The law puts the Executive Office of Health and Human Services (EOHHS) in charge of licensing, working with the Executive Office of Aging & Independence and the Department of Public Health. Agencies will need a state license to operate or advertise home care services, and EOHHS will have authority to inspect, investigate and enforce the law, including denying, suspending or revoking a license.

Licensed agencies will be required to:

• Conduct background checks on employees
• Meet state standards for worker safety and consumer protection
• Provide training on worker safety, abuse prevention and quality care
• Carry workers' compensation and liability insurance
• Meet operational, financial and ownership disclosure requirements set by the state

​Implementation timeline (per the enrolled bill; details will be finalized in regulation):

• Within 180 days of enactment: temporary licenses issued to Medicaid providers
• Within one year: EOHHS finalizes licensure regulations
• One year after regulations are finalized: all home care agencies must hold a license

​The law also creates a Home Care Oversight Advisory Council and a Home Care Worker and Abuse Stakeholder Advisory Committee to guide implementation. It establishes a special commission to study family caregiving policy, including whether spouses could be paid caregivers through MassHealth, and a separate Long-Term Services and Supports Commission to examine options for financing long-term care.
​
No agency action is required yet. Licensure will not take effect until EOHHS finalizes regulations, likely in mid-2027. Members should watch for EOHHS rulemaking notices and comment opportunities as the state builds out the licensing program. The enrolled bill text is available on the Massachusetts Legislature's bill history page for S.3170.

When a leader is struggling, it can be tempting to assume there’s a gap in knowledge, skill, or capability. We may increase oversight, provide more direction, recommend a book or course, or send someone to training.
Sometimes, that’s exactly what’s needed. Training can be incredibly valuable for building knowledge and acquiring new skills. But a performance challenge does not automatically tell us where the problem resides.

Looking Beyond the Skill Gap
A leader can be highly capable and still struggle. The challenge may be a lack of knowledge or skill. But it may also reflect unclear expectations, competing priorities, role demands, individual patterns and preferences, insufficient support, or an environment that makes the desired behavior difficult to sustain.

And sometimes, a leader understands exactly what’s expected but has not yet learned how to translate that understanding into behavior.

There’s often a gap between knowing what to do and being able to consistently do it.

Consider delegation. A leader can learn the principles of effective delegation and fully understand why it matters. But knowing how to delegate is different from recognizing the moment when the pressure is high, something needs to get done, and doing it yourself feels faster, easier, and more certain.

That’s where awareness matters: Can I recognize my instinct to step in? Can I understand what’s driving it? Can I notice the impact it may be having on the people around me? And can I create enough space to make a different choice?

Awareness creates choice. Turning that choice into a new way of leading takes intentional practice.

Development From the Inside Out
Before prescribing development, perhaps we need to create enough space to understand the person experiencing it. Ask them: What are you experiencing? What are you noticing? What feels difficult about this? What support would be helpful?
These questions do more than identify a skill gap. They invite the leader into the developmental process.

And that matters because people don’t experience or integrate development in the same way. We cannot assume two leaders will walk away from the same training, book, or conversation having made the same meaning from it or knowing how to apply it in the same way.

One person may readily connect a new concept to their work. Another may prefer clearly defined expectations, concrete examples, and a clear connection between the concept and how it translates into action. Someone else may need time to reflect, an opportunity to talk through what they are noticing, or support recognizing how their natural tendencies are influencing their behavior.

Effective development begins with understanding the person, not simply prescribing the solution. It also requires enough safety for honest self-examination.

When development feels primarily corrective or evaluative, people may naturally become more guarded. It’s difficult to become curious about our limitations, acknowledge an unintended impact, or experiment with something unfamiliar when we are focused on protecting ourselves.

But when people feel seen, supported, and safe enough to become curious about their own behavior, feedback can become information rather than judgment.

A developmental need does not have to mean, "I’m not capable." It can simply mean, "There’s another way I can approach this.”

Creating Meaning Before Action
Even awareness may not be enough. Trying something new requires effort.  It asks us to let go of what is familiar, even temporarily, and practice something that we may not yet feel confident doing. For an already-compressed leader, that effort matters.

If the reason for changing is little more than "because this is what you were taught" or "because this is what we expect," it can be difficult to sustain the motivation to keep practicing when the old behavior feels easier.

Development becomes more meaningful when leaders can connect what they are learning to something that matters to them. For example: Why does this matter in my role? What impact is my current approach having? How would I like it to be different? What kind of leader am I trying to become?

