If you are caring for an aging parent or a spouse with dementia in California and running on empty, respite care can give you a real break, and in most cases someone else pays for it.

Caregiving quietly wears down your own health. Federal data show that nearly 1 in 5 family caregivers reports fair or poor health, and depressive symptoms are roughly twice as common among caregivers as in the general population. Respite is not stepping away from the person you love. It is often what makes it possible to keep caring for them at home.

Respite care in California is not one program but a stack of payors: IHSS hours, CalAIM Community Supports, the state's Medi-Cal home- and community-based waivers, the Caregiver Resource Centers, the National Family Caregiver Support Program, Medicare hospice, and the VA. Many families qualify for more than one. To find your local help today, call the Eldercare Locator at 1-800-677-1116.

In This Guide

Why Respite Matters

Caregiving in America is not a niche experience. The 2025 AARP and National Alliance for Caregiving report found that 63 million Americans, nearly 1 in 4 adults, provided ongoing care in the past year, and 44% describe it as high-intensity. The single most documented way to keep a caregiver healthy and keep a loved one out of crisis nursing-home placement is structured, predictable respite. California's Master Plan for Aging makes this explicit in Goal Four, "Caregiving That Works," because the state's long-term-care system depends on family caregivers continuing to provide care at home.

Respite comes in four formats: in-home (a paid worker comes to you for a few hours), adult day (your loved one attends a structured daytime program), residential (an overnight to multi-week stay at a licensed facility), and emergency (short-notice care when a crisis hits). The payors below fund different combinations of these.

The Eight Ways to Pay for Respite Care in California

Do not ask "which one respite program am I eligible for?" Ask "which payors can I layer to get the hours my family actually needs?" Many California families combine IHSS with a voucher program like a Caregiver Resource Center.

Payor Who it is for What it funds
IHSS Full-scope Medi-Cal recipients who are 65+, blind, or disabled Personal-care hours in the recipient's own home, up to 195 or 283 a month
CalAIM Community Supports Members of a Medi-Cal managed care plan that elects the support A respite-type Community Support, where the plan elects to offer one
HCBS waivers (HCBA, MSSP, ALW) Full-scope Medi-Cal members at a nursing-facility level of care Services set by each waiver's care plan; ask the agency what respite it authorizes
Caregiver Resource Centers Family caregivers of adults with chronic or cognitive conditions Free assessment, counseling, and respite vouchers
NFCSP (via Area Agencies on Aging) Caregivers of adults 60+, or of anyone with dementia Respite vouchers, adult day, training
Regional Centers / SDP People with developmental disabilities Services coordinated in an Individual Program Plan; a self-directed budget under SDP
Medicare hospice Anyone on the Medicare hospice benefit Short inpatient respite stays
VA Enrolled veterans who meet the clinical criteria Home respite, adult day health, or a nursing-home stay capped at 30 days a year; at least 30 days a year for a PCAFC Primary Family Caregiver

1. IHSS, the Foundation

In-Home Supportive Services (IHSS) is California's Medi-Cal personal-care program for aged, blind, and disabled residents, and it is the largest source of family-caregiver respite in the state. The Legislative Analyst's Office projects roughly 771,650 IHSS recipients in 2025-26, and California is one of the few states that lets a spouse be the paid provider in its main Medicaid personal-care program. It is not labeled a respite program, but its hours can function as one.

IHSS authorizes monthly hours from a county social worker's in-home assessment, capped at 195 hours a month, or 283 for the severely impaired. Ask your county IHSS office whether a second provider can be added to the case to cover part of those authorized hours; that is how many family caregivers build in a break. Provider wage floors are set county by county and must meet at least California's minimum wage, which rose to $16.90 an hour on January 1, 2026; the state estimates the average IHSS cost at about $21.85 an hour. Because IHSS runs on self-direction, a spouse or parent can be the paid provider under the program's federal self-directed authority.

The catch: IHSS does not pay for a residential stay. If you need your loved one to stay overnight at a facility, you layer in another payor below.

2. CalAIM Community Supports

Under CalAIM, California's Section 1115 Medicaid demonstration, Medi-Cal managed care plans may offer optional Community Supports, pre-approved services delivered in place of standard Medi-Cal benefits. Whether a given plan covers respite this way varies by plan and county, and adoption changes each year.

Because it is optional, the only reliable way to know is to ask. Call your plan's member services line and ask directly whether it offers respite as a Community Support, how to get a referral, and what it authorizes. If the plan does not respond, the DHCS Office of the Ombudsman can escalate a Medi-Cal managed care complaint. Where a plan offers it, this support pairs well with IHSS: IHSS pays you to provide care, and the plan can fund a different worker to relieve you.

3. The Medi-Cal HCBS Waivers

California's Medi-Cal home- and community-based waivers serve full-scope Medi-Cal members who need a nursing-facility level of care, and each waiver sets its own service menu through a care plan, so ask the waiver agency directly what respite it can authorize for you. Apply early: the Assisted Living Waiver carries a large waitlist.

