Respite care is a valuable service for family caregivers that provides a break from the demands of caregiving. Most states cover respite services through Medicaid waivers that provide a range of home and community-based services, but many cap the amount of respite care covered.
Many states put a numeric cap on respite care (set limit of hours or days per service year), but caps vary widely from waiver to waiver. The cap per service year for adults ranges from 9 days (Tennessee) to 50 days (Arkansas) and the cap for children ranges from 7 days (Florida) to 180 days (Minnesota). Some states use other methods to determine service amounts, such as assessed need in an individual’s service plan.
This map, the first in a series, explores numeric caps on respite services for adults and children.
A detailed inventory of each state’s waiver respite service, along with links to each waiver, can be found in these charts:
*For purposes of this map, ‘no caps’ means the service limit is determined by an alternative method (i.e., assessed need in an individual’s service plan) or the cap is not specified in the waiver.
About This Map
NASHP conducted this scan of 1915(c) and 1115 Medicaid home and-community based service waivers for respite services covering older adults, adults with physical disabilities, and children and youth with special health care needs (CYSHCN), as well as Medicaid 1915(i) state plan amendments for CYSHCN.
In total, NASHP analyzed 82 waivers for older adults and adults with physical disabilities and 145 waivers and 8 1915(i) state plan amendments for CYSHCN. Our focus centered on service caps as one way to survey respite policy activity and identify state flexibilities that have direct impact on caregivers. While waiver authorities are not the only vehicle states use to provide respite, Medicaid is a large payer of long-term care services.
This analysis does not include waivers for adults with intellectual/developmental disabilities, traumatic brain injuries, behavioral health concerns, or HIV/AIDS. To learn more about waivers for these populations, see this respite service inventory for Medicaid waivers by the ARCH National Respite Network and Resource Center.
Acknowledgements: This project was made possible by support from The John A. Hartford Foundation and the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $992,990 with 75 percentage funded by ACL/HHS and $247,253 amount and 25 percentage funded by non-government source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
