RESPITE CARE SERVICES PROVIDER IN IDAHO

Fatumata Kaba
Jul 17
3 min read

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

Respite Care Services in Idaho provide short-term care and supervision to individuals with disabilities, chronic conditions, or aging-related needs, offering relief to their primary caregivers. These services are authorized under Idaho’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are essential in preventing caregiver burnout, promoting family stability, and maintaining participants’ safety and well-being in the community.

1. GOVERNING AGENCIES

Agency: Idaho Department of Health and Welfare (IDHW) — Division of Medicaid

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

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Respite Care Services meet Medicaid HCBS standards for participant-centered care

2. RESPITE CARE SERVICE OVERVIEW

Respite Care Services provide temporary substitute care for participants whose regular caregiver is unavailable due to vacation, illness, emergencies, or the need for personal time.

Approved providers may deliver:

Supervision and assistance with Activities of Daily Living (ADLs) such as toileting, grooming, eating, and mobility
Medication reminders (non-nursing tasks)
Health and safety monitoring
Engagement in recreational or educational activities
Overnight, daytime, or emergency respite care, depending on the needs identified in the participant’s Individualized Service Plan (ISP)

Respite services can occur in the participant’s home, the provider’s home, or an approved community setting and must not duplicate other Medicaid services provided concurrently.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Idaho Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through Idaho Medicaid Provider Enrollment
Maintain general liability and professional liability insurance
Develop participant-centered policies for intake, care coordination, documentation, and emergency response
Ensure staff meet background check, CPR/First Aid, and training requirements

4. IDHW PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Submit Provider Enrollment Application for Respite Care Services through Idaho’s Medicaid Management Information System (MMIS)

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, staff credentialing documentation, operational policies, and insurance certificates
Provide participant intake forms, scheduling templates, emergency contact protocols, and service tracking forms

Program Readiness Review:

IDHW reviews provider readiness, including participant protection standards, documentation systems, and Medicaid billing compliance

Approval & Medicaid Enrollment:

Upon approval, configure billing codes for Respite Care Services (typically billed hourly or per diem)

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Idaho Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
- Participant intake, caregiver coordination, and emergency contact procedures
- Supervision, ADL support, and medication reminder protocols
- Daily documentation, incident reporting, and participant monitoring procedures
- HIPAA confidentiality, participant rights, and grievance handling policies
- Staff credentialing, background checks, and ongoing training verification
- Medicaid billing, authorization tracking, and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Respite Care Program Manager / Supervisor

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

Role: Respite Care Workers / Direct Support Staff

Requirements: High school diploma or GED; CPR/First Aid certification required; experience supporting individuals with disabilities preferred; background screening clearance

All staff must complete:

HIPAA confidentiality and participant rights training
Person-centered care training and abuse prevention training
Emergency preparedness and incident management training
Annual competency evaluations and documentation standards training

7. MEDICAID WAIVER PROGRAMS

The following Idaho Medicaid Waivers authorize Respite Care Services:

Developmental Disabilities (DD) Waiver
Aged and Disabled (A&D) Waiver
Children’s Developmental Disabilities Waiver

Approved providers may deliver:

Planned respite care scheduled in advance
Emergency respite care due to caregiver illness or crisis
Daytime, overnight, or weekend respite options based on participant needs

8. TIMELINE TO LAUNCH

Phase: Business Formation and Credentialing Setup

Timeline: 1–2 weeks

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Idaho Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing System Configuration and Claims Readiness

Timeline: 30–45 days

9. CONTACT INFORMATION

Idaho Department of Health and Welfare (IDHW) — Medicaid Division

Website: https://healthandwelfare.idaho.gov/services-programs/medicaid-health

Centers for Medicare & Medicaid Services (CMS)

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

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

WCG supports respite care providers, home care agencies, and disability service organizations in launching Medicaid-compliant Respite Care Services under Idaho’s HCBS waiver programs.

Scope of Work: