1. Program Definition and Services

Respite Care Services in Tennessee provide short-term, substitute caregiving to individuals with disabilities or complex medical needs. The program aims to offer temporary relief to primary family caregivers to prevent burnout and support the individual's continued integration within the community, averting institutionalization. Services include:

• In-Home Respite: Temporary supervision, personal assistance (bathing, toileting, meals, and mobility), and companionship delivered directly in the individual’s private home by trained staff
• Out-of-Home Respite: Scheduled or emergency care delivered in a licensed provider-operated location, group setting, or facility to support family well-being

2. Regulations

The program is governed by the following regulations:

• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-03 (Application of Rules for Distinct Service Categories)
• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-11 (Minimum Program Requirements for Residential and Out-of-Home Care)
• TennCare Rules and Regulations, Chapter 1200-13-01 (Medicaid Long-Term Services and Supports and Home and Community-Based Services)
• Federal Home and Community-Based Services (HCBS) Final Settings Rule (42 CFR 441.301)

3. Licensing or Certification

Providers must be approved and certified by the Tennessee Department of Intellectual and Developmental Disabilities (DIDD) and/or credentialed through TennCare Managed Care Organizations (MCOs). If the agency offers out-of-home respite care in a provider-controlled environment, it must obtain a specific DIDD residential/facility license.

4. Responsible State Agency

The Tennessee Division of TennCare (the state Medicaid agency) and the Department of Intellectual and Developmental Disabilities (DIDD) share joint responsibility for reviewing provider infrastructure, inspecting out-of-home settings, and certifying respite care providers.

5. Application Process

The application process is conducted through the electronic TennCare Provider Registration Portal and the DIDD Provider Enrollment System. Providers must complete registrations and submit organizational profiles online to initiate network onboarding.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Proof of compliance with state safety, background check registries, and facility zoning laws (if applicable)
• Respite Care Services Policy & Procedure Manual (covering scheduling, emergency response, and intake workflows)
• Staff qualifications, fingerprints, and completed training records
• Proof of general commercial liability and professional liability insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity and whether facility licensure is involved. Providers should contact the DIDD Provider Enrollment Unit or individual MCO network managers for detailed information, with standard processing timeframes spanning 2 to 3 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their legal business entity with the Tennessee Secretary of State, secure a Federal Employer Identification Number (EIN), and obtain a Type 2 National Provider Identifier (NPI).

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access details for the DIDD Provider Orientation, Person-Centered Support Plan (PCSP) integration, and incident management tracks are sent to qualified applicants once preliminary paperwork is reviewed.

10. Additional Notes

• Out-of-home respite locations must ensure that intensive care settings meet all state accessibility, fire safety, and environmental safety guidelines
• All respite tasks must align precisely with the participant's authorized service lines and care plans
• All direct care staff and coordinators must conduct mandatory background clearances, elder/child abuse registry checks, and fingerprint screenings prior to service
• Providers must maintain detailed records of face-to-face shift logs, health monitoring entries, and timesheets for Medicaid documentation and billing

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Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

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