c. These waivers differ by state and are under benefits provided by Medicaid. 

*There may be a respite program under HCBS and what is known as Frail Elder Waiver (FEW) offered by your state Medicaid. The two waivers are separate but are similar in offering people with certain needs care services & support in the home or community. 

*To see if your state offers these community based waivers check Medicaid.gov (Home & Community Based Services 1915c) and CMS.gov (search State Medicaid Plans and Waivers, State Resources Map, State and Federal Relationships...)

*If you have senior Medicaid (65+) and have medical conditions then you likely qualify for services of said waivers. There is a designated agency in communities throughout the state that handles these waivers. Once you have Medicaid contact this agency and ask for a lists of services that they provide or specifically request Respite (AKA Caregiver Respite). 

*In my state/community Elder Services handles HCBS. I contacted case worker (A case worker is assigned after signing up for agency services, after Medicaid approval). I requested caregiver respite (You can just ask for respite stay services). I contacted the facility (skilled nursing center) in the area which accepts patients under this program, spoke with a social worker to check available beds and dates (saves time/energy if you make direct contact). Then (or at the same time as you inquire about the respite stay with the agency) you advise the agency of your selection. They process the request, which may involve nurse evaluation/approval, and approve or deny (if you apply/qualify for the waiver(s) then you likely qualify for all its services). Medicaid pays for the stay after agency approval. Check facilities in your area that participate, check for available beds/dates. In my state the respite length is 7 days, which I was informed by agency case manager that there is no known limit for the number of stays that can be requested (I'm sure there is a limit). From my experience it is easier if you have facilities, dates in mind then reach out to the facilities first before contacting the agency for approval/processing.

*I've have been approved for 7 day respite for mom, but waiting on available bed at the chosen facility. So this is something to consider/plan ahead. It's also not for everyone as some my not want placement out of the home.

Hope this helps someone else find caregiver respite and take a break. Best wishes to you all  in the new year!

Marta

Daughter:  this is a very nice thing you have done, sharing this information which you pursued with so much diligence. 

Would you care to share how you will spend this respite?

Jo C.

Thank you very much for this important information; I can well imagine it will be helping many other caregivers.

I will be saving this in my files for future reference to remind myself.

J.

abc123

Dear Wilted Daughter,

Thank you for sharing this with us. I'm happy that you will have a 7 day respite. Good for you! 

Wilted Daughter

Marta, LOL I don't know yet...I'll let you know when it's over (like a dream). 

I just thought it would be helpful for you guys to know. The process, benefits may differ between the states but the HCBS waiver is consistent by its design. 

Best wishes to you all!

dayn2nite2

OMG I had enough trying to keep track of the Medicaid rules when my mom was in a NH.  I'm kind of glad my state offers no waivers in my area, no nothing at home on Medicaid, because having to apply, wait for approval and plan for 7 days' respite almost sounds like more trouble than it's worth.