Massachusetts Respite Care for Families of Adults with Disabilities

What Respite Care Actually Means

Respite care provides temporary relief for the primary caregiver of an adult with a disability. A trained respite provider steps in to care for the individual — for a few hours, overnight, or for a weekend — so the family caregiver can rest, handle personal obligations, or simply take a break.

This is not a luxury. Families providing daily care for an adult child with significant behavioral, medical, or physical needs face burnout rates that are well documented. Respite care is a structural support designed to keep the primary caregiving arrangement sustainable over years, which in turn keeps the individual out of more costly residential placements.

DDS-Funded Respite Options

In Massachusetts, the Department of Developmental Services funds respite care through two channels:

HCBS Waiver Respite. If the individual is enrolled in a DDS HCBS waiver (Adult Supports, Community Living, or Intensive Supports), respite care is included in the waiver's service array. The amount of respite authorized depends on the individual's service plan and assessed needs. Waiver-funded respite can be delivered in the family home, in the respite provider's home, or in a licensed respite facility.

DDS Family Support Respite. For individuals who are DDS-eligible but have not yet been assigned a funded waiver slot (common for those on the Priority 2 waitlist), DDS may provide limited respite through its Family Support program. Family Support services are funded through direct state appropriations rather than waiver funding, and the hours available are typically more limited than waiver-funded respite.

In-Home vs. Out-of-Home Respite

In-home respite is the most common model. A trained worker comes to the family's home and provides care while the primary caregiver leaves. The individual stays in their familiar environment, which is often the least disruptive option for people who are sensitive to routine changes.

Out-of-home respite involves the individual spending time at a provider's home, a licensed respite facility, or a DDS-contracted residential program. This model is used for longer respite periods — weekends or vacations — and for situations where the individual benefits from a change of environment.

Some DDS-contracted agencies operate dedicated respite beds in group home settings, available to families on a rotating schedule. Availability varies significantly by region, and popular weekend slots often need to be booked months in advance.

How to Access Respite Care

If your family member has a DDS service coordinator, respite is requested as part of the annual Individual Service Plan meeting or through a direct request to the coordinator at any time. The coordinator authorizes the hours and connects the family with a provider agency.

For families using DDS Family Support (no waiver), contact your DDS area office and ask about available respite hours. Family Support services are allocated based on regional budgets, and the specific services available can change from year to year.

Important: respite care providers must meet DDS training and background check requirements. Families cannot simply hire any caregiver and have it funded as DDS respite. The provider must be affiliated with a DDS-contracted agency or approved through the DDS self-directed services model.

When Respite Is Not Enough

Respite care is designed for temporary relief, not as a substitute for daily programming or residential support. If the family is using every available respite hour and still struggling to maintain the caregiving arrangement, that is evidence for a conversation with the DDS service coordinator about escalating the priority level.

A family that documents increasing respite needs over time — along with changes in the caregiver's health, the individual's behavioral profile, or the safety of the home environment — builds the case for a priority reassessment from Priority 2 to Priority 1. Priority 1 cases are funded with reasonable promptness, but a reassessment does not guarantee a particular residential placement.

The Massachusetts SSI at 18 & Adult Disability Benefits Guide maps how respite care fits into the broader adult services landscape — including how DDS Family Support services bridge the gap while families wait for waiver funding.

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