Medical Respite

CMS approved Washington’s ‘Medicaid Transformation Project 2.0’ 1115 waiver to CMS in June 2023, adding recuperative care as a housing support under HRSN services. Medical Respite Care, grouped within the housing and transitional care portion of the 1115 waiver, is defined short-term post-hospitalization residential care and housing to support members in health and recovery from

The 1115 ‘Global Commitment to Health’ waiver amendment, adding recuperative care as an HRSN service, was approved Jan. 2, 2025, and will run through Dec. 31, 2027. The state defines recuperative care eligibility as follows; individuals who are experiencing homelessness or at risk of homelessness and who are experiencing a condition that requires ongoing recovery

CMS approved Utah’s amendment request for its 1115 Primary Care Network Demonstration waiver on Jan 8, 2025. The State now can provide temporary medical respite care for individuals covered under the adult expansion Medicaid program who are also chronically homeless and/or living in a supportive housing program. The state plans to contract with two providers

In December 2022, Rhode Island submitted their 1115 waiver extension request to CMS that included a request for authority to implement a Restorative and Recuperative Care Pilot program. As of the writing of this, that request remains under review with CMS; a decision is anticipated in July 2025. The state envisions that the Pilot will

If passed, Oregon SB 296 A would direct the Oregon Department of Human Services and the Oregon Health Authority to study ways to expedite the hospital discharge process for patients. Specifically directing the research of the effectiveness of medical respite care in aiding the hospital discharge process. Note: The Oregon 2025 State Legislative session will

North Carolina received approval in September 2022 to add medical respite care to its 1115 waiver as part of the state’s Healthy Opportunities Pilot Program (more details in our 2022 State of the States report). The state uses a universal coordination system for HOP services, allowing providers to gain care referrals, enroll potential Medicaid eligible

CMS approved New York’s ‘Medicaid Redesign Team’ 1115 waiver amendment request on Jan. 9, 2024, which includes recuperative care as an allowable health-related social need (HRSN) service. Individuals who 1. are homeless or at imminent risk of homelessness, 2. are transitioning out of institutions, and 3. who are at risk of incurring other Medicaid state