Big Win for HCAOA-WA in WA Cares Act!

The WA Cares Act is Washington State's public long-term care insurance program, designed to provide benefits for long-term care services to eligible residents starting in July 2026. It is the first of a kind in the nation. Funded through a payroll tax, it aims to help individuals cover costs associated with aging, disability, or chronic illness without depleting their savings. 

​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.