Please be sure to click on each tab under each heading to see survey results.

1 Responding Programs and States

The Survey was produced to determine the shared components of Lifespan Respite (LR) Voucher programs administered in different states. A total of 17 programs across 17 states participated in the survey as depicted in the map below.

2 COVID-19 Adaptations

2.1 Provider Requirements

Have you made any changes to respite provider requirements because of the COVID-19 pandemic?

2.2 Provider Changes

Please describe any changes to respite provider requirements because of the COVID-19 pandemic. (Responses listed alphabetically.)

  1. Extended expirations; increased collaboration among respite providers; increased customer service; from 2 Coalitions/year to every-other month; increased content on the website
  2. Now permitting individual providers who already have been involved in occasional hands-on, direct care for the care recipient to provide respite for caregiver.
  3. Respite provider can live in the home with the caregiver and care receiver.
  4. We began allowing respite providers to reside in the same home as the caregiver and/or care recipient.

2.3 Caregivers Served

Has the number of caregivers you serve or the dollars you expend on respite voucher services changed because of the COVID-19 pandemic?

2.4 Changes in caregivers or funding

Please describe any changes to the number of caregivers served or dollars spent because of the COVID-19 pandemic. (Responses listed alphabetically.)

  1. Assisted living facilities and adult day services were essentially closed for most of the year. Emergency services at nursing homes were curtailed because of health restrictions. At-home services lessened because of family hesitancy to allow others in to their homes.
  2. COVID-19 impacted 2020 more than it will this year, particularly summer camps. All were cancelled in 2020, but a few are operating this year, but only as day camps. Some families are not allowing anyone in their homes, but it is getting better and we expect to award all of our vouchers in 2021.
  3. issuing smaller awards of $500
  4. More caregivers awarded than can use the funds due to COVID. Increased support to assist folks navigate during this time of uncertainty, disruption, and change.
  5. Please note, we count clients not caregivers. The 285 is the approximate # of active clients. Covid has made projections tough. We saw a dip in the usage of respite but have seen an increase back to normal levels in recent months.
  6. Slight increase. We allowed clients in day center program to enroll in voucher while centers were closed.
  7. The NC Division of Aging and Adult Services received a NWD/ADRC COVID-19 Relief Fund grant. The Division, with staff support from the NC Lifespan Respite Program, is contracting with a statewide non-profit organization to expand respite options and provide more flexible COVID-related caregiver- directed respite.
  8. The number of requests for vouchers increased. No change to the maximum amount of respite that could be requested.
  9. The previous fiscal year had an increase in application rates, but a decrease in reimbursement rates. This fiscal year is attempting to make up for the reduced reimbursement rates, by promoting the program more broadly across the commonwealth (and by extending voucher periods).
  10. We’ve had a steady increase in approved applications since July 2020. Big spike in December 2020. We had some of our highest average hourly rates of pay for the months of Sept & Dec 2020. Balance of year, average hourly rate = $14.89; and Sept & Dec’s average hourly rate = $26.40.
  11. We did get extra dollars that we gave to caregivers that already spent their vouchers for the year. ($400 each additional)
  12. We have changed from $300 every 3 months to $400 every 4 months. During COVID we were using $400 every 3 months but recently moved to $400 every 4 months
  13. We saw a decrease in voucher usage due to the pandemic because people are social distancing

2.5 Additional Changes

Please describe any additional changes you may have made to your respite voucher program because of the COVID-19 pandemic (e.g., changes to respite provider requirements; caregiver or care recipient eligibility: dollar amount and duration of respite voucher; allowable respite locations). (Responses listed alphabetically.)

