RESPITE CARE SERVICES PROVIDER IN NEW YORK

Fatumata Kaba
Sep 4
4 min read

PROVIDING TEMPORARY RELIEF AND SUPPORT TO CAREGIVERS THROUGH COMPASSIONATE AND PROFESSIONAL CARE SERVICES

Respite Care Services in New York provide temporary, short-term care for individuals with disabilities, chronic conditions, or age-related challenges, allowing caregivers to take a break from their duties. These services are delivered in the individual’s home or in community-based settings, focusing on safety, supervision, and personalized care. Respite Care Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New York State Department of Health (NYSDOH)

Role: Administers Medicaid waiver funding for Respite Care Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Office for People With Developmental Disabilities (OPWDD)

Role: Provides oversight for respite services targeting individuals with developmental disabilities.

Agency: New York State Office of Mental Health (OMH)

Role: Ensures compliance for respite care programs serving individuals with mental and behavioral health needs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Respite Care Services meet safety, quality, and person-centered care standards.

2. RESPITE CARE SERVICES OVERVIEW

Respite Care Services offer caregivers temporary relief from their responsibilities while ensuring that the individual’s care needs are met. Services can be scheduled or provided on an emergency basis.

Approved providers may deliver:

Personal Care Support: Assistance with hygiene, grooming, and daily living activities.
Supervision and Safety Monitoring: Ensuring a safe environment during the caregiver’s absence.
Medication Administration: Managing prescribed medication regimens.
Recreational Activities: Engaging individuals in activities that promote physical and mental well-being.
Companionship: Offering social interaction to reduce isolation.
Health Monitoring: Checking vital signs and observing overall well-being.
Behavioral Support: Addressing emotional and behavioral needs during care.
Transportation Assistance: Helping individuals access community activities or medical appointments.
Crisis Intervention: Providing immediate support during emergencies or changes in health status.
Documentation: Maintaining accurate records of services delivered and care outcomes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Respite Care provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for respite care, emergency response, and safety protocols.
Ensure staff complete required background checks, health screenings, and respite care training.

4. NEW YORK PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application via the eMedNY Portal for Respite Care Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, respite care policies, and staff training documentation.

Program Readiness Review:

NYSDOH, OPWDD, and OMH evaluate provider readiness, including safety protocols, staff qualifications, and caregiver support plans.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Respite Care Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Respite Care Policy & Procedure Manual including:
- Care planning and individualized support procedures
- Safety, supervision, and health monitoring protocols
- Emergency response and crisis intervention guidelines
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for care tracking and Medicaid billing
- HIPAA compliance, participant rights, and grievance handling
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Respite Care Program Director

Requirements: Bachelor’s or Master’s degree in social work, healthcare administration, or a related field; experience in program management and caregiver support.

Role: Respite Care Aides

Requirements: High school diploma or equivalent; experience in personal care assistance and caregiving; background clearance.

Role: Certified Nursing Assistants (CNAs)

Requirements: CNA certification; experience in direct patient care and supervision; background clearance.

All staff must complete: