In Washington State, respite care for a family caregiver comes through several separate programs, and their eligibility rules keep many of them apart. A person who chooses Medicaid Alternative Care must choose it instead of traditional services such as COPES or Community First Choice, and Family Caregiver Support Program respite is only for families whose loved one is not on a state or Medicaid funded long-term care service. Which door is yours depends on whether your loved one already gets Medicaid in-home care, is 55 or older and needs nursing-home-level care, is a veteran, or is on none of these programs, in which case your Area Agency on Aging is the place to start.

If you're caring for a parent, spouse, or adult child in Washington, you've likely felt the weight of doing it without a break. Respite is not a luxury. Caregivers who take planned breaks tend to stay healthier, avoid burnout, and keep their loved ones at home longer than caregivers who push through alone.

Why Respite Care Matters for Washington Caregivers

Caregiving without breaks is not sustainable. Family caregivers who never step away carry higher rates of burnout, chronic illness, and depression, and the person they care for often ends up in a nursing facility sooner as a result. Respite is not stepping away from your loved one. It is what makes staying possible.

If you're in a crisis right now, contact your Area Agency on Aging (AAA), which runs Washington's Family Caregiver Support Program, and ask what respite help is available. You can reach your AAA through the Eldercare Locator at 1-800-677-1116. If you're planning ahead, the rest of this guide walks through Washington's funded options in detail.

How to Pay for Respite Care in Washington State

Washington's respite routes are largely alternatives to one another rather than parallel options, so which one fits depends on your loved one's age, level of care, Medicaid enrollment, and whether they served in the military. The table below compares the payers at a glance before the sections that follow explain how to reach each one. If your loved one is 55 or older and meets nursing facility level of care, check MAC and TSOA early, knowing that new enrollment has been paused since December 1, 2025.

Program Who pays Eligibility and cost Available in 2026?
CFC Relief Care Washington Apple Health (Medicaid) CFC functional and financial eligibility; uses hours already in the CARE plan, adds none Yes, for CFC clients receiving in-home care
MAC / TSOA caregiver respite Washington Medicaid (Section 1115 demonstration) Age 55+ and nursing facility level of care. MAC: meets Medicaid financial eligibility, such as CN or ABP Apple Health, and not using Medicaid-funded LTSS. TSOA: not Medicaid-eligible, with its own income and resource limits New enrollment paused since December 1, 2025; statewide waitlist
FCSP respite (NFCSP) Federal Title III-E, through your Area Agency on Aging Care receiver not on a state or Medicaid funded long-term care service; no charge at or below 40% of state median income, full cost at 100% or more Yes, subject to local funding and possible wait lists
PCAFC respite U.S. Department of Veterans Affairs VA's PCAFC eligibility rules Yes, at least 30 days a year for an approved Primary Family Caregiver
Adult day and short-term facility respite Family (private pay), unless a program above applies Not applicable Yes

1. Medicaid Relief Care (Community First Choice)

What it is: If your loved one receives in-home care through Apple Health's Community First Choice, Relief Care lets a second Individual Provider or agency provider step in as a back-up to their primary paid personal care provider. It does not add any hours to the monthly hours generated by the CARE assessment; it is an alternate use of those hours. Its providers are Individual Providers employed through CDWA, the state's single Consumer Directed Employer, and home care agencies., If your loved one is on the COPES waiver rather than CFC, ask the case manager which in-home services the waiver covers, and note that Family Caregiver Support Program respite is not open to a caregiver whose loved one receives COPES.

Who pays: Washington Apple Health (Medicaid). Under Washington's CFC rule, a client who receives services through CFC only and lives in their own home will not have to pay toward the cost of their care. A person may receive both CFC and home and community based waiver services, such as COPES, at the same time, and a client on both may be required to pay toward the cost of their care, so ask the case manager what your loved one's monthly share will be.

How to access it: Ask your loved one's case manager about Relief Care in the CARE plan. The client selects, schedules, supervises, and dismisses their Individual Provider, and a family member can become a paid Individual Provider through CDWA, though under Apple Health long-term services and supports a spouse cannot be paid to care for a spouse.,

Eligibility: CFC is a Medicaid state plan benefit under Section 1915(k) of the Social Security Act. A case manager's CARE assessment must show your loved one needs an institutional level of care, or will likely need that level of care within thirty days unless CFC services are provided. They must also be eligible for a categorically needy (CN) or alternative benefit plan (ABP) Apple Health program, or for a home and community based waiver with at least one waiver service every month.

