April 15, 2024

This April, the Consumer Directed Employer Rate Setting Board is meeting to set the hourly Medicaid reimbursement rate for the Consumer Directed Employer (CDWA). The decisions made will directly affect the funding for wages and benefits for all home care workers in Washington. As we navigate the challenges of historically high inflation, it is crucial that this new Labor Rate reflects significant improvements for our next Union contract.

This year, we’re asking the Rate Setting Board to set a Labor Rate that allows home care workers to receive:

  • Wages of $25/hour
  • Continued affordable health care with reliable coverage so people don’t lose their health care if their hours drop one month
  • Meaningful increases to our retirement benefits
  • More paid time off, paid holidays, and mileage pay

This is the first step in the process that leads to bargaining. Just like with our current Union contract, the rate and funding increase still need legislative approval. Once the rate is agreed upon, our Union will start to negotiate a contract with CDWA on how to use that funding to improve wages and benefits. And then we’ll go to the legislature to approve the new funding.

This is a critical opportunity to ensure that our caregivers are supported as we provide essential services to our community.

Stay informed and engaged as we advocate for these necessary changes.

In Spring 2022, SEIU 775 caregivers and our Union participated in the newly established Rate Setting Board.

The Rate Setting Board, which is made up of 14 people including caregivers, SEIU 775, and advocates for seniors and people with disabilities, will set the hourly Medicaid reimbursement rate for the Consumer Direct Employer (CDE), effectively determining how much money will be allocated to caregivers for negotiating wages and benefits in our next union contract.

The CDE rate includes two parts:

  • The labor rate which can only be spent on wages and benefits for home care workers, and which also sets the parity rate for home care agencies
  • And the administrative rate, which is the payment to Consumer Direct (CDWA) for their administrative duties.

Just like with our current Union contract, the rate and funding increase still has to be approved by the legislature.

Learn more about the Rate Setting Board, who’s on the Board, and meeting information on DSHS’s website.

Why was the Rate Setting Board created?

In 2018 DSHS established a Consumer Directed Employer Program, making the CDE the legal employer for all IPs in WA with Consumer Direct (CDWA) taking on this program. Part of the implementation of the CDE program was the move to a Rate Setting Board, which was supported by caregivers.

The adoption of the Rate Setting Board means:

  1. Home care workers have a direct say over how much funding is provided to the Consumer Directed Employer for wages and benefits.
  2. The Board not only includes caregivers and our Union but also advocates for seniors and people with disabilities, giving our clients a voice as well.
  3. As part of the parity law, the Board will decide how much funding goes to agencies for bargaining as well.

When is this in effect?

The Rate Setting Board will meet in the Spring of 2022 to determine the first CDE rate. Once the rate is agreed upon, our Union will start to negotiate a contract with CDWA over how to use that funding to improve wages and benefits. And then we’ll go to the legislature to approve the new funding.

This process will repeat itself with the Board meeting every even year to vote on the CDE rate, which should align with our bargaining years.


After multiple meetings since March with caregivers sharing their stories and discussions between the Board members, the Board made a unanimous decision in August – and we have good news to report!

Because of all the work by members who testified, signed our petition, wrote handwritten letters to the Board, called the Governor’s office, and more, we won a significant increase in the labor rate!

This rate is what funds wages and benefits for IP home care workers, and for AP home care workers through parity. If approved by the legislature, the rate will be in effect July 1, 2023, through June 30, 2025. While we still need to bargain our Union contracts with CDWA and agencies, we’re expecting this rate increase to allow us to:

  • Make our temporary hazard pay wage increases permanent!
  • Win substantial wage increases above and beyond the current hazard pay wage rates!
  • Make significant improvements in health benefits, plus improvements to other benefits

Bargaining with CDWA will start this fall. And after that, the Washington State Legislature to has to approve the rate increase in early 2023 before we go to the bargaining table with all of our agencies. This means we need to make sure we elect legislators who support caregivers in the election this November!  

Our work cannot be done by just anyone, and it cannot be done for free. We will continue to fight for the pay, protections, and respect that we deserve – at the bargaining table for our Union contracts, in this year’s election, and in next year’s legislative session!