1 

Federal Lifespan Respite Program: 

Data Elements

version August 19, 2022

Section A: Federal Lifespan Respite Program – Care Services Delivered

Item 1 – Federal Lifespan Respite Care delivered

Indicate the cumulative number over the course of the project period. Enter “0” for none.

 Cumulative total 

Hours of respite care delivered to date, in increments of 0.25 

Expenditures to date on respite care delivered $ 

Does your state deliver Federal Lifespan Respite Care via vouchers? If yes, please complete 

Item 2: 

Item 2 – Federal Lifespan Respite Care delivered via voucher

Indicate the cumulative number over the course of the project period. Enter “0” for none.

Note: For grants that provide respite care ONLY through vouchers, numbers in Item 2 will 

match those in Item 1 above. 

 Cumulative total 

Hours of respite care delivered to date via redeemed vouchers 

Expenditures to date on respite care via redeemed vouchers $ 

Item 3 – Sources of match for the Lifespan Respite Care Program 

Indicate all sources of match funding received over the course of the project period. 

Check all that apply

State government funds 

Local/community government funds 

Foundation funds 

In-kind sources 

Other funding source(s) 
2 

Item 4 – Location of Federal Lifespan Respite Care

Indicate the number of unique caregivers served in each location over the course of the project 

period. Caregivers who receive respite care in more than one location should be counted once for 

each applicable category.

 Cumulative Number of 

Caregivers Receiving Each 

Type of Respite 

In-home respite (day) 

In-home respite (overnight) 

Out-of-Home respite (day) 

Out-of-Home respite (overnight) 

Emergency respite 

Respite care location missing 

Item 5 – Total people served by the Federal Lifespan Respite Program Funds

Indicate the number of unique individuals in each category over the course of the project period.

 Cumulative, 

Unduplicated Total 

Total caregivers served through Federal Lifespan Respite 

Program Services 

 

Caregivers who received respite care 

Caregivers who received training 

Total care recipients (children and adults for whom Federal 

Lifespan Respite Program caregivers provided care)

 

Section B: Federal Lifespan Respite Program – Caregiver Demographics

Indicate the cumulative number over the course of the project period. Enter “0” for none. Ensure 

that totals for each item add up to the same number reported in Section A, Item 5, line 1. 

Item 1 – Caregiver Age 

 Cumulative, 

Unduplicated Total 

18-24 years 

25-39 

40-64 years 

65 years and over 

Age missing 
3 

Item 2 – Caregiver Gender Identity

 Cumulative, 

Unduplicated Total 

Woman 

Man 

Non-binary/non-conforming 

Other gender identity 

Gender missing 

Item 3 – Caregiver Transgender 

 Cumulative, 

Unduplicated Total 

Transgender 

Not transgender 

Transgender missing 

Item 4 – Caregiver Sexual Orientation

 Cumulative, 

Unduplicated Total 

Lesbian or gay 

Straight, that is, not gay or lesbian 

Bisexual 

Other sexual orientation 

Sexual orientation not known by participant 

Sexual orientation missing 

Item 5 – Caregiver Geographic Location

 Cumulative, 

Unduplicated Total 

Urban 

Suburban 

Rural 

Frontier 

Geographic location missing 
4 

Item 6 – Caregiver Ethnicity

 Cumulative, 

Unduplicated Total 

Hispanic or Latino 

Not Hispanic or Latino 

Ethnicity Missing 

Item 7 – Caregiver Race 

Respondents may select more than one category, so the total may be greater than the total in

Section A, Item 5, line 1.

 Cumulative Total 

American Indian or Alaskan Native 

Asian or Asian American 

Black or African American 

Native Hawaiian or other Pacific Islander 

White 

Race missing 

Item 8 – Caregiver Relationship to Care Recipient 

 Cumulative, 

Unduplicated Total 

Adult child of the care recipient 

Parent of the care recipient 

Spouse or partner of the care recipient 

Grandparent of the care recipient 

Other kin caregiver (e.g., aunt, sibling) 

Other relationship 

Relationship missing 
5 

Section C: Federal Lifespan Respite Program - Care Recipient Demographics

Indicate the cumulative number over the course of the project period. Enter “0” for none. Ensure 

that totals for each item add up to the same number reported in Section A, Item 5, line 5. 

