RESPITE CARE SERVICES PROVIDER IN HAWAII

OFFERING TEMPORARY RELIEF FOR PRIMARY CAREGIVERS WHILE ENSURING CONTINUITY OF CARE AND SUPPORT FOR PARTICIPANTS

Respite Care Services in Hawaii provide short-term, substitute care for individuals with disabilities, chronic health conditions, or aging-related needs to relieve family members or regular caregivers. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and aim to prevent caregiver burnout, promote family stability, and ensure individuals continue to receive person-centered care.

1. GOVERNING AGENCIES

Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division

Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Respite Care Services

Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)

Role: Administers HCBS waiver respite services for individuals with intellectual and developmental disabilities (IDD)

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Respite Care Services meet Medicaid HCBS quality standards

2. RESPITE CARE SERVICE OVERVIEW

Respite Care Services provide temporary relief to caregivers by offering direct care, supervision, and support for the participant.

Approved providers may deliver:

• In-home respite services (provided at the participant’s residence)

• Out-of-home respite services (in an approved community or facility setting)

• Scheduled or emergency respite care

• Support with Activities of Daily Living (ADLs) such as bathing, eating, toileting, and mobility

• Health and safety monitoring

• Engagement in recreational and social activities during respite sessions

• Overnight or daytime coverage, depending on the participant and caregiver needs

All services must be tied to goals in the participant’s Individualized Service Plan (ISP) and must not duplicate services received through other Medicaid programs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)

• Obtain EIN from the IRS and NPI (Type 2)

• Enroll as a Medicaid provider through Hawaii’s Med-QUEST Division

• Complete DDD Provider Certification for respite services (for DD/ID Waiver participants)

• Maintain general liability and professional liability insurance

• If providing out-of-home respite, meet any applicable licensing requirements for the facility (if overnight care is provided)

4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Respite Care Services through Hawaii’s Med-QUEST Division

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, service descriptions, staff credentialing documentation, and insurance certificates

• Provide sample respite service schedules, emergency protocols, and participant intake forms

Program Readiness Review:

• DHS and DOH review provider readiness, including participant protection measures, staff training protocols, service documentation systems, and Medicaid compliance procedures

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Respite Services (hourly, daily, or overnight rates based on the model)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Hawaii DCCA)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake, caregiver coordination, and service authorization tracking

  • Respite service delivery and daily activity documentation

  • Emergency response and health monitoring protocols

  • Participant rights, HIPAA confidentiality, and grievance resolution procedures

  • Staff credentialing, background checks, and competency verification

  • Medicaid billing, service authorization tracking, and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Respite Services Program Manager/Supervisor

Requirements: Experience in direct care, personal assistance, or human services management preferred; background screening clearance

Role: Respite Care Workers / Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; CPR/First Aid certification preferred; background screening clearance

All staff must complete:

• HIPAA confidentiality and participant rights training

• Abuse prevention, incident reporting, and emergency preparedness training

• Participant safety, ADL/IADL support, and community integration training

• Annual continuing education related to direct care best practices and Medicaid compliance

7. MEDICAID WAIVER PROGRAMS

The following Hawaii Medicaid Waivers authorize Respite Care Services:

• Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver

• Community Care Services (CCS) Program (if respite services support participants’ continued community living)

Approved providers may deliver:

• In-home respite care tailored to participant and family needs

• Out-of-home respite care in approved community settings

• Emergency or scheduled respite services

• Daily, hourly, or overnight supervision, depending on participant needs

8. TIMELINE TO LAUNCH

Phase: Business Formation and Initial Credentialing Setup

Timeline: 1–2 weeks

Phase: Med-QUEST Provider Application and Readiness Review

Timeline: 60–90 days

Phase: Staff Hiring, Credentialing, and Participant Intake System Setup

Timeline: 30–45 days

Phase: Medicaid Enrollment and Billing System Configuration

Timeline: 45–60 days

9. CONTACT INFORMATION

Hawaii Department of Human Services (DHS) — Med-QUEST Division

Website: https://medquest.hawaii.gov/

Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)

Website: https://health.hawaii.gov/ddd/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII RESPITE CARE SERVICES PROVIDER

WCG supports direct care agencies, caregiving organizations, and respite providers in launching Medicaid-compliant Respite Care Services under Hawaii’s HCBS waiver programs.

​Scope of Work:

• Business registration and EIN/NPI setup

• Medicaid provider enrollment and DHS respite certification support

• Development of Respite Care Services Policy & Procedure Manual

• Staff credentialing templates and participant intake/coordination forms

• Medicaid billing setup and claims management

• Website, domain, and email setup

• Participant intake, service scheduling, and daily documentation templates

• Emergency response planning and incident management procedures

• Quality assurance programs for participant safety and caregiver satisfaction tracking

• Community outreach and caregiver support network development strategies

Continue To Our Client Portal To Get Started

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