Key Takeaways
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Maryland respite care is available through several separate programs. State respite services, caregiver-support programs, Medicaid waivers, and private-pay home care follow different rules.
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Maryland families caring for someone with a developmental or functional disability may qualify for the DHS Respite Care Program. Eligibility for care and eligibility for an income-based subsidy are separate decisions.
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Certain Maryland Medicaid programs and waivers include respite care. Community Options, Community Pathways, and the Autism Waiver are important examples. Coverage depends on eligibility and approved services.
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Community First Choice does not list a separate respite-specific service. It provides personal assistance and other home and community-based supports for eligible participants.
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Maryland Access Point is an important starting point, but it is not the only route. DHS respite, DDA services, and the Autism Waiver have their own entry paths.
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Private-pay in-home care may offer more scheduling flexibility because it does not require waiver enrollment. Availability still depends on location, staffing, schedule, and care needs.
Last reviewed: October 15, 2026.
This guide was checked against current information from Maryland DHS, the Maryland Department of Health, Maryland Department of Aging, DDA, MSDE where applicable, and COMAR.
You may be helping a parent or relative bathe, prepare meals, move safely, or get to appointments while also managing work and family life. If you need time away from daily caregiving, respite care may give your family another option.
Maryland does not use one single respite-care system. The Department of Human Services has its own respite program. Maryland Medicaid has programs and waivers that may include respite. Local Area Agencies on Aging also help connect caregivers with support.
This guide focuses on five major Maryland respite-care routes and several related Medicaid options. You will learn who each route may help, how Medicaid respite works, how long care may last, where to start, and what to ask before choosing a provider.
Quick Facts: Maryland Respite Care
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Maryland Access Point helps with aging, disability, and long-term care navigation:
1-844-627-5465
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For the DHS Respite Care Program, contact your local Department of Social Services or the respite provider serving your area.
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Autism Waiver Registry:
866-417-3480
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Developmental Disabilities Administration:
410-767-5600
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COMAR means the Code of Maryland Regulations. It contains Maryland's official program rules.
What Is Respite Care in Maryland?
Respite care is short-term, temporary care that gives a family or informal caregiver time away from their usual caregiving duties. Maryland's Department of Human Services uses respite services to support eligible people with developmental or functional disabilities and their families.
Respite may be planned ahead. Under some programs, it may also be used during a crisis. The exact setting, amount of care, and provider rules depend on the program.
Respite Care vs. Regular Home Care
Regular home care is ongoing help with daily activities. Respite care is temporary care that gives the person's usual caregiver time away.
Adult day services provide support during set daytime hours at a center. Assisted living provides residential support. A family may use more than one type of care at different times, but each service has its own rules and payment source.
Which Maryland Respite Program May Fit Your Family?
This guide focuses on five major Maryland routes. Other specialized programs may also exist, so use this comparison as a starting point rather than a complete list of every possible service.
Maryland respite care programs at a glance
| Program |
Who It May Help |
What It Can Offer |
Where to Start |
| DHS Respite Care Program |
Maryland families or individuals affected by a developmental or functional disability |
Short-term respite at home or in an approved setting; an income-based subsidy may be available |
Local Department of Social Services or local DHS respite provider |
| Maryland Family Caregiver Support Program |
Eligible caregivers of older adults or people with Alzheimer's or related disorders, plus certain older relative caregivers |
Caregiver information, connections to services, counseling, and respite-related support based on local availability |
Maryland Access Point or local Area Agency on Aging |
| Community Options Waiver |
Adults age 18+ who meet nursing-facility level-of-care and Medicaid requirements |
Home and community-based services, including temporary respite through qualified providers |
Maryland Access Point |
| Community Pathways Waiver |
People with a developmental disability who meet ICF/IID level-of-care and other waiver rules |
Respite care plus other DDA supports |
DDA Regional Office |
| Autism Waiver |
Eligible children and young adults with autism |
Respite care plus other Autism Waiver services |
Autism Waiver Registry, 866-417-3480 |
HCBS means home and community-based services. These programs help eligible people receive support in their home or community instead of an institution.
