Following advocacy by HCAOA Connecticut, the committee approved several changes to the original proposal, including removing CPR and First Aid training requirements, reducing the required training hours from ten to eight, allowing approved training to transfer across employers, exempting certified home health aides from duplicative training, and limiting the requirement to direct care staff.
 
HCAOA Connecticut continues to work with lawmakers and state agency officials on additional issues, including allowing agencies to advertise caregiver competencies based on training, applying the training requirements to registries, and securing Medicaid reimbursement for training costs for HCBS providers.
 
Members can discuss caregiver training requirements and other key home care policies with lawmakers, fellow chapter members and industry leaders at Care at Home Day at the Capitol March 18 at 10:30 a.m., organized in collaboration with Connecticut Association for Healthcare at Home.

Scaling Medication Management Without Scaling Labor: A New Service Model for Home Care Providers
As client need rises and workforce shortages persist, medication management remains one of the riskiest and most resource-intensive elements of home care. Medication errors and non-adherence are leading drivers of avoidable hospitalizations among older adults. But traditional approaches including manual pill setup, reminder calls and additional visits require continuous staff time and coordination.

A new service model enables agencies to deliver safer, more consistent medication support with minimal labor commitment, often less than one hour of PCA time per client per month. All while maintaining caregiver awareness and clinical accountability.

Why Medication Management is a Strategic Pressure Point
For many agencies, medication support drives:

• Unplanned visits and schedule disruptions
• Exposure to liability from missed or incorrect doses
• Higher-acuity clients requiring disproportionate staff time
• Barriers to serving rural or geographically dispersed clients

These pressures increase operating costs and constrain growth. As agencies expand into higher-acuity care or rural markets, medication management often becomes the limiting factor.

A Low-Labor, Technology-Enabled Model
The Medication Assistance Service powered by Ōmcare pairs in-home automated dispensing with pharmacy fulfillment and remote adherence visibility. It shifts routine medication administration from staff visits to technology-enabled oversight while preserving safety and coordination.
Core components include:

• In-home automated medication dispensing aligned to prescribed schedules using the Ōmcare Home Health Hub®
• Pre-packaged medications delivered directly to clients’ homes
• Automated alerts and dispense with verified adherence
• Missed-dose alerts and adherence tracking
• One-touch video connection to family or care teams
• 24/7 pharmacy support

Operational and Financial Benefits

​1. Reduce medication risk and liability
Automated dispensing adds a consistent safety layer, decreasing two common sources of incidents and claims: manual handling errors and documentation gaps.

2. Prevent avoidable hospital utilization
Real-time adherence visibility enables early intervention when doses are missed, helping stabilize clients at home and supporting value-based care performance.

3. Extend workforce capacity without hiring
Medication oversight occurs without increasing visit frequency. Caregivers can focus on personal care and functional support instead of pill setup and reminders.

​4. Expand into rural and low-density markets
Automated dispensing and pharmacy delivery reduce the need for frequent in-person medication visits, making long-drive clients and dispersed territories more economically viable.

5. Add a differentiated, reimbursable service line
The Medication Assistance Service can be offered as a private-pay add-on or embedded in higher-acuity care packages, increasing revenue per client without proportional labor cost.

Light-Touch Implementation
Most agencies integrate the service into existing workflows:

• Identify clients with complex regimens or adherence risk
• Enroll and install in the home
• Document oversight during routine care reviews
• Respond only to adherence alerts or regimen changes

Because pharmacy packaging and device management are handled externally, ongoing staff involvement remains minimal.

Positioning for Higher-Acuity Growth
Medication complexity will continue to rise with aging populations and earlier hospital discharge. Agencies that adopt low-labor medication support can safely serve higher-acuity clients, differentiate in competitive markets and extend services beyond traditional geographic limits.

A technology-enabled Medication Assistance Service offers a practical path to improve outcomes while controlling labor costs. Sustainable growth is now possible for providers navigating workforce constraints and increasing clinical demand.

See how this service fits into your care model at omcare.com. Contact us to schedule a discovery call at 952-456-6848 or support@omcare.com.

Our goal is to make content easier to scan, quickly connect you to valuable resources, and provide a more meaningful hub for association and industry news. Each edition will feature the latest from HCAOA and around the home care world, spotlight members making headlines, and introduce new associate members who bring tools and services that can support your agency’s work.

We know your inbox is crowded, so we focused on clarity and relevance. Expect concise updates, clear links to member benefits, and timely items that tie back to the association’s mission to empower agencies through advocacy, collaboration, and education. In that vein, we’re embracing our roots and our role as the voice of the industry by calling this newsletter Home Care Voice.

Whether you’re scanning between meetings or looking for content to share with your team, this newsletter is designed to help you stay in the know and make the most of your HCAOA membership. Stay tuned for the first issue in your inbox March 4 and let us know what you think by emailing allisond@hcaoa.org.

That’s why HCAOA, along with a broad coalition of national stakeholders, strongly supports the Continuous Skilled Nursing Quality Improvement Act of 2025 (H.R. 6592 / S. 1920). This bipartisan legislation modernizes Medicaid’s approach to continuous skilled nursing and provides long-overdue clarity and support for families and care providers.

Why this legislation matters

For too long, Medicaid’s “private duty nursing” benefit has lacked the structure and consistency needed to serve today’s medically complex population:

• Families struggle to secure adequate nursing hours.
• Providers must navigate conflicting regulations and outdated terminology.
• Workforce challenges persist due to policy ambiguity and inconsistent oversight.

The Continuous Skilled Nursing Quality Improvement Act directly addresses these issues by establishing clear national standards and updating the HCBS framework to reflect modern care models.

What the bill would do

If enacted, the legislation would:

• Modernize terminology by replacing “private duty nursing” with “continuous skilled nursing services.”
• Create national quality standards through an HHS-led stakeholder working group.
• Reduce regulatory burden by clarifying that Medicaid providers are not subject to Medicare home health participation requirements.
• Strengthen HCBS options by ensuring continuous skilled nursing services are explicitly included in waiver programs.
• Update Medicaid quality measures related to skilled nursing.

These improvements would increase transparency, support workforce stability, and ensure that medically fragile children and adults can receive consistent, high-quality care in their homes and communities.

How you can help
​
While momentum is building in Congress, your voice is essential to move this bill forward. We encourage all HCAOA members to contact your members of Congress through our Voter Voice campaign.
​
For questions about the legislation or the advocacy campaign, please contact HCAOA Vice President of Government Relations, Eric Reinarman, at eric@hcaoa.org.

Capitol Club Briefing
Featuring Congressman Mike Carey (OH)
Exclusive access for Capitol Club-Level Advocacy Fund contributors
Wednesday, February 11 | 1 P.M. ET

This briefing is available exclusively to Capitol Club-level contributors to the HCAOA Advocacy Fund and will feature candid discussion on the federal issues shaping home care policy, including time for Q&A with Congressman Carey, plus timely advocacy and policy updates from HCAOA leadership.

A $500 donation to HCAOA’s Advocacy Fund provides access to the Capitol Club Briefing and supports the advocacy work that protects home care at both the federal and state levels.
Together, we ensure home care’s voice is heard—clearly, consistently, and powerfully.

​DONATE HERE: Advocacy Fund - Home Care Association of America 

By engaging a diverse group of stakeholders, the caucus will identify opportunities to support home care services for medically vulnerable children, adults, and seniors across the state who rely on access to these essential services in order to live independently and safely within their own homes.
 
RSVP TO JOIN

HCAOA is advocating on members’ behalf to walk back these reductions — and we need your help.

We know these reductions are already creating real strain on agencies, caregivers, and the veterans you serve. As we continue pressing the VA and congressional offices to correct these cuts, we need to show the human and operational consequences in a way that numbers alone cannot.

Your personal stories are the most important tool we have right now — we want to hear from you.

