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The National Family Caregiver Support Program (NFCSP) provides grants to the states to support a range of programs that assist caregivers in caring for their loved ones at home for as long as possible. One of these programs is the Caregiver Respite Care program. These programs are funded by the U.S. Department of Health and Human Services Administration on Aging and are typically administered on the local level by the Area Agencies on Aging Network.
Caregiver respite programs provide trained caregivers that attend to the individual in need of care to give the primary caregiver time to relax and attend to their own needs. Typically respite care occurs in the family home, but can occur in adult day care centers or overnight residential facilities.
Alone, respite care is not a solution to paying for senior care, but when combined with other care options such as tax credits, transportation assistance and adult day care, respite care might make the difference that enables a senior to continue receiving care in the home instead of moving into a residential community.
The process for obtaining respite care differs with each administering agency but typically it works as follows. A caregiver contacts their local Area Agency on Aging (AAAs) and has on-the-phone pre-screening. This is followed by a home visit by a respite care manager that assesses the needs of the care recipient, talks with family members and may talk with their doctor.
If approved for respite care, the caregiver typically receives a voucher for a certain number of hours or a dollar amount. They can then interview potential respite providers, usually from a pre-approved list provided by their AAA. On occasion, the AAA has a list of volunteers from which the family can choose. It is normal to ask the respite caregiver questions about their background and caregiving experience so that the family is comfortable.
Eligibility requirements for respite care differ with each administering AAA. The information that follows is typical. However, one should check with their local AAA for specific details.
When receiving respite care, there are two different age requirements: the age of the care recipient and the age of their primary caregiver. The majority of AAA’s require that a caregiver be at least 18 years old and the care recipient be 60+ years old, although some require 65+. The majority of AAA’s also allow caregivers 18 years and older to care for individuals with Alzheimer’s or a similar disorder, regardless of the age of the care recipient.
Ninety percent of respite care programs have some health status requirements. These vary by program; some require nursing home level of care, others require the care recipient be unable to perform at least two activities of daily living, such as bathing, grooming, and dressing, and others are based on having a specific condition, such as Alzheimer’s, Parkinson's, or dementia. A supporting physician statement may be required.
Typically, there are no requirements that the caregiver be a family member to receive respite care, only that they are the primary individual providing care. Caregivers are generally not required to reside with the individual in need of care.
The NFCSP’s Respite Care Program's intention is to give priority to older persons with low incomes when choosing their beneficiaries. Most AAAs will assess the income and sometimes the assets of the care recipient. While there are not published financial limits, and some programs do not have income and asset limits, a rule of thumb is those seniors whose incomes fall within 200% of the Federal Poverty Level (FPL) will be eligible for respite care. In 2018, the projected, annual income limit for an unmarried, widowed or otherwise single individual is $24,280. The limit for married couples or two-person households is projected at $32,920. Note in Alaska and Hawaii, these amounts are slightly higher. That said, individuals with the greatest need are given priority for services.
A caregiver’s or care recipient’s veteran status is not a factor in determining eligibility for NFCSP’ respite care. Note that there is another respite care program specifically for veterans.
The Area Agencies on Aging that administer NFCSP’s Respite Care Program have specific coverage areas. Care recipients must reside within their Agency’s coverage area, which typically are determined by county.
Other additional requirements for the NFCSP’s Respite Care Program may exist. These can include:
Although funds for respite care are sometimes given to the caregiver or directly paid to the vendor, respite care vouchers are most commonly utilized. Vouchers can be redeemed from a pre-approved list of home care providers, although some administrating agencies may provide their own respite caregivers. Vouchers can usually be redeemed for respite care in the home, in adult day care, or in an overnight residential facility. Respite services may include preparation of meals, light housecleaning, companionship, supervision, and assistance with personal care.
The respite care limits differ with each Area Agency on Aging that administers the program. One AAA published their limits as 32 hours of respite care every 3 months and another published theirs as $3,500 in services per year. However most AAAs do not publish this information, as it changes continuously based on availability and budget.
The eligibility evaluation and processing period also changes with each AAA provider. Applicants should expect to wait several months between initial contact and actually receiving the care. Waiting lists sometimes exist that can significantly lengthen the time before receiving care.
Most commonly, respite care from the Area Agencies on Aging is offered free of charge. However, some agencies require a co-payment based on income. For example, they may grant $500 of respite care, but a 20% co-pay is required for the services. Said another way, a family pays $100, and in return, receives $500 worth of care.
Applications for respite care are available at one's local Area Agency on Aging.