Paying for respite care: What Is Respite Care? | National Institute on Aging

How to Pay for Respite

aThe following list of possible federal, state, and private funding sources to help pay for respite is by no means exhaustive. For additional possible federal respite funding sources and how to connect to them, see Federal Funding and Support Opportunities for Respite. Information on federal programs that support respite is presented in a summary table.

Lifespan Respite Care Programs

Not every state has a Lifespan Respite Care Program, but those that do often provide respite vouchers, grant or stipend programs to help families pay for respite through self-directed programs, especially for those caregivers who do not qualify for other publicly funded programs. See if your state has a Respite Voucher Program and apply.

Lifespan Respite Care grantees may also support volunteer or faith-based respite services that offer free or low-cost respite care. State Lifespan Respite Care programs often work in collaboration with a State Respite Coalition. Contact your State Lifespan Respite Care Program or State Respite Coalition for more information.

Medicaid Waivers:

Generally, every state offers some respite assistance though various Home and Community-based Medicaid Waivers. To find out which waivers that pay for respite are available in your state and information about eligibility, see ARCH’s Medicaid Waivers for Respite Support.  Each state’s eligibility criteria and funding for waivers are different and you should also check with your state’s Medicaid office.

Medicaid State Plan:

If you live in a state that adopted the Section 1915(i) Medicaid State Plan Option for Home and Community-Based Services and the person you care for qualifies for Medicaid under income guidelines, respite may be covered under your state’s Medicaid plan without the need for a waiver. In FY 2020, 13 states (AR, CA, CT, DE, DC, ID, IN, IA, MI, MS, NV, OH, and TX) offered this option.  

State Self-Direction Programs

If a person with a disability or chronic condition is eligible for Medicaid, they may qualify for financial assistance that can be used to purchase necessary home and community-based services and supports, including payment to the family caregiver or to pay for respite. Such programs are sometimes known as cash & counseling, consumer or self-directed programs, or other names selected by the state. Find state Self-Direction Programs on the Applied Self-Direction (asd) website,

Medicare Hospice Benefit:

If someone is eligible for Medicare and is in hospice, their caregivers are eligible for the Medicare respite benefit under Hospice Care. See more about the Medicare Hospice Benefit.

Medicare Advantage Plans:

Medicare Advantage plans may now cover non-medical supplemental benefits such as adult day services and respite. Other optional covered services that benefit the plan holder as well as their family caregivers may include home care, transportation to appointments, meal delivery and home modifications. Read more.

National Family Caregiver Support Program:

Funding may be available through the National Family Caregiver Support Program, which is administered through your local Area Agency on Aging (AAA), if you are caring for someone over the age of 60 or someone of any age with Alzheimer’s or other dementias. Funding for respite may also be available if you are a grandparent or other relative age 55 or older caring for a child or if you are parent or other relative age 55 or older caring for an adult child with disabilities. Visit the Eldercare Locator to contact your AAA about respite funding options.

State Family Caregiver Support or Respite Programs:

If your state has a state-funded family caregiver support or respite program, you may have respite funding available. Visit Services by State from the Family Caregiver Alliance for more information about a range of caregiving supports.

Veterans:

Veterans eligible for outpatient medical services can also receive non-institutional respite, outpatient geriatric evaluation and management services, and therapeutically-oriented outpatient day care. Respite care may be provided in a home or other non-institutional setting, such as a community nursing home. Ordinarily, respite is limited to no more than 30 days per year. The services can be contracted or provided directly by the staff of the Veterans Health Administration (VHA) or by another provider or payor.

A program administered by the Department of Veterans Affairs, the Program of Comprehensive Assistance to Family Caregivers is available to eligible Veterans who elect to receive their care in a home setting from a primary family caregiver. For more information, visit the VA Caregiver Support Program or call the VA Caregiver Support Line at 1-855-260-3274.  See ARCH’s Nine Steps to Respite for Military and Veteran Caregivers for more information and additional resources.

Military Families:

Military families should also look to TRICARE’s Extended Care Health Option (ECHO) or the Military Exceptional Family Member Program (EFMP), which offers respite to anyone in the military who is enrolled in the EFMP and meets the criteria. See Matrix of Federal Programs for Respite for Military and Veteran Families for funding sources that also may be available to military families for respite.

The Respite Relief program from the Elizabeth Dole Foundation provides free in-home respite care for military and Veteran caregivers through CareLinx.  Read more and apply.