ICF/IID means intermediate care facility for individuals with intellectual disabilities. Maryland uses this term as a level-of-care test for some waiver programs. A person does not have to live in that type of facility to meet the standard.
Maryland DHS Respite Care Program
The Maryland DHS Respite Care Program is one statewide respite option for people with developmental or functional disabilities and their families. It is not a Medicaid waiver.
Current Maryland rules include families living with a person who has a developmental or functional disability, eligible individuals who do not live with family, and eligible people living in foster homes.
The program's income rule applies to the subsidy, not to the basic definition of respite eligibility. Under current COMAR, an applicant may qualify for a subsidy when total income is at or below 150% of Maryland's median income adjusted for family size.
The program is delivered locally. If your local Department of Social Services does not provide respite directly, it can direct you to the respite provider serving your area.
Maryland Family Caregiver Support Program
The Maryland Department of Aging oversees this program and works with local partners, including Area Agencies on Aging.
- Adult family members or informal caregivers age 18+ caring for someone age 60+
- Adult family members or informal caregivers age 18+ caring for someone of any age with Alzheimer's disease or a related disorder
- Older relatives who are not parents, age 55+, caring for a child under age 18
- Older relatives who are not parents, age 55+, caring for an adult age 18 to 59 with a disability
This is not a Medicaid waiver. Contact Maryland Access Point or your local Area Agency on Aging to ask which caregiver services are available in your area.
Community Options Waiver
The Community Options Waiver, also called the Home and Community-Based Options Waiver, is a Maryland Medicaid waiver for adults age 18+ who meet nursing-facility level-of-care and other eligibility rules.
A nursing-facility level of care means Maryland has determined that a person needs the type of support normally provided in a nursing facility, even if services will be received in the community.
For a fuller explanation of eligibility and enrollment, see the
Maryland Community Options Waiver guide.
DDA Community Pathways Waiver
The Community Pathways Waiver is operated through Maryland's Developmental Disabilities Administration.
Applicants must have a developmental disability, meet ICF/IID level-of-care requirements, and meet the waiver's technical and financial rules. There is no age limit.
A Coordinator of Community Services can help with planning and approved services after the appropriate DDA process. Respite care is one of the waiver's listed supports.
Maryland Autism Waiver
The Maryland Autism Waiver supports eligible children and young adults with autism.
Current rules require an autism spectrum disorder diagnosis, ICF/IID level of care, and other medical, technical, and financial requirements. The participant must be at least age 1 and may remain eligible through the end of the school year in which they turn 21.
The participant must also have an IFSP or IEP with at least 15 hours per week of special education and related services. The waiver currently has a waitlist.
Does Maryland Medicaid Cover Respite Care?
Yes, certain Maryland Medicaid programs and waivers may cover respite care for eligible participants. Coverage is not automatic simply because someone has Medicaid. The person must meet the program rules, enroll when required, and have the service authorized.
Community Options Waiver and Respite Care
Community Options includes a temporary respite benefit. Under current Maryland provider rules, a respite provider must already be enrolled as an assisted living provider under the waiver or as a Maryland Medicaid nursing facility provider.
Maryland's currently approved waiver limits temporary respite to no more than 14 days within a 12-month period. Current COMAR also limits respite reimbursement to 14 days per occurrence.
This benefit is different from ordinary in-home personal care.
Community Pathways and Respite Care
Community Pathways includes respite care as a waiver support. Depending on the approved Person-Centered Plan, respite may be provided in the participant's home, a respite provider's home, a licensed residential site, a certified camp, or another setting approved by DDA.
A Person-Centered Plan is the written plan that describes the person's goals, support needs, and approved services.
