Respite Services are provided to caregivers of Members who require intermittent temporary supervision. The services are provided on a short-term basis because of the absence of or need for relief for those persons who normally care for and/or supervise them.
Respite Services are non-medical in nature and may include any of the following:
- Services provided by the hour on an episodic basis because of the absence of or need for relief for those persons normally providing the care to individuals
- Services provided by the day/overnight on a short-term basis because of the absence of or need for relief for those persons normally providing the care to individuals
- Services that attend to the Member's basic self-help needs and other activities of daily living, including interaction, socialization, and continuation of usual daily routines that would ordinarily be performed by those persons who normally care for and/or supervise them
- Home Respite Services are provided to the Member in his or her own home or another location being used as the home
Eligibility Requirements
- Members are eligible for Respite Services if they live in the community and are compromised in their Activities of Daily Living (ADLs) and are therefore dependent upon a qualified caregiver who provides most of their support, and who require caregiver relief to avoid institutional placement are eligible for Respite Services.
Exclusions
- In the home setting, these services, in combination with any direct care services the Member is receiving, may not exceed 24 hours per day of care.
- Service limit is up to 336 hours per calendar year. The service is inclusive of all in-home services. Exceptions to the 336-hour-per-calendar-year limit can be made, with L.A. Care authorization, when the caregiver experiences an episode, including medical treatment and hospitalization that leaves the Member without their caregiver. Respite support provided during these episodes can be excluded from the 336-hour annual limit.
- Respite Services cannot be provided virtually (e.g., via telehealth).