Funding for Adult Day Services:

Original Medicare does not cover the cost of adult day services, but Medicaid can pay all the costs in a licensed center with a medical model or an Alzheimer’s environment if the senior qualifies financially. Some centers offer need-based scholarships. Others may use a sliding fee scale based on income. Private medical insurance policies sometimes cover a portion of adult day services costs when registered, licensed medical personnel are involved in the care. Long-term care insurance may also pay for adult day services, depending upon the policy. Dependent care tax credits may be available to the caregiver as well.  See also Medicare Advantage above.

Private Funding Sources for Caregivers of Persons with Dementia:

The Association for Frontotemporal Degeneration has a Comstock Respite Grant Program. Read more and apply.

The HFC In-Home Care Grant Program relieves caregivers, giving them time to rest, recharge and focus on their personal and professional life. Delivered with our partner, Home Instead, HFC’s Care Grants provide 3-6 months of free, professional, in-home care.

Contact your local Alzheimer’s Association or Alzheimer’s Foundation members to learn what kind of financial assistance may be available for respite care.

Private Funding Sources for Caregivers of  People with Disabilities or Chronic Diseases

Some local or state affiliates of organizations such as Easterseals, The Arc, National Multiple Sclerosis Society, and the ALS Association may offer respite funding assistance or services on a sliding fee scale.  Financial assistance for respite care (up to $500 annually) is available from NORD, the National Organization for Rare Diseases for caregivers who meet income eligibility guidelines and are caring for a child or adult with a confirmed rare disease diagnosis.

Faith-based Organizations

Many faith-based organizations, such as Lutheran Services in America, provide a range of home and community-based services, including respite, for disabled people, older adults, and their family caregivers at no or low cost. Check with your local faith organization.

Who pays for respite care? What you need to know

It can be both emotionally and financially challenging to see a loved one’s health decline with age. You’ll likely have to ask difficult questions like when might it be time for a move into a long-term care facility? Or perhaps you’ll need to hire home care. But in many cases, family caregivers step in.

Should you decide that your older loved one will age in place under the care of a loved one, whether for economic or emotional reasons, it’s unrealistic to assume that the family caregiver will always be able to provide the constant care that they need. That’s why planning for respite care is essential both for the senior as well as their primary caregiver.

What is respite care?

Even if you feel like you’re doing fine handling it all on your own, caring for an aging parent or older loved one can be both mentally and physically taxing. But it also isn’t logistically feasible to devote 100% of your time to caregiving responsibilities. That’s where respite care comes in. 

This is short-term relief or respite, typically for a family member taking care of a loved one, and is a way of giving the primary caregiver a break or allowing them to go away for a short period of time. Typically, this temporary coverage for a set amount of days, not a few hours, and is usually for one to four weeks. 

Care might be provided in-home by a professional caregiver from an agency or the loved one might go to an assisted living or memory care facility — sometimes as a trial for a future admission, explains Glenn Lane, founder of Westchester Family Care in Mamaroneck, New York. You might also consider an adult day care. 

Whether provided at home or a facility, respite care provides personal time and backup support for the senior’s primary caretaker. This is essential for their mental and emotional health as well as the well-being of the senior. “Caregivers need a break because caregiving is physically and emotionally demanding,” says Marguerita Cheng, certified financial planner and Chief Executive Officer of Blue Ocean Global Wealth in Gaithersburg, Maryland.   

How much does respite care cost?

When you pay for respite care, you are paying for someone to take over all primary caregiving responsibilities so how much this costs depends on many factors. These include:

• Services. Does your loved one require personal care, medical assistance or just recreational services?

• The length of time you need care for.

• The state you live in.

• Location of care. Is it private, at-home care, at a day program like adult day care or at an overnight facility? 

According to the latest Genworth Cost of Care Survey, the national median hourly cost of homemaker services is $23.50 and a home health aide is $24.00. The national median daily rate for adult day health care is $74 and an assisted living facility $141. 

The most affordable option: Depending on an older adult’s needs, daily respite services outside the home, like a day program, are typically the most affordable option and tend to cost $10 to $20 per hour, notes Elle Billman, program coordinator of Colorado Respite Coalition.

The second most affordable option: In-home respite care might be the next most budget-friendly choice. Because it involves a trained professional coming to the senior’s location to provide one-on-one care, home care typically costs more at $20-35 per hour, says Billman.

The most expensive option: This would involve temporarily moving a senior into an overnight facility. Lane explains that although costs vary depending on the region where the care is provided or the facility is located, he estimates a short-term stay in an assisted living facility would be 10-20% more than the normal costs for a long-term resident in that region. This fee covers the room or apartment, housekeeping and meals in addition to assistance with activities of living and companionship for the agreed upon amount of time.

How to pay for respite care

Whether your respite care has an hourly or daily rate, the costs are likely to add up quickly. That’s why many family caregivers and older adults turn to insurance for help. However, not all insurance even partially covers this type of care, let alone fully. 