  1. Allow re-application while we have no wait lists, allow dual enrollment in day center programs and voucher program if center is closed or client is not comfortable using the center.
  2. COVID-19 Updates Effective April 1, 2020 To provide additional support to unpaid caregivers during the COVID-19 pandemic, the following changes to the Lifespan Respite Care Grant Service Standards are effective immediately and will remain in effect until the emergency has ended as declared by the Governor of North Dakota: * The requirement that the provider cannot reside in the same household as the care recipient is waived. o This will eliminate the concern of having an individual from the outside come into the home. o Examples: ? A student that is home from college could be the respite provider. ? An adult child who moves in with their parents to assist with caregiving could be the respite provider to give the primary caregiver a break. * Virtual respite can be utilized if the health and safety of the care recipient can be assured. o A provider can utilize technology to interact face-to-face with the care recipient while the caregiver receives a break. ? Examples: * A provider can play online games with the care recipient so the caregiver can step away and have a cup of tea. * A provider can virtually watch a favorite tv show with the care recipient that is of interest to the care recipient, such as a game show, western, etc. o Platforms such as Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, Whatsapp video chat, Zoom, or Skype are examples of technology that can be used. o This will eliminate the concern of having an individual from the outside come into the home. * Lifespan Respite funding may be available regardless of how much respite the caregiver is receiving from other public funding sources. o If a professional determines that additional respite is needed to provide relief to the caregiver, Lifespan Respite Care funding may be available. * The regular application process is still the preferred method to access Lifespan Respite funding. During this pandemic, funding can also be accessed by professionals emailing the Aging Services Division at https://carechoice.nd.assistguide.net/contact-us with the following information: o Caregiver and Care Recipient Names o Address(s) o Caregiver and Care Recipient Ages o Amount of respite requested o Only Page 3 of the application must be submitted ? This will confirm via electronic signature that the caregiver has made and independent choice of provider(s) * Provider Agreements and Substitute W-9’s can be submitted directly to the Aging Services Division at * When possible, the professional making the referral should provide the caregiver and the provider with the required documents as indicated in the Standards.
  3. Expansion of recreation, educational classes, duration
  4. Extension of use of voucher funds
  5. Monthly allotments that were not used during shutdowns were added to remaining contract months and new spending plans were signed to utilize higher spending limits.
  6. N/A
  7. No changes in eligibility or provider requirements. We increased voucher amounts from $500 to up to $1,500. With a supplement to our Lifespan 20 grant, we are providing PPE (masks, sanitizing kits) to family caregivers for themselves and their respite providers.
  8. none
  9. Now permitting individual providers who already have been involved in occasional hands-on, direct care for the care recipient to provide paid respite for caregiver.
  10. Offered $400 - up from $300. Respite provider can live in the home with the caregiver and care receiver Waived the household income
  11. Services have continued throughout pandemic. All applications processed as received.
  12. The biggest changes implemented has been a flexible voucher dated that can extend beyond the original 90 day period without the need for reapplication, and allowing individuals who have limited finances to take multiple reimbursements (instead of 1-$400.00 reimbursement they can take 4-$100.00 reimbursements spread across the 90 days or longer, if needed.
  13. We allowed a larger use of “banking” of hours. For those families that could not use their monthly allocation of funds, we allowed them to apply them to future months as long as it occurred in their current eligibility year.
  14. We allowed caregivers to use vouchers for virtual camps for their kids.
  15. We also added the opportunity to receive items that would help caregivers get additional respite without having to leave the house such as robotic pets, weighted blankets, puzzles etc. We also provided PPE packets with masks, gloves, sanitizer and antibacterial soap for our caregivers/respite providers.
  16. We extended voucher deadlines to allow caregivers more time to utilize funds.
  17. We specifically designed our Caregiver Respite Grant Program (its not really a voucher program) to meet the needs of the family caregiver and care recipient. With the differing levels of acquity, what one can do with $500 is different than what another can attain with $500. We monitor our average award and our average hourly rate to see if we are in reasonable market ranges. Data tells a story, so if they are higher for one month, it is usually because respite care was provided in a nursing home level care or other high level acuity care.

2.6 Permanent Changes

Do you anticipate that these changes will be permanent? (Responses listed alphabetically.)

