Respite Care 624-05-15-48

(Revised 1/15/21 ML #3606)

View Archives

 

 

Respite is available to children currently involved with a local Human Service Zone through child protection services, in-home services, or foster care programming. In addition, respite is allowed for children previously involved who have since entered guardianship or were adopted. Respite is also available to children under the custody of Tribal social services as Title IV-E eligible and Division of Juvenile Services open in the foster care program. Children in foster care may require additional support to maintain stability in their primary placement. Respite care is defined by foster care policy as temporary relief care for a child with special medical, emotional or behavioral needs, which requires time-limited supervision and care by a licensed provider.

 

**NOTE** Respite is not substitute care. There are times when a foster parent is unavailable to care for a foster child due to other commitments (vacation, funeral, special out of town event, etc.) Respite cannot be used when a foster parent is unavailable and in need of substitute care.

 

All children in North Dakota foster care are eligible for respite; even if the child is placed in unlicensed relative care or placed out of state. A foster child must be provided respite care by a licensed foster parent or a licensed child care provider. A licensed child care provider can only be utilized during daytime hours and respite cannot exceed 10 hr/week unless otherwise approved by the Field Service Specialist. The licensed provider must sign a respite provider agreement (SFN 929) and register on OMB vendor registry website as proof of a signed W-9 for reimbursement.

 

Examples of Foster Youth who can Utilize Respite:

1. Primary Placement:

• Foster child in a licensed foster home
• Foster child in unlicensed relative placement
• Foster child is on a trial home visit
• Foster child in kinship relative care (TANF recipient)

2. Appropriate scenarios for respite:

• Child is destroying property at the foster home; foster parents ask for help in re-grouping to see if a small stay elsewhere will help the child better engage in the primary home.
• Child is living with unlicensed relative (grandma). Child is very busy and Grandma is stating a weekend to recharge her battery would be helpful for her own mental health needs and to stabilize the placement ongoing.
• Child is living with unlicensed relative (grandma). The toddler foster child is very busy and Grandma is stating two mornings a week (8 hr/wk) for the next two months would be helpful so she can recharge her battery and complete household tasks she is unable to do when the child is in the home. A licensed child care provider could provide respite to grandma for the 8 hr/wk.
• Child is missing his siblings; because of this the foster parents indicate his behaviors are escalating in the primary placement. The case manager reaches out to see if the foster parents who have the other two siblings would be willing to offer respite for a weekend sibling visit and to monitor the placement stability, child behaviors, etc.
• Foster parents are going to a wedding where there will be loud music, lots of people, etc. They indicate the foster child with autism does not do well in large groups and would benefit from a short respite stay while they attend the wedding for two days. In this case, the case manager could approve respite if the child’s behaviors would result in additional cares.

3. Inappropriate scenarios for respite:

• Foster parents are going to a wedding and they would rather not have to bring all of the children… this is substitute care, not respite.
• Foster parents are asking to discontinue their responsibility as the primary placement. A new placement option should be identified in lieu of respite stays.

 

Respite Referral/Request

Foster care case managers can request respite services by completing the SFN 925, Respite Care Referral. This form must be submitted in advance to the Children and Family Services assigned Field Service Specialist for pre-approval. The form was created to help Field Service Specialist verify the need for respite care, review the licensing capacity of the family being asked to provide the respite, while tracking the programs utilizing respite care.

 

Respite Reimbursement

Respite care funds are maintained at NDDHS Children and Family Services (central office) and paid to licensed providers by NDDHS Fiscal. Reimbursement is allowed for pre-planned respite and will only occur if the respite arrangement is pre-approved by the Field Service Specialist. Respite care is limited to 96 hours at the “emergency rate” of $38/day. However, if the child’s level of care is beyond the daily rate and the foster child is currently receiving an EMP, the higher daily rate may be reimbursed to the respite provider.

 

Respite care can cover additional costs of reimbursement if needed specific to child care and transportation to and from school of origin. If a foster child is with a primary provider who does not utilize child care during the week, but the respite provider does work fulltime and would need child care during the week; the child care costs to a licensed child care setting can be made to the respite provider to assist with the care of the child during the respite stay. All additional costs must be pre-approved by the case manager and approved by the Field Service Specialist.

 

Respite care can cover additional costs for licensed foster care providers specific to child care and transportation to and from school of origin. If a foster child is with a primary provider who does not utilize child care during the week because they do not work, however the respite provider does work fulltime and would need child care during the week; the child care costs to a licensed child care provider can be made to the respite provider to assist with the care of the child during the respite stay. All additional costs must be pre-approved by the case manager and approved by the Field Service Specialist.

 

Respite care provided by a licensed child care provider during daytime hours that exceeds $38/day must have a receipt or bill provided to the Field Service Specialist to support the cost of the care. Child care costs vary per community standards, respite can pay the community rate. Respite in a child care setting is capped at 10 hours per week, unless approved by the Field Service Specialist.

• Paid Placement: The licensed foster parent providing respite care can claim the child care costs under the primary foster parent irregular payment category 40 (if applicable) or claim under “additional costs” on the form.
• Unpaid Placement: The unlicensed relative caregiver would need the child care provider to complete the form and claim the child care costs of $38/day. If the cost of the respite offered by a licensed child care provider exceeds $38/day, a receipt or bill would be required to justify the expense of the child care costs.

Respite payments are made outside of the foster care payment system and are in addition to the primary placement maintenance rate. Respite reimbursement will be made by NDDHS directly to the licensed provider listed on the SFN 929.

 

Licensed Provider – Amendment to the license

The SFN 929, respite agreement, must be completed and pre-approved for a licensed foster home providing temporary respite. The Department is not required to amend the foster care license to accommodate the short-term respite placement, so long as the SFN 929 is signed and reviewed granting permissions to proceed. The Department must review the license with the requesting foster care case manager to discuss need, sleeping arrangements, bed space and appropriateness of the respite in lieu of amending the formal license.

 

Relative Caregivers

A foster child may be in a primary placement with an unlicensed relative caregiver. The relative caregiver can request respite care in efforts to support the child’s needs and maintain stability in placement. The foster care case manager must receive approval from the Field Service Specialist in order to proceed with planning for a respite care arrangement. The case manager is responsible to assist with paperwork and seek to identify a licensed foster parent willing to offer temporary respite.

 

Therapeutic Foster Care Providers

Agency providers offering therapeutic foster care services (Ex: PATH and LSS) have policy and procedure to administer respite payments within their agency structure. A therapeutic provider is required to sign the SFN 929, respite agreement, when:

1. Respite to Non-Agency Client: In order to offer respite services to a child who is not a current client in placement with the agency, the provider must sign a SFN 929 to provide respite and be reimbursed directly from the Department.
2. Respite to Agency Client: In order to offer respite internally from one agency provider to another, a SFN, 929, respite agreement is only required when the foster home is licensed for a specific number of beds, but the respite stay will bring the therapeutic provider over the licensing capacity. An additional Department payment is not associated with the internal agency respite payment structure, however, the Department must pre-approve these respite placements in efforts to eliminate the need to amend the license.