Respite use rises; state and regional centers point to workforce, language and transportation barriers

Department of Developmental Services staff and regional center directors told the subcommittee that in‑home respite use and spending have increased over the past several years, but families still face barriers to receiving authorized hours.

Nechi Gates, chief deputy director of program services at DDS, said in‑home respite caseloads rose from about 85,000 to roughly 150,000 between fiscal years 2016–17 and 2023–24, a growth she called in line with regional center caseload increases. DDS described several delivery options — agency respite, participant-directed employer-of-record models, and respite available within the Self‑Determination Program — and said the department is developing a standardized vendorization process and a standardized respite support tool to promote consistency. Gates also said a guide to regional center services is available on the department website in seven languages.

Mark Klaus, executive director of the San Diego Regional Center, described local differences: in Imperial County, where 86 percent of residents identify as Hispanic, about half of families served have respite authorizations and the majority use a combined participant-directed/agency employer-of-record model. Klaus said Imperial County shows high utilization where families can hire trusted community members through the employer-of-record option; by contrast, more rural areas face sparse provider pools and transportation barriers.

DDS gave demographic data for respite users: 46 percent Hispanic, 21 percent White, 11 percent Asian, 14 percent other and 8 percent Black; language data indicated 75 percent English, 21 percent Spanish and 4 percent a combination of Chinese, Vietnamese and other languages.

Committee members and witnesses emphasized the human consequences of interrupted caregiver sleep and asked whether service coordinators probe family health and capacity during individual program planning (IPP). Regional center and DDS witnesses said the standardized IPP, person-centered thinking training for staff and upcoming tools will better surface family needs and that some local vendors hire family-referred workers to expand culturally and linguistically appropriate options.

DDS said the standardized respite assessment tool and procedures will train regional centers and begin use in January 2026; the department also said workforce shortages remain the most important constraint on service delivery, particularly for medical or behavioral respite and in remote areas.