  1. Maybe
  2. n/a
  3. No
  4. No
  5. No
  6. No
  7. Not sure.
  8. The increased amounts per family may stay.
  9. To be determined
  10. Very possible. We are using a survey to determine the usefulness of the items.
  11. Virtual respite was used very little but we may continue to allow it. We may continue to allow Lifespan vouchers for caregivers receiving respite from other sources if the professional who is submitting the app deems it essential.
  12. We are pleased that our Caregiver Respite Grant Program is already flexible enough to support family caregivers regardless of extenuating circumstances or an international pandemic.
  13. We expect that the need and desire for services will increase when the pandemic is under control. Families have informed Catholic Social Services that they expect to resume or increase services when they feel it is safe to have more help in the home.
  14. We will continue to review and evaluate the changes.
  15. Yes and no
  16. Yes, I think making this program as flexible to the primary caregivers needs is what makes this program so useful and beneficial to our applicants.
  17. Yes, the changes were permanent during the pilot program and found to work better for caregiver to fully utilize the program.

3 Age Distributions

3.1 Caregivers

What are the ages served in your LR voucher program? (Caregivers)

State Caregiver
Age Range
Alabama Adults Only
Arizona All ages apply
Colorado Adults Only
Idaho Adults Only
Montana All ages apply
Nebraska All ages apply
Nevada All ages apply
North Carolina Adults Only
North Dakota Adults Only
Oklahoma All ages apply
Rhode Island Adults Only
South Carolina Adults Only
South Dakota Adults Only
Tennessee All ages apply
Virginia Adults Only
Washington All ages apply
Wisconsin All ages apply

3.2 Care recipients

What are the ages served in your LR voucher program? (Care recipients)

State Care Receiver
Age Range
Alabama All ages apply
Arizona All ages apply
Colorado All ages apply
Idaho All ages apply
Montana All ages apply
Nebraska All ages apply
Nevada All ages apply
North Carolina All ages apply
North Dakota All ages apply
Oklahoma 0 - 60 years
Rhode Island All ages apply
South Carolina All ages apply
South Dakota All ages apply
Tennessee All ages apply
Virginia All ages apply
Washington All ages apply
Wisconsin All ages apply

3.3 Age distribution

What is the anticipated percentage of caregivers by age group that will receive LR vouchers this fiscal year?

Caregiver Age Group 1-25% 26-50% 51-75% None We don’t collect
0 - 18 years 3 0 2 11 1
19 - 40 years 12 4 0 1 0
41 - 60 years 6 9 2 0 0
61 - 80 years 5 10 1 1 0
81+ years 12 3 0 1 1

4 Household Income

4.1 Eligibility Requirement

Do your LR Voucher program funding streams impose household income eligibility requirement?

4.2 Describe Requirement

(Responses listed alphabetically.)

  1. INCOME LEVELS (312% Federal Poverty Level) Family Size Monthly Income 1 $3,317 2 $4,483 3 $5,647 4 $6,811 5 $7,978 6 $9,142 7 $10,305 8 $11,472 Family Size Maximum Financial Resource Limit 1 $35,000 2 or more $50,000
  2. Prior to COVID we had a household income eligibility of $90,000 or less but during COVID we have eliminated the household income as eligibility.
  3. Proof of care recipient income (and spouse, if applicable) must be documented to qualify for subsidies other than $500/year. Household income required if recipient in under age of 18.
  4. We look at income to see if it is high enough to require a co-pay. Does not happen too often. We look at net income and subtract ALL medical related expenses of the family if under 18 and of individual/spouse if over 18.

4.3 Income guidelines

4.4 Verification

Are income and resources verified?

4.5 Tools

How are income and other resources verified?

verification responses
Copy of tax return requested 2
Other 3

4.6 Other

Other forms of verification included: (Responses listed alphabetically.)

  1. Financial criteria and verification is completed during the application process which includes a review of bank statements and other financial documents.
  2. May provide bank statement or SS statement or check stubs
  3. Proof of income, including Social Security, pensions, earned income , if present.

5 Cost Sharing

5.1 Cost Sharing Requirement

Do you incorporate cost sharing in your voucher program that operates on a sliding fee scale?

5.2 Describe Requirement

(Responses listed alphabetically.)

