Application Information (English)

About the Alabama Lifespan Respite Reimbursement Program

What is Respite?

A temporary short break to give relief to family caregivers from the extraordinary intensive demands of providing ongoing care in the home for a loved one with special needs.

A person who provides full-time (40 or more hours per week) of unpaid care to assist with activities of daily living (bathing, dressing, feeding, medication management, errands, chores, etc.) for a parent, spouse/partner, child, sibling, grandparent, or other family member who requires full-time care due to a disability or chronic illness. 

A family member who requires full-time care due to a disability or chronic illness (proof of diagnosis required).

A person hired by the Primary Caregiver to give them a short break (respite) from daily caregiving duties. Respite provision at onsite, fee-based respite day/evening
programs and camps are also eligible for reimbursement. What is Respite Reimbursement? Alabama Lifespan Respite does not employ Respite Providers. Therefore, Caregivers are responsible for identifying, hiring, and training Respite Providers (or enrolling their Care Recipient in a day/evening program or camp) to receive respite and will be reimbursed for services rendered based on timesheet guidelines. Reimbursement is not income and should not affect SSI benefits.

Timesheets are simply a paper form that documents when and how long respite took place and who provided the respite (Respite Provider). Need help completing your timesheet? 

Once a Caregiver applies and is qualified for the respite reimbursement program, the Caregiver will receive a welcome packet with instructions and a timesheet indicating the amount of reimbursement award they will receive for a specific period of time. 

Caregivers may choose anyone they wish to provide respite and may require training (such as CPR or basic First Aid), if they so choose, but the level of training is at the discretion of the Caregiver. The Respite Provider must be at least age 18 and may not live in the same home as the Care Recipient. More than one Respite Provider may provide respite during the dates listed on the timesheet and be recorded as such. Caregivers/Respite Providers mutually determine a rate of pay. Respite can be provided in-home or onsite at a community respite program. 

When respite service is completed, the Respite Provider signs the timesheet to confirm the date and time respite was received. The Caregiver will pay the Respite Provider out-of-pocket and submit the completed/signed timesheet to Alabama Lifespan Respite, who will issue a check to reimburse the Caregiver (based on award amount that must be utilized during the specified time frame). Once Alabama Lifespan Respite receives the completed/signed timesheet and verifies information, reimbursement will be issued to the Caregiver within 30 days.

STOP! Please read the following information fully before completing your application.

Are you a full-time, unpaid, family caregiver for a loved one of any age with a chronic illness or disability that requires around-the-clock care? Do you need a break (also known as respite)? If so, you are invited to *apply for the Alabama Lifespan Respite Reimbursement program.

*If you have applied for and received respite reimbursement from Alabama Lifespan Respite after July 1, 2025, there is no need to reapply. Re-enrollment information will be sent to
recipients annually. NOTICE: The completion of this application does not guarantee the awarding of financial assistance from Alabama Lifespan Respite. Please note that while Alabama Lifespan Respite wishes we could help all qualified individuals who seek assistance, regrettably we only have limited funds to meet the needs of qualified caregivers. Therefore, we can only respond to
requests based on our available resources.

Please mark that you have read and understand each of the following guidelines before applying for the Alabama Lifespan Respite Reimbursement Program.
Caregiver Gender:
Is your gross monthly income above $1,500?
Preferred Method of Contact:
1. How are you (Primary Caregiver) related to the Care Recipient? I am their...
2. Please specify military status:
Active or Retired
3. Please select your race:
4. Please identify your ethnicity.
6. How many hours of care do you provide in a week (please estimate)?
5. Do you (Primary Caregiver) and the Care Recipient live in the same household?
7. Are you interested in receiving information about free caregiver mental health counseling, education, and supports?
Medicaid Waiver Home Based Services
Veteran’s Administration (Aid and Attendance)
Alabama Cares
Autism Society of AL
HEARTS
ALS
Alabama Head Injury Foundation
Other
10. ¿Prefieres recibir información en inglés o español?
Gender:

El plazo de inscripción ya ha finalizado.

Por favor, indique que ha leído y comprendido cada una de las siguientes directrices antes de solicitar el Programa de Reembolso de Servicios de Respiro de Alabama.
Género del cuidador:
¿Tus ingresos brutos mensuales superan los 1.500 dólares?
Forma de contacto preferida:
1. ¿Qué relación tienes (como cuidador principal) con la persona a la que cuidas? Soy su...
2. Please specify military status:
Active or Retired
3. Please select your race:
4. Indique su origen étnico.
6. ¿Cuántas horas de cuidado prestas a la semana (por favor, haz una estimación)?
5. ¿Viven usted (cuidador principal) y la persona a la que cuida en el mismo hogar?
7. ¿Te interesa recibir información sobre asesoramiento, formación y apoyo gratuitos en materia de salud mental para cuidadores?
Medicaid Waiver Home Based Services
Veteran’s Administration (Aid and Attendance)
Alabama Cares
Autism Society of AL
HEARTS
ALS
Alabama Head Injury Foundation
Other
10. ¿Prefieres recibir la información en inglés o en español?
Sexo: