Respite Care 607-05-70-45-20-01

(Revised 10/1/2024 ML 3868)

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Throughout the life of the case, managing safety and providing service is achieved by ongoing engagement and assessment conducted by the agency. Respite care is defined as a pre-planned arrangement available to a parent/caregiver who needs temporary relief care for a child who requires time-limited supervision and support by an eligible respite care provider. Children may require additional support to maintain stability in their primary placement and respite care is a service the agency can consider. Respite care can be a highly effective reasonable effort to prevent removal from the home.

 

Eligible Children

Respite care is available to children under the age of 18 involved with the following public agencies:

 

Human Service Zones

• Child Protection Services (CPS)

• Case Management (In Home/Foster Care)

 

Division of Juvenile Services (DJS)

• Foster care placement

 

Tribal Social Services

• Foster care (IV-E) clients

 

Post-Adoption

• Department subsidy recipient only, must first expend funding from ND Post Adopt.

• A department subsidy recipient who is dually involved with a Human Service Zone and post adopt services may access CFS respite funds while their case remains open with the Human Service Zone.

 

Post-Guardianship

• Department subsidy recipient and those who were previously involved in North Dakota child welfare within the last 12 months prior to the establishment of a guardianship, must first expend funding from ND Post Adopt.

• A department subsidy recipient who is dually involved with a Human Service Zone and post guardianship services may access CFS respite funds while their case remains open with the Human Service Zone.

 

Relative Caregivers

A child may be in a primary placement with an unlicensed relative caregiver. The relative caregiver can request respite care in an effort to support the child’s needs and maintain placement stability. A child does not have to be under public custody of an agency or have a supervision order to access respite care.

 

Respite Care Request and Provider Agreement

The public agency staff is responsible to assist with completing the required paperwork and identify a licensed provider willing to offer respite care.

1. Public agency staff will submit Part 1 of the SFN 929, “Respite Care Referral and Agreement” requesting a pre-approval to the CFS Licensing Unit at cfslicensing@nd.gov.

    

2. If the request is approved the public agency staff must submit the SFN 929 “Respite Request and Provider Agreement” Part 2. This form must be submitted via email to the CFS Licensing Unit no greater than 30 days after the respite care episode has occurred in order to ensure reimbursement is made to the provider timely.

Respite care providers can only provide respite care to the child identified on the agreement. One SFN 929 can accommodate multiple respite care episodes for the same child if it is clearly documented on the form.

 

Respite Care Providers

A child must be provided respite care by:

• Licensed foster parents;

• Licensed child care providers; or

 

In order to receive reimbursement, the licensed provider must:

1. Sign the SFN 929 specific to the respite care provided to each eligible child.

 

2. Register with the Office of Management and Budget’s (OMB) vendor registry by

a. Electronically self-registering at the vendor registry website (https://www.nd.gov/omb/vendor/vendor-payments); or

b. Manually signing and submitting a W-9 (SFN 53656) and voided check.

 

Amendment to a Foster Parent License

The Department is not required to amend a foster parent’s license to accommodate respite care when the SFN 929 is signed. The form provides a waiver in the event the number of beds needed when providing respite care exceeds the number on the license.

 

The Department will review the foster parent licensed bed capacity, discuss need, sleeping arrangements, and appropriateness of the respite care in lieu of amending the formal license.

 

Treatment Foster Care Providers

Agencies offering treatment foster care services (i.e., Nexus-PATH) have policy and procedure to administer respite care payments within their agency structure. A treatment foster care provider is required to sign the SFN 929 when:

 

1. Respite Care to a Non-Agency Client: In order to offer respite care to a child who is not a current client in placement with the agency, the provider must sign the SFN 929 to provide respite care and be reimbursed directly from the Department.

    

2. Respite Care to an Internal Agency Client: If the respite care episode will bring the treatment foster care provider over the licensing capacity, the provider must sign the

   SFN 929. A Department payment is not associated with the internal agency respite care payment structure. However, the Department must pre-approve these respite care episodes in an effort to eliminate the need to amend the license.

 

Length, Duration, and Frequency of Respite Care

There is no limit on the number of respite care requests an eligible child may receive; however, there is a limit to the length of time for each episode. Each respite care episode cannot exceed:

 

Overnights

A respite care episode is defined as no greater than 4 calendar days per week.

 

Non-overnights

A respite care episode is defined as no greater than 12 hours per week, unless otherwise approved by the department.

 

Respite Care Reimbursement

Respite care funds are maintained at the Department and managed by Children and Family Services. Reimbursement is allowed for pre-planned and pre-approved respite care needs. Reimbursement is paid directly to the licensed provider listed on the SFN 929.

 

Foster Care Provider

Daily rate is determined by the Department and managed by Children and Family Services. For more information about the current respite care rate refer to the maintenance rate sheet. The rate is subject to change dependent on program budget.

 

If there is a child in foster care receiving an excess maintenance payment (EMP), the child's EMP may be reimbursed if the child's daily rate + EMP are higher than the respite care rate determined by the department.

 

Child Care Provider

Child care costs vary per community standards. The Department will pay the community rate.

 

Additional Costs

Respite care funds can cover additional costs associated with providing respite care and such costs must be pre-approved by Children and Family Services. Additional costs may include but are not limited to:

• Excess costs related to transportation to/from the child’s school of origin.