What looks like resistance may reflect the discomfort of letting go of what feels comfortable and trying something they haven’t yet mastered.

That connection between awareness and action is important. We are not simply asking someone to perform a different behavior. We are helping them understand why the change matters and what becomes possible when they practice it.

From Learning to Practice
Training and coaching can both play important roles in this process, but they serve different purposes.

Training can introduce knowledge, teach skills, and provide useful frameworks. Coaching creates space to explore how that learning intersects with the individual: their strengths, behavioral tendencies, experiences, role, and work environment. It can also help identify the barriers, fears, or patterns that may emerge when someone tries to put that learning into practice.

Much of leadership development then happens in ordinary moments: a difficult conversation, a decision made under pressure, the choice to delegate instead of stepping in, or the moment we pause long enough to recognize our impact.
​
The workplace isn’t only where leadership development is applied, but also where much of leadership development actually happens. And with practice, something that initially requires considerable thought and effort can gradually become another way a leader knows how to respond.

Creating the Conditions for Growth
Perhaps before asking "What training does this leader need?" we first need to ask: What’s really happening here? And then: What would help this leader practice something different?

Leadership development is not something we simply deliver to people. It is something we intentionally cultivate with them.
That means creating enough safety for awareness, enough space to understand what the individual is experiencing, enough meaning to make change worth the effort, and enough opportunity to practice a different response.

And once that practice begins, another question emerges: What helps those new behaviors last?

he update is part of a new two-track revalidation strategy under which nearly 76,000 South Carolina Healthy Connections Medicaid providers will be assigned to either rapid or routine revalidation. 
SCDHHS cited recent utilization trends and its experience administering the Medicaid program as the basis for adding personal care providers to the rapid revalidation category, which also includes durable medical equipment suppliers, home health agencies, rehabilitative behavioral health services providers, licensed independent practitioners and applied behavior analysis providers. The agency has identified 5,713 providers for rapid revalidation over the next 12 months. 
For providers selected for rapid revalidation, the process will include documentation review, site visits and fingerprint-based criminal history background checks. 
SCDHHS has begun mailing revalidation letters to providers designated as high risk, with additional letters expected in the coming weeks. Each notification will include a unique revalidation code required to begin the process. Providers should not attempt to begin revalidation until they receive official notification from SCDHHS. 
The department's existing guidance recommends that providers confirm information such as their NPI, tax ID, mailing address, service location and provider name is current so they are prepared when their revalidation period begins. Providers should also note the deadline included in their individual notification; SCDHHS generally requires the online portion of the revalidation application be completed within 30 days of notification. Failure to complete required revalidation can result in termination from the Healthy Connections Medicaid program and interruption of Medicaid payments. 
HCAOA encourages South Carolina members participating in Medicaid personal care programs to watch for correspondence from SCDHHS and begin gathering and reviewing enrollment, ownership and other documentation that may be needed for the enhanced revalidation process. Questions can be directed to the Provider Service Center at (888) 289-0709, option four, or through SCDHHS's revalidation resources. ​

The increase is required under a 2019 state law that ties Connecticut's minimum wage to changes in the federal employment cost index. Under the law, the commissioner of the Connecticut Department of Labor calculates the percentage change in the index for the 12-month period ending June 30 and must announce any adjustment by Oct. 15 each year. Adjustments take effect the following Jan. 1. 

Connecticut Labor Commissioner Danté Bartolomeo reported that the employment cost index rose 3.2% over the 12 months ending June 30, 2026, resulting in a 54-cent increase to the minimum wage. 

Lamont said the law is designed to ensure wages keep pace as the economy grows, adding that too many low-wage workers have not shared in that growth. Lt. Gov. Susan Bysiewicz said the annual adjustment allows the state's minimum wage to respond to economic conditions while keeping it among the highest in the country. 

HCAOA Connecticut Chapter Chair Marlene Chickerella of B&M Homemaking in West Haven said the chapter supports fair wages for caregivers but cautioned that the increase adds pressure to small home care businesses already managing rising labor costs. She said the chapter's Medicaid committee, led by Mario D'Aquila, is developing a strategy ahead of the 2027 budget session to push for Medicaid reimbursement rates that keep pace with wage growth and inflation. 
​
HCAOA Connecticut plans to make member engagement a priority as it builds its case with state legislators for a Medicaid rate increase to offset the added labor costs. ​

Following Governor Mikie Sherrill's signing of P.L. 2026, c.45, the Division is updating its regulations to align with the new law. While that regulatory process is underway, the Division has announced that it is temporarily suspending the requirement for Health Care Service Firms to submit a financial audit or financial report as part of the September 2026 renewal.