Autism Waiver and Respite Care
Respite is a covered Autism Waiver service. For dates of service on or after July 1, 2023, current COMAR allows up to 96 respite units on one date of service and up to 1,344 respite units per State fiscal year.
One unit equals 15 minutes. That equals up to 24 hours on one date of service and up to 336 hours per State fiscal year.
What About Community First Choice?
Community First Choice, or CFC, is a Maryland Medicaid home and community-based services benefit. Its service list includes personal assistance, nurse monitoring, home-delivered meals, assistive technology, accessibility adaptations, and other supports.
CFC does not list a separate respite-specific service. Personal assistance under CFC and respite care under another program are not automatically the same benefit.
A Note About Increased Community Services
Maryland's Increased Community Services Program, or ICS, also lists respite among its services.
ICS is a specialized Medicaid program for certain people who meet its rules. An individual cannot apply directly. Medicaid must make the referral.
How Long Can Respite Care Last?
There is no single Maryland-wide respite limit. Each program uses its own rules.
Published respite limits by Maryland program
| Program |
Published Limit |
Time Period |
| DHS Respite Care Program |
Up to 24 hours of hourly respite in periods under 10 hours, plus up to 14 days of daily respite. One unused daily-care day may convert to 10 hours. |
Per State fiscal year |
| Community Pathways Waiver |
Up to 720 total respite hours unless DDA authorizes more |
Per Person-Centered Plan year |
| Community Options Waiver |
Up to 14 days of temporary respite under the approved waiver |
Within a 12-month period; COMAR also limits reimbursement to 14 days per occurrence |
| Autism Waiver |
Up to 96 15-minute units, equal to 24 hours, on one date of service; up to 1,344 units, equal to 336 hours |
Per date of service and per State fiscal year |
Local or county-funded programs may use different limits. Do not assume hours from separate programs can automatically be combined. Confirm your available amount with the program that approved your care.
Not sure which Maryland care option fits?
Tell Cottage Home Care Maryland who needs care, what daily help they need, the schedule you are considering, and whether you are exploring Medicaid or private pay. Our Maryland team can explain the Cottage-supported options that may fit and point you toward the correct state route when another agency controls eligibility.
Cottage does not decide Medicaid or waiver eligibility. Call
(667) 400-0648
or email
maryland@cottagehomecare.com.
Who Qualifies for Respite Care in Maryland?
There is no single eligibility test for all Maryland respite care. Eligibility depends on the program.
Maryland respite program eligibility at a glance
| Program |
Main Requirement |
Age Rule |
Financial Rule |
| DHS Respite Care Program |
Developmental or functional disability under DHS rules |
No single age limit stated in the program eligibility rule |
Subsidy is income based; current threshold is tied to 150% of Maryland median income adjusted for family size |
| Family Caregiver Support Program |
Must fit one of Maryland's caregiver eligibility categories |
Caregiver 18+ for older-adult or dementia categories; certain non-parent older relatives must be 55+ |
Not a Medicaid waiver; local service availability and priorities may apply |
| Community Options Waiver |
Nursing-facility level of care |
18+ |
Monthly income may not exceed 300% of SSI benefits; countable assets may not exceed $2,000 or $2,500 depending on eligibility category |
| Community Pathways Waiver |
Developmental disability and ICF/IID level of care |
No age limit |
Applicant income may not exceed 300% of SSI benefits; countable assets may not exceed $2,000 or $2,500 depending on eligibility category |
| Autism Waiver |
Autism diagnosis, ICF/IID level of care, and qualifying IFSP or IEP |
Age 1 through the end of the school year when the participant turns 21 |
Applicant income may not exceed 300% of SSI benefits; countable assets may not exceed $2,000 or $2,500 depending on eligibility category |
These rules belong to different programs. A denial from one program does not automatically mean your family is ineligible for every other respite or home-care option.
