Respite care in Iowa is the planned, funded break that lets a family caregiver keep going, and more than one program can pay for it.

Iowa Medicaid's home and community-based services (HCBS) waivers are one route: the Consumer Choices Option (CCO) lets a waiver member hire their own workers, and Consumer-Directed Attendant Care (CDAC) through an agency provider, called Attendant Care since January 1, 2026, covers hands-on help. The National Family Caregiver Support Program (NFCSP), delivered through Iowa's Area Agencies on Aging, is another., For veterans, VA's Program of Comprehensive Assistance for Family Caregivers (PCAFC) gives approved Primary Family Caregivers at least 30 days of respite care per year. If you are running on no sleep and cannot picture stepping away even for an afternoon, this guide shows which route fits and how to start.

Why Respite Care Matters for Iowa Caregivers

Needing a break from caregiving is not a sign you do not love the person you are caring for. The federal National Family Caregiver Support Program exists to help family and informal caregivers care for their loved ones at home for as long as possible, and respite care is one of the services it funds.

You do not have to earn a break by reaching caregiver burnout first. If you need one soon, call the Iowa Aging & Disability Resource Center at 1-800-779-2001 to reach a system navigator who can connect you to your Area Agency on Aging. The rest of this guide walks through the programs that may help pay for time off.

Respite Care in Iowa: Your Funded Options

Which route fits depends on your loved one's Medicaid enrollment, age, and veteran status. Adult day care is a setting those routes can pay for, not a separate funder. Here is how the options in this guide compare before the detail below.,

Route Who it helps Who pays How to start
CCO and agency Attendant Care, formerly CDAC (Medicaid waivers) A loved one enrolled in an Iowa Medicaid HCBS waiver Iowa Medicaid Your case manager, services, or assigned MCO
NFCSP respite (via AAAs) Caregivers of someone 60 or older, or of someone with dementia at any age, plus relatives 55 and older raising a child or caring for an adult with a disability; a family caregiver gets respite only when caring for someone 60 or older who is frail Older Americans Act (federal grants to states), not Medicaid Your Area Agency on Aging (Iowa ADRC, 1-800-779-2001)
Adult day care (a setting, not a separate funder) Caregivers who want respite outside the home Medicaid waiver services or NFCSP respite Your case manager, or your AAA (Iowa ADRC, 1-800-779-2001)
VA respite Approved PCAFC Primary Family Caregivers, who get at least 30 days of respite a year; other caregivers of veterans can ask the Caregiver Support Line about support services U.S. Department of Veterans Affairs VA Caregiver Support Line: 1-855-260-3274

1. CCO and Attendant Care (Formerly CDAC): Iowa Medicaid Waiver Services

If your loved one is already on an Iowa Medicaid HCBS waiver, start here. Iowa HHS lists respite and adult day care among the Elderly Waiver's services, and CMS describes that waiver as serving people 65 or older who meet a nursing facility level of care.

Attendant Care, called Consumer-Directed Attendant Care (CDAC) through December 31, 2025, is one of Iowa Medicaid's waiver services, and Iowa's 2011 CDAC member handbook describes it as a direct, hands-on service. Iowa ended Individual CDAC (ICDAC), the individual-provider type, on December 31, 2025. Iowa HHS announced the end in advance and told members to enroll in the Consumer Choices Option below or with an agency provider before that date, and its service-code guide set December 31, 2025 as the end date for individual CDAC service plans. From January 1, 2026, a member who wants to self-direct this care does so through CCO only, and the agency service continues under the name Attendant Care. Attendant Care is available on the Elderly Waiver and on the Health and Disability, Brain Injury, Physical Disability, AIDS/HIV, and Intellectual Disabilities waivers; the Health and Disability Waiver's approved amendment says the renamed Attendant Care and Skilled Attendant Care keep the same scope. Iowa's 2011 CDAC member handbook says your loved one must already be on a waiver, can request CDAC as a waiver service, and needs the case manager or service worker to agree that CDAC is right for them. The handbook describes two kinds of CDAC services, unskilled and skilled; skilled services are more medical in nature, and a licensed nurse or therapist must supervise the provider who does them. It also says CDAC cannot provide personal supervision or someone to stay overnight. The handbook predates the 2026 changes, so confirm current rules with the case manager or MCO.

Consumer Choices Option (CCO) is Iowa's individual-budget model. Your loved one controls a targeted amount of Medicaid dollars, is the employer of their staff, sets the wages, and chooses the workers. The CCO guide's example of what the budget can buy is to hire individuals, including family members and friends, to provide personal assistance. Members can work with an Independent Support Broker on the budget, a service Iowa has given notice it intends to make optional so a member could work with their case manager instead, and a Financial Management Service keeps the allowance in a separate account, pays workers once their time cards are approved, and makes sure laws such as payroll taxes are obeyed.