   

• Child care costs when a child placed with a primary provider does not utilize child care during the week, but the respite care provider works fulltime and would need child care during the day. The child care costs to a licensed child care setting can be included as additional costs paid to the respite care provider. A SFN 920 is required to be completed and submitted as part of the reimbursement.

 

Respite Care Examples

Primary Placement

• Child in the home of parent/guardian/ adoptive family

• Child in the home of a relative or fictive kin on a voluntary basis

• Child in a licensed foster home

• Child in an unlicensed relative placement (including TANF Kinship)

• Child on a trial home visit

 

Approved Scenarios

• A mother of a substance exposed newborn would like to participate in day treatment services and needs a break from the high demands of her baby. The Plan of Safe Care developed includes respite care so that she has the opportunity to focus on her treatment and to provide support to her and the newborn.. Respite care is provided so that she has the opportunity to focus on her treatment and to provide support to her and the newborn.

   

• Child is living with mom and three siblings. There was a recent CPS assessment opened. The two youngest children are very busy, and the CPS worker recognizes mom would benefit from one weekend of respite care each month to provide relief and support to her, and to stabilize the children in the home.

   

• A toddler child is living with grandma. The child requires extra supervision that is taxing for the grandma. The case manager recommend respite care two mornings a week for the next two months to give grandma a break, complete household chores, and grocery shop.

   

• Child is destroying property; the primary caregiver asks for help to re-group and seeks respite care to temporarily provide relief and support.

   

• Child is placed in a licensed foster home apart from siblings. The case manager and foster parent observe his behaviors are escalating and he misses his siblings. The case manager arranges respite care with the siblings’ foster parents once per month for a weekend visit. This respite care arrangement is intended to assist with placement stability, child behaviors, sibling connections, etc.

   

• Foster parents are going to a wedding out of town where there will be loud music, lots of people, etc. They indicate the child placed in their home with severe autism does not do well in large groups and would benefit from respite care while they attend the wedding for two days. Given the needs of the child, the case manager requests respite care to assist in meeting the child’s needs, manage placement stability, and support the foster parents.

 

Scenarios Not Approved

• Mom is asking for respite care for her three children over the weekend because she does not have any family supports locally and she wants to go to camping with her friends. Respite care is not intended to provide babysitting services.

   

• Foster parents are going to a wedding out of town and they would prefer to not bring the children placed in their home. The children do not have special needs or cares that would prohibit them from attending such an event. Substitute care may be an option in this situation.

   

• Grandma is caring for grandchildren under public custody of a Human Service Zone. She is asking to discontinue her responsibility as the primary placement of the children because the fulltime arrangement is too much for her. A new placement option should be identified in lieu of respite care.

   

• The children reside with their mom and are open with the agency for case management. The mom has registered for parenting classes but does not have child care during the time classes occur. This is an appropriate referral for Prime Time Child Care, not respite care.

 

Qualified Residential Treatment Program (QRTP) Aftercare Respite

Eligible Children

QRTP Aftercare Respite is available to former qualified residential treatment program residents who were approved through the QRTP assessment process and are engaged in the six-month aftercare program.

 

QRTP Respite Care Providers

Dakota Boys and Girls Ranch

 

QRTP Aftercare Respite Request

A ND QRTP operating an aftercare respite program will have familiarity with these youth as they have been previously placed at the QRTP for treatment and are currently engaged in aftercare programming through the QRTP. The QRTP Family Engagement Specialist will work in conjunction with the legal custodian, parent or guardian to identify services and support to the help maintain the child in the community. A facility operating an aftercare respite program will require the legal custodian, parent or guardian to sign the aftercare respite agreement prior to or upon admission to the aftercare respite program. When a child is admitted for respite, the QRTP will develop an abbreviated plan supporting a short-term refocus and addressing needed services and supports to return to the community.

A ND QRTP operating an aftercare respite program, may allow for respite admissions from an active aftercare client served by another ND QRTP.

 

Length, Duration, and Frequency of QRTP Aftercare Respite Episodes

There is no limit on the number of aftercare respite requests an eligible aftercare client may receive; however, there is a limit to the length of time for each episode. Each aftercare respite episode cannot exceed 7 calendar days from admission. An aftercare client may not receive more than 14 calendar days of QRTP aftercare respite in a 30-day period.

 

Aftercare Respite Reimbursement

North Dakota QRTP aftercare respite reimbursement will be managed through the CFS Licensing Unit.

Eligibility criteria for reimbursement through the CFS Licensing Unit are specific to QRTP aftercare clients in currently or previously involved with a:

1. Human Service Zone

2. Tribal IV-E

3. Division of Juvenile Services

Invoices will be submitted by the QRTP to the CFS Licensing Unit, who will verify if the child is still in public custody or was previously in public custody during the 6-month aftercare period.

1. If the child is still in public custody with an open foster care episode in the case management system, the CFS Licensing Unit will enter and approve the Group Home Approval and enter the QRTP aftercare respite episode as a secondary placement into the case management system, so payment can be managed through the payment system.

2. If a child is no longer in public custody and the foster care episode is closed in the case management system. The CFS Licensing Unit will reimburse the QRTP provider directly.

 

NOTE: QRTP aftercare respite episodes do not count towards a child’s placement maximums