Committee hears bill to tighten accountability and cap admin share on Medicaid home‑care vendor rates

Committee staff briefed members on gross substitute Senate Bill 6,019, which revises how home care agency vendor rates and administrative rates are defined and calculated. Jackie Cobble, staff to the committee, said the bill requires parity between agency providers and individual providers, defines administrative rate components, and prohibits the rate setting board from recommending an administrative share greater than 20% of the vendor rate; if the board cannot reach agreement by Aug. 1, DSHS must determine the rate consistent with that 20% threshold. Beginning 07/01/2027, DSHS or its designee must verify agencies have spent each portion of the vendor rate as designated.

Public witnesses urged the committee to adopt the measure to ensure compensation flows to direct caregivers. Dimas Nistorenko (SAU 775) said the bill "ensures that Medicaid home care funds are used exactly as you intend to compensate direct care workers" and described the change as closing a loophole that allowed some agencies to divert funds away from caregivers. Daryl Johnson, a home care worker and union bargaining team member, described two decades of caregiving and said low pay threatens workforce retention: "I'm doing all the work... while getting paid lower." Supporters said the bill's 80% floor for caregiver pay and 20% cap on administrative or profit amounts would direct more Medicaid funding to direct care.

DSHS told staff there would be no fiscal impact for FY27 because calendar 2027 rates have already been established and the department expects to implement verification within existing staff capacity.