  1. Level 0 $12,880 individual income Level 1 $16,100 Level 2 25,760 Level 3 $38,640 Level 4 over $38,640
  2. We look at income to see if it is high enough to require a co-pay. Does not happen too often. We look at net income and subtract ALL medical related expenses of the family if under 18 and of individual/spouse if over 18.

6 Disabilities Served

Please select areas of disabilities served

6.1 Areas of Disabilities Served

Disabilities Responses
Cognitive Impairment or Dementia 17
Behavioral Challenge 15
Developmental and/or Intellectual Disabilities 17
Functional limitation due to Aging 16
Learning Disabilities 12
Mental Health Issues 16
Physical Disabilities 17
Other 8

6.2 Other Areas

Other areas of disabilities served include: (Responses listed alphabetically.)

  1. Any diagnosis
  2. Children and adults of risk of abuse or neglect
  3. Memory Condition (Alz); Neurological (ABI, ALS, etc.); TBI; Parkinson’s; Medical Supports needed; Special Considerations; Paralysis
  4. Special health care needs, medically complex or significant medical/health condition.
  5. Stroke, PTSD, seizures, diabetes, multi-child family, autism
  6. TBI/Medically fragile
  7. traumatic brain injury, stroke, cancer, chronic illnesses, individuals who need assistance with multiple activities of daily living
  8. We follow the Maternal and Child Health broad definition of special healthcare needs. We include “at risk” for abuse and neglect.

7 Target Groups

If you target or prioritize groups to receive respite vouchers, please specify the groups

7.1 Groups

Groups Responses
Hispanic families 2
Other 3
Rural Families 4
Veterans 1
We don’t Prioritize 13

7.2 Other Groups

Other groups include: (Responses listed alphabetically.)

  1. Care Recipients aged 18-59
  2. Current target populations are: -caregivers caring for a loved on with dementia -grandparents caring for a grandchild(18 and under) with a disability -other relative caregivers(not parents/spouse/adult children) caring for a family member ages 19-59 with a disability
  3. Native Americans

8 Provider Qualifications

8.1 Requirements

Do you have requirements for respite providers?

8.2 Requirement Type

Kinds of requirements:

Requirements Responses
Background Check 4
Certifications 1
Provider Must Live Outside the Home 7

8.3 Other Requirements

Other requirements include: (Responses listed alphabetically.)
  1. 18 years or older
  2. Fingerprint background checks
  3. Must be 16 or older. Primary caregiver and parents cannot be provider but other household members can be. Also, once our new State Regulations go into effect, we will require all providers to have background checks and complete new provider orientation.
  4. Must be at least 18 years of age and older. Must not have power-of-attorney or guardianship for the care recipient. Until recently, individual provider could not be already involved in hands-on, direct care for the care recipient.
  5. Must be at least 18 years or older and eligible to work in the US.
  6. Must be at least age 18 or older
  7. Provider must be 18 years of age or older.
  8. Respite provider must be 18 years old or older and have a social security card. During COVID we have waived the restriction of respite providers “must not reside with the caregiver and care receiver”.
  9. Signed Interagency Agreement; Policies and Procedures; Submit a signed application; and Proof of Insurance

8.4 Minimum Age

Is there a minimum age for a respite provider? If so, what is the minimum age>

State Provider Age Required Minimum Age
Alabama Yes 18
Arizona Yes 18
Colorado No –
Idaho Yes 18
Montana Yes 18
Nebraska Yes 16
Nevada Yes 18
North Carolina Yes 18
North Dakota Yes 18
Oklahoma Yes 18
Rhode Island Yes 18
South Carolina Yes 18
South Dakota No –
Tennessee Yes 18
Virginia Yes 18
Washington No –
Wisconsin Yes 18

9 Provider Limitations

Does the administering agency limit providers to … (response options: Vetted/approved agency, Provider list, Informal providers (e.g., family and friends, Other, No limits on respite providers)

9.1 Providers

Limitations Responses
Vetted/approved agency 2
Provider list 2
Other 2
No limits on respite providers 12

9.2 Other Limitations

Other Limitations include: (Responses listed alphabetically.)

  1. 18 years or older
  2. Fingerprint background checks
  3. Must be 16 or older. Primary caregiver and parents cannot be provider but other household members can be. Also, once our new State Regulations go into effect, we will require all providers to have background checks and complete new provider orientation.
  4. Must be at least 18 years of age and older. Must not have power-of-attorney or guardianship for the care recipient. Until recently, individual provider could not be already involved in hands-on, direct care for the care recipient.
  5. Must be at least 18 years or older and eligible to work in the US.
  6. Must be at least age 18 or older
  7. Provider must be 18 years of age or older.
  8. Respite provider must be 18 years old or older and have a social security card. During COVID we have waived the restriction of respite providers “must not reside with the caregiver and care receiver”.
  9. Signed Interagency Agreement; Policies and Procedures; Submit a signed application; and Proof of Insurance

10 Provider Training

10.1 Providers

Do you require training for respite providers? No states reported that they require training of respite providers.

11 LR Voucher Implementation

11.1 Anticipated LR Voucher Funding

How much LR Voucher funding does your state anticipate expending on respite vouchers, this fiscal year? Enter zero if none

State Amount ($)
Alabama 333,635
Arizona 15,000
Colorado 36,700
Idaho 145,000
Montana 150,000
Nebraska 500,000
Nevada 141,603
North Carolina 372,000
North Dakota 42,000
Oklahoma 100,000
Rhode Island 300,000
South Carolina 211,800
South Dakota 35,000
Tennessee 120,000
Virginia 100,000
Washington 104,000
Wisconsin 40,000

11.2 Total Caregivers

How many total caregivers does your state’s LR voucher program anticipate serving this fiscal year?

11.3 Percentage LR Grant Funds

Please estimate what percentage of the LR funds are from the federal respite grant. Please enter zero if none

Literal responses were:

  1. 0
  2. 0
  3. 16.5
  4. 35
  5. 60
  6. 75
  7. 100
  8. 100
  9. 100
  10. 100
  11. 100
  12. 100
  13. 100
  14. 100
  15. 104000
  16. 120000

12 Caregiver Employment

12.1 Voucher Tied to Employment Status

Eligibility based on the employment status of the caregiver?

12.2 Employment Outside Home

Percentage of caregivers employed outside home

Caregivers Employed
Outside Home 		Number of Programs
1-25% 2
26-50% 4
51-75% 4
We do not collect this data 7

13 Reimbursement

13.1 Family caregiver or provider

Do you reimburse the family caregiver or the respite provider?

13.2 Amount LR Voucher

What is the approved amount of a single LR voucher?

13.3 Time Frame LR Voucher

What is the time frame of that voucher (in days)?

Timeframe
(Days) 		Number of Programs
3 1
5 1
14 1
60 1
90 7
160 1
180 1
365 4

14 Administrative Issues

14.1 Average time

What is the estimated average administrative time spent per voucher (in hours)?

Voucher Admin Time
(Hours) 		Number of Programs
0.00 1
0.75 1
1.00 1
1.50 1
2.00 4
2.50 1
3.00 2
5.00 3
8.00 2
18.00 1

14.2 Voucher Renewal

Can the voucher be renewed?

14.3 How Often

How often can the voucher be renewed?

Frequency of Renewal
(in days) 		Number of Programs
1 1
3 1
90 2
160 1
270 1
365 5
NA 6

15 Funding Sources

15.1 Availability

Funding resources available for LR voucher

Other Resources Responses
State/legislative appropriation 5
Lifespan Respite Grant 15
Other federal or State funding 8
Private funding 2
Fundraising 3
Grant opportunities 4
Other 1

15.2 Other Sources

Other sources reported:

  1. We do get some donations that are available

16 Liability

16.1 Concerns

Do you address liability concerns?

16.2 Address liability

How do you address liability concerns?’

Ways to Address Responses
Family caregiver signs a liability waiver 11
Other 10

16.3 Other ways

Other ways included: (Responses listed alphabetically.)

