Respite Care Services in Massachusetts provide short-term relief to primary caregivers of individuals with physical, cognitive, or behavioral health challenges. Services are offered in the individual's home, a community setting, or an alternative licensed site. These supports are authorized and reimbursed through MassHealth waiver programs, including the DDS Waivers and the ABI/MFP Waivers.

1. GOVERNING AGENCIES

Agency: MassHealth (Massachusetts Medicaid)
Role: Funds respite care through waiver programs and ensures compliance with HCBS regulations

Agency: Department of Developmental Services (DDS)
Role: Oversees respite for individuals with intellectual/developmental disabilities (IDD)

Agency: Massachusetts Rehabilitation Commission (MRC)
Role: Oversees ABI and MFP Waiver respite supports for individuals with brain injuries

Agency: Department of Public Health (DPH) (for facility-based respite)
Role: Licenses facilities that provide overnight or medical respite care

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Sets federal standards for waiver-funded respite under HCBS

2. RESPITE SERVICE OVERVIEW

Respite care is intermittent, time-limited care provided to individuals to give caregivers a break. Respite may be:

• Planned or emergency
• Hourly, daily, or overnight
• Provided in-home, community settings, or licensed facilities
• Delivered by trained direct care staff, nurses, or certified aides

Service goals:

• Prevent caregiver burnout
• Avoid unnecessary institutionalization
• Support family stability and long-term caregiving

3. SERVICE TYPES & FUNDING PATHWAYS

Type of RespiteSettingFunding Waivers

In-home respiteParticipant’s residenceDDS, ABI, MFP, AFC, CFC

Out-of-home respiteStaffed residence or facilityDDS, MRC, MassHealth

Emergency respiteCrisis-approved settingsDDS or MRC approval

4. PROVIDER REQUIREMENTS

For In-Home or Community-Based Respite:

• Register business entity (LLC or nonprofit)
• Obtain EIN and Type 2 NPI
• Enroll as a MassHealth waiver provider via ePREP
• Apply with DDS or MRC (if serving individuals under those waivers)
• Maintain liability insurance and background check policies
• Train respite staff in person-centered care and safety

For Facility-Based Overnight Respite:

• Obtain license from DPH as a group residence, if applicable
• Meet COMAR / HCBS safety and staffing standards
• Conduct fire safety and emergency preparedness planning

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC certificate
• EIN and NPI confirmation
• Waiver provider enrollment confirmation
• Respite care service model or program description

Policy & procedure manual including:

• Intake forms and caregiver consent
• Emergency contact and health information logs
• Staff supervision and scheduling protocols
• Incident reporting and participant rights
• HIPAA compliance and data protection policies
• Medication administration (if applicable)
• Crisis support and behavioral response plans

6. STAFFING REQUIREMENTS

Role: Respite Worker / Direct Support Professional (DSP)
Requirements: Experience with the target population, CPR/First Aid, CORI check

Role: Program Supervisor / RN (if applicable)
Requirements: Oversees care plans and coordinates backup support

Training Requirements:

• Person-centered care and HCBS rights
• Abuse/neglect reporting (MANDATED)
• Emergency and crisis procedures
• Infection control and safety

Optional: MAP training (for med admin)

7. MEDICAID WAIVER PROGRAMS THAT COVER RESPITE

DDS Waivers (via Department of Developmental Services):

• Community Living Waiver – For individuals living in the family home
• Intensive Supports Waiver – For 24/7 care settings
• Adult Supports Waiver – For part-time support needs

ABI & MFP Waivers (via MRC):

• ABI Residential Habilitation Waiver
• ABI Non-Residential Habilitation Waiver
• MFP-Community Living and Residential Supports

Other Funding Sources:

• Family Support Centers (state-funded short-term respite)
• Children’s Behavioral Health Initiative (CBHI) (respite for youth with SED)
• Autism Division (DESE/DDS) for school-age children

8. TIMELINE TO LAUNCH

Phase: Business Formation & Service Model Planning
Timeline: 1–2 weeks

Phase: Policy Manual and Staff Onboarding
Timeline: 2–4 weeks

Phase: Waiver Enrollment via DDS/MRC or ePREP
Timeline: 4–8 weeks

Phase: Referral Partnerships and Service Start
Timeline: Ongoing

9. CONTACT INFORMATION

MassHealth LTSS Provider Enrollment (ePREP)
Website: https://massfinance.ehs.state.ma.us

​Department of Developmental Services (DDS)
Website: https://www.mass.gov/orgs/department-of-developmental-services
Regional Contacts: https://www.mass.gov/dds-regional-offices

​Massachusetts Rehabilitation Commission (MRC)
Website: https://www.mass.gov/orgs/massachusetts-rehabilitation-commission

​Department of Public Health (DPH)
Website: https://www.mass.gov/orgs/department-of-public-health

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10. SCOPE OF WORK

• Business registration and Medicaid waiver enrollment
• Program model and service setting design (in-home or facility-based)
• Full policy & procedure manual for compliance
• Staff training packets and emergency forms
• Participant intake, consent, and incident documentation
• Billing setup and LTSS tracking tools
• Referral outreach to DDS, MRC, and family support centers
• Templates for scheduling, backup care, and care plan updates