RESPITE CARE SERVICES PROVIDER IN OREGON

Fatumata Kaba
Oct 7
4 min read

DELIVERING TEMPORARY RELIEF TO CAREGIVERS WHILE ENSURING SAFE, COMPASSIONATE SUPPORT FOR INDIVIDUALS WITH SPECIAL NEEDS

Respite Care Services in Oregon are Medicaid-funded supports that provide short-term, substitute care for individuals with disabilities, chronic conditions, or age-related needs — allowing primary caregivers to take a break from their caregiving responsibilities. These services help prevent caregiver burnout and promote the health and safety of both the caregiver and the person receiving care. Respite is delivered in-home, at a certified provider’s site, or in the community and is authorized through Oregon Medicaid (Oregon Health Plan), including HCBS Waivers and the K Plan.

1. GOVERNING AGENCIES

Agency: Oregon Department of Human Services (ODHS) – Aging and People with Disabilities (APD), Developmental Disabilities (DD)

Role: Authorizes and coordinates respite care services through local APD or CDDP (Community Developmental Disabilities Programs).

Agency: Oregon Health Authority (OHA)

Role: Administers the Oregon Health Plan (OHP), oversees Medicaid operations, and ensures waiver compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Oversees federal standards for respite care under HCBS authorities like 1915(c) and 1915(k).

Agency: Oregon Secretary of State (SOS) – Corporation Division

Role: Registers businesses and maintains corporate filings for provider entities.

2. RESPITE CARE SERVICES OVERVIEW

Respite Care allows caregivers of individuals with significant support needs to rest, travel, or attend to personal matters while ensuring the individual continues to receive proper care.

Approved providers may offer:

In-Home Respite: Temporary support delivered at the individual’s residence.
Out-of-Home Respite: Care in a provider's certified home, foster care, or community setting.
Facility-Based Respite (optional): Short stays in licensed adult foster homes or residential care settings.
Planned or Emergency Respite: Scheduled relief or crisis-response options.
Personal Support & Monitoring: Assistance with ADLs, medication reminders, and supervision.
Documentation: Progress notes, care logs, and Medicaid billing forms.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your entity with the Oregon Secretary of State.
Secure an EIN from the IRS and obtain a Type 2 NPI.
Enroll as a Medicaid provider through the Oregon Health Plan Provider Portal.
If providing services to individuals with developmental disabilities, become certified through ODHS-DD.
If offering out-of-home care, comply with adult foster home or residential licensing through ODHS.
Carry appropriate liability and workers’ compensation insurance.
Develop a Respite Care Services Policy & Procedure Manual based on service type and target population.

4. OREGON PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity and acquire EIN, NPI, and insurance.

Step 2: Complete Medicaid enrollment via OHP’s Provider Portal.

Step 3: For DD respite, work with your local CDDP to gain certification and connect with case management entities.

Step 4: If applicable, apply for adult foster home licensing through APD.

Step 5: After approval, begin coordinating with service coordinators and accepting clients.

5. REQUIRED DOCUMENTATION

Business registration and Articles of Incorporation
EIN and NPI confirmation
Insurance certificates (liability, workers’ comp)
ODHS-DD or APD respite provider certification (as applicable)
Respite Services Policy Manual covering:
- Intake and service planning
- Emergency protocols and backup staffing
- Personal care and medication assistance guidelines
- Incident reporting and documentation templates
- Participant rights and caregiver consent forms
- Quality assurance procedures and recordkeeping
- Medicaid billing and EVV tools

6. STAFFING REQUIREMENTS

Role: Respite Care Provider / Direct Support Professional (DSP)

Requirements: ODHS-approved; background check; experience with ADLs and behavioral support (if applicable).

Role: Program Supervisor / Coordinator

Requirements: Oversight of documentation, staff scheduling, and training. Strong understanding of DD/APD service systems.

Role: RN or Licensed Practitioner (optional)

Requirements: For respite clients with skilled care needs or nursing oversight.

All staff must complete:

CPR/First Aid and abuse reporting training
HIPAA and participant confidentiality modules
EVV and documentation procedures
Emergency preparedness and behavior support (if applicable)
Annual re-certification and performance evaluation

7. MEDICAID WAIVER PROGRAMS

Respite Care Services are available through:

K Plan (Community First Choice 1915(k)) – allows flexible in-home respite for OHP members with support needs.
APD Waiver Services – for seniors and adults with physical disabilities.
IDD Waivers (DD Services) – for individuals with intellectual or developmental disabilities.
Children’s Waiver and Medically Fragile Waivers – for families caring for children with special needs.
OHP State Plan Respite – for short-term support under specific eligibility.