4. The Caregiver Resource Centers

The Caregiver Resource Centers (CRCs) are the most caregiver-centered respite option in California, and they require no Medi-Cal enrollment. California funds 11 regional CRCs administered through the California Department of Aging and supported in part by the federal National Family Caregiver Support Program. They provide free caregiver assessment, counseling, respite, education, support groups, and referrals to families of adults with cognitive impairment or chronic conditions.

CRC respite vouchers fund time-limited substitute care; they do not replace IHSS hours and do not count as wages, so they layer on top of IHSS rather than trading against it. Find your regional center through the statewide directory at caregivercalifornia.org or call the Department of Aging Aging and Adult Information Line at 1-800-510-2020.

5. NFCSP Through Area Agencies on Aging

The federal National Family Caregiver Support Program (NFCSP), authorized under Title III-E of the Older Americans Act, funds five categories of caregiver help, including respite, delivered through local Area Agencies on Aging. Eligibility turns on your caregiving relationship, and there are four routes in: adult family members or other informal caregivers of someone 60 or older; caregivers of any age caring for someone with Alzheimer's or a related disorder; older relatives other than parents, age 55 and older, caring for a child under 18; and older relatives including parents, age 55 and older, caring for an adult aged 18 to 59 with a disability.

Respite amounts and any caps are set by each Area Agency on Aging, not federally, so the amount varies by county. This is often the lowest-burden entry point for a family not yet on Medi-Cal. Use the Eldercare Locator at 1-800-677-1116 to reach your local agency.

6. Regional Centers and the Self-Determination Program

For a loved one with a developmental disability, services run through the Department of Developmental Services and its statewide network of 21 community-based regional centers, which coordinate what the person receives through an Individual Program Plan. Ask the regional center's service coordinator what respite the plan can authorize and in what setting. The Self-Determination Program (SDP) is the consumer-directed alternative that lets a family control an individual budget and choose providers, including, in defined circumstances, family members paid through a financial management service.

7. Medicare Hospice Respite

If your loved one is on the Medicare hospice benefit, inpatient respite care is one of its four covered levels of care. The hospice arranges a short stay at an inpatient facility so the family caregiver can rest, and the beneficiary pays only 5% of the Medicare-approved amount for that inpatient respite. Inpatient respite is meant for short stays, so ask the hospice how long a stay it can arrange and how often.

This benefit is badly underused. When the hospice nurse asks how you are doing, the right answer, if you are exhausted, is to ask for inpatient respite. Take it.

8. VA Respite

For a veteran, the VA offers respite to give the family caregiver a temporary break, and it can be both generous and fast. Respite is delivered as in-home care, adult day health, or a short stay in a VA Community Living Center or community nursing home (nursing-home respite is capped at 30 days per calendar year). All enrolled veterans are eligible if they meet the clinical criteria for the service and it is available.

An approved Primary Family Caregiver in the Program of Comprehensive Assistance for Family Caregivers (PCAFC) receives at least 30 days of respite a year as part of the benefit. PCAFC serves veterans with a VA disability rating of 70% or higher who need at least six months of continuous in-person personal care and are enrolled in VA health care, and a spouse can serve as the caregiver. Veterans can also direct their own budget to hire respite providers through Veteran-Directed Care. To start, call the VA Caregiver Support Line at 1-855-260-3274.

What Respite Care Costs in California

If no program covers the break, you can still hire help and pay privately, and it helps to know the going rate before you call around. In the CareScout 2025 Cost of Care Survey, the median for non-medical in-home care in California was about $40 an hour, or roughly $91,520 a year at 44 hours a week, well above the national median of about $35 an hour. A short stay in an assisted living community, a common form of residential respite, runs a California median of about $84,000 a year, roughly $7,000 a month, though short-stay respite is billed by the day or week. These are industry-survey medians, not fixed rates, and they climb as care needs grow.

For scale on the high end, the statewide Average Private Pay Rate for nursing-facility care, the divisor Medi-Cal uses in its transfer-penalty math, is reported at about $14,440 a month for 2026; DHCS publishes the updated figure each year, usually at the end of January. That is exactly why the funded options above matter: a few hours of paid respite each week adds up fast, and the Medi-Cal, CRC, NFCSP, and VA paths exist so the cost does not fall entirely on your family.

How to Get Respite Care in California

For most California families starting from zero, this is the order that works.

1
Step 1

Apply for IHSS if your loved one has full-scope Medi-Cal

Call your County IHSS office. Even if you stay the primary provider, ask whether a second provider can be added to the case so someone else can be paid for part of the authorized hours.

2
Step 2

Call your Caregiver Resource Center at 1-800-510-2020

Ask for a caregiver assessment and which respite vouchers your family qualifies for. There is no Medi-Cal requirement.