Best for: Families already receiving CFC in-home care whose primary paid provider needs back-up.

2. MAC and TSOA Caregiver Respite (Currently Waitlisted)

What they are: Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA), funded under Washington's Medicaid Transformation Project Section 1115 demonstration, support unpaid family caregivers of people age 55 and older who meet nursing facility level of care and live in a private residence. They fund caregiver supports such as respite, training and education, and specialized medical equipment and supplies, not an hourly wage. Their caregiver assistance services include, among other things, short-term respite so the caregiver can attend an educational event or training series.

How much respite they fund: In-home respite (including a bath aide) and out-of-home respite are step three services, and your caregiver must complete a TCARE assessment to access step three. The services in the care plan are capped at the limits in WAC 388-106-1920: the maximum amount of step three services is published on DSHS's ALTSA/HCS rates website, unless the department authorizes additional funds through an exception to rule.

MAC is for a person who meets Medicaid financial eligibility requirements, such as eligibility for CN or ABP Apple Health, is not using Medicaid-funded long-term services and supports, has an unpaid caregiver age 18 or older, and chooses MAC instead of COPES or CFC. TSOA is for a person who does not currently meet Medicaid financial eligibility; it has its own income and resource limits and does not require an unpaid caregiver. Estate recovery does not apply to services paid by either program.

The critical caveat: Effective December 1, 2025, MAC and TSOA paused new enrollment because of projected overspending and established a statewide, first-come, first-served waitlist under WAC 388-106-1975. People already enrolled keep their enrollment, presumptive eligibility screenings have stopped, and there is no set timeline for when the pause will end. Verify the current enrollment status before relying on these programs.,

How to apply: Applicants reach both programs through an Area Agency on Aging or Home and Community Services.

Best for: An unpaid family caregiver of someone age 55 or older who meets nursing facility level of care, is not on CFC or COPES, and needs funded respite and caregiver supports rather than hourly paid care.

3. Respite Through NFCSP and Washington's Family Caregiver Support Program

What it is: The National Family Caregiver Support Program (NFCSP), authorized under Title III-E of the Older Americans Act, makes grants to states to fund five categories of caregiver services: information, help accessing services, counseling, support groups and training, respite care, and supplemental services on a limited basis. Area agencies on aging, or entities they contract with, provide those services. In Washington, NFCSP respite reaches families as the Area Agencies on Aging's Family Caregiver Support Program (FCSP).

Who the federal program serves: Family and informal caregivers of adults age 60 and older; caregivers of people of any age with Alzheimer's disease or a related disorder; older relatives (age 55 and older, not parents) caring for children under 18; and older relatives, including parents, age 55 and older caring for adults ages 18 to 59 with disabilities. An older relative caregiver must live with and be the primary caregiver for the child or adult. For respite, the older person cared for must be frail: unable to perform at least two activities of daily living without substantial human assistance, or, due to a cognitive or other mental impairment, needing substantial supervision because they behave in a manner that poses a serious health or safety hazard to themselves or another person.

Washington's added conditions: FCSP respite is open only to a caregiver whose care receiver is not receiving a state or Medicaid funded long-term care service, such as COPES, personal care services, or a DD waiver. The caregiver must also provide an average of at least forty hours a week of care or supervision, or live with an adult who needs continuous care or supervision, and must not receive financial payment for the care.

What it costs: FCSP respite runs on a sliding scale. There is no charge to a care receiver whose income is at or below 40% of state median income, based on family size, and a care receiver whose gross income is 100% of state median income or more must pay the full cost of the respite care services. Ask your AAA what applies to an income between those two points.

How to access: Use the Eldercare Locator at 1-800-677-1116 to reach your regional AAA. If sufficient funds are not available when you request services, the AAA may set up a wait list to prioritize clients as funding becomes available.

Best for: An unpaid family caregiver whose loved one is not on COPES, personal care services, or another state or Medicaid funded long-term care service.

