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Parents of medically complex minors seek right to be paid caregivers under proposed waiver change
Summary
House Bill 1200 would require DDA to seek a Medicaid waiver amendment allowing parents to be paid for extraordinary care of minor children; parents, nurses and providers testified about caregiver shortages and financial strain, and supporters said the change could keep children at home and reduce high institutional costs.
Representative Jamila Taylor introduced House Bill 1200, which would direct the Developmental Disabilities Administration to seek federal Medicaid approval to allow parents of minors with extraordinary, assessed care needs to be paid as caregivers under waiver rules.
"This is not the typical, just feed and clothe your children," Representative Jamila Taylor said, urging the committee to recognize that some parents provide extraordinary personal care that exceeds ordinary parenting duties and that the workforce shortage has left families without alternatives.
Committee staff explained federal Medicaid rules generally bar payment to legally responsible individuals but allow states to request waivers in narrowly defined circumstances; HB 1200 directs DDA to submit a waiver amendment by Jan. 31, 2026, and defines "extraordinary care" initially by CARE assessment categories (E or B high) with a phase-in through 2031.
Parents, clinicians and providers gave extended testimony about the scale of unmet in-home hours, caregiver shortages and the financial and emotional toll on families. Jessica Morrow, a parent from Lake Stevens, described a son born at 25 weeks with cerebral palsy and autism who requires 24/7 care; she said institutional placement out of state had been suggested to her family and that in-home paid parental caregiving would avert that outcome. "If I could be employed as the caregiver it would allow us to move off of other state supports," she said.
Nurses and providers said parental caregivers have clinical competence in many medically complex cases and that reimbursing parents can reduce reliance on institutional care and stabilize families. Michelle Hagerstrom, a nurse manager, said the bill would "provide the financial relief they need and enable them to maintain their own health and well-being, ensuring that they can continue to care for their child." Providers also cautioned that the policy should be implemented with safeguards and adequate program administration.
No committee vote was taken. Witnesses urged quick action, saying the change would not expand the total authorized hours but would expand the available workforce and allow families to use hours they now cannot access because no outside caregiver is available.
