RESPITE CARE SERVICES PROVIDER IN TEXAS

PROVIDING TEMPORARY RELIEF TO FAMILY CAREGIVERS WHILE SUPPORTING THE HEALTH AND SAFETY OF INDIVIDUALS WITH DISABILITIES IN HOME AND COMMUNITY SETTINGS

Respite Care Services in Texas offer short-term, planned or emergency relief for primary caregivers of individuals with disabilities, chronic illnesses, or complex care needs. These services are reimbursable under various 1915(c) Medicaid Waiver programs such as HCS, CLASS, TxHmL, DBMD, and MDCP, and are overseen by the Texas Health and Human Services Commission (HHSC).

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1. GOVERNING AGENCIES

Agency: Texas Health and Human Services Commission (HHSC)

Role: Administers waiver programs, approves providers, and oversees reimbursement for respite care services.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Ensures state waiver programs meet federal Medicaid HCBS requirements, including caregiver support.

2. RESPITE CARE SERVICES OVERVIEW

Respite care provides temporary relief for unpaid caregivers while ensuring the participant continues to receive safe and appropriate care. It can be delivered in the participant's home, a provider’s facility, or community-based settings, based on the Individual Plan of Care (IPC) or Person-Directed Plan (PDP).

Service formats may include:

• In-home respite: Supervision and support provided at the participant’s residence

• Out-of-home respite: Provided in licensed foster homes, group homes, or day programs

• Emergency respite: For crises when caregivers are unavailable

• Planned respite: Scheduled breaks for families based on need or risk of burnout

All services must prioritize health, safety, and community inclusion while the primary caregiver is away.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Texas Secretary of State

• Obtain EIN and Type 2 NPI

• Enroll as a Medicaid provider via TMHP (Texas Medicaid & Healthcare Partnership)

• Apply for waiver-specific contract approval with HHSC (e.g., HCS, CLASS, MDCP)

• If offering out-of-home respite, obtain applicable residential licensure through HHSC

• Maintain general liability and professional insurance

• Develop a Respite Services Policy & Procedure Manual

4. TEXAS PROVIDER ENROLLMENT PROCESS

Step 1: Form business entity and secure EIN/NPI

Step 2: Enroll with TMHP as a Medicaid provider

Step 3: Submit a waiver contract application to HHSC (indicating respite as a service offering)

Step 4: Provide staff credentialing, documentation tools, and policy manual

Step 5: Complete readiness review and begin receiving authorizations from case managers

5. REQUIRED DOCUMENTATION

• EIN, NPI, Articles of Incorporation

• TMHP enrollment and HHSC waiver contract

• Insurance certificates and staff background checks

• Respite Services Policy Manual including:

  • Staff supervision and training policies

  • Incident prevention and reporting protocols

  • Daily service documentation templates

  • Emergency contact, evacuation, and health procedures

  • Participant rights, grievance, and abuse prevention procedures

  • Service authorization tracking and billing forms

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP) / Respite Caregiver

Requirements: High school diploma/GED, CPR/First Aid, abuse prevention training, background check

Role: Program Supervisor (optional for in-home, required for out-of-home settings)

Requirements: Experience managing waiver services and staff coordination

All staff must complete:

• HHSC-required HCBS waiver training

• Individual-specific health and safety training

• Emergency and crisis response readiness

• Daily documentation and service verification procedures

• Confidentiality and HIPAA training

7. MEDICAID WAIVER PROGRAMS

Respite Care is available under:

• HCS (Home and Community-Based Services)

• CLASS (Community Living Assistance & Support Services)

• TxHmL (Texas Home Living)

• DBMD (Deaf Blind with Multiple Disabilities Program)

• MDCP (Medically Dependent Children Program)

• YES Waiver – For children with serious emotional disturbances

• STAR+PLUS – Limited in-home respite for certain eligible adults

8. TIMELINE TO LAUNCH

Phase: Business Formation & Manual Development

Timeline: 1–2 months

Phase: TMHP Enrollment & HHSC Waiver Application

Timeline: 2–3 months

Phase: Staff Hiring & Training

Timeline: 30–60 days

Phase: Contract Execution & Referral Activation

Timeline: Begins after HHSC readiness review and service authorization

9. CONTACT INFORMATION

Texas Health and Human Services Commission (HHSC)

Website: https://www.hhs.texas.gov

Texas Medicaid & Healthcare Partnership (TMHP)

Website: https://www.tmhp.com

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG assists caregivers, community programs, and provider agencies in launching Medicaid-approved respite care services across Texas.

Scope of Work:

• TMHP and HHSC waiver enrollment guidance

• Custom Respite Services Policy & Procedure Manual

• Staff orientation checklists and supervision logs

• Daily care logs, emergency plan templates, and safety forms

• Billing tools, authorization tracking sheets, and client rights documentation

• Optional: facility licensure support for out-of-home settings

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.