How to Apply for or Find Respite Care in Maryland
Step 1: Identify the Right Starting Point
Start with the person's age, disability, care needs, and current Medicaid status.
- For aging, disability-resource navigation, or Community Options questions, contact Maryland Access Point.
- For the DHS Respite Care Program, contact your local Department of Social Services or local DHS respite provider.
- For Community Pathways, contact a DDA Regional Office.
- For the Autism Waiver, use the Autism Waiver Registry and your child's school Autism Waiver contact.
- For private-pay care, contact the home-care provider directly.
Step 2: Gather the Information You May Need
The exact documents depend on the program. For DHS respite, you may need information about the person's disability, living arrangement, current services, income, medical or psychological information, and informal caregiver.
For the Autism Waiver, families should also be ready to provide information related to the child's IFSP or IEP.
Step 3: Contact the Correct Maryland Entry Point
For Community Options and general long-term care navigation, call Maryland Access Point at
1-844-627-5465.
For Community Pathways, contact your DDA Regional Office. DDA's main number is
410-767-5600.
For the Autism Waiver, call the Registry at
866-417-3480.
For program questions, families may also contact their child's school Autism Waiver Coordinator or MSDE at
410-767-0264.
Step 4: Ask About Funding and Actual Availability
Program eligibility and immediate provider availability are not the same thing. Ask whether you are on a registry or waitlist, how the service is authorized, and which approved providers currently have availability in your area.
Types of Respite Care Available in Maryland
Common types of respite care
| Type |
What It Means |
Examples of Maryland Routes |
| In-Home Respite |
A qualified caregiver provides temporary care in the person's home |
DHS Respite, Community Pathways, Autism Waiver, privately arranged home care |
| Out-of-Home Respite |
Temporary care takes place outside the person's usual home |
DHS-approved respite settings, DDA-approved settings, and other program-specific settings |
| Facility-Based Respite |
Temporary care through an approved facility provider |
Community Options assisted living or nursing facility providers |
| Crisis Respite |
Temporary care needed because of an unexpected caregiver or family situation |
DHS respite may be used in a crisis, subject to program rules and provider capacity |
Not every program or provider offers every type of care. Always confirm the setting and availability before making plans.
How Much Does Respite Care Cost in Maryland?
There is no single Maryland respite-care rate. What a family pays depends on the program, provider, setting, hours, location, and level of help needed.
State-Funded or Subsidized Respite
The DHS Respite Care Program uses an income-based subsidy system. Under current COMAR, applicants at or below 150% of Maryland's median income adjusted for family size may qualify for a subsidy.
Medicaid-Funded Respite
For an eligible person enrolled in a Medicaid program or waiver that includes respite, the service must be authorized under that program's rules.
A plan of service is the written plan that lists approved services and providers. Payment rules and any participant financial responsibility depend on the person's Medicaid eligibility and program.
Private-Pay Care
Private-pay cost depends on the provider, county, shift length, care needs, schedule, and whether the family needs short visits or longer coverage.
If you want Cottage's current private-pay price for your situation, ask for a written estimate based on the care and schedule you need instead of relying on a statewide average.
How to Choose a Respite Care Provider
Before choosing a provider, ask questions that match your family's actual care needs:
- Which Maryland program or funding source does this provider participate in?
- Is care provided at home, in a facility, or both?
- Can staff help with bathing, dressing, toileting, meals, and mobility?
- Do staff have experience with dementia, autism, or developmental disabilities when needed?
- What background screening is completed?
- Who supervises the care plan?
- What happens if the scheduled caregiver is unavailable?
- Are weekend services available?
- Is overnight care available for this specific service?
- Are there minimum shift requirements?
- What is included in the written rate?
- Are there added charges?
- How does intake work?
- How soon is a caregiver actually available?
- What happens if your family has an urgent or last-minute need?
A DHS respite provider, DDA respite provider, Community Options provider, and private-pay residential service agency do not all operate under the same approval rules. Ask which program and license apply to the service you are considering.