  1. Because voucher program is designed as a reimbursement, the family caregiver is responsible for finding, choosing, hiring, training, scheduling and paying for whichever respite provider they choose (either trained or untrained)
  2. Caregiver is the employer of record with FMS.
  3. insurance
  4. Liability is addressed in program expectations, and caregiver must sign certification form stating that they understand that any liability concerns rest between them and the respite providers they hire.
  5. provide information on paper
  6. require agency to have general liability insurance, fingerprint and background check
  7. Since we only offer self/family-directed respite, the caregiver may be liable. We education them regarding their responsibility and options for protections.

17 Case Management

17.1 Services

Do you specifically provide case management services to help family caregivers across respite and other supports?

17.2 Support

Would case-management services be helpful to your caregiver?

18 Voucher Categories

18.1 Provisions

Do you provider vouchers for?

Voucher Purposees Number of Programs
Planned Respite 14
Emergency Respite 13
Caregiver Educational Programs 13
Other 3

18.2 Other categories

Other voucher categories: (Responses listed alphabetically.)

  1. Summer Camps (day and overnight) which would fall under planned respite.
  2. The program has in limited instances, reimbursed the cost of travel for a relative to come from out of state to provide respite for the primary caregiver and has also reimbursed the cost of lodging and entertainment that a primary caregiver incurred to send their special needs child with a respite provider to spend the weekend in a hotel room, watch movies at a theatre and get dinner so they could have a break and their child could have a fun weekend away.
  3. We do not specify how a caregiver goes about achieving respite. If they need it, if they are eligible, they get it. Respite is in the eye of the caregiver - it can be information, peace of mind, going to the grocery store, vacation, support groups, educational opps, etc.

19 Planned Respite Vouchers

19.1 Guidelines

Do you have written guidelines for implementation of planned respite vouchers?

19.2 Explain

Explain your planned respite voucher guidelines. (Responses listed alphabetically.)

  1. Caregiver is responsible for recruiting, hiring, trainings, and supervising employees, including monitoring services performed, verifying timesheets submitted for payroll an making a determination of terminating services. Also tracking to ensure they stay within spending plan agreements and maintaining contact with program coordinator.
  2. Caregiver is sent income guidelines for subsidy, FAQs which address requirements and eligibility.
  3. Eligibility: Unpaid family caregivers who care for a loved one with a significant disability, special need or chronic illness, requiring 24/7 care. SCRC serves all ages of caregiver and care receiver but does focus on parents of children (young or adult) with special needs and family caregivers of adults under the age of 60 with disabilities or special health needs. SCRC coordinates with AAA/ADRC/FCSP to serve family caregivers of care receivers over the age of 60. Use of funds: Vouchers are used to pay for breaks from hands-on caregiving. They may not be used to pay: the family caregiver directly for the care he/she is providing, a family member or friend who resides in the home to provide care; for care of a loved one while the caregiver goes to work; or for care that occurred before the voucher was issued.
  4. Internal policies and procedures. Caregivers receive frequently asked questions that cover most guidelines. For example, who can be provider, what documentation is required, funds are limited to reimburse respite provider.
  5. Mapped process; online guides for our FamilyForce Salesforce based data system; written emails, etc. etc. etc.
  6. Not sure I understand what is meant by “implementation”. We have written Service Standards for the vouchers but we do not have specific requirements for how a caregiver can use their respite.
  7. People apply or renew on an annual basis to determine eligibility and then they are approved for 1 year before they could renew again.
  8. Reimbursement for personal-choice option respite. Caregiver is responsible for training provider of their choosing and having the provider complete a timesheet (date/hours of service/rate of pay/contact info). Caregiver verifies by signature and submits for reimbursement.
  9. The NC Lifespan Respite Program Operations Manual outlines respite voucher guidelines. The program is a consumer-directed program that is intended to serve those caregivers who are “falling through the cracks” because they are unable to access other sources of publicly funded respite and cannot pay privately. Caregivers must be at least 18 years old and a resident of NC, Caregivers must be providing unpaid care for an individual of any age. Neither the caregiver nor the care recipient can be receiving ongoing, publicly funded in-home care or respite care, including adult day care services. The program is application-based and reimburses up to $500 in respite care services per calendar year. Caregivers can choose from a variety of options to provide their respite services.
  10. The only guidelines for the use any respite is that the grant program should be to supplement, not supplant any existing respite services.
  11. We have a LR manual
  12. We have a policy and procedure manual

20 Emergency LR Voucher Implementation

20.1 Guidelines

Do you have written guidelines for implementation of emergency respite vouchers?