Item 1 – Care Recipient Age

 Cumulative, 

Unduplicated Total 

Under 18 

18-24 years 

25-39 years 

40-64 years 

65 years and over 

Age missing 

Item 2 – Care Recipient Gender Identity

 Cumulative, 

Unduplicated Total 

Woman/girl 

Man/boy 

Non-binary/non-conforming 

Other gender identity 

Gender missing 

Item 3 – Care Recipient Transgender for Care Recipients age 18 and older 

 Cumulative, 

Unduplicated Total 

Transgender 

Not transgender 

Transgender missing 
6 

Item 4 – Care Recipient Sexual Orientation for Care Recipients age 18 and older 

 Cumulative, 

Unduplicated Total 

Lesbian or gay 

Straight, that is, not gay or lesbian 

Bisexual 

Other sexual orientation 

Sexual orientation not known by participant 

Sexual orientation missing 

Item 5 – Care Recipient Geographic Location

 Cumulative, 

Unduplicated Total 

Urban 

Suburban 

Rural 

Frontier 

Geographic location missing 

Item 6 – Care Recipient Ethnicity

 Cumulative, 

Unduplicated Total 

Hispanic or Latino 

Not Hispanic or Latino 

Ethnicity Missing 

Item 7 – Care Recipient Race 

Respondents may select more than one category, so the total may be greater than the total in 

Section A, Item 5, line 5. 

 Cumulative Total 

American Indian or Alaskan Native 

Asian or Asian American 

Black or African American 

Native Hawaiian or other Pacific Islander 

White 

Race missing 
7 

Section D: Federal Lifespan Respite Program - Respite Training

Item 1 – Hours of Respite Training Provided through the Federal Lifespan Respite

Program grant 

Indicate the cumulative number of training hours over the course of the project period. Enter “0” 

for none. 

 Cumulative total 

Hours of respite training provided to paid and volunteer respite 

providers, in increments of 0.25 

 

Hours of respite training provided to caregivers, in increments of 

0.25 

 

Section E: Awareness

Item 1 – Respite Program Website and Registry for your State 

Enter “yes” or “no” to indicate the current existence of a website or registry.

 Yes/No

Does your state have a respite program website or webpage? 

If yes – does the website or webpage use the title or 

description “Lifespan Respite”? 

 

Does your state have a registry of respite providers? 

If yes – is your respite registry available online? 

Item 2 – Access to/Awareness of Respite Program Website and Registry for Your State 

Indicate the cumulative number of unique visitors over the course of the project period. Enter “0” 

for none or “n/a” if your state does not have a website or registry available to caregivers.

 Cumulative, 

unduplicated total 

Total respite program website visitors 

Total respite registry webpage visitors 
8 

Item 3 – Outreach Activities to Build Respite Program Awareness Across the Lifespan

Indicate the outreach activities your project has engaged in over the course of the project period. 

 Yes/No

Hosted respite conference(s) 

Community presentations 

Social media posts 

Radio advertisements 

TV advertisements 

Newspaper advertisements 

PSAs 

e-Newsletters 

Item 4 – Number of e-newsletter subscribers

Indicate the total number of e-newsletter subscribers as of the final date of the project period. If 

your project does not distribute an e-newsletter enter “n/a.” 

 Current number

Subscribers 

Section F: Lifespan Respite Program System and Providers

Item 1 – Lifespan Respite Program Coalition Meetings 

Indicate the cumulative number of meetings over the course of the project period. 

 Cumulative Number 

How many meetings has your state Lifespan Respite Program 

coalition or organization convened over the course of the project 

period? 

 

Item 2 – Lifespan Respite Program Coalition Members

Indicate the current number as of the final date of the reporting period. 

 Current Number

How many individuals are currently members of your Lifespan 

Respite coalition?

 

How many organizations are currently members of your Lifespan 

Respite coalition?

 
9 

Item 3 – Lifespan Respite Providers

Indicate the current number of respite providers as of the final date of the reporting period. 

 Current number

Number of respite provider organizations