• Will these cuts force you to reduce VA caseloads, struggle with staffing, limit coverage in rural areas, or absorb losses that threaten your ability to serve veterans?
• Will this necessitate cutting veterans hours or your ability to accept new VA clients?
• Are you worried about caregiver retention because the rates can’t support competitive wages?

All this matters: These are exactly the stories that help federal officials understand why the current rates are woefully inadequate.

Please email HCAOA any stories you’re comfortable sharing about how these cuts affect your operations, your staff, and the veterans in your care. Even a short example is valuable. We will use these stories only to support advocacy efforts to reverse the reductions. 

Thank you for everything you do for veterans and for helping us show the VA what is at stake.

 

This call is open to all who are engaged in chapter and advocacy work and is designed to provide context, connection, and an opportunity to hear what’s happening across states. With continued policy activity at both the state and federal levels, this is a chance to step back, see the bigger picture, and understand how local efforts fit into national advocacy goals.
 
What to Expect
During the call, participants can expect:

• A brief look at recent accomplishments and progress across chapters
• An overview of emerging federal policy priorities and the broader advocacy landscape
• Highlights of common themes and issues chapters are navigating across states
• An opportunity to hear how advocacy efforts are shaping priorities moving forward

 
The goal of this call is to share information, reinforce alignment, and highlight how collective efforts across states are moving the needle.
 
Why Attend
Whether you’re closely involved in advocacy or looking to stay informed, this call will help you:

• Understand key policy issues affecting home care in 2026
• Learn what chapters across the country are working on
• See where advocacy efforts are focused and why
• Stay connected to the broader home care network

 
Click HERE to register for the event

Because home care is all we do, our team understands the systems, workflows, and pressures you navigate every day. From scheduling and billing to payroll and reporting, we know how your operations function and what it takes to keep them financially healthy.
​
Our goal is simple: help agency owners gain clarity, improve profitability, and free up more time to focus on impacting lives.

Our services include:
• Monthly Accounting & Financial Reporting
 Clean books, reconciled accounts, and financial statements that make sense, delivered consistently and tailored to home care.

• Fractional CFO Advisory
 Strategy sessions, financial performance analysis, and actionable insights to support confident decision-making, plus access to the Client Compass, our customizable financial analytics report that highlights your agency’s opportunities for savings and growth.

• Billing & Payroll Services
 Streamlined processes that strengthen cash flow, reduce errors, and ensure caregivers are paid accurately and on time.

• System Integrations
 We help your client management and payroll systems work seamlessly with your accounting software for accurate, real-time financial visibility.

• Tax Planning & Preparation
 Proactive strategies for agency owners to minimize tax burden and plan wisely for the future.

At The Home Care CPAs, we believe agency owners deserve more than basic bookkeeping. You deserve a partner who understands your world, anticipates challenges, and supports the decisions that shape your business and the lives you touch.

If you are looking for a financial partner who truly “gets” home care, we would love to connect.
​
Learn more: TheHomeCareCPAs.com
Contact: info@TheHomeCareCPAs.com

​The implementation of the Washington Cares Act has begun with providers signing up for the program to offer home care services to participants. Many home care agencies, both private pay and Medicaid, are currently negotiating contracts with the state to provide care.
 
It came to our attention that deep within the home care agency contract there was language which required an 80/20 split between wages and administrative costs. When discovered, HCAOA-WA immediately reached out to the Director of the WA Cares Program and requested a meeting to discuss. That meeting happened in early January. Jeff Wiberg, Tim Cooke and Leslie Emerick discussed how this split was not feasible for our home care agencies. We explained specifically why the costs of running an agency would make this contract a losing proposal for our providers and under the current contract, they would not be able to sign and participate in providing care for the program. The WA Cares team was receptive to changing the contract language and have since taken the 80/20 rule out of the contract language.
 
This outcome is a powerful reminder that when our industry speaks with one unified voice, it is heard. Because HCAOA-WA was at the table advocating on behalf of home care providers, real-world operational concerns were elevated, understood, and addressed. This is exactly how meaningful change happens—through collective advocacy, credible relationships, and informed leadership representing our members.
 
