overall service plan is within the member's ISP cost limit; and service plan is adequate and meets the individual's needs in the community. The provider includes his/her telephone number and address in the written request. The MCO provides written approval or disapproval of the request. In reviewing requests to exceed the respite limit, the MCO must consider the intent of espite ervices to relieve the caregiver during emergency or planned short-term periods. Approval to exceed the 30day maximum should be related to situations such as: members caregivers become ill, hospitalized or have a family emergency; extenuating circumstances that care to be required beyond routine or periodic respite relief; or a breakdown in member and/or family support, causing an increased risk of institutionalization because of the physical burden and emotional stress of providing continuous support and care to a dependent person. 7320 In-Home Respite Care Revision ; Effective , In-home respite care offers services provided by managed care organization (MCO) contracted providers, on a basis, to members unable to care for themselves because of the absence or need of relief for their unpaid caregiver. In-home respite care is provided in the member's own home, as authorized on the member's , Individual Service Plan (Pg. 1), when the unpaid caregiver needs relief. The provider is responsible for providing the tasks authorized on the member's ISP and , Needs Assessment Questionnaire and Task/Hour Guide, and , Addendum to Form H2060, during the time is receiving in-home respite care. The provider must document in the member's clinical record: the in-home espite ervices provider was given a briefing on the member's status, needs and preferences prior to delivering services; and dates and duration of the services delivered.
overall service plan is within the member's ISP cost limit; and service plan is adequate and meets the individual's needs in the community. The provider includes his/her telephone number and address in the written request. The MCO provides written approval or disapproval of the request. In reviewing requests to exceed the respite limit, the MCO must consider the intent of espite ervices to relieve the caregiver during emergency or planned short-term periods. Approval to exceed the 30day maximum should be related to situations such as: members caregivers become ill, hospitalized or have a family emergency; extenuating circumstances that care to be required beyond routine or periodic respite relief; or a breakdown in member and/or family support, causing an increased risk of institutionalization because of the physical burden and emotional stress of providing continuous support and care to a dependent person. 7320 In-Home Respite Care Revision ; Effective , In-home respite care offers services provided by managed care organization (MCO) contracted providers, on a basis, to members unable to care for themselves because of the absence or need of relief for their unpaid caregiver. In-home respite care is provided in the member's own home, as authorized on the member's , Individual Service Plan (Pg. 1), when the unpaid caregiver needs relief. The provider is responsible for providing the tasks authorized on the member's ISP and , Needs Assessment Questionnaire and Task/Hour Guide, and , Addendum to Form H2060, during the time is receiving in-home respite care. The provider must document in the member's clinical record: the in-home espite ervices provider was given a briefing on the member's status, needs and preferences prior to delivering services; and dates and duration of the services delivered.
sph-rev-18-2-section-7000.docx