In Washington State, a family caregiver can fund respite care from at least five different sources, and most families never learn the money is already there. From Medicaid-authorized respite hours to free grants through your local Area Agency on Aging, the help exists once you know which door to open.

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 and need emergency respite, call Community Living Connections at 1-855-567-0252 or the statewide DSHS Home and Community Services line. 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

Six routes fund respite in Washington, and which one fits depends on your loved one's age, Medicaid enrollment, and whether they served in the military. The table below lets you compare the payers at a glance before the sections that follow explain how to access each one. MAC and TSOA are the two programs to check first if your loved one is 55 or older, because their new enrollment is paused.

Program Who pays Income test Available in 2026?
Medicaid CFC / COPES respite Washington Apple Health (Medicaid) Yes, functional and financial Yes; CFC is an entitlement with no waitlist
MAC / TSOA caregiver respite Washington Medicaid (1115 demonstration) MAC: Medicaid-eligible; TSOA: higher income and asset limits New enrollment paused since December 1, 2025; statewide waitlist
NFCSP respite Federal Title III-E, via your Area Agency on Aging Amounts and caps set by each local agency Yes
VA respite / PCAFC U.S. Department of Veterans Affairs No; requires VA health enrollment, not Medicaid Yes, for enrolled veterans
Adult day and short-term facility respite Family (private pay), unless a program above applies Not applicable Yes

1. Medicaid In-Home Respite (CFC, COPES, and Apple Health LTSS)

What it is: If your loved one receives Apple Health long-term services and supports through Community First Choice, COPES, or Medicaid Personal Care, their authorized care hours can include planned respite. Respite is built into the care plan and delivered by a hired Individual Provider through CDWA, the state's single Consumer Directed Employer.,

Who pays: Washington Apple Health (Medicaid), through the same LTSS programs that fund ongoing personal care.

How to access it: Talk to your loved one's DSHS case manager and ask for respite to be included in the authorized care plan. You can hire a family member, friend, or other qualified Individual Provider as the respite worker through CDWA.

Eligibility: The care recipient must be enrolled in CFC, COPES, or another Apple Health LTSS program and meet the standard functional and financial criteria. Because CFC is a Medicaid state plan entitlement, there is no waitlist.,

Best for: Families already in the Washington Medicaid LTSS system.

2. MAC and TSOA Caregiver Respite (Currently Waitlisted)

What they are: Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) are Washington's most direct programs for unpaid family caregivers of people age 55 and older. Unlike CFC, they fund the caregiver's needs directly, including respite care, caregiver training, and supplies, rather than an hourly wage.

MAC serves people who are Medicaid-eligible but choose not to enroll in CFC or COPES and who have an unpaid caregiver. TSOA serves people who are not financially eligible for Medicaid, with higher income and asset limits, and does not require an unpaid caregiver.

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 benefits; new applicants join the waitlist. Verify the current enrollment status before relying on these programs.

How to apply: Contact Community Living Connections at 1-855-567-0252 or your local Home and Community Services office to be added to the waitlist.

Best for: An unpaid family caregiver of someone age 55 or older who needs funded respite and caregiver supports rather than hourly paid care.

3. Free or Low-Cost Respite Through NFCSP

What it is: The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, passes federal dollars through Washington's Area Agencies on Aging and Disability (AAADs) for five categories of caregiver services: information, help accessing services, counseling and training, respite care, and supplemental services on a limited basis.

Who qualifies: Family and informal caregivers of adults age 60 and older; caregivers of any age caring for someone with Alzheimer's disease or a related disorder; older relatives (age 55 and older) caring for children under 18; and older relatives (age 55 and older) caring for adults ages 18 to 59 with disabilities.

What it covers for respite: In-home respite, adult day services, short-term facility respite, and emergency respite, depending on what each AAA has contracted. Respite amounts and any per-caregiver caps are set at the state and local level, not by the federal program, so they vary by AAA region.

How to access: Call 1-855-567-0252 (Community Living Connections) or use the Eldercare Locator at 1-800-677-1116 to reach your regional AAA.

Best for: Any Washington family caregiver, regardless of the care recipient's finances. NFCSP is one of the most underused respite funding sources in the state.

