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Become A Certified Provider

Resource Manual

Module 1: INTRODUCTION TO RESPITE

Allocation and Payment

Respite Care has two basic levels of service. Each of the two levels reflects the amount of care needed by a child and is determined according to the following criteria:

Activities of Daily Living and Communication Needs: Does the child function independently in this area or does he/she require minimal assistance? Is the child totally dependent?
Behavior: Does the child have challenging behaviors or mild problems that the typical person could deal with, or does the child have behaviors that require a higher skill level of a provider?
Medical: Does the child have good health or is he/she in need of a respite provider who is trained to meet the needs of children with moderate to severe medical needs?

Level I: Basic allocations are given to children with mild to moderate delays, stable conditions, mild behavioral issues and the presence of stabilizing medication. This level also includes children who exhibit moderate to severe needs in care, have seizure activity or atypical behaviors requiring behavior management skills. They may require frequent medication changes, which may not always stabilize the behavior. Therapeutic Crisis Intervention (TCI) or other behavioral intervention training is suggested for working with children who have emotional or behavioral diagnoses.

Level II: These children exhibit the highest needs, having severe medical, behavioral or emotional needs, which require a high level of skill from a provider. Children at this level can exhibit aggressive and/or assaultive behaviors. Behavioral intervention training is highly recommended.

Non-certified providers are reimbursed at a lower rate than certified providers. This is shown below:

	NON-CERTIFIED Rate of Pay	CERTIFIED Rate of Pay
Level I	$7.00/hr. up to $70.00/day	$9.00/hr. up to $90.00/day
Level II	$9.00/hr. up to $90.00/day	$11.00/hr. up to $110.00/day

All providers (certified and non-certified) must have a current W-9 and Independent Contractor Vendor of Respite Services Agreement on file before providing Respite services, in compliance with federal law. The Respite Program processes billing forms weekly, however Providers must allow two full weeks (14 days) from the date the bill is received in the office for payment to arrive.

Request for reimbursement must be submitted in a timely manner. Check with your regional Respite Program for their requirements for billing.

	Quarters	Due no later than
1st	July 1 - September 30th	October 7th
2nd	October 1 - December 31st	January 7th
3rd	January 1 - March 31st	April 7th
4th	April 1 - June 30th	July 7th

Billing forms received after the 7th will be paid from the next quarter's allocation as long as funding is available. Families are not able to carry hours from one quarter to another without the pre-approval of the Program Director. Billing forms received after the close of the fiscal year (July 7th) will be returned unpaid.

Mileage may be paid to certified respite providers willing to travel in excess of 25 miles, one-way in order to provide services to a family. Mileage above 25 miles one-way will be reimbursed as regional Program budgets allow. Check with your Regional Program for rate of reimbursement. Bus fare and/or ferry fare for certified providers may also be reimbursed if these are the primary means available for getting to a family's home. The Program Director must pre-approve the re-imbursement rates before payment will be authorized.

Long-distance telephone calls are not reimbursable. Parents who request providers to take their child to activities that charge a fee (ex: amusement parks, movie theaters, museums) must be responsible for paying for the child. Parents must also negotiate payment for care of siblings who are not eligible for services through the Respite Program. Providers may not care for more than three children in any one family at any time, nor can they care for children from different families at the same time.

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