Here’s what you need to know about each type of policy.

Health insurance: This type of insurance simply doesn’t cover respite care, explains Cheng.

Medicare: This federal government health insurance program provides medical benefits for qualifying individuals as well as those over 65. But according to Brad Baune, a wealth management advisor at Northwestern Mutual in Mendota Heights, Minnesota, Medicare generally only covers short-term overnight stays at a hospital or skilled nursing facility after a qualifying hospitalization up to five days. “Medicare can help if you qualify, but often you will not be able to choose your facility,” says Baune.

However, for respite care for a hospice patient, coverage is much more substantial. Medicare-certified hospice care, including medical, nursing, social, aide and homemaker services are all covered. For inpatient respite care, you may have to pay 5% of the Medicare-approved amount.

Medicaid: Although funded by the federal government, this is a state-run program for qualifying lower-income individuals so exact benefits are dependent upon where you live. Some states provide some respite care assistance under Medicaid’s Home & Community-Based Care Services waiver program.

Long-term care insurance: Depending on the existing plan, LTC insurance will provide coverage for custodial care in a nursing home, home health care or adult daycare, explains Price.

Veterans benefits: For qualifying veterans and survivors who are housebound or need help with daily activities, monthly respite care assistance is offered through the VA Aid and Attendance benefit. Additional respite care support may be available depending on where you live, including nursing home respite care for up to 30 days per year. 

Other helpful respite care resources

Cheng recommends the following for those looking for additional respite care assistance:

• The ARCH National Respite Locator Service for help finding local services in your community.
• The Well Spouse Association provides support for loved ones of chronically ill or disabled people along with information on local support groups.

Despite the cost of respite care, Cheng hopes that primary caregivers realize that this temporary respite from caregiving can be priceless. “Caregivers experience emotional, mental, physical and financial stress — plus, they can also feel overwhelmed and isolated,” she says. “Don’t be afraid or feel guilty about asking for help.” 

The authorities of the Volgograd region have outlined two options for changing the waste management operator

Society

13 Jul 14:04, 2 photo

The head of the regional committee of nature spoke about the departure of the regional operator for the treatment of solid waste, and also told the residents of Volgograd whether they are waiting for changes in tariffs for garbage removal.

Previously, Gorodskiye Vesti reported that on July 12, a procedure was launched in the Volgograd Region to deprive Cimatic-Volgograd of the status of a regional operator from July 14, 2023.

Today, July 13, a press conference was held at the RIAC site to discuss this issue. Aleksey Sivokoz, Chairman of the Committee for Natural Resources, Forestry and Ecology of the Volgograd Region, named the grounds for revoking the company’s license.

The reason for making such a decision was repeated violations of the rules for the provision of public services (lack of high-quality and timely removal of MSW from container sites), debt to operators for the management of MSW (exceeded 1/12 of the required gross revenue), violation of the terms of the agreement concluded between the reoperator and Volgograd region regarding the untimely provision of a bank guarantee. Also, this decision was influenced by the non-compliance of the work of the regoperator with the requirements of federal legislation, numerous acts of the prosecutor’s response to these facts, and the recommendations of the Ecological Council under the Volgograd Regional Duma.

– The Committee has taken various actions to resolve this problem and stabilize the situation in the region. There was a constructive dialogue. For some time, we have been trying to get the regoperator to start fulfilling its obligations with high quality, – Alexey Sivokoz explained. – However, we have seen that there are no trends for improvement. As soon as events occurred that allowed us to deprive the reoperator of this status, we did it.

Let’s also note that until the conclusion of a new contract with another regoperator, Citymatic-Volgograd LLC will be obliged to perform its work.

– Nothing will change in bills for residents. In accordance with the requirements of the legislation (Decree of the Government of the Russian Federation of November 14, 2022 No. 2053 “On the peculiarities of indexation of regulated prices (tariffs) from December 1, 2022 to December 31, 2023 and on amendments to certain acts of the Government of the Russian Federation”), they will continue current rates apply. The revision will be carried out throughout the country when the relevant federal act is issued. In this case, new tariff decisions will come into force on July 1, 2024, the Tariff Regulation Committee of the Volgograd Region told Gorodskiy Vesti.

The procedure for changing a regional operator will be as painless as possible for residents of the Volgograd region.

– The task of the authorities is, first of all, so that residents do not notice the change of the regional operator, so that there are no failures with the timely removal of municipal solid waste, therefore, the legislator provided that in the event of depriving a legal entity of the status of a regional operator before choosing a new regional operator, the regional operator , which was deprived of the status, performs all duties for the treatment of municipal solid waste. Nothing should change for us during the transitional period. Within a year, the authorized body will select a new regional operator on a competitive basis, with which it will conclude a new agreement based on the results of the competition and will be assigned the status of a new regional operator, – said Alexei Sivokoz, head of the regional nature committee.

