The purpose of this document is to provide basic information about respite services available through
Medicaid in each of the 50 states and the District of Columbia. The primary focus of this guide is on the
§1915(c) home and community-based services (HCBS) waivers that states historically have used to
provide long-term services and supports (LTSS) to Medicaid participants who are aging or who have
specific disabilities or chronic conditions. Current health care reform efforts, the transition of Medicaid
toward more flexible and expanded home and community-based services, and the movement of more
states to managed long-term services and supports (MLTSS) have created additional avenues for states
to provide these services. This movement has increasingly utilized managed care §1915(b) waivers and
§1115(a) demonstration waivers. Therefore, this document also includes, when appropriate,
descriptions of other types of Medicaid waivers and demonstrations that states are using to provide
respite and other home and community-based services.