20.2 Explain

Explain your emergency respite voucher guidelines (Responses listed alphabetically.)

  1. Must be an unplanned or unexpected situation such as attending a funeral, caregiver needs surgery, etc. $300 is the amount given. Usually used within one month of the issuance but can be extended.
  2. Referred to as exceptional circumstance or crisis respite. There is a separate application to describe need for additional financial support.
  3. Respite Emergency funds are available for one-time assistance to help meet the emergency needs of caregivers. In an event of an unplanned circumstance that results in an unavoidable absence of the primary caregiver, or the primary caregiver needs other assistance, the emergency funds will provide caregivers the ability to quickly find their care recipient care during this short term.
  4. Right now, we simply move them to the top of the list in order to issue quickly. However, as part of the Lifespan 2020 grant, we are developing emergency voucher guidelines and emergency respite options with community partners. We are starting this process working with our State Committee on Respite.
  5. Same as above.
  6. Same as regular respite voucher guidelines.
  7. The only guidelines for the use any respite is that the grant program should be to supplement, not supplant any existing respite services.
  8. The RI Office of Healthy Aging approves clients in needs of emergency assistance. Catholic Social Services arranges for payment to vendor agency.
  9. These are also included in our NC Lifespan Respite Program Operations Manual The NC Lifespan Respite Program recognizes that there may be emergencies or other special circumstances where an exception to our usual guidelines is warranted when all other sources of respite funding have been exhausted. Emergencies include, but are not limited to: caregiver illness, illness of another family member or loved one, a funeral/wake, major damage to the caregiver’s or care recipient’s home, or other family emergency or crisis. Respite application includes a box to check if request is emergency.

21 Fraud

21.1 Prevention

Do you have controls in place to prevent fraud?

21.2 Explain

Please explain how you prevent fraud (Responses listed alphabetically.)

  1. Applications are only accepted from professionals who are familiar with the caregiving situation. Audit is conducted. Billings are monitored/reviewed prior to reimbursing.
  2. Caregiver burden interview over the phone, caregiver must submit photo ID for self and care receiver and for respite provider, timesheet to request reimbursement must be signed by caregiver and respite provider, application has list of requirements that must be checked or initialed.
  3. Income is documented, provider agencies are monitored through frequent contact and review of billing.
  4. Our fiscal agent has fraud prevention checks printed. We also vet the vouchers for duplicate dates and over spending.
  5. Payment directly to the vetted provider
  6. Proof of diagnosis is required. Care provider contact info is required to verify services rendered.
  7. RPA application requests when they learn/know a voucher recipient has funding that impacts their eligibility to notify us, and they do. We ask all voucher recipients on the application, have set the system to notify us and when contacting applicants can indicate if approved or in review status, etc.
  8. The application for respite is submitted on behalf of the caregiver by a referring agency professional. The professional must certify that the family is ineligible for any other respite source, has exhausted all available respite resources and is unable to pay privately, or is on a waiting list for respite resources. The caregiver and respite provider must sign an agreement about the services to be provided, and both must sign the Record of Respite Services to indicate the days and hours of respite provided. The caregiver must submit both of these documents in order to be reimbursed.
  9. The best we can do is have them sign a document indicating they will use the funds as directed. In order to receive a respite grant, we require documentation from a long term care waiver agency indicating they have applied for the LTC program and are either denied, or waitlisted, or funds have run out or are committed. Counties, ADRC’s and other like agencies usually provide such documentation to us.
  10. The primary caregiver must sign and date after the provider to ensure they have reviewed and approved the billing document.
  11. The program uses a three tiered approach. The first is a set of acknowledgements that must be initialed and signed on the application that the program is to be used for its intended purpose by the person applying for the program (that they are the full-time caregiver and live with the person they are caring for, the understand what this program is designed for, that they understand that the funds are designed for respite purposes only, that they are responsible for the proper execution of the program, etc.). The second is a reimbursement form that tracks the dates of service with rate of pay and total amount paid that must be certified by the respite provider (and they must list a phone number) and then signed at the bottom by the applicant that the above is true and correct. And finally they are required to provide verification of payment for the services listed on the reimbursement form (paid invoice, cancelled check, bank records, etc.) If there is any doubt about the service, the agency will call the respite provider and ask for verbal confirmation of the stated services. If there are any discrepancies that cannot be resolved, the reimbursement may be denied.
  12. To help prevent fraud, a timesheet documenting the respite provided must be signed by both the family caregiver and respite provider before submitted for reimbursement. SCRC staff may contact either party to verify timesheet. Additionally, we require that the primary caregiver send a copy of the respite provider’s driver’s license or state issued ID. This shows proof the respite provider exists, is at least 18 years old and does not reside in the home of the caregiver and care receiver.
  13. Verification of caregiving relationship by third party. Caregiver does not receive funds directly. Caregiver signs timesheets to verify services received.
  14. Voucher tracking
  15. We look closely at vouchers and application materials and make sure signatures match. Random, frequent phone calls.

