Missouri manual section 6.23
Out-of-home respite
Official service name: Out of Home Respite
Out of Home Respite provides temporary care outside the person's home so the customary caregiver can receive planned relief. It must be identified through the planning process and provided in a qualified residential, respite, or relief-home setting; it is not a permanent placement.
What the manual describes
What this service can help with
- Giving a customary caregiver planned short-term relief
- Providing temporary support outside the person's home
- Using a qualified residential facility, stand-alone respite facility, ICF/IID, State Habilitation Center, or approved shared-living relief setting
- Arranging either a full day of respite or a shorter period when the approved setting and authorization support it
Source-backed working pathway
To establish you'll probably need:
These steps translate the cited manual section into a practical review sequence. Confirm the current local process before acting.
Identify the caregiver-relief need through the planning process.
Describe who normally provides care, why temporary relief is needed, the requested dates, and why care outside the home is an appropriate short-term arrangement.
Define the person's support and setting needs.
Document the supervision, accessibility, communication, behavior-support, medication, health, and personal-care needs that a temporary setting must be able to meet.
Identify a qualified temporary setting.
Confirm that the proposed facility or relief home has the required Department of Mental Health contract and the certification, accreditation, licensure, or good-standing status required for that setting type.
Check annual use and any exception before scheduling.
Ask the support coordinator to confirm how many Out of Home Respite days have already been used, which limit applies to the proposed setting, and whether a written regional-office exception is required.
Confirm authorization and the handoff plan.
Before the stay begins, confirm the approved dates, provider, funding and room-and-board treatment, and required attendance and progress documentation. As practical handoff preparation, also confirm arrival and pickup, medication and support instructions, and emergency contacts.
Important boundaries
Limits that may affect fit or authorization
- The need must be identified through the planning process, and the service is temporary rather than permanent placement.
- The manual limits Out of Home Respite to 60 days per year unless the Division of Developmental Disabilities regional office director or designee grants a written exception.
- Respite in an ICF/IID or State Habilitation Center cannot exceed 30 days.
- The manual also states a total six-month limit and requires settings serving a person for more than 60 days to meet federal home- and community-based settings requirements. The current application of those limits and any exception must be confirmed before relying on them.
- A host home provider cannot provide Out of Home Respite while another person is residing in that home and receiving host-home services.
- Room and board cannot be federally funded unless it is part of respite in a state-approved facility that is not a private residence.
- The manual's billing table lists a maximum of one day unit per day or 64 fifteen-minute units per day when the service lasts less than 24 hours. Current authorization and billing rules must be confirmed before relying on those amounts.
- Comprehensive and Community Support waivers remain under a temporary renewal extension through December 27, 2026, or until CMS grants final approval. Confirm the currently approved rules with the support coordinator; proposed renewal changes are not automatically active.
Do not assume this part
Questions to confirm locally
- Is Out of Home Respite identified and authorized in the current person-centered service plan?
- Which qualified settings currently have the capacity and support profile needed for the requested dates?
- How many respite days have already been used, and which annual, setting-specific, or total limit applies?
- Is a written regional-office exception required before the proposed stay can occur?
- If a host-home relief setting is proposed, is the home eligible to provide respite at that time?
- How will room and board, transportation, medications, health instructions, emergency communication, and pickup be handled?
- What attendance records, progress notes, or other documentation must be completed?