4. Adult Day Programs

What they are: Adult day health centers and adult day services provide structured daytime programming in a community setting, typically 4 to 8 hours a day, with meals, activities, socialization, medication administration, and varying levels of nursing oversight. For a family caregiver, adult day is a consistent way to reclaim reliable daytime hours.

Cost in Washington: In 2025, adult day health care in Washington ran a median of about $5,395 a month (about $64,740 a year), per the CareScout 2025 Cost of Care Survey, an industry survey rather than a government figure. Confirm current pricing directly with the center.

Who pays:

  • MAC or TSOA (currently waitlisted, and only for families not on CFC or COPES) fund out-of-home respite for an unpaid family caregiver; ask your AAA or Home and Community Services whether a day program qualifies.
  • Long-term care insurance: many policies cover adult day under a home and community-based services rider.
  • Private pay is the default for families not accessing Medicaid or another funded program.

How to find programs: The Eldercare Locator (1-800-677-1116) connects you by ZIP code to services in your community, including your local Area Agency on Aging.

Best for: Caregivers who need consistent weekday respite while the care recipient benefits from social engagement, structured activities, and supervision.

5. VA Respite Care for Veterans

What it is: The VA respite benefit covered here is part of PCAFC: a veteran's approved Primary Family Caregiver receives at least 30 days of respite care per year. For other VA caregiver services, the VA Caregiver Support Line can connect you to your local VA Caregiver Support Program team.

Veteran-Directed Care (VDC): If your spouse is a veteran and qualifies for Veteran-Directed Care, DSHS says the program may allow you to be hired as their paid caregiver.

PCAFC: A veteran's approved Primary Family Caregiver in the Program of Comprehensive Assistance for Family Caregivers receives at least 30 days of respite care per year, alongside caregiver education and training and mental health counseling. VA's first screen has four requirements, all of which must be true: a VA disability rating of 70% or higher, discharge from the U.S. military or a date of medical discharge, a need for at least 6 months of continuous, in-person personal care services, and enrollment in VA health care. Those four are necessary but not sufficient: you and the veteran apply together, and the regulation adds further conditions, including that the same personal care is not already regularly provided by another person or program. Confirm current authorized days with your VA Caregiver Support Coordinator.

How to access: Contact the VA Caregiver Support Line at 1-855-260-3274 (Monday through Friday, 8 a.m. to 8 p.m. ET) or talk to the Caregiver Support Coordinator at your VA medical center. If you are in crisis, get help from the Veterans Crisis Line instead: call 988 (press 1) or text 838255.

Best for: Families of veterans who may qualify for PCAFC or Veteran-Directed Care.

6. Short-Term and Emergency Respite

Short-term facility respite (also called short-stay or scheduled respite) places the care recipient in an assisted living or memory care community for a few days to a few weeks while the caregiver takes time off. Most assisted living facilities in Washington offer short-stay respite at a nightly rate; confirm availability and pricing directly with the facility.

Emergency respite is for unexpected caregiver crises: a hospitalization, a medical emergency, or a sudden inability to provide care. Contact your AAA as the first step, tell them it is an emergency, and ask what respite help is available.

How you pay: Short-term facility respite is typically private pay unless FCSP or MAC and TSOA respite funds apply.

How to Get Started With Respite Care in Washington State

1
Step 1

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

Your AAA runs Washington's Family Caregiver Support Program, can tell you whether FCSP respite is open to your family, and is one of the two doors to MAC and TSOA.

2
Step 2

If your loved one gets CFC in-home care, ask the case manager about Relief Care

It lets a second provider cover for the primary paid provider, using hours already in the plan.

3
Step 3

If your loved one is 55 or older, meets nursing facility level of care, and is not on CFC or COPES, ask about the MAC or TSOA waitlist

These are the alternative track, not an add-on, so this step is instead of step 2, not after it. The waitlist is first-come, first-served, so adding your name is what positions you if enrollment reopens. Contact your AAA or Home and Community Services office.

4
Step 4

If your loved one is a veteran, call the VA Caregiver Support Line at 1-855-260-3274

Ask about PCAFC, which includes at least 30 days of respite a year for an approved Primary Family Caregiver.

5
Step 5

Line up an adult day program in your region

The Eldercare Locator can connect you to services near you, and a day or two a week in a quality program can reset a caregiver's whole week.

