4510. Respite for Licensed Foster Parents, Unlicensed Relative Caregivers and Other Suitable Persons

Respite services can play an important role in preventing placement disruption. These services are available for licensed foster parents, unlicensed relative caregivers and other suitable persons with placement of children in CA or Tribal custody. Caregivers should be encouraged to access respite care services in emergent situations and to prevent disruption of the child from their home.

Service Definition

1. Respite care service pursuant to this section (4510) is the temporary, time limited relief for substitute parenting or caregiving of a child. Respite care can be arranged in advance or on an emergency basis.
2. Respite care services for licensed caregivers, are intended to meet the following needs:
   1. To offer relief from parenting and caregiving responsibilities;
   2. To allow the caregiver personal time away from home;
   3. To provide substitute care in the absence of the caregiver;
   4. To provide opportunities to attend overnight training.
   5. To allow caregivers access to substitute caregiving to meet emergent situations for the caregiver;
   6. To prevent placement disruption.
3. Respite care services for unlicensed relative caregivers or other suitable persons (See Practices and Procedures Guide Section 4261) are intended to meet the needs of children and families in emergency situations and when the placement is at risk of disruption.
4. Payment for respite services is not available to individuals who reside or live in the caregiver's residence. Respite services may be provided by a relative of the child or caregiver, only when the respite care provider resides outside the child's current placement.
5. Respite care that is provided outside the child's caregiver's home must be provided by individuals who are licensed foster parents or licensed child care providers.
6. Unlicensed respite providers can provide paid respite services only in the child's caregiver's home. Unlicensed respite providers must (1) successfully complete a FamLink background clearance and Washington State Criminal check and (2) meet the standards identified in WAC 388-148-1320. Background checks for unlicensed respite providers providing respite in licensed foster homes will be completed by Division of Licensed Resources (DLR) staff, or in the case of respite services for unlicensed relative caregivers, background checks will be completed by the assigned CA social worker.
7. The social worker or licensor will verify that the respite provider has experience and/or training to deal with the particular special needs of the child in care such as dealing with children who are medically fragile, children who have been sexually and/or physically aggressive or assaultive.
8. Licensed child care providers may be used to provide respite care services for respite that is less than 24-hour duration. Respite payment to licensed child care providers is paid at the regional child care rates using the appropriate SSPS respite payment code. SSPS child care codes in the 2800 series are not used to authorize respite payment.
9. Licensed providers for respite service must not exceed their licensed capacity and must meet Minimum Licensing Requirements (MLRs) while providing respite.
10. Licensed caregivers using paid respite services, may not provide respite to other children (paid or exchange), during the period of paid respite.
11. Child-specific respite care plans are an element of the child's case plan. As appropriate, the need for continued respite service is reviewed at service re-authorization and/or during multidisciplinary staffings.
12. Respite care payments remain the fiscal responsibility of the originating region and office during courtesy supervision activities.

Respite Care Category Descriptions

1. Retention Respite provides licensed CA caregivers, licensed Tribal foster parents, and licensed Private Child-Placing Agency foster parents providing care for CA-placed children, with regular "time off" from the demands of caregiving responsibilities. Retention Respite guidelines are:
   1. Retention respite is intended to provide regular, monthly breaks from the demands of foster parenting and can also be used to meet emergent needs of licensed caregivers.
   2. Retention respite is awarded on a monthly basis per CA, Tribal, or Private Agency foster home caring for CA children.
   3. Retention respite is earned by eligible licensed caregivers at a rate of two (2) days per month.
   4. Retention respite is authorized in daily units only.
   5. The licensed caregiver home may accumulate or 'bank' a maximum of fourteen (14) days of retention respite days to be used at one time. Licensed caregivers should be encouraged to use retention respite as it is earned.
   6. Newly licensed caregivers will have a 30-day waiting period from the first eligible child placement before accruing retention respite.
   7. A licensed caregiver must provide foster care to one or more children at least twenty (20) days in a month to earn retention respite for that month.
   8. When a day of retention respite is authorized, respite is normally paid for each eligible foster child in the home, regardless of how long the child has been in placement in the home. However, a licensed caregiver can elect to use retention respite for only one child, even though more than one child is in the placement. Whether retention respite is used to meet the needs of one or more children, the time used will be deducted from accrued retention respite days.
   9. Licensed caregivers and social workers should be aware of pending respite plans in the caregiver's home when a child is placed. Efforts should be made to avoid changes in caretakers for a child shortly after placement.
   10. The respite provider must have experience and/or training to deal with the particular special needs of the child in care such as dealing with children who are medically fragile or children who have been sexually and/or physically aggressive or assaultive.
   11. Regions will develop a process to authorize and monitor retention respite eligibility and utilization for CA foster homes.
   12. Tribal and Private Agencies shall monitor retention respite eligibility and utilization for their licensed homes, and will coordinate with CA regional management to develop a process to access and report retention respite usage.
2. Child-Specific Respite (CSR) provides unlicensed relative caregivers, other suitable persons, licensed CA caregivers, licensed Tribal foster parents, and licensed Private Child-Placing Agency foster parents providing care for children placed by CA, with the opportunity for relief from the caregiving responsibilities that are linked to the medical, behavioral or special needs of an individual child. The CSR guidelines are:
   1. CSR is authorized on a case-by-case basis consistent with the written service plan for the child.
   2. CSR is authorized in half-day or daily increments. Half-day will be authorized for respite services 0 - 5 hours and daily respite will be authorized for respite services greater than 5 hours.
   3. CSR is part of a child's unique service plan. The need for continued service is reviewed at service re-authorization and during multidisciplinary staffing.
   4. CSR for more than 1 week must have Area Administrator approval.
   5. CSR may be discontinued based on an updated assessment of the needs of the child.
   6. In calculating CSR, the worker should consider the availability of relief from caregiving responsibilities provided through retention respite, school, other relatives, family time and sibling and relative visitation schedules, etc.
3. Exchange Respite is the relief from parenting responsibilities, which is negotiated and arranged between licensed caregivers and does not include payment of CA funds. Exchange respite guidelines are:
   1. Licensed caregivers must remain within their licensing requirements (i.e. capacity, age, gender, etc.).
   2. Licensed caregivers must notify the child's social worker(s) of exchange respite services prior to the respite occurring.
   3. The social worker will verify that there are no licensing complaints pending which would preclude the respite provider from caring for the child.
   4. The social worker will inform the respite provider of any special needs of the child, supervision requirements and safety issues prior to initiating respite.

Procedures for Access

1. Retention Respite is authorized through SSPS by the regional designee responsible for monitoring the accrual and utilization of retention respite for foster families.
2. The assigned social worker for each child in a licensed home shall be notified that retention respite is being authorized.
3. Child-Specific Respite (CSR) is authorized through SSPS by the assigned social worker for the child.
4. For unlicensed relative caregivers and other suitable persons, the assigned social worker shall explore other family support options prior to requesting respite services.

Respite Care Payment

1. Child-Specific Respite (CSR) services, from 0 - 5 hours will be reimbursed at the half-day rate posted in the SSPS Manual.
2. CSR services more than 5 hours will be reimbursed at the daily rate posted in the SSPS Manual.
3. Retention respite is authorized in daily units only and reimbursed at the daily rate posted in the SSPS Manual.

Respite Care Rates

1. Respite rates for licensed CA relative and foster homes, licensed Tribal foster homes, and licensed Private Child-Placing Agency foster homes providing care for CA-placed children are determined by the child's assessed foster care rate level and are listed in the SSPS manual. Exceptions to the maximum respite care rate may be authorized only with administrative approval.
2. Respite rates for unlicensed relative caregivers or other suitable persons would be authorized at the Basic Respite rate listed in the SSPS manual for children in level 1 or 2 foster care.
3. For unlicensed relative caregivers or other suitable persons, respite rates above the respite rate for a child in level 1 or 2 foster care requires the completion of an Exception request (DSHS form 05-210). The exception request should include an assessment of the supervision needs of the child, behavioral, medical, developmental and social needs of the child, and any special needs that would indicate a higher rate, The exception request will require supervisory and area administrator approval.
4. Respite for unlicensed relative caregivers or other suitable persons may be authorized for up to 7 days per month. Any respite beyond the 7 days will require area administrator approval.
5. Payment for respite provided by licensed child care facilities is paid at the Region's established child care rate, using SSPS 3220 or 3221 payment codes. SSPS chapter 2800 Child Care payment codes are not used to authorize respite payment.
6. Regional management may establish payment rates below the maximum rate listed in the SSPS Manual.