Who can you hire? For CDAC, Iowa's 2011 member handbook says the attendant must be at least 18, must have the training or experience to meet the member's needs, and can be a family member, friend, or neighbor, but cannot be the member's spouse, or the parent, stepparent, or guardian of a member under 18. That handbook was written for the Individual CDAC arrangement that ended December 31, 2025, and no current source confirms its rules carry over to agency Attendant Care or CCO, so confirm hiring rules with the case manager or MCO. Iowa's administrative rule treats payment as incorrectly made when the worker is the member's spouse or the parent of a minor child, but the January 2025 text of Iowa's CMS-approved Elderly Waiver says payments may be made to any relative including a spouse (though the same text bars a spouse from self-directed homemaker work), and the approved Health and Disability Waiver amendment lets a spouse provide services as an Attendant Care agency or CCO employee when the service planning team finds the needed services "extraordinary," so confirm a spouse's case with the case manager or MCO. Under that same rule, payment to a guardian or other legal representative is not treated as incorrect when it is made under a waiver attendant care agreement or a CCO employment agreement. Under Iowa's Health and Disability Waiver rule, respite cannot be provided to a member whose usual caregiver is also their paid attendant care provider, so ask the case manager how being paid affects respite.,

How to start: Contact your loved one's case manager, services, or assigned managed care organization (MCO). For Attendant Care (formerly CDAC), request it as a waiver service; for CCO, ask about working with a broker or the case manager on the budget. If you do not yet have a case manager, start at Iowa Medicaid or call the Iowa Aging & Disability Resource Center at 1-800-779-2001.,

2. NFCSP Respite Through Iowa's Area Agencies on Aging

If your loved one is not on Medicaid, do not stop reading here. This route does not require Medicaid at all.

What it is: The National Family Caregiver Support Program (NFCSP), funded under Title III-E of the Older Americans Act, makes federal grants to states, and its services are provided by Area Agencies on Aging or the entities they contract with. In Iowa, six Area Agencies on Aging cover all 99 counties. The program funds information about services, help gaining access to them, counseling, support groups, caregiver training, respite care, and limited supplemental services. Respite gives temporary relief at home, in adult day care, or in an institutional setting.,

No Medicaid required. NFCSP is funded under the Older Americans Act, and none of the federal caregiver groups below requires Medicaid enrollment; they are defined by who you care for.

Who qualifies: Adult family members or other informal caregivers of someone 60 or older; caregivers of a person of any age with Alzheimer's disease or a related disorder; relatives age 55 and older, other than parents, caring for a child under 18; and relatives age 55 and older, including parents, caring for an adult age 18 to 59 with a disability. An older relative caregiver must live with, and be the primary caregiver for, the child or adult with a disability. For a family caregiver, respite and supplemental services are available only where the person cared for is an older individual (60 or older) who is frail: unable to perform at least two activities of daily living without substantial human assistance, or needing substantial supervision because a cognitive or other mental impairment leads to behavior that poses a serious health or safety hazard.,

How much respite will you get? The answer comes from your local agency. Under the Older Americans Act, Area Agencies on Aging, or the entities they contract with, provide the respite, and services may be informed through the use of caregiver assessments. Call your Area Agency on Aging (the Iowa Aging & Disability Resource Center at 1-800-779-2001 can tell you which one), ask for NFCSP caregiver support and respite, and ask whether they offer a caregiver assessment.,

3. Adult Day Care as a Respite Setting

If you need regular time away while your loved one is cared for outside the home, an adult day program is worth asking about.

What it is: Adult day care is one of the settings in which NFCSP respite can be provided, alongside respite at home or in an institutional setting.

Who pays: If your loved one is on Iowa's Elderly Waiver, ask the case manager about adult day care, which Iowa HHS lists among that waiver's services. NFCSP respite through your Area Agency on Aging can also be provided in an adult day care setting.,

Where to ask: Ask your Area Agency on Aging whether its respite can be provided in an adult day care setting. If you do not know which agency to call, the Iowa Aging & Disability Resource Center at 1-800-779-2001 connects you to a system navigator.

4. VA Respite for Veterans

If the person you care for served, check with VA before you pay for private care.

Where to start: VA's Caregiver Support Line gives caregivers of veterans information on support services, counseling, educational offerings, and more, and it can connect you directly to your local VA Caregiver Support Program team.

The PCAFC benefit: Primary Family Caregivers approved under the Program of Comprehensive Assistance for Family Caregivers (PCAFC) receive respite care as part of the benefit, along with a monthly stipend VA has described as nontaxable. VA's first screen has four requirements for the veteran, and all four must be true: a VA disability rating of 70% or higher, a discharge from the U.S. military or a date of medical discharge, a need for at least six months of continuous, in-person personal care, and enrollment in VA health care. Those four are necessary but not the whole test; you and the veteran apply together, and VA assesses further conditions during the application. A spouse can serve as the caregiver under PCAFC, whatever the answer under Iowa Medicaid.

How to start: Call the VA Caregiver Support Line at 1-855-260-3274, Monday through Friday, 8 a.m. to 8 p.m. ET, and ask to be connected to your local VA Caregiver Support Program team.

See Iowa VA Aid and Attendance benefits for additional VA financial support toward the cost of care.

