Respite Care

Service Standard

Respite Care Service Standard print version

Subcategories	Service Units
Day Care – Infected Child (under 13)	Per hour
Day Care – Infected Adult	Per hour
Respite Care Sporadic relief of the caregiver of any aged, infected client.	Per hour

Health Resources & Services Administration (HRSA) Description:

Respite Care is the provision of periodic respite care in community or home-based settings that includes non-medical assistance designed to provide care for a HRSA Ryan White HIV/AIDS Program (RWHAP)-eligible client to relieve the primary caregiver responsible for the day-to-day care of an adult or minor living with HIV.

Program Guidance:

Recreational and social activities are allowable program activities as part of a respite care service provided in a licensed or certified provider setting including drop-in centers within HIV Outpatient/Ambulatory Health Services or satellite facilities.

Language assistance must be provided to individuals who have limited English proficiency and/or other communication needs at no cost to them in order to facilitate timely access to all health care and services.

Subrecipients must provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area to inform all individuals of the availability of language assistance services.

All AAs and subrecipients must establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organizations’ planning and operations.

Limitations:

Funds may not be used for off premise social/recreational activities or to pay for a client’s gym membership. Direct cash payments to clients are not permitted.

Services:

Services funded under this category are provided in community or home-based non- medical assistance programs designed to relieve primary caregiver(s) responsible for providing day-to-day care. A caregiver is defined as someone who either cares for a person living with HIV or is a person living with HIV who is responsible for taking care of children.

In those cases where funds are allocated for home-based respite care, such allocations should be carefully monitored to assure adherence with the prohibition on direct payments to eligible individuals. Such arrangements may also raise liability issues for the funding source which should be carefully weighed in the decision-making process.

Telehealth and Telemedicine is an alternative modality to provide most Ryan White Part B and State Services funded services. For the Ryan White Part B/SS funded providers and Administrative Agencies, telehealth and telemedicine services are to be provided in real-time via audio and video communication technology which can include videoconferencing software.

DSHS HIV Care Services requires that for Ryan White Part B or SS funded services providers must use features to protect ePHI transmission between client and providers. RW Providers must use a telehealth vendor that provides assurances to protect ePHI that includes the vendor signing a business associate agreement (BAA). Ryan White Providers using telehealth must also follow DSHS HIV Care Services guidelines for telehealth and telemedicine outlined in DSHS Telemedicine Guidance.

Service Standard and Measure

The following Standards and Measures are guides to improving health outcomes for people living with HIV throughout the State of Texas within the Ryan White Part B and State Services Program.

Standard	Measure
Initial Brief Assessment: Agency staff will initiate an intake within five (5) business days of the referral to include: Client’s support system. Needs of the client. Supporting documentation of the need for respite care will be included in the assessment. If informal respite care is to be used, assessment must include qualifications of the client’s personal support network provider.	Percentage of clients with documented evidence of an initial brief assessment completed within five (5) business days of the referral in the client’s primary record.
Plan of Care: In collaboration with the client and client’s family, a plan of care will be developed within ten (10) business days of initial brief assessment. The plan of care should be signed and dated by both the client and/or client’s family or legal guardian and is in the client’s primary record. A copy of the plan will be offered to the client and documented in the client’s record. The Plan of Care should include: Objective for respite care Estimate the number of respite care visits anticipated/services to be provided Setting type respite services will be provided in for the client Documentation that the plan of care is being followed may include at a minimum: Sign-in sheet documenting attendance in a facility or documentation of informal personal support network provider attendance in the home. Objective should be listed at the top of the sign-in sheet or documentation for reimbursement by the informal personal support network provider. Plan of care should be reviewed at least every six (6) months to see if progress is being met towards meeting objective of the respite care with documentation present in the client’s primary record.	Percentage of clients with documented plan of care developed within ten (10) business days of the initial brief assessment in the client’s primary record. Percentage of clients with updated and reviewed plans of care every six (6) months documented in the client’s primary record.
Referrals: If the needs of the client are beyond the scope of the services provided by the agency or clients informal support network, an appropriate referral to another level of care is made. Documentation of referral and outcome of the referral is present in the client’s primary record.	Percentage of clients with documented referrals for services beyond the scope of respite care provider in the client’s primary client record. Percentage of clients that were referred to another level of care have documentation of referral outcome in the client’s primary record.
Discharge: The agency and client will collaborate on a discharge plan once objectives have been met. Reasons for discharge may include: Services are no longer needed Services needed are outside the scope of respite care Client is deceased Client has moved out of the area Unacceptable client behaviors as defined per agency policy Client has not attended or received respite care per agency policy and procedure	Percentage of clients with documented evidence of reason for discharge in the client’s primary record.

Standard

Measure

Initial Brief Assessment: Agency staff will initiate an intake within five (5) business days of the referral to include:

Client’s support system.
Needs of the client.

Supporting documentation of the need for respite care will be included in the assessment.

If informal respite care is to be used, assessment must include qualifications of the client’s personal support network provider.

Percentage of clients with documented evidence of an initial brief assessment completed within five (5) business days of the referral in the client’s primary record.

Plan of Care: In collaboration with the client and client’s family, a plan of care will be developed within ten (10) business days of initial brief assessment. The plan of care should be signed and dated by both the client and/or client’s family or legal guardian and is in the client’s primary record. A copy of the plan will be offered to the client and documented in the client’s record.

The Plan of Care should include:

Objective for respite care
Estimate the number of respite care visits anticipated/services to be provided
Setting type respite services will be provided in for the client

Documentation that the plan of care is being followed may include at a minimum:

Sign-in sheet documenting attendance in a facility or documentation of informal personal support network provider attendance in the home.
Objective should be listed at the top of the sign-in sheet or documentation for reimbursement by the informal personal support network provider.

Plan of care should be reviewed at least every six (6) months to see if progress is being met towards meeting objective of the respite care with documentation present in the client’s primary record.

Percentage of clients with documented plan of care developed within ten (10) business days of the initial brief assessment in the client’s primary record.

Percentage of clients with updated and reviewed plans of care every six (6) months documented in the client’s primary record.

Referrals: If the needs of the client are beyond the scope of the services provided by the agency or clients informal support network, an appropriate referral to another level of care is made.

Documentation of referral and outcome of the referral is present in the client’s primary record.

Percentage of clients with documented referrals for services beyond the scope of respite care provider in the client’s primary client record.

Percentage of clients that were referred to another level of care have documentation of referral outcome in the client’s primary record.

Discharge: The agency and client will collaborate on a discharge plan once objectives have been met.

Reasons for discharge may include:

Services are no longer needed
Services needed are outside the scope of respite care
Client is deceased
Client has moved out of the area
Unacceptable client behaviors as defined per agency policy
Client has not attended or received respite care per agency policy and procedure

Percentage of clients with documented evidence of reason for discharge in the client’s primary record.

References

HRSA/HAB Division of Metropolitan HIV/AIDS Programs Program Monitoring Standards – Part A April 2013. p. 46-47. Accessed on October 12, 2020.

HRSA/HAB Division of State HIV/AIDS Programs National Monitoring Standards – Program Part B April 2013. p. 45-46. Accessed October 12, 2020.

Virginia Department of Health Division of Disease Prevention HIV Care Services Respite Care 2009- 2010

HRSA/HAB Ryan White Program & Grants Management, Policy Notices and Program Letters, Policy Change Notice 16-02

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Respite Care

Service Standard

Health Resources & Services Administration (HRSA) Description:

Program Guidance:

Limitations:

Services:

Service Standard and Measure

References