Respite Referral

Heart For Home (H4H) provides respite care for foster children, adopted children eligible for respite through medical subsidy, and kinship caregivers of children in foster care.

Respite Care Criteria:

Homes can provide respite for a few hours up to 5 days.
A child must have an established stable placement.

A child must return to their placement home after respite; respite homes cannot be used as a borrowed bed.

Respite Request Process:

Requests must come through our referral portal by the child’s worker.
- Once a request is submitted worker will get a secure link to upload the MDHHS 6072 form these can be found online.

Agencies cannot request respite directly from H4H homes.

Foster parents cannot request respite directly from H4H homes.

A virtual meeting will be requested between, foster care agency, H4H, and both the foster placement and respite provider, this covers respite details such as dates, transportation, and obligations (parenting time, therapy, etc.).

After respite, the child’s worker provides a feedback form to ensure quality reporting.

If respite services are secured after this referral has been submitted, please notify us as soon as possible so we can cancel the referral

Respite Request form

Respite homes can not be used as emergency placements.

Respite is only to be used for children with an established stable placement.

Adoptive Child Respite

Respite can be requested for an adoptive child if they have active medical subsidy

Respite is intended to provide the adoptive parent(s)/legal guardian(s) with restorative time away and the adoptive child a break from their routine schedule to support the well-being of the family.

Each child is eligible for 12 units every three months.
- A single unit is equal to any part of one calendar day. Anything less than a full day is equal to one unit.
This form is the form it will ask you to upload after you submit a request following the link below.

Respite Request form