3
Step 3

Ask your Medi-Cal managed care plan about CalAIM Community Supports

Ask directly whether the plan covers respite as a Community Support and how to get authorized.

4
Step 4

Reach your Area Agency on Aging through the Eldercare Locator at 1-800-677-1116

AAAs run NFCSP respite vouchers and adult day subsidies for caregivers of adults 60 and older.

5
Step 5

Call the VA Caregiver Support Line at 1-855-260-3274 first if your loved one is a veteran

Ask about respite through the local VA medical center and eligibility for PCAFC.

Eldercare Locator A free, nationwide ACL service that connects older adults, families, and caregivers to services in their community, including your local California Area Agency on Aging, which is the office that runs NFCSP respite and caregiver support. Lines are open Monday through Friday, 8 a.m. to 9 p.m. ET. 1-800-677-1116 eldercare.acl.gov
California Department of Aging Directs you to your regional Caregiver Resource Center and MSSP site. 1-800-510-2020 aging.ca.gov
VA Caregiver Support Line Respite and caregiver benefits for families of enrolled veterans, including PCAFC. 1-855-260-3274 caregiver.va.gov
DHCS Office of the Ombudsman Escalates Medi-Cal managed care problems, including denied Community Supports. dhcs.ca.gov
Your next step Call your Caregiver Resource Center at 1-800-510-2020 to ask for a caregiver assessment and the respite vouchers your family qualifies for this month.

Frequently Asked Questions

Does California Medi-Cal pay for respite care?

Yes, through several paths. IHSS authorizes personal-care hours in your loved one's own home; the HCBA, MSSP, and Assisted Living waivers build a care plan for members at a nursing-facility level of care; and a Medi-Cal managed care plan may elect to offer a respite-type Community Support under CalAIM. Ask your county and your plan which applies to you.

Can I use IHSS hours for my own respite if I am the paid provider?

Often, yes, but your county decides. Talk to your County IHSS office about adding a second provider to the case so someone else can be paid for part of the authorized hours while you step away. Any provider they add completes the same standard enrollment you did.

Is there respite in California if I am not on Medi-Cal?

Yes. The Caregiver Resource Centers and the Area Agencies on Aging both fund respite without any Medi-Cal enrollment, based on your caregiving relationship. Call the CRC network at 1-800-510-2020 or the Eldercare Locator at 1-800-677-1116.

My husband is on hospice. Can I take a break using the Medicare respite benefit?

Yes. Tell the hospice nurse you want inpatient respite. The hospice arranges a short stay at an inpatient facility, and you pay only 5% of the Medicare-approved amount for that respite. Ask the hospice how the benefit period rules apply to you.

How much VA respite can a veteran's family get?

An approved Primary Family Caregiver in PCAFC receives at least 30 days of respite a year, and nursing-home respite is capped at 30 days per calendar year. Outside PCAFC, all enrolled veterans are eligible if they meet the clinical criteria for the service and it is available. Call the VA Caregiver Support Line at 1-855-260-3274.

Can a family member be paid to provide the care in California?

Yes. IHSS runs on self-direction, so a spouse or parent can enroll as the paid provider, and the Self-Determination Program lets families of people with developmental disabilities direct a budget and choose providers. This is separate from respite but often runs alongside it.

What if my loved one refuses respite?

This is common. Introduce the respite worker as a helper rather than a caregiver, start with short one-to-two-hour visits to build comfort, keep the same worker, and involve your loved one in choosing them. Your Caregiver Resource Center has decades of experience with this, so ask for help.

How do I know if I am in burnout?

Watch for sleep disruption, persistent low mood, social withdrawal, irritability, and new physical symptoms. Federal data show caregivers report worse health than non-caregivers across most measures, and depressive symptoms are about twice as common. If that sounds like you, a Caregiver Resource Center assessment is the place to start.

Learn More

CaregiverRespite Care for Family Caregivers: The 50-State GuideWhat respite care is and how to pay for it in 2026: the main types, free NFCSP grants, Medicaid and VA respite, and a link to every state guide. CaregiverHow to Get Paid as a Family Caregiver in CaliforniaCalifornia's eight paid family caregiver programs: IHSS, VA Aid and Attendance, Paid Family Leave, and more, with 2026 rates and how to apply. CaregiverCalifornia Caregiver ProgramsA guide to every California caregiver program in 2026: IHSS pay for family, VA pathways, CalAIM respite, Paid Family Leave, Resource Centers, and tax breaks. CaregiverCaring for a Loved One with Dementia in CaliforniaCalifornia dementia caregiving: how to get paid through IHSS (spouses included), Medi-Cal long-term care, the legal quartet, respite, and where to start. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. CaregiverCalifornia Caregiver HubCalifornia family caregiver guide: IHSS, VA programs, SDP, PFL, CalAIM, the 11 Caregiver Resource Centers, and the CDA Information Line at 1-800-510-2020.

Find personalized help navigating California respite care at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.