SKILLED RESPITE SERVICES PROVIDER IN ALABAMA

Fatumata Kaba
Jun 27
4 min read

Updated: Jun 30

SUPPORTING INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES BY PROVIDING TEMPORARY RELIEF TO PRIMARY CAREGIVERS THROUGH LICENSED NURSING SUPPORT

Skilled Respite Services in Alabama are designed to offer temporary, medically necessary relief to the primary caregivers of individuals with intellectual and developmental disabilities (IDD). These services are provided by licensed nursing professionals and are used when the individual requires medical oversight or skilled care during the caregiver’s absence. Skilled Respite Services are authorized under Alabama’s Home and Community-Based Services (HCBS) Medicaid Waivers and must comply with standards set by the Alabama Department of Mental Health (ADMH).

1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)

Role: Approves providers, monitors service delivery, and ensures skilled care is provided according to HCBS waiver standards

Agency: Alabama Medicaid Agency

Role: Manages Medicaid provider enrollment, billing, and reimbursement for Skilled Respite Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures services are delivered in compliance with Medicaid HCBS waiver rules

2. SKILLED RESPITE SERVICE OVERVIEW

Skilled Respite Services provide short-term care by licensed nurses to individuals with IDD whose medical needs exceed the scope of standard respite care. These services ensure the individual's safety and medical stability in the absence of their regular caregiver. Providers may deliver:

Administration of medications and treatments
Monitoring of medical conditions and vital signs
Respiratory care, feeding tube support, catheter care, or wound care
Health-related support and documentation of nursing interventions
Emergency medical response and communication with healthcare providers

These services must be medically necessary, time-limited, and delivered by appropriately licensed professionals in accordance with the individual's plan of care.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Alabama Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Possess a valid Alabama Home Health or Nursing Agency license (if applicable)
Employ licensed Registered Nurses (RNs) and/or Licensed Practical Nurses (LPNs)
Maintain documentation systems for skilled care delivery, medication administration, and shift notes
Implement HIPAA-compliant processes and emergency procedures

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Request the Skilled Respite Services Provider Application Packet from ADMH
Submit a service plan outlining the types of skilled care to be provided, nursing supervision structure, and emergency protocols
Include policies for training, documentation, and consent for medical interventions

Background & Credentialing:

Background checks and drug screening for all staff
Verification of current nursing licenses and certifications
Proof of liability insurance and current CPR certification for all nurses

Program Readiness Review:

Review of nursing documentation templates, emergency procedures, and client consent processes
Evaluation of clinical supervision practices and care delivery standards
System for monitoring medical stability and adverse event reporting

Approval & Medicaid Enrollment:

Once approved by ADMH, enroll with Alabama Medicaid as a provider of Skilled Respite Services
Add the appropriate skilled nursing billing codes to your Medicaid provider profile

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC Certificate
IRS EIN Letter
NPI confirmation
Facility lease or proof of in-home/mobile operations
RN/LPN licensure documentation and supervisory structure
ADMH-Compliant Policy & Procedure Manual including:
- Medical documentation standards and treatment logs
- Health and safety protocols
- Consumer rights and consent to treatment
- Incident and emergency response procedures
- Confidentiality and HIPAA compliance policies
- Staff orientation, training logs, and shift documentation
Signed service agreements and skilled respite consent forms

6. STAFFING REQUIREMENTS

Role: Director of Nursing / Clinical Supervisor

Requirements: Registered Nurse with Alabama license; experience in disability services or home health care

Role: Licensed Nurse (RN or LPN)Requirements: Active Alabama license; CPR certification; skilled care experience with IDD population preferred

All staff must complete:

ADMH orientation and HCBS waiver training
Annual training in clinical documentation, emergency procedures, and abuse prevention
Continuing education to maintain licensure and competencies

7. MEDICAID WAIVER SERVICES

The following Alabama Medicaid Waivers authorize Skilled Respite Services: