NASHP convened 13 state teams from its Caregiving State Policy Learning Collaborative in June 2025 to learn from experts and each other about innovative models, strategies, and policies that can improve the delivery of family caregiving services, including respite care. One session, “Respite Care Training and Workforce Registries,” brought together subject matter experts and state speakers from North Dakota and Wisconsin to address the pressing challenges and opportunities in the respite care workforce. The discussion centered on the National Respite Care Provider Training (NRCPT), a free evidence-informed training program for respite care providers, and how workforce registries can help connect caregivers with qualified professionals, ensuring high-quality support for caregivers.
The Workforce Behind the Care
Family caregivers often say what they most need is a break. Respite care — for example, provided by aides who can provide temporary, intermittent care or by adult day centers — can give families this needed break. The big problem is finding a well-qualified workforce that can provide the care.
The fundamental challenges facing the respite care workforce mirror those of the broader direct care workforce. Despite being one of the fastest-growing sectors in the U.S. — driven largely by an aging population — respite care providers and the direct care workforce often face low wages, limited career advancement opportunities, and inadequate training and supervision. These systemic issues hinder recruitment and retention, ultimately affecting the quality and availability of care.
At the session, subject matter experts emphasized the need to break down silos between respite care providers and the broader direct care workforce such as personal care and home care aides. Rather than treating these as separate entities, there is an opportunity to create unified career pathways and matching service registries that allow individuals to move fluidly between roles and advance in their career path, enhancing both workforce flexibility and career development.
National Respite Care Provider Training
The NRCPT, in part funded by the U.S. Administration for Community Living, is a free, online, self-paced entry-level curriculum centered on 10 core competencies and consists of 10 courses. This training is designed to be accessible in a variety of settings, with materials available in English and Spanish. It is structured to support both the paid workforce and volunteers (i.e., family and friends of caregivers) who have never provided respite or would like to refine their skills. The training can serve as a foundational step in a broader career ladder. The training is replicable and scalable by a replication toolkit to facilitate state-specific adoption.
Ten sites across the U.S. tested the training curriculum and a specialized respite provider recruitment campaign during a 12-month pilot. After positive results, many of them are continuing to use the curriculum after the pilot testing period.
Final evaluation results show that learners reported improved confidence in respite provider core competencies. Most learners were new to respite (62 percent), lived in small towns (population between 2,500 and 49,000 people) (40 percent) or rural communities (population less than 2,500 people) (23 percent), and indicated they are very likely (67 percent) to provide respite in the next six months. Key lessons from the pilot included the importance of marketing the training as a recruitment tool, forming partnerships to support outreach and recruitment, and connecting trained providers to respite opportunities through registries and other platforms.
Workforce Registries and Training: Lessons from North Dakota and Wisconsin
Direct support workforce registries are online platforms that connect people needing care to qualified service providers. The types of workers listed on a registry can include job titles such as home care worker, home health aide, personal care attendant, and direct support professional, among others. According to data from PHI, 12 states operate regional or statewide matching service registries. Similarly, respite registries connect both the care recipient and their caregiver to a qualified respite provider.
North Dakota: North Dakota’s Qualified Service Provider (QSP) and QSP Agencies Public Registry includes a wide range of service providers — not just those offering respite care. It captures essential information such as service type, contact details, agency affiliation, personal preferences, and geographic location. A standout feature of North Dakota’s registry is its real-time updating system. Providers enroll through a dedicated portal, and an interface feeds information into the registry to ensure updates are reflected daily. This commitment to accuracy enhances the registry’s reliability and usability for care recipients and family caregivers. Through the NASHP learning collaborative, the state is exploring the use of the National Respite Care Provider Training and integrating it into the registry platform.
Wisconsin: The Wisconsin Respite Care Registry offers family caregivers the ability to search for respite care providers that offer in-home and facility-based respite. Respite Care Association of Wisconsin (RCAW) created the National Respite Care Provider Training and administers the respite care provider registry for the state. RCAW is funded by state general revenue and some federal grant funding. Both independent respite providers and provider agencies can create a user-friendly profile on the registry, including a short biography, which orients potential caregivers and care recipients to a more personalized introduction to the provider.
Providers from Wisconsin that have completed the National Respite Care Provider Training are integrated into the registry. The registry also includes strong disclaimer language clarifying that it does not guarantee care connections, emphasizing that RCAW is not the employer and the need for individuals to vet providers independently. The Wisconsin Department of Justice’s Wisconsin Online Record Check System can conduct a background check on behalf of the caregiver for a small fee. The registry is limited to respite care providers rather than the broader direct care workforce. Conversely, family caregivers can also post their caregiving needs on Respite Connections, acting as a reverse registry.
Conclusion
The direct care workforce is one of the fastest growing occupations in the U.S. — with statistics showcasing a projected 772,000 new jobs by 2034. Respite care providers are integral to the overall workforce as they provide caregivers a much-needed break. As an emerging innovation from NASHP’s Caregiving State Policy Learning Collaborative, state governments have made investments in supporting family caregivers — including the provision of respite care. Research has found that when older adults’ caregivers receive supports that include respite, caregiver outcomes improve, older adults’ nursing home placement is delayed, and hospital readmissions and emergency room expenditures are decreased. The insights shared in this paper offer states examples to strengthen their respite care workforce to help ensure that caregivers have access to high-quality respite care.
Additional Resources
ARCH National Respite Network and Resource Center
- List of state respite registries
- ARCH/RCAW Webinar:Building Respite Registries to Meet the Needs of Families
- Presentation slides from the 2025 National Lifespan Respite Conference in Huntsville, Alabama: “Respite Care Worker Registries — Three State Perspectives”
North Dakota Department of Health and Human Services
Respite Care Association of Wisconsin (RCAW)
- National Respite Care Provider Training and Toolkit
- The National Respite Care Provider Training and Toolkit is now available. Read more in this overview.
- Fill out the request form to download the toolkit.
- Access the National Respite Care Provider Training (NRCPT)
- Learn more and read the course descriptions.
- The training is available in English and Spanish. See also the step-by-step guide to navigate the sign-up process.
- Wisconsin Respite Care Registry
PHI
- Matching service registries
- Evaluation on Carina matching service registry
Acknowledgments
This project is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,250,000 with 75 percentage funded by ACL/HHS and $416,667 and 25 percentage funded by non-government source(s). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.
NASHP would also like to thank The John A. Hartford Foundation and the Ralph C. Wilson, Jr. Foundation for their support of this session and the NASHP Caregiving State Policy Learning Collaborative. Additionally, NASHP wishes to thank the speakers for this session: Jill Kagan from ARCH National Respite Network and Resource Center (ARCH), Lisa Schneider from the Respite Care Association of Wisconsin (RCAW), Kimberly Whitmore from Marquette University, Amy Robins from PHI, and Nancy Nikolas-Maier from the North Dakota Department of Health and Human Services. In addition, NASHP is grateful for its partnership with ARCH and RCAW in the development and dissemination of the Administration for Community Living (ACL)-funded National Respite Care Provider Training (NRCPT).
