Subcommittee bars per-visit pay for home health, adopts funding for BOLI enforcement

The Ways and Means Human Services Subcommittee on June 12, 2025, approved amendments to Senate Bill 1168 to prohibit home health agencies and hospice programs from paying staff on a per-visit basis and added funding to enforce the change.

The bill expands the prohibition on per-visit pay beyond nurses to include home health care staff and hospice staff, listing home care workers, direct care workers, physicians, nurse practitioners, psychiatrists, psychologists, volunteers and certain supervisors. The Bureau of Labor and Industries (BOLI) is given enforcement responsibility under the measure.

A dash A3 amendment adopted by the subcommittee adds $159,362 from the general fund to hire one position at BOLI to manage the expected increase in complaints and investigations. LFO recommended adoption of the dash A3 amendment; the subcommittee voted to move SB 1168 as amended to the full Ways and Means Committee with a “do pass” recommendation.

During debate, Senator Hayden proposed a dash 2 amendment to preserve the ability of employers to set productivity standards while creating a process for employees to seek individualized exemptions. Senator Hayden said, “what the amendment does is says that the agency would still be able to have some productivity standards, but the employee, with these productivity standards would be able to come back and say that they want an exemption… the procedures would have to be based on individualized needs and care goals.” The motion to adopt the dash 2 amendment failed on a roll call.

Representative Sharp supported Senator Hayden’s intent to preserve reasonable productivity metrics tied to federal requirements and said those metrics “are doing that in order to meet Medicare requirements.” Representative Deal described the metrics as necessary for providers to remain viable, saying, “Any business has to have some kind of performance metrics in order to… keep the lights on.”

The bill’s sponsor clarified that SB 1168 does not forbid employers from setting productivity benchmarks; it prohibits tying pay reductions to failure to meet per-visit metrics. The subcommittee record shows objections noted for the record from Representative Scharf and Representative Diehl; otherwise the amendment and motion to move the bill passed and will be carried to the full committee and to the floors as assigned.

The subcommittee’s action adds a statutory enforcement role for BOLI and a staffed enforcement function funded by the state general fund. The bill text and adopted amendments will determine the final regulatory and employer obligations should the full committee and both chambers approve the measure.