How to Start Respite Care in Iowa

1
Step 1

Contact your Area Agency on Aging first

If you do not know which one serves you, call the Iowa Aging & Disability Resource Center at 1-800-779-2001 to speak to a system navigator. Your agency delivers NFCSP respite, counseling, and caregiver training, and NFCSP does not depend on Medicaid.,

2
Step 2

If your loved one is on an Iowa Medicaid waiver, call the case manager

Ask about respite as a waiver service and whether CCO or agency Attendant Care (formerly CDAC) fits. If there is no case manager yet, start at Iowa Medicaid.

3
Step 3

Ask your AAA whether respite can be provided in adult day care

Adult day care is one of the settings in which NFCSP respite can be provided.

4
Step 4

If your loved one is a veteran, call the VA Caregiver Support Line

Call 1-855-260-3274, ask to be connected to your local VA Caregiver Support Program team, and ask about the PCAFC benefit, which includes respite.,

Your next step You do not have to wait until you are running on empty to make the first call. Start with your Area Agency on Aging, reachable through the Iowa Aging & Disability Resource Center at 1-800-779-2001, for respite that does not depend on Medicaid, and ask your case manager about CCO or agency Attendant Care (formerly CDAC) if your loved one is on a waiver. Or chat with Brevy's care navigator for a shortlist built around your loved one's Medicaid enrollment, age, and veteran status.

Where to Get Help in Iowa

Iowa Area Agencies on Aging Six agencies cover all 99 counties and deliver NFCSP services, including respite, counseling, and caregiver training. 1-800-779-2001 (Iowa Aging & Disability Resource Center; a system navigator can tell you which agency serves you) hhs.iowa.gov/health-prevention/aging-services/iowa-area-agencies-aging
Iowa Medicaid (CCO and Attendant Care) The Consumer Choices Option and agency Attendant Care (formerly CDAC) for members on an HCBS waiver. contact your case manager, services, or assigned MCO hhs.iowa.gov/medicaid
VA Caregiver Support Line Information on VA caregiver support services and a direct connection to your local VA Caregiver Support Program team, Monday through Friday, 8 a.m. to 8 p.m. ET. 1-855-260-3274 www.caregiver.va.gov/support/support_benefits.asp

Frequently Asked Questions

Does Attendant Care (CDAC) or CCO respite require my loved one to already be on an Iowa HCBS waiver?

Yes. Both are part of Iowa Medicaid's HCBS waivers. For CDAC, now called Attendant Care, Iowa's 2011 CDAC member handbook says your family member must already be on a waiver, such as the Elderly Waiver or Brain Injury Waiver, can request CDAC as a waiver service, and needs the case manager or service worker to agree it is right for them. For CCO, contact the case manager, services, or assigned MCO. If your loved one is not yet on a waiver, contact Iowa Medicaid or call the Iowa Aging & Disability Resource Center at 1-800-779-2001.

Can I be paid to provide respite to my own parent under Attendant Care (CDAC) or CCO?

Possibly. Iowa's payment rule names a member's spouse and the parent of a minor child, not an adult child. The 2011 CDAC handbook allows a family member who is at least 18 and has the training or experience needed, but it was written for the Individual CDAC arrangement that ended December 31, 2025, and no current source confirms its rules carry over to agency Attendant Care or CCO, so confirm hiring rules with the case manager or MCO. The CCO guide's example of what a budget can buy is hiring family members and friends. If you are your parent's guardian or legal representative, you can be paid only under a waiver attendant care agreement or a CCO employment agreement. If you want to be paid as a caregiver more broadly, see the Iowa guide to getting paid as a family caregiver.,

Do I need to be on Medicaid to qualify for NFCSP respite?

No. NFCSP is funded under the Older Americans Act, and none of its federal caregiver groups requires Medicaid. Eligibility turns on who you care for, mainly someone 60 or older or someone with dementia at any age, and a family caregiver gets respite only when the person cared for is 60 or older and frail. Your Area Agency on Aging, or an entity it contracts with, provides the services, so ask it what is available.,

My spouse has Alzheimer's and I am the only caregiver. Can the AAA help?

Yes. NFCSP serves caregivers of a person of any age with Alzheimer's disease or a related disorder, with information, help gaining access to services, counseling, support groups, and caregiver training. Respite is narrower: for a family caregiver, it is available only where the person cared for is 60 or older and frail, which includes needing substantial supervision because a cognitive or other mental impairment leads to behavior that poses a serious health or safety hazard. If your spouse is under 60, you cannot get NFCSP respite as a family caregiver, but the other services are open to you. A separate group, relatives 55 and older who live with and are the primary caregiver for an adult age 18 to 59 with a disability, is not held to the 60-and-frail condition, so ask the agency whether you fit it. Call your Area Agency on Aging (the Iowa Aging & Disability Resource Center at 1-800-779-2001 can tell you which one) and say you are caring for someone with dementia. Ask about counseling, support groups, caregiver training, and respite.,

What if my family member is not on Medicaid and I cannot afford private respite?

None of NFCSP's federal caregiver groups requires Medicaid; they are defined by who you care for, and Iowa's Area Agencies on Aging deliver the services. Call the Iowa Aging & Disability Resource Center at 1-800-779-2001 to find your agency and explain your situation.,

Learn More

Find personalized help mapping Iowa respite options to your family's situation 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.

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