With the Washington State Legislature refusing to further delay funding for Initiative-1029—the caregiver training and certification plan passed in November 2008—it appears that the initiative will go into effect January 1, 2011.

Private Duty Home Care agencies are deciding now how to meet the provisions of the Initiative. Some things are certain, however. I-1029 requires that all caregivers working for home care agencies have 75 hours of additional training even if they are simply weekend companions and perform nothing more complex than meal preparation or light housekeeping. As a result, home care will become more expensive for senior Washington State residents who are not Medicaid-eligible. It will become more difficult for private duty home care agencies to retain quality caregivers. The high testing and certification fees will create an additional barrier for experienced and capable caregivers wishing to work in a field predicted to grow tremendously in the next 10 years.

An additional problem is the “one size fits all” approach this initiative takes. It mandates the same training for part-time companions, adult family home caregivers, and home care aides working for high acuity Medicaid clients. A coalition of groups working on behalf of seniors and home care agencies vigorously opposed it and worked to remove or modify provisions and delay implementation. The coalition included the Washington Private Duty Association, the Home Care Association of Washington, Aging Services of Washington, and many other groups of professionals working with seniors and their families. The prime sponsor of the initiative was the union representing both state-paid Medicaid independent providers and caregivers working for Medicaid agencies.

Our efforts simply could not withstand the enormous political pressure placed on the Legislature. Despite a budget deficit of over $2 billion, $4.3 million will now go to fund I-1029 next year alone, with tens of millions in the years to come.