A shift from public to private oversight to relieve headaches for the state has caused pay delays for some caregivers.
The state has given a private company administrative control of Medicaid caregivers, but the hand-off has left some without pay for weeks, including two caregivers who spoke with The News Tribune. The caregivers' union filed a grievance against the new employer last month.
Washington State Department of Social and Health Services' Home and Community Services Director Bea Rector confirmed that there have been paycheck holdups.
"We all have a very high priority that we want them to get paid. We want them to get paid timely, and we want their pay to be accurate," she said. "Anybody who doesn't get paid the right amount on time, that's a big deal."
Washington's DSHS oversees more than 48,000 "individual provider" caregivers statewide. A person with Medicaid in need of at-home care hires an individual provider. The state pays for and oversees the caregiver, but due to overwhelmed staff, the state moved these employers to a contracted employer in early March.
In 2019, the state agreed to a nine-year, $572 million contract with Consumer Direct Care Network to become the employer of the independent provider caregivers. After years creating the Washington branch, the company now handles all employment, payroll and administrative functions of managing this workforce.
Most caretakers are getting paid timely and accurately after a few-weeks delay, Rector said, but there have been hiccups in moving tens of thousands of caregivers under Consumer Direct Washington.
Consumer Direct Washington told The News Tribune that staff is addressing payment concerns for new employees as soon as possible.
"Anytime CDWA is made aware of one of these discrepancies, it is immediately addressed and rectified," the company said in a statement.
The caregiver's union said members have faced difficulties with their paychecks during the transition. While Consumer Direct Washington has been responsive to complaints, SEIU 775's Interim Communications Director Allison Tabiando said the sheer volume of people moving under their system has caused some delays.
"Our union has filed a grievance on behalf of those affected, and we are working to ensure that caregivers not only get the pay they earned, but are also made whole for any late fees or other additional financial burdens they incurred as a result of late or incorrect pay," she said.
The state transferred its oversight of these caregivers because staff struggled to meet the demands of both the clients and caregivers.
State case managers were overwhelmed with assessing the needs of clients while also overseeing the homecare workers, Rector said.
"As our workforce has gotten more diverse and sophisticated and large, it has taken more and more time for case managers to manage that workforce so that clients have access to care," she said. "They have less time to deal with really complex chronic conditions and social economic needs of the client."
Consumer Direct Washington's spokesperson Coco Ballew said the company is in the middle of "an unprecedented transition" as an entirely new social services program with new systems, new processes and new administrative support.
"We understand the frustration of our new employees when they are affected by these discrepancies and we offer our sincere apologies," CDWA said.
Other states have seen payment concerns with the CDWA's parent company, Consumer Direct Care Network.
A Virginia caregiver told a local news station in 2019 that the company had not paid her for months. Ballew said the problems in Virginia were due to similar transition issues and payroll concerns for the caregiver mentioned were quickly resolved.
"In the case in Virginia, CDCN was transitioning from one payroll provider to another which required accurate data from the previous provider to ensure a smooth transition," Ballew said.
Asked if the state knew about payout concerns in other states, Rector said the company was one of two bidding companies for the state contract and the only one with successful contract negotiations.
"We have found this contractor to be extremely responsive. They are problem solvers," Rector said.
Consumer Direct Washington won't oversee all individual providers.
King and Pierce County providers were included in the first wave of transfers to Consumer Direct Washington, but language barriers and paperwork held some back.
The state estimates that about 9,000 of the 48,000 will continue to be employed by the state, due to hiring discrepancies for Consumer Direct Washington.
"The mass sheer numbers of people that are in that hiring process, and and can get stuck at different points in that hiring process," Rector said.
Rector believes any payment problems individual providers have will be resolved in the coming weeks. Those still facing difficulties have been asked to contact firstname.lastname@example.org.