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Behavior Respite

Behavioral Respite Services shall mean short-term behavior-oriented services for a waiver participant who is experiencing a behavioral crisis that requires removal from the current residential setting in order to resolve the behavioral crisis.

Behavioral Respite Services shall be provided in a setting staffed by individuals who have received training in the management of behavioral issues.  Direct support staff must have received training in the prevention and management of crisis behavior.  Behavioral Respite Services may be provided in a Medicaid-certified ICF/IID, in a licensed respite care facility, or in a home operated by a licensed residential provider.  Behavioral Respite Services shall not be provided in a home where a waiver participant lives with family members unless such family members are also waiver participants receiving Behavioral Respite Services.  Family member shall be interpreted to mean the mother, father, grandmother, grandfather, sister, brother, son, daughter, or spouse, whether the relationship is by blood, by marriage, or by adoption.

The Behavioral Respite Services provider shall be responsible for providing an appropriate level of services and supports 24 hours per day during the hours the waiver participant is not at school; including behavioral supervision and intervention for aggressive or inappropriate behavior that jeopardizes the health and safety of the waiver participant or others.  The Behavioral Respite Services provider shall oversee the waiver participant’s health care needs.  Behavioral Respite Services providers shall be responsible for the cost of any Day Services needed while the waiver participant is receiving Behavioral Respite Services.

Reimbursement for Behavioral Respite Services shall not include payment for Behavioral Respite Services provided by the spouse of a waiver participant.  The Behavioral Respite Services provider and provider staff shall not be the parent or custodial grandparent of a waiver participant under age 18 years, whether the relationship is by blood, by marriage, or by adoption; and reimbursement shall not include payment for Behavioral Respite Services provided by such individuals.

With the exception of transportation to and from medical services covered through the Medicaid State Plan/TennCare Program, transportation shall be a component of Behavioral Respite Services and shall be included in the reimbursement rate for such.

A waiver participant who is receiving Behavioral Respite Services shall not be eligible to receive Personal Assistance, Respite, or Day Services (which would duplicate services that are the responsibility of the Behavioral Respite Services provider). Restraints shall not be used unless used in accordance with the department’s policy on use of restraints.

Applicable limits, if any, on the amount, frequency, or duration of this service:
Behavioral Respite Services shall be limited to a maximum of 60 days per waiver participant per waiver year.

 

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