Some of you may remember that in May 2023, the Centers for Medicare and Medicaid Services (“CMS”) proposed a series of rule changes intended to help promote the availability of home and community-based services (“HCBS”) for Medicaid beneficiaries. Chief among these proposals was a new rule that would require HCBS agencies to spend at least 80% of their Medicaid payments for homemaker, home health aide, and personal care services on direct care worker compensation (the “80/20 Rule”). Intended to help stabilize the HCBS workforce, the proposal faced immediate backlash from HCBS providers and Medicaid agencies, who expressed concern that the 80/20 rule would harm HCBS providers by mandating specific allocations to worker compensation and bogging down providers and Medicaid agencies with burdensome reporting requirements.
 
This is a huge win for our home care agencies that want to participate as providers under the new WA Cares Act. More importantly, it underscores why belonging to HCAOA is so important. Advocacy works when providers are united, engaged, and represented—and this success is proof that HCAOA ensures our voices are not only heard, but taken seriously. We will continue negotiating final language changes and advocating for our members so agencies can participate in this program in a way that is both sustainable and financially viable. Together, we are shaping policy that works for home care.

• Roughly a third of respondents are concerned about profitability and revenue growth.
• More than 45 percent expect the One Big Beautiful Bill to hinder company growth, with reduction in the Medicaid provider tax cited as the biggest impediment, followed by restrictions on higher payments in Medicaid expansion states.
• Approximately half believe the economy will impact their businesses.

The survey also measured trends in AI adoption. Leaders increasingly expect AI to improve and streamline operations, with 64% of respondents anticipating the biggest benefit from automatic scheduling and client-caregiver shift matching. More than half believe AI will support workforce stability by improving the overall caregiver experience.

“We’re seeing AI move from nice-to-have to essential, helping agencies support their caregivers and deliver better care with the resources they have,” said AxisCare CEO Todd Allen.
​
To read the full report, download the white paper from AxisCare.

The raise is required to occur due to indexing language written into the New Jersey Constitution that ensures the statewide minimum wage keeps pace with inflation.
​
But that’s not the case in many other states. Budget and finance writer John Reitmeyer reports.
Read more here ​​Minimum wage inches up

“Direct care workers make independence possible for hundreds of thousands of New Jerseyans, and their work is fundamental to the health, safety, and dignity of the people who we serve,” Commissioner Sarah Adelman said. “This strategic plan reflects our commitment to building a stronger, more supported, and more sustainable workforce - one that is valued for its skill, compassion, and essential role in New Jersey’s communities and economic success.”

The plan outlines more than 40 data-driven strategies to improve recruitment, strengthen training and career pathways, and support the long-term retention of direct care workers including direct support professionals (DSPs), certified home health aides (CHHAs), personal care assistants, certified nursing assistants (CNAs), peer recovery specialists, youth support professionals, and self-directed employees.

Developed through more than a year of collaboration among Human Services and the departments of Labor & Workforce Development, Children and Families, Education, the Office of the Attorney General’s Division of Consumer Affairs, the Office of the Secretary of Higher Education, and the Higher Education Student Assistance Authority, the plan draws on workforce data and extensive engagement with stakeholders. Input came from listening sessions with direct care workers, employers and consumers, and support from the Direct Care Workforce Strategies Center and partners such as PHI.
​
“If we want New Jerseyans to live and age in their community with dignity, stability, and choice, we must ensure the workers who make that possible have the support, respect, and opportunities they deserve,” Commissioner Adelman said. “This strategic plan reflects what we heard directly from families, workers, and providers across the state, and it outlines actions that will strengthen pathways into the field and better support workers on the job.”

Read more HERE.

​The Department, beginning this month, plans to begin efforts to voluntarily bring into compliance agencies that have not registered; following a short grace period, the Department may escalate its efforts and begin enforcement proceedings if agencies fail to comply with registration requirements.
 
As of Jan. 1, 2026, 959 home care agencies had registered with the Department. In recent years, about 1,200-1,400 agencies had registered, according to the Department’s licensing division.