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Committee advances bill to allow paid family caregivers for some Medicaid recipients
Summary
The House Health Committee voted 4-0 to pass Senate Bill 56, which would allow family members — and, as drafted in the Senate, some non‑relatives — to serve as paid caregivers under the supervision of a registered nurse for a small group of Medicaid private duty nursing recipients.
The House Health Committee on Oct. 27 voted 4-0 to pass Senate Bill 56, which would let a family member of a Medicaid enrollee be recognized and paid as a caregiver to provide services under the direction of a registered nurse.
The bill targets a narrow population: children under 21 who qualify for private duty nursing services. Committee members and agency staff said the change would affect roughly 150 children and could reduce Medicaid costs; a sponsor stated it could save “up to, I think, dollars 3,100,000.0 savings, over the course of a year, for the Healthcare Authority.”
Supporters told the committee the measure responds to chronic shortages of home nurses that leave families without full coverage of private duty nursing hours. Christina Foss, chief of staff at the Healthcare Authority, said the proposed caregivers would be employed through a home health agency, which would perform background checks and the usual hiring checks and balances.
Foss said, "the caregiver would be, employed through a home health agency. So they would actually have employment, under that umbrella. And so home health agency would be doing a background check on them. They would be doing all the regular checks and balances that they would normally do with any employee." She also said registered nurses would supervise the caregivers and that program integrity tools such as electronic visit verification would be used to verify hours.
Committee members raised several concerns during questioning. Representative Snead and others asked why the Senate-drafted language used the phrase "family member" while seeming to allow non‑family caregivers; the presenter said the committee could consider renaming the category to "caregiver" if the definition caused problems. Representative Rowe and other members pressed whether background checks would flag pending investigations or prior allegations of exploitation; Foss said the agency uses multiple data sources for provider contracting and offered to research whether pending charges reliably appear in those checks.
Members also asked who would monitor day‑to‑day care. Foss said oversight would be shared: the employing home health agency would supervise its employees and the Healthcare Authority would retain audit and program-integrity authority, including electronic visit verification and periodic in‑person checks by an RN.
Sponsors said the policy is intended for caregivers who otherwise could not staff the full hours needed for very fragile children — for example, to allow parents who cannot leave the home because of 24/7 care needs to still receive paid assistance for some duties. Foss described the approach as a model used in other states and supported by the agency's member advisory task force.
The committee recorded a do‑pass recommendation and voted 4 aye, 0 nay to send the bill to the next committee.