How Cottage Home Care Can Help Maryland Families
Cottage Home Care Maryland LLC
RSA License No. 02496
Licensed as a residential service agency by the Maryland Department of Health, Office of Health Care Quality.
Cottage Home Care Maryland
provides in-home support through private pay and lists Community First Choice and Community Options among the Maryland care pathways it helps families explore.
For private-pay families, short-term in-home care may be used when the usual family caregiver needs coverage. Availability depends on the person's needs, location, schedule, and current staffing.
For Medicaid families, Cottage can help explain the home-care pathways it supports and assist with relevant care-planning or enrollment steps. Cottage does not make Medicaid or waiver eligibility decisions.
The Community Options respite benefit is separate from regular in-home personal care. Its respite providers must meet the provider requirements set by Maryland Medicaid.
For a broader look at care choices beyond respite, see our guide to
home care in Maryland.
How We Checked This Guide
We checked the program names, eligibility rules, service limits, and contact information in this guide against current Maryland government and regulatory sources.
Maryland program rules, phone numbers, service limits, and provider availability can change. When a state agency or case manager gives you newer program information, follow the current official guidance.
Maryland Respite Care FAQs
Does Maryland Medicaid pay for respite care?
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Certain Maryland Medicaid programs and waivers may cover respite care for eligible participants. Important examples include the Community Options Waiver, Community Pathways Waiver, Autism Waiver, and the specialized Increased Community Services Program. Community First Choice does not list a separate respite-specific service.
How long can respite care last in Maryland?
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It depends on the program. DHS allows up to 24 hours of hourly respite plus up to 14 days of daily respite per State fiscal year. Community Pathways generally allows up to 720 total respite hours per Person-Centered Plan year unless DDA authorizes more. The approved Community Options waiver limits temporary respite to no more than 14 days within a 12-month period, while COMAR also limits reimbursement to 14 days per occurrence. The Autism Waiver allows up to 24 hours on one date of service and up to 336 hours per State fiscal year.
Can respite care be provided at home?
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Yes. In-home respite is available through some Maryland programs, including the DHS Respite Care Program, Community Pathways Waiver, and Autism Waiver. Families may also arrange private-pay in-home care for temporary caregiver coverage. Private-pay home care is separate from a Medicaid respite benefit.
Is emergency respite care available in Maryland?
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Maryland DHS respite can be used in a crisis under program rules. Same-day or emergency availability still depends on the local provider, available staffing, and the person's care needs.
Is respite available for someone with dementia?
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Yes. Maryland's Family Caregiver Support Program includes eligible adult caregivers who care for someone of any age with Alzheimer's disease or a related disorder. Other options may include Medicaid programs when the person meets their rules, or private-pay in-home care.
Does Maryland have respite care for adults with disabilities?
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Yes. The DHS Respite Care Program serves eligible people with developmental or functional disabilities. Adults with developmental disabilities may also qualify for respite through the Community Pathways Waiver if they meet DDA and Medicaid waiver requirements.
Is respite care available for children with autism?
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Yes. Maryland's Autism Waiver includes respite care for eligible participants. Current eligibility includes an autism diagnosis, ICF/IID level of care, age and education requirements, and Medicaid financial rules. The waiver currently has a waitlist.
Need help arranging care while you take a break?
You do not need to know the exact program name before you call. Tell our Maryland team what your relative needs help with and when you need coverage.
We can discuss:
- Bathing, dressing, toileting, meals, and mobility
- The days and hours your family needs help
- Private-pay in-home care
- Cottage-supported Maryland Medicaid pathways where applicable
- What information to prepare before intake
- The next step if a state program, rather than Cottage, controls eligibility
Cottage Home Care Maryland LLC, RSA License No. 02496.
Licensed as a residential service agency by the Maryland Department of Health, Office of Health Care Quality.
Sabine DurgaramDPS/RN
