Voice: Ire over Consumer Directed Employer bill

Advocates: High cost; no accountability; and no help for parent providers

There has been a lot attention this week paid to SB 6199, a bill requested by the Department of Social and Health Services that makes costly administrative changes to in-home care services available to Medicaid eligible older adults and people with developmental disabilities.

It creates a Consumer Directed Employer (CDE) for individual providers. This new entity would act as the legal employer of individual providers, thus clarifying that they are not state employees. The CDE would perform administrative functions related to providing personal care, respite care, and other services to individuals with functional disabilities.

The person receiving services of an individual provider would become the managing employer with the authority to select, hire, schedule, supervise, and dismiss an individual provider.

The bill also establishes a rate-setting board and a process to set labor rates for payments to individual providers and an administrative rate to be paid to the CDE.

SB 6199 is controversial, in part, because of the high cost: Almost $30 million over the next four years. Early supporters were not anticipating such a high fiscal note. It also would allow SEIU to negotiate a contract that requires individual providers to pay union dues.

The bill comes at a time when family members providing care say they are under increasing stress and in some cases are reporting significant reduction in service hours.

The Arc of Washington and the Washington State Developmental Disability Council are concerned that there isn't accountability built into the bill; the administrative changes are vague; and the bill does nothing to address the needs of family providers.

For instance, there are significant problems with IPOne - the payroll system - that would not be fixed. There are privacy concerns about Electronic Visit Verification that would not be addressed. There are no consumers included on the proposed rate setting board. At a fundamental level, the bill fails to recognize the role of parent providers.

SB 6199 is scheduled for a public hearing Feb. 20 in the House Committee on Health Care & Wellness at 8:00 am.