VA Caregiver Support Line Information and connections to local VA Caregiver Support Program teams for family caregivers of veterans, Monday through Friday, 8 a.m. to 8 p.m. ET. In a crisis, get help from the Veterans Crisis Line instead: call 988 (press 1) or text 838255. 1-855-260-3274 www.caregiver.va.gov
Eldercare Locator A free nationwide service of the federal Administration for Community Living that connects you by ZIP code to services in your community, including your local Area Agency on Aging, in-home help, and transportation. 1-800-677-1116 eldercare.acl.gov/home

Not sure which Washington respite program fits your family? Chat with Brevy's care navigator for a personalized list of funded respite options based on your loved one's age, health status, and Medicaid enrollment.

Frequently Asked Questions

Does Washington Medicaid pay for respite care?

In limited ways. If your loved one gets in-home care through Community First Choice, Relief Care lets a second provider back up their primary paid provider, but it adds no hours to the CARE plan. MAC and TSOA fund capped respite for unpaid caregivers of people 55 and older who meet nursing facility level of care, as an alternative to CFC and COPES, though new enrollment has been paused with a waitlist since December 1, 2025. You choose between the two tracks; you do not stack them.

Is there free respite care available without Medicaid?

Sometimes. Washington's Family Caregiver Support Program, funded by federal Title III-E dollars through your Area Agency on Aging, offers respite to an unpaid caregiver whose loved one is not on a state or Medicaid funded long-term care service. There is no charge when the care receiver's income is at or below 40% of state median income, based on family size, and a care receiver at 100% of state median income or more pays the full cost., Use the Eldercare Locator at 1-800-677-1116 to reach your AAA.

What are MAC and TSOA, and are they still available?

Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) are Washington programs that fund respite and caregiver supports for unpaid family caregivers of people age 55 and older who meet nursing facility level of care. They are an alternative to CFC and COPES, not an addition: MAC is for people who meet Medicaid financial eligibility, such as CN or ABP Apple Health, and who are not using Medicaid-funded long-term services and supports, and TSOA is for people who do not currently meet Medicaid financial eligibility, under its own income and resource limits. Effective December 1, 2025, both paused new enrollment and established a statewide waitlist. People already enrolled keep their enrollment, and there is no set timeline for reopening. Check the current status with your AAA or Home and Community Services before relying on these programs.,

Can I hire a family member for respite through Medicaid?

Yes, with one major exception. Family members who care for a relative can become paid caregivers through CDWA when the relative qualifies for Medicaid long-term services and supports, and on CFC a second Individual Provider can provide Relief Care as back-up to the primary provider., Under Apple Health and long-term services and supports, though, you cannot be paid to care for your spouse. DSHS names two programs that do allow it: Veteran Directed Care, if your spouse is a veteran and qualifies, and WA Cares, if your spouse has earned WA Cares benefits and meets the required level of need. A caregiver who is paid for the care cannot also receive FCSP respite.

Does Medicare cover respite care in Washington?

Not for routine respite. Medicare covers respite only as short-term inpatient respite care inside its hospice benefit, for a beneficiary who has elected hospice. Outside hospice, Washington families fund respite through Medicaid, NFCSP, the VA, or private pay.

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, NFCSP respite with no income test, Medicaid and VA respite, and every state guide. CaregiverHow to Get Paid as a Family Caregiver in WashingtonGet paid to care for a family member in Washington in 2026: Community First Choice individual providers, CDWA, the WA Cares spousal pathway, and VA options. 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. VA BenefitsVA Aid and Attendance in WashingtonVA Aid and Attendance in Washington 2026: who qualifies, up to $34,488 a year for a veteran with a spouse, how to apply, and free WDVA help. Care TypesThe Cost of Senior Care in WashingtonWhat senior care costs in Washington in 2026: assisted living runs about $7,600 a month, a nursing home about $13,155 a month. See every setting and how to pay. CaregiverCaregiver Programs in WashingtonEvery caregiver program in Washington: paid family caregiver pathways, the new WA Cares spousal benefit, MAC/TSOA, NFCSP grants, VA benefits, and taxes.

Find personalized help navigating respite care options in Washington 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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