Committee hears HB 96 to create home care advisory board and require agencies to dedicate 70–80% of Medicaid personal-care funding to worker pay

Representative Mike Prox, sponsor of House Bill 96, told the House Health and Social Services Committee that HB 96 would create a Home Care Employment Standards Advisory Board to develop recommendations on Medicaid rates and policies to improve wages, recruitment and retention of direct care workers. Prox said the bill would also require agencies providing personal care services to spend at least 70% of annual Medicaid funding received for those services on wages and benefits for direct care workers, increasing to 80% by July 1, 2030 unless the agency obtains a hardship exemption.

Riley Nye, staff to Representative Prox, read the bill sections into the record, detailing board composition and duties. The board would include a chair, six voting members and four nonvoting members appointed by the commissioner of health, meet at least three times per year, publish biannual and annual reports, and have access to data needed to perform its duties. The bill sets a deadline for appointing the first board and requires the board’s first meeting on or before Oct. 1, 2025; it also requires a preliminary internet publication no later than July 1, 2026. Section 6 conditions part of the act on approval or determination of approval necessity by the U.S. Department of Health and Human Services for state plan amendments.

Testimony from union and caregivers emphasized workforce shortages and the need for greater transparency on how Medicaid personal-care rates are spent. Alexis Rodich, director of policy and research at SEIU 775, said the state faces a demographic shift and a shortage of direct care workers, particularly outside population centers. Rodich said, "More transparency such as the reporting requirements in this bill would not only help enforce the labor rate requirements in this bill, but it also gives the department and the Office of Rate Review more information with which to assess the efficacy of rates and then rate setting processes going forward." Riley Nye told the committee, "It's my understanding that it's currently 50/50" when asked what proportion of current funding goes to pay and benefits. Tony Newman, director of the Division of Senior and Disability Services, said the state would need to file a Medicaid state plan amendment for parts of the bill and that the federal Centers for Medicare & Medicaid Services typically responds to such requests within a prescribed timeline that can take a few months.

Caregivers who testified described long work histories and low pay and urged support for the bill to improve wages, benefits and staffing. The committee asked several technical questions about scope (the bill is directed toward Medicaid-funded services required under the new Medicaid "Ensuring Access" rule) and implementation (staffing needs at the Division of Senior and Disability Services; a fiscal note requested two staff positions to support the board’s work).

Chair Representative Mina set an amendment deadline for HB 96: Wednesday, April 2, at noon. Public testimony for HB 96 was recorded; the transcript includes multiple caregiver accounts and the invited testimony summarized above.