Also, according to the expert, in the event of a deterioration in the environmental situation, if the regional operator refuses to fulfill its obligations, then criminal liability will follow.

In addition, it is possible to select a temporary reoperator for the treatment of MSW until a new reoperator is selected on a competitive basis.

– We will be closely monitoring this now, and in case of deterioration of the ecological situation in the region, such a decision may be made, – said Sivokoz.

In July, payment for garbage collection will be made, according to the expert, to the regional operator Citymatic-Volgograd. After the deprivation of the status, until the selection of a temporary re-operator or until elections are held on a competitive basis, payment will also be made to the former re-operator “Citimatic”. Only after choosing a new regoperator, the data in the payment will change.

– Who will apply on a competitive basis, we do not know – assured the head of the regional committee of nature.

It is noted that now, when choosing a new reoperator, the experience of waste disposal companies will be taken into account.

– Residents of the Volgograd region have the opportunity to conclude an agreement with a new regional operator in writing or not to conclude in writing, since the regional operator is obliged to provide them with a service, – said Sivokoz, noting that most residents of Volgograd and the region do not have contracts for provision of services, and this is not a violation of the law.

Garbage containers that are in the yards of Volgograd residents and residents of the region will not be taken anywhere, they will be taken over by local governments and will remain in their original places.

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Author: Ekaterina Danilova

tko briefing Regoperator Citymatic

Temporary care for the disabled

Care for the disabled has a number of special features. Moreover, it may vary depending on the severity of the condition of the ward. For this reason, there is a division into temporary and long-term care. Knowing the nuances allows you to decide which strategy is appropriate in a particular case, and make the right decision. And also to protect the interests of a person with a disability, if necessary.

What is respite care?

When a patient needs constant care after suffering a serious illness, injury or surgery for only a certain period of time, care is provided temporarily. In this case, the caregiver performs his duties only during the period of rehabilitation or complication of the patient’s health condition. In addition, the recommendations of the attending physician on terms and other parameters are taken into account.
It is also possible to provide respite care in a hospital setting if professionals have assessed the risks and concluded that it would be appropriate to place the disabled person in a medical facility. As a rule, this measure is required in case of a sharp deterioration in the patient’s condition and the presence of a threat to health and life. Rehabilitation after suffering attacks and illnesses can also be carried out in boarding houses with treatment.

What are the features of long-term care for a disabled person?

Long-term care is required for those people who suffer from serious illnesses and have disabilities. In most cases, the caregiver will carry out caregiving duties until the end of the patient’s life or the end of the contract if it has been decided to terminate the partnership. Then the relatives or representatives of the disabled person are looking for another person or organization that will provide the patient with the necessary assistance.
As a rule, disabled people of the 1st group and 2nd groups of incapacity need exactly long-term care, since the deviation of indicators from the norm can reach up to 100%. Accordingly, in this case, a person is not able to live independently and perform the usual things. Disabled people of the 1st group and incapacitated persons need constant help from relatives, guardians, trustees and third parties so that their quality of life remains at a decent level. It is worth considering the fact that independent living and the lack of control by an able-bodied person can be dangerous for both the disabled person and the people around him.
Also, the goal of long-term care for a disabled person is rehabilitation, including social rehabilitation. In this case, the caregiver gradually teaches the ward to perform those actions that allow him to carry out the features of the physical condition. Long-term care is possible not only in special institutions, such as boarding houses for the disabled with treatment, but also at home.
As a rule, a nurse is hired for home care. The contract is concluded by relatives or representatives of the disabled person in case of his incapacity. Also, the opinion of a disabled person is not taken into account when choosing a candidate for the position of a carer or caregiver, or a FOU. Depending on the condition of the patient and the availability of free time for relatives of a person with a disability, a nurse may be hired on a part-time basis, with accommodation and other types of employment. In addition, it is important that the part-time carer is a nurse, as long-term care responsibilities include providing medical services. For example, a nurse should give injections, perform massages, take medical records, and stop seizures.
As for boarding houses with treatment, they must have a license without fail. This document guarantees that qualified specialists work in the institution, the rooms are equipped with the necessary equipment, residential and other premises are suitable for people with disabilities, the building is not in an emergency condition. Nurses are constantly on duty in boarding houses with treatment, doctors regularly make rounds and monitor the condition of patients, nurses provide comprehensive assistance to guests. A balanced menu has also been developed and a system of five or six meals a day has been introduced.