By 2009, growing attention was being given to siblings and grandparents who were serving as primary caregivers for family members with disabilities. As more individuals lived at home and in community settings, family members increasingly stepped into long-term caregiving roles. Federal initiatives such as the Lifespan Respite Care Program and the National Family Caregiver Support Program supported states in strengthening respite systems and recognizing a broader range of caregivers as eligible for services, including grandparents raising grandchildren and siblings providing ongoing support.

During this period, research and advocacy highlighted significant unmet respite needs. Grandparents raising grandchildren often faced financial strain and limited access to tailored services, while siblings reported needing more information, planning support, and involvement in long-term decision-making. In Washington and across the country, recognition grew around the importance of expanding access to both planned and emergency respite services to sustain families and prevent caregiver burnout