What This Means for Providers
For the September 2026 renewal cycle:

• A financial audit is NOT required.
• A financial report is NOT required.
• A financial statement is still required pursuant to N.J.A.C. 13:45B-13.5A(a).

​The Division emphasized that, "for the avoidance of doubt," providers should not submit a financial audit or report with their upcoming renewal application, but they must continue to submit the required financial statement.

An Immediate Result of HCAOA Advocacy
This guidance follows Governor Mikie Sherrill's signing of legislation last month that HCAOA worked to advance through the legislative process.

The law modernizes outdated financial reporting requirements for licensed home care providers while directing the Division of Consumer Affairs to update its regulations through the formal rulemaking process. Until those regulations are finalized, the Division has provided this interim guidance to ensure providers understand their obligations for the upcoming renewal period.

This announcement represents one of the first tangible implementation steps following enactment of the legislation and provides regulatory relief for providers preparing their renewal applications.

HCAOA will continue monitoring the rulemaking process. We will keep members informed of additional guidance and future regulatory updates as they become available.

Effective Jan. 1, 2027, the law requires that when assisted living establishments, shared housing establishments, community living facilities and life care facilities refer residents to home care providers with whom they do not already have a contractual relationship, those referrals must go only to providers licensed under the Illinois Home Health, Home Services, and Home Nursing Agency Licensing Act. 
The law also directs the Illinois Department of Public Health to develop and publish a one-page consumer flyer explaining: 

• Important information about choosing caregivers 
  

• The differences between licensed and unlicensed home care and home health providers 
  

• Common risks associated with unlicensed providers 
  

• How consumers can verify an agency's licensure through the state of Illinois 
  

Facilities must provide this information to residents who are referred to, or who request referrals for, home care services. 
The HCAOA Illinois chapter led the advocacy effort behind the bill, building relationships with lawmakers and working the legislative process from introduction to signing. HCAOA also credits Rep. Suzanne Ness, Sen. Mary Edly-Allen, the bill's co-sponsors, Pritzker, and the providers and advocates who supported the effort. 
HCAOA will work with state leaders and providers as the law is implemented ahead of its Jan. 1, 2027, effective date. ​

I’ve noticed that leadership begins to shift when we intentionally create space to become curious:

• Curious about what an employee is experiencing
• Curious about what motivates them
• Curious about what challenges they may be navigating
• Curious about the strengths they bring that may not be fully recognized

Curiosity is often the first signal that another person has been truly seen. It’s surprisingly easy to lose this in the pace of the day.
 
When people feel truly seen, conversations change and trust begins to grow. Leaders gain a deeper understanding of how to support each individual in a way that aligns with who they are, not simply the role they perform.
 
Trust Signals Trust
Trust is often discussed as something employees should have in their leaders. Equally important is the trust leaders communicate to their employees.
 
Every interaction communicates what we believe about another person — their abilities, judgment, perspective, and potential.
 
When leaders invite input, ask thoughtful questions, delegate meaningful responsibility, and coach rather than solve, they communicate a powerful message: “I trust your judgment.”
 
Conversely, when leaders consistently second-guess decisions, take work back, provide answers before employees have an opportunity to think, or require approval for every step, they may unintentionally deliver a different message: “I don’t trust your judgment, and neither should you.”
 
As the parent of a teenage daughter, I’ve been reminded of this lesson in an unexpected way. Like many parents, my instinct is to step in, offer advice, advocate on her behalf, or help her navigate the complexities of high school and adolescence. I’m often tempted to show her how I would approach the situation.
 
I’ve been practicing something different. I’ve been intentionally creating space.
 
Rather than immediately offering answers or anecdotes, I’ve practiced asking questions, listening more, and allowing her to work through challenges in her own way.

I’ve discovered that she often already knows more than I realize. When I slow down enough to ask questions instead of offering answers, she doesn’t simply solve the problem — she finds her own way through it. I’ve watched her advocate for herself, express her perspective, and navigate difficult situations with growing confidence. By intentionally stepping back, I’ve communicated something words alone never could: “I trust you.”
 
Watching her reminded me that confidence rarely develops because someone continually steps in with the answer. More often, it grows because someone consistently creates the space for others to discover the answer and trust themselves in the process. Over time, I’ve watched her trust herself more and more.
 
