If you are the person who makes sure your family member is safe every day, you also need time away: to sleep, to work, to see a doctor, or just to rest. Minnesota's disability and elderly waivers can pay for that. The service is called respite, and it is one of the most useful and least understood services on a waiver plan.
This guide explains how respite works under Minnesota's waivers, using the rules in the Minnesota Department of Human Services (DHS) Community-Based Services Manual page on respite. Rules change, and every support plan is different, so confirm the details with your county case manager.
What respite is
DHS defines respite as "short-term care services provided to a person when their primary caregiver is absent or needs relief." A trained staff person takes over the care and supervision your family member needs, so you can step away.
Respite is about care and safety, not teaching new skills. DHS says it covers the "level of supervision and care that is necessary to ensure the person's health and safety." It does not cover services aimed at training or habilitation. Those are separate services, such as individualized home supports with training. And if what you need is help keeping the house clean and running rather than someone to step in for you, homemaker services may fit better.
Which waivers pay for respite
Respite is covered under the Brain Injury (BI), Community Alternative Care (CAC), Community Access for Disability Inclusion (CADI), Developmental Disabilities (DD) and Elderly Waiver (EW) plans, and under Alternative Care (AC). If you're not sure which waiver your family member has, CADI waiver eligibility in Minnesota covers the most common one for adults.
Who counts as the "primary caregiver"
Respite exists to support the caregiver, so DHS sets rules about who that is. They differ by waiver.
On BI, CAC, CADI and DD, the primary caregiver must:
- Be principally responsible for the person's care and supervision.
- Live at the same address as the person, as their primary residence.
- Own or lease that home.
On AC and EW, the primary caregiver must be principally responsible for the person's care and supervision, and either not be paid at all or be paid for only part of the time they provide care. On these programs the caregiver does not need to live in the same house.
In practice, this means respite on the disability waivers is mostly for families caring for an adult in the family home.
In-home and out-of-home respite
DHS describes two kinds:
- In-home respite happens in the person's own home. It can include time out in the community, such as a park, a library or a mall, while the person keeps living at home.
- Out-of-home respite happens somewhere other than the person's home, in a licensed or unlicensed setting. It can also include time out in the community.
DHS lists the settings where out-of-home respite can happen, each with its own age and licensing rules, such as adult foster care homes, community residential settings, camps and some unlicensed settings for adults. Your case manager can tell you which ones fit your family member's waiver and needs.
A provider giving in-home respite must hold a Minnesota 245D license as a basic support service provider, or a Chapter 144A license with a home and community-based services designation. Some individual caregivers can be excluded from 245D licensing; your case manager can explain when that applies.
Overnight and longer stays
Many families need help most at night, or for a whole weekend. Respite can be authorized in 15-minute units for shorter visits or as daily units for longer ones:
- On BI, CAC, CADI and DD, the county must use a daily rate when respite runs 10 or more hours in a day.
- On AC and EW, the daily rate is used when respite runs 12 or more hours, or overnight.
For out-of-home 24-hour respite, DHS limits a stay to a maximum of 30 consecutive days per respite occurrence, and the length of the stay must be written into the support plan.
What respite does not cover
Knowing the limits up front saves frustration later. According to DHS, respite does not cover:
- Services aimed specifically at training and habilitation.
- Room and board when respite happens in the person's home or in an unlicensed setting. Room and board is covered when respite is provided in a licensed setting.
- Remote support during out-of-home respite. In-home respite in 15-minute units can be delivered through remote support if it meets DHS's remote support rules.
- On the DD Waiver, a short-term admission to a nursing facility.
Respite also generally can't be added when the person already receives one of these services, because those services already include round-the-clock support:
- Community residential services (BI, CAC, CADI, DD)
- Integrated community supports, or ICS (BI, CAC, CADI, DD)
- Customized living (BI, CADI, EW)
- Family residential services using shift staffing (BI, CAC, CADI, DD)
- Adult foster care (EW)
DHS makes exceptions during a declared community emergency or disaster.
How to get respite added to a support plan
- Talk to your case manager. Respite is authorized by the lead agency, usually your county, on your family member's support plan. Explain what you need: a few hours a week, regular overnights, or a planned weekend away.
- Describe your caregiving honestly. At a MnCHOICES assessment or a plan review, say what you do each day and where you need relief, so it can be written into the support plan.
- Choose a provider. The provider must be enrolled with DHS for respite and properly licensed for the setting. Our list of questions to ask a 245D provider works for respite providers too.
- Plan the first visit. A good respite provider will want to learn your family member's routine, medications, likes and triggers before the first long shift.
Respite with Midway Homes
Midway Homes Adult Care LLC is a Minnesota 245D-licensed provider, and respite care is one of the basic support services we offer families caring for an adult at home. We serve Ramsey, Hennepin, Dakota, Scott, Washington, Chisago and Pine counties.
If you're caring for someone and running on empty, call 612-416-8555. We'll talk through what kind of respite would help and whether your family member's waiver covers it. If another provider is a better fit, we'll tell you.