22 Data Collection System

22.1 Information

Do you have a data collection system in place to track vouchers use and other relevant information?

22.2 Other

What data collection system do you use to track voucher use? (Responses listed alphabetically.)

  1. Access and Excel spreadsheets
  2. Connected Families > Family Force on a Salesforce platform
  3. Developer custom designed and created an Access database for our program.
  4. Excel Spreadsheet
  5. excel spreadsheet and survey
  6. Excel spreadsheet that has all the relevant information is used.
  7. Microsoft Excel
  8. Program coordinator utilized Microsoft excel & forms to collect and track data.
  9. QuickBooks data base, invoices processed by staff supervisor. All services approved by staff in-house prior to payment being authorized by Fiscal Department.
  10. Salesforce
  11. Spreadsheet
  12. Utilization of database provided by the State Unit on Aging, which is also used by Area Agencies on Aging; also a tracked of funds expended using an Excel sheet.
  13. We enter in AIM and a QuickBase database to report Lifespan and state vouchers to the SCDOA. We use an in-house database developed and customized by a SC Vendor to track all vouchers including those paid with donations and private foundation dollars.
  14. We have a comprehensive database that we plug information into (this part is new as a result of our federal lifespan respite grant). We’ve collected a significant amount of data via an excel spreadsheet that we call our Monthly Data Report that we use to analyze what’s going on with our programs and share this info with our Board of Directors.
  15. We have internal systems through the State that help us collect and calculate data.
  16. We use RedCap at SoonerSUCCESS. The accountant that is our fiscal agent also has an online process separate from RedCap.

23 Additional Comments

Any additional comments/suggestions? (Responses listed alphabetically.)

  1. CDR LR is gaining popularity in our rural communities
  2. Happy to share any of our applications, forms, surveys, data collection, etc.
  3. It has taken awhile for Lifespan to gain traction. Good news….many more apps have been coming in. Bad news…..we are soon out of funds for the vouchers. We are working on the budget to see if we can free up additional dollars for vouchers.
  4. It would help to have a definition of respite, that might include different types of respite, such as paying for camps, telehealth programs, tablets.
  5. n/a
  6. N/A
  7. N/A
  8. No additional comments/suggestions
  9. None
  10. None
  11. None at this time.
  12. Our vouchers are not time limited but there are follow-up calls if they are not being used after 6 months to see if they are still needed or if we can help them to use it in any way. This is an ongoing process that has proven very useful for us.
  13. Sorry this is a day late! Got buried in my inbox.
  14. Thank you for compiling and helping us all learn, grow, and serve!
  15. This information is based on a pilot program that ran from December 2018 to December 2020, and has ended.
  16. We have used our Lifespan voucher funding to fund community grants/caregiver boxes. We also fund educational vouchers so caregivers can attend educational events that are applicable to their loved one and also focusing on self-care.