Leadership often works the same way. When we consistently communicate trust in another person’s judgment, perspective, and ability to navigate challenges, we don’t simply strengthen trust in the relationship. We create the conditions where people begin trusting themselves.
 
When leaders consistently communicate trust, employees become more willing to contribute ideas, navigate ambiguity, take ownership, and continue growing. Trust in their own judgment grows not because someone continually provides the answers, but because someone consistently communicates “I trust you to think this through.”
 
People often reconnect with trust in themselves through the trust we consistently communicate.
 
Creating Space Together
One of the most practical ways leaders communicate trust is through consistent one-on-one conversations: Not as status updates. Not simply as performance reviews. But as intentional space for leadership conversations.
 
Regularly cadenced one-on-ones create an opportunity to move beyond the checklist and into meaningful conversation. These conversations create space to exchange ideas, share two-way feedback, explore development, identify barriers, and advocate for one another’s success before they become larger challenges.
 
Perhaps most exceptionally, they create an opportunity to hear what might otherwise remain unspoken.
Rather than asking only for a weekly report, consider asking:

• What has been going well?
• Where have you felt challenged?
• What are you noticing?
• What strengths have you been able to use lately?
• What support would be most helpful right now?
• What ideas or observations haven’t had a chance to be shared?

Questions like these communicate that employees are valued above what they produce, for what they think, observe, experience, and contribute.

Seeing the Person Behind the Performance
Leadership isn’t only about directing work. It’s about helping people to reconnect with their ability to think, contribute, grow, and trust themselves. It’s about developing people.

People who feel seen are more likely to feel valued. People who feel valued are more willing to contribute. People who consistently experience trust begin trusting themselves.

Creating intentional space to truly see the people we lead may be one of the most important leadership practices we have. Before people consistently trust their own voice and experiences, they often need someone else to communicate “I trust yours.”

Creating intentional space to truly see another person may be one of the most important leadership practices we have. Because when people feel seen, trusted, and believed in, they often begin reconnecting with those same qualities within themselves. And that simple act of seeing another person clearly may be where lasting trust — and lasting leadership — begins.
​
But awareness and trust are only the beginning. The next challenge is helping those moments become lasting leadership habits, and that’s where intentional development matters most.

SPA 26-AA, posted June 30, was the first of the two. It implements reimbursement increases for the Community First Choice (CFC) benefit to comply with a collective bargaining agreement (CBA) between the state's PCA Workforce Council and the union representing self-directed personal care attendants (PCAs). The Connecticut General Assembly approved the agreement's extension through June 30, 2027, on April 30. Effective July 1, the amendment raises payment rates for applicable CFC services, including specified hourly wage increases required under the CBA. The comment period for SPA 26-AA closed July 14. 

The second amendment, SPA 27-0005, posted July 15, renews the state plan's home and community-based services (HCBS) option under Section 1915(i) of the Social Security Act, which supports the Connecticut Home Care Program for Elders (CHCPE). If approved, the renewal would take effect Feb. 1, 2027, for an additional five-year period and make technical and routine operational changes to the program. DSS is accepting written comments on this amendment through Aug. 14. 
​
Both amendments will ultimately go to the Centers for Medicare & Medicaid Services (CMS) for federal approval. DSS is accepting written comments on SPA 27-0005 through Aug. 14. Comments can be emailed to Public.Comment.DSS@ct.gov, or mailed to Department of Social Services, Medical Policy Unit, 55 Farmington Avenue, 9th Floor, Hartford, CT 06105, referencing SPA 27-0005. ​

The case, Bolina v. AssureCare Adult Home LLC, centered on a state law exempting live-in caregivers in Adult Family Homes from certain wage and hour protections. The Court found that exemption violates the Washington Constitution. Read the full decision. 

An Adult Family Home is a licensed residential setting in Washington that provides personal care, room and board and other long-term care services to a small number of residents in a home-like environment. Some Adult Family Homes employ caregivers who both live and work at the residence. 

The ruling is limited to Washington’s Adult Family Home industry. It does not apply to traditional home care agencies that provide services in clients’ homes, and it has no effect on the federal companionship exemption under the Fair Labor Standards Act, including any future action by the U.S. Department of Labor to restore that exemption. 

What the court did not decide 
The ruling leaves several questions open. The Court did not decide whether the live-in exemption is unconstitutional in all industries or occupations involving live-in employees, whether it violates the state’s equal protection clause, a claim still pending in the trial court, or whether the decision applies retroactively or only prospectively. The Court expressly left that last question for the trial court to resolve. 

