As a provider of home health or adult-day care services in Washington state, you’re operating in a landscape that is about to shift. The state’s public long-term care insurance program, the WA Cares Fund, is now entering a phase that has direct implications for your agency’s funding, client eligibility and service delivery. In this blog, we will walk through what’s changing, what it means for your agency, and what steps you should take now to stay ahead.
What’s Changing: The WA Cares Fund & Related Developments
Here are the key points you need to know:
- The WA Cares Fund was created by Washington’s legislature under the Long-Term Services & Supports Trust Act. It asks workers in the state to contribute via a 0.58% payroll deduction, beginning July 2023, in order to earn access to a lifetime benefit when they need long-term care.
- Benefits from the Fund become accessible starting July 1, 2026 for eligible workers who meet contribution and eligibility criteria.
- Recent legislative changes expand the program’s flexibility: workers who had private LTC (long-term care) insurance exemptions may now opt into WA Cares; the 10-year contribution rule has been simplified so that people who leave the workforce for a time aren’t penalised as harshly.
- One upcoming ballot measure Senate Joint Resolution 8201 will ask voters whether the Fund should be allowed to invest in equities (stocks) to improve returns.
In short: Washington is making its home- and community-based care funding model more robust. But that also means agencies must be ready for shifts in eligibility, reimbursement, service demand and compliance.
Why This Matters to Home Care & Adult Day Care Agencies
Here are the practical implications for your business:
1. Eligibility & Demand May Change
With WA Cares making more benefits available (and with eligibility tweaks), you may see an uptick in clients who are funded through this program, especially in home-based settings or adult-day services. That could translate into more demand — but also more competition.
Additionally, clients may have access to larger benefit pools for services like home modifications, respite, and adult‐day care via the Fund.
2. Funding & Reimbursement Landscape
When clients rely on state-backed funds (or programs linked to them), your agency must ensure billing, documentation and service delivery are aligned with program requirements. Mistakes can lead to claim denials or delays. The tweaks to WA Cares (for example, allowing supplemental private LTC insurance) may influence clients’ funding mix.
3. Compliance, Documentation & Service-Plan Readiness
Given the state-driven nature of this Fund, regulatory requirements will matter. Agencies offering adult-day programs must comply with Washington’s WAC 388-71 standard for adult-day services. For home care, service plans, documentation, caregiver credentials and staff scheduling become more critical as funding sources diversify.
Being able to generate audit-ready documentation is a competitive advantage.
4. Strategic Positioning: Growth Opportunity
Change always brings opportunity. Agencies that position themselves early as “WA Cares-ready” (meaning able to serve clients funded through the WA Cares Fund, maintain high documentation standards, and deliver outcome-oriented services) may stand out in marketing and referral networks.
Marketing your agency’s readiness (for example: “We accept WA Cares Fund clients”, “We specialise in adult-day care using WA Fund benefits”, etc.) can help drive growth.
What Your Agency Should Do Now
Here’s a checklist to ensure your agency is ready:
- Review your current client funding mix: How many clients currently rely on state funds, private pay, Medicaid, etc.? What changes might arise if WA Cares-funded clients increase?
- Update your contracts, service plans and documentation templates: Make sure your service-plans, care-goals, staffing records and compliance documentation are robust.
- Train your staff on WA Cares fundamentals: Ensure your intake, billing and care teams understand the WA Cares Fund: eligibility, benefit limits, provider network requirements.
- Audit your scheduling and staffing model: If demand increases, are you ready with enough qualified caregivers or adult-day staff? Are your staff credentials, training and ratios compliant with WAC 388-71 and other applicable rules?
- Position your agency in the market: Update your website, marketing materials and referral outreach to reflect that you are WA Cares-ready. Highlight your experience with home-based services, adult-day care, documentation excellence and compliance.
- Use technology to support readiness: Software like home health care software & Adult day care software that help you manage care-plans, scheduling, billing, documentation, and compliance will be a major advantage for your agency. For example, a system like myEZcare can streamline all of these tasks.
- Monitor legislative and ballot developments: Keep an eye on the SJR 8201 vote, regulatory guidance from the Washington State Department of Social and Health Services (DSHS) and updates to the WA Cares program. These could bring further changes.
Why Readiness Matters for Your Bottom Line
When a funding model changes, agencies that are ready will capture more of the opportunity; those that lag may face operational risks — such as claim delays, staffing shortages or client churn. By being proactive, your agency not only protects itself but also positions for growth in a competitive Washington market.
Final Thoughts
Washington’s long-term care funding environment is evolving, and your agency has a clear choice: treat this as a passive trend or see it as an opportunity. By taking strategic action now refining your systems, training your staff, updating your marketing, and embracing technology you can be one of the agencies that thrives in the new era.
The clients you serve deserve reliable, modern, compliant care. You deserve a sustainable and growing business. Being WA Cares-ready is a win-win.
