Senate Bill 103 (SB103)     relates to health care by requiring entities participating in Medicaid personal care programs to report to the Health Care Authority on the status of the direct care workforce and requiring the Health Care Authority to develop reports on the direct care work force. 

 Senate Bill103 (SB103)  requires that by March 1, 2026, and annually thereafter, each personal care service provider agency shall, in a form and manner prescribed by the Authority, submit data on the direct care workers providing agency-based community benefits at the personal care service provider agency.  The data shall include information on the: (1) total number of: 
(a) full-time direct care workers employed by the personal care service provider agency. 
(b) part-time direct care workers employed by the personal care service provider agency; 
(c) direct care workers who are independent contractors contracted with the personal care service provider agency. 
(d) direct care workers who have ceased providing personal care services for the personal care provider agency in the previous twelve months. 
(e)  vacant full-time and part-time direct care worker positions as of the end of the previous calendar year; and 
(f) hours of overtime pay received by each direct care worker.
(2) percentage of the previous calendar year that each direct care worker was employed at the personal care service provider agency, either as an employee or independent contractor. 
(3) total length of employment for each employee as of the end of the previous calendar year; 
(4) hourly wage paid to each direct care worker during the previous calendar year;
(5) total amount of money paid to direct care workers for travel in the previous twelve months; 
(6) availability of fringe benefits for direct care workers employed at the personal care service provider agency.  Data on fringe benefits shall include the number and percentage of full-time and part-time employees that receive:
 (a) health insurance.
(b) dental insurance; 
(c)  vision insurance; 
(d)  life insurance; 
(e)  disability insurance; 
(f)  tuition reimbursement; 
(g)  retirement benefits;
(h)  paid leave other than sick leave; and 
(i)  any other type of fringe benefit that the personal care service provider agency offers; 
(7)  other expenditures paid by personal care service provider agencies related to direct care workers, including: 
(a) training for direct care workers; 
(b)  discretionary travel benefits; and 
(c) personal protective equipment; and (
8) demographics of the direct care workers employed by the personal care service provider agency, including each direct care worker's: 
(a)  age;
(b)  gender; 
(c)  race and ethnicity; 
(d)  highest educational level attained; 
(e)  certifications; and 
(f)  duration of direct care work experience. 
 By March 1, 2026, and annually thereafter, each Medicaid managed care organization and financial management agency shall, in a form and manner prescribed by the authority, submit data on the direct care workers providing self-directed community benefits.  The data shall include information on the:
(1)  total number of: 
(a)  full-time direct care workers providing personal care services through the self-directed community benefit program;
(b)  part-time direct care workers providing personal care services through the self-directed community benefit program; 
(c)  direct care workers who are independent contractors contracted to provide personal care services through the self-directed community benefit program; 
(d)  direct care workers who have ceased providing personal care services through the self-directed community benefit program in the previous twelve months; and
 (e)  hours of overtime pay received by each direct care worker providing personal care services through the self-directed community benefit program; 
(2)  percentage of the previous calendar year that each direct care worker was employed at the provider agency, either as an employee or independent contractor; 
(3)  hourly wage paid to each direct care worker during the previous calendar year; and 
(4)  demographics of the direct care workers providing personal care services through the self-directed community benefit program, including each direct care worker's: 
(a)  age; 
(b)  gender; 
(c)  race and ethnicity; 
(d)  highest educational level attained;
 (e)  certifications; and 
(f)  duration of direct care work experience.


This legislation also requires by July 1,2026 and annually thereafter the Authority shall submit a report to the Interim Legislative Health and Human Services Committee, the Legislative Finance Committee, the Governor, and the advisory group required in another Section. 
Also, by July1,2030, the Authority shall perform a study on the cost of providing personal care services and recommendations on reimbursement. The study is to be submitted to the same legislative committees, the Governor and interest advisory committees as listed above.
The study shall consider federal requirements related to payment adequacy and the level of reimbursement required to: 
(1) stabilize the direct care workforce; 
(2) reduce direct care workforce vacancies; 
(3) allow direct care workers to receive an hourly wage of at least one hundred fifty percent of the state minimum wage; and 
(4) ensure adequate access to personal care services for eligible Medicaid recipients.
Finally, the Authority is to establish an interested parties advisory group that will meet at least every two years and provide recommendations to the Authority on reimbursement in regard to: personal care, home health aides, homemaker and habilitation services. The advisory group shall consist of direct care workers, eligible Medicaid recipients or their representatives and Authority staff. 




 

 Committee Substitute 02/26/2025in SHCAP 
SHCAPcs/SB103: 
Section 1, Subparagraph B is rewritten to include disaggregated data and length of employment. Other forms of information are struck from the original SB103. 
“B.  By March 1, 2026, and annually thereafter, each personal care service provider agency shall, in a form and manner prescribed by the authority, submit data on the direct care workers providing agency-based community benefits at the personal care service provider agency.  The data shall include information on the: (1)  total number of full-time and part-time direct care workers employed at the personal care service provider agency; (2)  disaggregated demographic information on direct care workers employed at the personal care service provider agency that includes: (a)  age; (b)  gender; and (c)  race and ethnicity; (3)  highest, lowest and average hourly wage paid to direct care workers employed at the personal care service provider agency; (4)  average length of employment for direct care workers employed at the personal care service provider agency; (5)  vacancy and turnover rates for direct care workers employed at the personal care service provider agency; and (6)  availability and type of benefits provided by the personal care service provider agency to direct care workers. “
Section 1, Subparagraph C is rewritten to include new measures 3 thru 4 to include shortage of workers and demographic information through the self-directed community benefit program. 
C.  “By March 1, 2026, and annually the wage of direct care workers providing personal care services through the self-directed community benefit program; (3)  the percentage of eligible medicaid recipients enrolled in the self-directed community benefit program who are unable to receive services due to a shortage of direct care workers; and (4)  disaggregated demographic information on the direct care workers providing personal care services through the self-directed community benefit program that includes: (a)  age; (b)  gender; and (c)  race and ethnicity.”
Measures are rewritten to evaluate the Recommended reimbursement rates from the cost study and shall include consideration of the following factors:
Section 1, Subparagraph E., “(1)  federal requirements related to payment adequacy; (2)  the additional costs that would be incurred by personal care service provider agencies if direct care workers employed by personal care service provider agencies were to be paid at least one hundred fifty percent of the state minimum wage; (3)  recent and projected changes in costs due to factors that include direct and indirect costs, inflation and changes in the applicable minimum wage; and (4)  direct care worker vacancies that affect personal care service provider agency costs.”