(a) The Texas General Appropriations Act authorizes reimbursement to the enrolled child's family for respite services that are not directly related to IFSP goals.
(b) Respite services are defined as the care of an enrolled child by a relative or substitute caregiver on a short-term or intermittent basis to provide the child's parent with a break from caring for his or her child. Respite services do not include the routine care of a child for the purposes of allowing a parent to attend work or school.
(c) The contractor must develop and implement a process for administering the state funded reimbursement of respite services.
  (1) The contractor may collaborate with other ECI contractors within their respective consortium to administer the funds.
  (2) The contractor must identify existing respite resources in the community, including potential respite service providers and additional funding sources before authorizing state funded respite reimbursement.
  (3) The contractor may provide reimbursement for up to 20 hours of respite per child per month, based on the individual needs of the family. The contractor may exceed the 20 hours respite limit only if:
    (A) the family has more than one child enrolled in the ECI program; and
    (B) the IFSP team determines that the children cannot be cared for by a single respite provider.
  (4) If the parent and the service coordinator do not agree on the complexity of care, based on the needs of the child, and the ECI reimbursement rate, the program director decides the complexity of care and reimbursement rate.
  (5) The contractor must have a process for prioritizing requests for state funded respite reimbursement. The process must include consideration of:
    (A) how respite will benefit the family relationship; and
    (B) past use of respite services.
  (6) If state respite funds are not available at the time of a request, the contractor places the eligible family on a waiting list for respite funds.
  (7) State respite funds cannot be used to pay:
    (A) insurance co-payments, insurance deductibles, or insurance premiums;
    (B) a parent to provide respite services to his or her own child;
    (C) individuals who live in the same household as the child;
    (D) individuals under 18 years of age; or
    (E) costs for the care of siblings of the eligible child.
(d) The contractor must maintain auditable records of state funded respite reimbursement.
(e) The contractor must report the number of children whose families received state funded reimbursement of respite services for each month of the contract period as directed by HHSC.
(f) The service coordinator must:
  (1) assist the parent in identifying available family and community resources;
  (2) assist the parent in determining the type (for example, individual setting, group setting, care in the child's home, or care out of the child's home) and frequency of respite needed;
  (3) assist the parent in applying for available state funds for reimbursement of respite services, if needed;
  (4) determine the complexity of care, based on the needs of the child;
  (5) inform the parent of the following:
    (A) state funds under this provision are limited;
    (B) the state's annual hourly limits per child;
    (C) the hourly co-pay based on family size and income;
    (D) the state's level of reimbursement based upon the complexity of care, frequency, and hourly co-pay;
    (E) the contractor's criteria for prioritizing requests for state funds for reimbursement of respite services and placement on the waiting list; and
    (F) the process for requesting a review and decision by the program director if the parent and the service coordinator do not agree on the frequency and complexity of care, based on the needs of the child, and the ECI reimbursement rate.
(g) The service coordinator must explain to the parent their responsibility regarding state funded reimbursement for respite services. The parent is responsible for:
  (1) selecting and supervising a respite provider;
  (2) scheduling the respite care with the provider;
  (3) paying the provider after the respite care is provided;
  (4) submitting the completed respite voucher to the contractor within one month of the voucher's expiration date;
  (5) assuming any liability for the selection and use of specific respite providers; and
  (6) complying with any potential tax or IRS requirements related to the use of state funded respite reimbursement.
(h) The following events must occur in order:
  (1) the contractor determines the number of hours and the level of care for each month, the number of months approved, the beginning and ending dates of the agreement, and the hourly co-pay required;
  (2) the contractor completes all required information on the respite funding agreement;
  (3) the parent, the service coordinator or other assigned staff member, and the program director (or designee), sign the completed respite funding agreement;
  (4) the contractor gives the parent a respite voucher for each calendar month in which respite services are approved;
  (5) the parent schedules respite with the respite provider;
  (6) the respite provider signs the respite voucher after providing the respite care;
  (7) the parent completes, signs, and returns the voucher to the contractor within one month of the voucher's expiration date; and
  (8) the contractor reimburses the parent within 30 days of receipt of an accurately completed voucher.

Source Note: The provisions of this §350.1108 adopted to be effective September 1, 2013, 38 TexReg 5524; amended to be effective June 30, 2019, 44 TexReg 3280; transferred effective March 1, 2021, as published in the Texas Register February 5, 2021, 46 TexReg 941