Washington State’s Consumer Directed Employer Model  

The Washington State Department of Social and Health Services recently completed a multi-year project that created a co-employment relationship between in-home care clients as the managing employer and a Consumer Directed Employer (CDE) as the legal employer. In-home personal care and respite services are authorized for clients by the Washington State Department of Social and Health Services’ (DSHS) Aging and Long-Term Support Administration and Developmental Disabilities Administration. These services are performed by approximately 48,000 individual providers. Prior to this project, separate providers were individually contracted with DSHS or the local area agencies on aging.

The move to a Consumer Directed Employer model shifted the employment-related activities that DSHS was engaging in for individual providers to the new employer. This move helped DSHS realize the goal of increasing the capacity of case management, customer service, and other social services staff to focus on core case management activities.

The change also streamlined the process for providers. It provided them with one source for questions and support related to employment, payroll, and monitoring the timely completion of their required background checks and training requirements.  Service recipients continue to select, schedule, manage and dismiss their care providers.

The change began with a pilot in fall 2021, followed by a two-phase rollout in early 2022. Full implementation was completed by May 31, 2022.

In preparation for this change, DSHS planned and implemented an organizational change strategy that included a large-scale communication and readiness plan including, but not limited to:

· Regular input from a strategic development group consisting of people currently receiving in-home care, individual providers, stakeholders, and the public;

· Consultation with tribal governments;

· Informational materials sent via email and by the U.S. Postal Service;

· Messaging and handouts offered by case managers and contracts staff;

· Monthly webinars; and,

· DSHS project team participation in various conferences and summits.

Through a competitive procurement and negotiation process, Consumer Direct Care Network of Washington (CDWA) was selected and contracted with DSHS to serve as the CDE. As part of the Consumer Direct Care Network currently active in 15 states across the country, CDWA draws on more than 30 years of experience supporting innovative home care for individuals, families, and caregivers.