A First-in-Nation Program
Simplify Your Home Care Operations
CareCade helps DDA and HCBS providers manage scheduling, EVV, and billing in one platform.
On July 1, 2026, Washington becomes the first state in America to offer universal long-term care insurance through the WA Cares Fund. After years of planning and a pilot program in four counties, benefits will be available statewide.
For families navigating developmental disabilities services, this represents a significant new resource. For agencies, it's a new payment stream to understand.
How WA Cares Works
The Benefit
Qualified workers can access up to $36,500 (adjusted for inflation over time) to pay for long-term care services when they need assistance with three or more activities of daily living.
According to DSHS, the benefit can cover:
- Home care aides - Professional caregivers in your home
- Family caregivers - Including spouses and other relatives
- Home modifications - Ramps, grab bars, accessibility improvements
- Meals and transportation - Support services that enable independent living
- Residential care - When home-based care isn't sufficient
Who Qualifies
Most Washington workers earn access by contributing to the fund through payroll deductions (0.58% of wages). You qualify for benefits when you:
- Have contributed for the required period (typically 10 years, with faster pathways available)
- Need assistance with three or more activities of daily living
- Apply and are approved through the WA Cares process
The Commonwealth Fund calls it "full speed ahead" for what could become a model for the nation.
Why This Matters for Home Care
The Long-Term Care Crisis
The numbers are staggering:
- $5 trillion - Annual US healthcare spending, roughly 18% of GDP
- 90% of those costs go to chronic and mental health conditions
- 53 million Americans provide unpaid family care worth $870 billion annually
- Most Americans have no long-term care insurance
According to PwC's Future of Health report, healthcare is shifting from hospital-centric to home-based models. WA Cares accelerates this transition by funding care where people actually live.
Filling the Gap
Medicare doesn't cover long-term care. Medicaid requires spending down assets. Private long-term care insurance is expensive and often unavailable.
WA Cares fills this gap for Washington's working families—providing a benefit that's:
- Universal - Available to all qualifying workers
- Portable - Stays with you regardless of employer
- Flexible - Covers multiple types of care
- Affordable - Funded through modest payroll contributions
What Families Need to Know
If You're Already Receiving DDCS Services
WA Cares benefits are separate from and in addition to Medicaid waiver services. If your family member receives services through IFS, Basic Plus, Core, or other DDA waivers, WA Cares could provide supplemental support.
Potential uses:
- Additional respite hours beyond waiver limits
- Home modifications not covered by your waiver
- Transportation for activities outside service plans
- Paying a family member to provide supplemental care
Paying Family Caregivers
One of the most significant provisions: WA Cares allows you to pay qualified family members to provide care, including spouses.
This recognizes what AARP research has documented: 63 million Americans already provide unpaid care. WA Cares lets some of that care become compensated.
Requirements for family caregiver payments:
- The family member must meet program qualifications
- Care must be documented appropriately
- Services must align with the beneficiary's care needs
The Application Process
Starting January 2026, the pilot program began accepting applications in Lewis, Mason, Spokane, and Thurston counties. Statewide applications open July 1, 2026.
To apply:
- Verify your contribution history at wacaresfund.wa.gov
- Gather documentation of your care needs
- Submit your application through the WA Cares portal
- Complete the assessment process
- Receive your benefit determination
What Agencies Need to Know
A New Payment Source
WA Cares represents a new revenue stream for home care agencies. Families with WA Cares benefits may:
- Supplement Medicaid-funded hours with WA Cares payments
- Pay for services not covered by their waiver
- Choose your agency for private-pay services funded by WA Cares
Documentation Requirements
While WA Cares is more flexible than Medicaid, agencies accepting these payments should still maintain:
- Clear records of services provided
- Documentation of caregiver qualifications
- Verification of visit times and activities
Agencies using modern EVV and documentation systems will be well-positioned to serve WA Cares beneficiaries.
Pricing Considerations
WA Cares pays directly to beneficiaries, who then pay providers. This is different from Medicaid's agency-to-state billing model.
Consider:
- Your private-pay rate structure
- How to communicate pricing to families
- Payment collection processes for this new payer type
Recent Changes Under Senate Bill 5291
Senate Bill 5291, signed May 2025, made significant improvements:
Rejoining the Program
Workers who previously opted out with private insurance can rejoin before July 1, 2028. This provides a second chance for those who may have underestimated their future care needs.
Supplemental Insurance
A new framework allows private insurers to offer policies that complement WA Cares benefits. Families wanting coverage beyond $36,500 now have coordinated options.
Simplified Qualification
The previous requirement for five consecutive years of contributions within a ten-year period has been removed, making qualification more straightforward.
Out-of-State Portability
Starting July 2026, workers who relocate outside Washington can elect to continue participation. Benefits become accessible outside Washington starting July 2030.
Seven States Are Watching
According to NPR, seven other states—including California and New York—are considering similar programs.
Washington is the proving ground. How WA Cares performs will influence whether public long-term care insurance becomes a national model.
The Bigger Picture
PwC projects a $1 trillion shift in healthcare spending by 2035, moving from:
- Hospital-centric care → Home-based care
- Episodic treatment → Continuous support
- Administrative overhead → Direct care delivery
WA Cares aligns with this transformation. By funding care in homes and communities rather than institutions, Washington is betting on the future of healthcare delivery.
How CareCade Supports WA Cares Families
Whether you're receiving Medicaid services, using WA Cares benefits, or both, CareCade provides the visibility families need:
Track All Care in One Place
The Family Portal shows you:
- When caregivers arrive and depart (verified)
- What activities occurred during visits
- Progress on care goals over time
- Communication from your care team
This works regardless of how care is funded—Medicaid, WA Cares, or private pay.
Documentation for Any Payer
CareCade's documentation tools help agencies serve families across payment sources:
- GPS-verified visits satisfy any payer's verification needs
- Activity logs document what services were provided
- Reports can be generated for WA Cares, Medicaid, or family records
Peace of Mind
The question every family asks—Is my loved one getting good care?—doesn't change based on who's paying.
CareCade answers that question with verification, documentation, and transparency. Whether your care is funded by Medicaid, WA Cares, or your own resources, you deserve to know.
Action Steps
For Families
- Check your eligibility at wacaresfund.wa.gov
- Understand your current benefits - Know what your DDA waiver covers and where gaps exist
- Consider family caregiver options - Could a family member provide supplemental care?
- Plan your application - Gather documentation of care needs before applying
For Agencies
- Understand the benefit structure - Know what WA Cares covers and how payments work
- Prepare your private-pay processes - Ensure you can accept payments from WA Cares beneficiaries
- Train staff on documentation - Even flexible payers appreciate clear records
- Communicate with families - Help them understand how WA Cares can supplement their care
Looking Ahead
WA Cares launches into a challenging environment—Medicaid cuts, budget pressures, and a caregiver shortage affecting every state.
But it also represents hope. A recognition that long-term care is a universal need. A commitment to funding care in homes and communities. A model that other states are watching.
July 2026 marks a new chapter for Washington families. Be ready.