This act creates a temporary statutory section directing the Health Care Authority (HCA) to seek federal Centers for Medicare and Medicaid Services (CMS) consultation by December 1, 2025, for a state plan amendment (SPA). The SPA would, if approved by CMS, allow Medicaid payment to a home health agency for specified complex care services as part of the private duty nursing benefit for enrollees under age 18, when all listed conditions are met: the caregiver is a parent, guardian, family member, or similar close relation; the caregiver has completed at least 75 hours of instruction offered by an accredited home health agency and has been determined competent to provide the complex care services; the caregiver is educated and trained by a registered nurse licensed under chapter 18.79 RCW; and the caregiver is employed by a home health agency licensed under chapter 70.126 RCW that has a provider agreement with HCA or a managed care organization. The act requires HCA to report to the Legislature’s appropriate policy and fiscal committees by January 1, 2026 on the feasibility of obtaining the SPA and specifies that the new section expires December 31, 2026. This is a procedural change seeking federal approval to expand who may be paid for certain Medicaid private duty nursing services under chapter 74.09 RCW; it does not create a new crime or change penalties. The text does not define “complex care services,” how “determined to be competent” is assessed, which accrediting organizations are recognized, or any payment rates or detailed implementation procedures.

If enacted, the Health Care Authority will be required to pursue federal approval to allow Medicaid payments to home health agencies when a child’s family member who has completed at least 75 hours of agency-led instruction, been trained by a licensed nurse, and is employed by a licensed home health agency provides complex care. Practically, this could open a path for families of children under 18 who now receive private duty nursing to be hired through agencies and for agencies to bill Medicaid for that care, but it only happens if CMS approves the state plan amendment and the program details (rates, what counts as “complex care,” and competency standards) are later defined. The groups most affected are families of children on the medical assistance private duty nursing benefit, home health agencies, registered nurses who would provide the training, managed care organizations, and the HCA. Agencies would likely need to develop or expand training and employment processes and secure accreditation and provider agreements to participate, which could raise costs and administrative work; they could also gain new billing revenue if approved. HCA must seek CMS consultation by December 1, 2025 and report on feasibility to the Legislature by January 1, 2026, but key details about payments, definitions, accrediting bodies, and competency assessment are not provided here, and the section expires December 31, 2026.