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 often the most consistent and affordable 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, per the CareScout 2025 Cost of Care Survey (an industry survey, not a government figure). Social-model programs generally cost less than health-model centers, and per-day rates vary by region and level of care, so confirm current pricing directly with the center.

Who pays:

  • NFCSP grants through your AAA can offset adult day costs.
  • MAC or TSOA (currently waitlisted) can cover adult day as a respite service.
  • 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: DSHS licenses adult day health programs in Washington. Contact your local AAA through Community Living Connections (1-855-567-0252) for a regional directory.

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: Veterans enrolled in VA health care can access respite care through their VA medical center, including in-home aide services for a limited number of days per year, short-term placement in a VA Community Living Center or contracted facility, and adult day health care at VA sites.

Veteran-Directed Care (VDC): Under Veteran-Directed Care, the veteran receives a flexible monthly budget and can direct it toward respite for their caregiver. VDC is available through the VA Puget Sound Health Care System and the VA Portland Health Care System in partnership with Washington's AAADs.

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 as part of the benefit package, alongside caregiver training and mental health counseling. 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.

Best for: Families of veterans enrolled in VA health care, especially those already in 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. Washington's AAADs maintain emergency respite through NFCSP funds. Call Community Living Connections at 1-855-567-0252 as the first step in any emergency.

How you pay: Short-term facility respite is typically private pay unless NFCSP funds apply, MAC or TSOA is available, or the care recipient's Medicaid care plan authorizes it.

How to Get Started With Respite Care in Washington State

1
Step 1

Call Community Living Connections at 1-855-567-0252

The statewide line connects you to your regional AAAD, where a counselor can assess your situation and tell you which of the programs above you qualify for, including whether NFCSP respite is open in your region.

2
Step 2

Ask your DSHS case manager to add respite to the care plan

If your loved one is on CFC, COPES, or Medicaid Personal Care, respite hours can be authorized and delivered by an Individual Provider through CDWA.

3
Step 3

Join the MAC or TSOA waitlist

Even with new enrollment paused, adding your name positions you for when slots reopen. Contact your Home and Community Services office or Community Living Connections.

4
Step 4

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

VA respite benefits do not require Medicaid eligibility and are often as generous as Medicaid respite.

5
Step 5

Line up an adult day program in your region

Your AAA keeps a regional directory, and a day or two a week in a quality program can reset a caregiver's whole week.

Community Living Connections The statewide entry point to your regional Area Agency on Aging and Disability, NFCSP respite, and MAC/TSOA waitlist enrollment. 1-855-567-0252 www.dshs.wa.gov/altsa/home-and-community-services
VA Caregiver Support Line Support and referrals for family caregivers of veterans, including VA respite and PCAFC, Monday through Friday, 8 a.m. to 8 p.m. ET. 1-855-260-3274 www.caregiver.va.gov
Eldercare Locator A free national service that connects you to local Area Agencies on Aging and respite services by ZIP code. 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?

Yes, through several programs. If your loved one is enrolled in Community First Choice, COPES, or Medicaid Personal Care, their care plan can include authorized respite hours delivered by a hired Individual Provider. MAC and TSOA specifically fund respite for unpaid caregivers, though new enrollment is paused with a waitlist as of December 1, 2025.,

Is there free respite care available without Medicaid?

Yes. The National Family Caregiver Support Program (NFCSP), funded by federal Title III-E dollars, provides free or low-cost respite through Washington's Area Agencies on Aging and Disability. Amounts and any caps are set by each local agency. Call Community Living Connections at 1-855-567-0252 to find out what is available in your area.

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. Effective December 1, 2025, both paused new enrollment and established a statewide waitlist. People already enrolled keep their benefits; new applicants join the waitlist. Verify the current status with Community Living Connections before relying on these programs.

Can I hire a family member for respite through Medicaid?

Yes, if your loved one is on CFC or COPES and has respite authorized in their care plan. The respite worker is hired through CDWA as an Individual Provider. Family members can be paid, but a spouse cannot be paid to care for a spouse, and a parent cannot be paid to care for their own child under 18.,

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, free NFCSP grants, Medicaid and VA respite, and a link to 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 new 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, monthly rates up to $2,874, how to apply, and free help from WDVA and county service officers. 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 $157,859 a year. 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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Brevy Care Team

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