Implications for home care agencies 
The decision appears to have limited direct application to traditional licensed home care agencies. The Court’s analysis focused on caregivers who live and work in licensed Adult Family Homes and provide around-the-clock care while residing at the worksite. Most Washington home care agencies provide scheduled services in clients’ private homes and generally do not employ caregivers under a live-in Adult Family Home model. 

Agencies that operate Adult Family Homes or use live-in caregiver arrangements at those homes should review the decision closely and monitor the litigation as it continues. 
​
HCAOA will continue to track developments in Olympia, Washington, D.C. and elsewhere, and will keep members informed as this case progresses. ​

The New Jersey Legislature passed S3463/A4790 June 30. The bill would raise the Medicaid audit threshold for Health Care Service Firms from $250,000 to $500,000, extend the audit submission deadline to Sept. 30, modernize financial reporting requirements, and allow qualified out-of-state certified public accountants to conduct audits, among other changes.
​
HCAOA New Jersey has advocated for the reforms since they were introduced, arguing they preserve the state’s existing oversight framework while updating requirements that had grown burdensome and costly for providers. Chapter leaders, engaged members, bill sponsors, and the association's contract lobbyist, Dennis Marco of Porzio Government Affairs, worked together to advance the legislation. Members testified before lawmakers, met with legislators, and responded to advocacy alerts throughout the process.

The bill builds on an earlier administrative change from the New Jersey Division of Consumer Affairs, which extended Health Care Service Firm registration deadlines and gave agencies additional time to complete required financial reporting. That change offered short-term relief; S3463/A4790 would provide a longer-term legislative fix by modernizing the underlying statutory requirements. Read HCAOA's previous update on the registration changes.

The legislation's unanimous, bipartisan passage in both chambers reflects broad agreement that home care providers should be able to spend more time caring for New Jersey residents and less time navigating outdated administrative requirements, according to HCAOA.

Gov. Sherrill has not yet acted on the bill. HCAOA is asking New Jersey members to contact her office and urge her to sign S3463/A4790 into law.

Members with questions can contact HCAOA Director of Government Relations Allison Cramer or join the association's monthly Government Relations Office Hours, held the second Wednesday of each month. Find details on the HCAOA events calendar.

Visit the Legislative Action Network page to write to Gov. Sherrill.

Often, the challenge isn’t the volume of work, or even the work itself. It’s that the space between what happens and how we respond has become increasingly small.

We move from one demand to the next without enough time to notice what’s happening within us. When space disappears, we become reactive — not because we lack experience or we aren’t capable, but because reacting requires less cognitive effort than intentionally choosing a response.

How to Start
When the pace of the day begins to take over, intentionally creating space can help you move from reacting to responding. Begin by creating a brief moment of space: Pause. Breathe. Notice.

A pause isn’t inactivity. It’s a leadership decision. Even 10 seconds gives you room to ask:

• What’s actually happening here?
• What does the situation need from me?
• Am I reacting or am I responding?
• Which leadership strength is most useful right now?

And that creates awareness. Awareness doesn’t change the situation itself, but it changes how you enter that situation.

Expanding Your Options
When we’re under pressure, our minds naturally look for the fastest path forward. We rely on familiar patterns because they’re efficient, often reaching for the strengths that have served us well.

Sometimes that’s good. Other times, it’s like using a steak knife to cut a watermelon: The knife isn’t wrong, it simply isn’t the best tool for what the moment requires.

Awareness creates choice. Without awareness, choice becomes difficult to access. And choice creates intentional leadership.

Leading with Intention
Intentional leadership is difficult to access when every moment is spent reacting.

The pace of home care may never slow down. But creating moments of space — even brief ones — can change how we experience it, how we lead through it, and ultimately how we support the people who depend on us.

Creating space doesn’t eliminate the demands of leadership. The emails will still arrive. Staffing challenges will still occur. Regulations will continue to evolve. The goal isn’t to remove complexity, but to prevent complexity from determining how you lead.

With awareness comes the ability to notice not only what’s happening around you, but what’s happening within you. You begin to notice when frustration is driving your communication, when urgency is shaping your decisions, or when exhaustion is narrowing your perspective. That awareness creates an opportunity to choose a different response.

Leadership has never been only about making decisions. It’s about how we show up while making them: When we’re fully present, we listen differently. We become more curious. We respond with greater intention.

Creating space is where awareness begins. And awareness is where leadership begins to change.