What is the fate of home care in Washington? That question is on the minds of home care advocates as lawmakers continue to wrestle over the fate of the so-called Build Back Better package.

While it seems that the portion slated for home- and community-based services appears to be intact, how much will go to Medicaid HCBS, the extent it will help family caregivers and what it will do for caregivers’ pay remain to be seen.

One objective the legislation has achieved, as we have written about, is to raise the profile of the field. Whoever would have thought that home care would make up a significant portion of a domestic legislation package?

There is a lot of muscle behind this package, including one organization whose sheer existence likely gives home care agency owners some indigestion. The Service Employees Union has been advocating hard for the bill that would raise Medicaid reimbursements to states, which would, in turn, increase workers’ wages.

Mary Kay Henry, the president of the SEIU, expressed the importance of the legislation this week to Diane Eastabrook, staff writer of McKnight’s Home Care Daily Pulse:

“The biggest number possible allows us a once-in-a-generation chance to meet the moment of crisis that working people are in and invest in the first ever targeted jobs program that puts women of color and all women at the center of recovery where these women have been the hardest hit by the pandemic,” Henry said.

Of course, Henry is also capitalizing on this moment in history, as the pandemic has taken a major toll on working people, to achieve another big win: organizing the field.

“People decide enough is enough. I deserve better,” she said.

How should home care agency owners feel about Henry’s unabashed enthusiasm to organize home care? They could take it as a shot across the bow – or as a challenge to do right by employees.  

It’s a complicated set of circumstances. The SEIU both supports raising workers’ wages through Medicaid increases — which is hard to argue with — but also potentially forcing home care agencies, many of whom are already cash-strapped, to pay out higher wages and more benefits.

As the saying goes, politics makes strange bedfellows.

Liza Berger is editor of McKnight’s Home Care. Email her at [email protected]. Follow her @LizaBerger19.