A WAAFHA Call for Sensible Regulation, Provider Accountability, and Faster Inspections.
KEY TAKEAWAY: Washington is experiencing a growing need for safe, community-based long-term care. Adult family homes are uniquely positioned to meet that need, but unnecessary regulatory barriers prevent many qualified providers from serving two additional residents.
Thousands of older adults and people with disabilities want to live in real homes—not large institutions. Washington law already permits an adult family home to care for as many as eight residents with approval from the Department of Social and Health Services (DSHS).
However, providers seeking approval for a seventh or eighth resident must satisfy numerous conditions, including operating-history requirements, prior inspections, financial and management reviews, sprinkler requirements, an additional inspection, and other approval steps (RCW 70.128.066).
WAAFHA believes Washington should preserve essential health and safety standards while simplifying and accelerating the process for qualified providers to operate eight-bed homes.
Two More Beds Can Make a Significant Difference
Permitting a qualified adult family home to serve eight residents instead of six would increase access to care without requiring the construction of a new institutional facility. Those two additional beds could:
- Provide placements for people waiting in hospitals because appropriate residential care is unavailable.
- Help families keep loved ones closer to their communities.
- Expand Medicaid capacity in areas experiencing placement shortages.
- Help providers absorb rising expenses for wages, food, insurance, utilities, training, and regulatory compliance.
- Strengthen the financial stability of small residential-care businesses.
- Create additional caregiving jobs.
An eight-resident home remains fundamentally different from a large assisted-living facility or nursing home. It can still provide the personal relationships, familiar surroundings, home-cooked meals, and individualized attention that make the adult family home model successful.
Washington Should Replace Delay With a Risk-Based System
The state should not compromise resident safety. But protecting residents does not require treating every provider as if the provider presents the same level of risk.
Providers with strong compliance histories should be eligible for a streamlined eight-bed approval process. The state could establish objective qualifications, including:
- A satisfactory compliance record.
- Adequate staffing for the residents’ assessed needs.
- Successful emergency-evacuation demonstrations.
- Proper fire protection and working safety equipment.
- Sufficient bedroom, bathroom, dining, and common areas.
- Written confirmation that the home can meet each resident’s needs.
- Disclosure and advance notice to current residents and their representatives.
Once those requirements are documented, DSHS should be required to approve or deny the application within a clearly defined period.
The current law already recognizes risk-based oversight to some extent. Licensed homes are generally inspected at least every 18 months, with an annual statewide average of 15 months. A home with three consecutive citation-free inspections and no qualifying complaint violations may be permitted to go as long as two years without a full inspection (RCW 70.128.050). Washington should build upon that principle.
Self-Reporting Can Reduce Backlogs Without Eliminating Oversight
WAAFHA supports a structured self-reporting program for established providers with demonstrated records of compliance. Self-reporting should supplement—not eliminate—state oversight.
Qualified providers could submit periodic electronic safety certifications covering matters such as:
- Smoke and carbon-monoxide alarms.
- Fire extinguishers and sprinkler system servicing.
- Emergency lighting and accessible exit routes.
- Fire drills and evacuation records.
- Medication-storage procedures.
- Caregiver credentials and required training.
- Background-check compliance.
- Resident-assessment and negotiated-care-plan reviews.
- Required maintenance and correction of known hazards.
Providers could be required to upload dated photographs, service certificates, drill logs, training records, and signed attestations. False reporting should carry meaningful penalties, including fines, loss of self-reporting eligibility, restrictions on admissions, or license action.
DSHS would retain authority to conduct random audits, investigate complaints, inspect homes with compliance concerns, and enter a home immediately when resident health or safety may be at risk. This approach would allow inspectors to devote more time to:
- Homes with serious or repeated violations.
- Complaints involving abuse, neglect, exploitation, or unsafe care.
- New providers who need closer oversight.
- Homes undergoing significant operational changes.
- Situations involving an immediate threat to residents.
Responsible providers should not be trapped in an inspection backlog when their documentation and compliance history demonstrate that they are operating safely.
Senator Pedersen’s Openness Is Encouraging
During a recent meeting with WAAFHA, Senator Jamie Pedersen signaled that he may be open to supporting reforms that would allow qualified adult family homes to serve eight residents and reduce unnecessary regulatory barriers.
WAAFHA welcomes that openness and looks forward to working with Senator Pedersen and other legislators on a carefully designed proposal. His willingness to listen is an important first step, although it should not be characterized as a formal endorsement unless and until he publicly supports specific legislation.
This should not be a partisan issue. Expanding access to responsible, home-based care benefits residents, families, hospitals, taxpayers, caregivers, and communities throughout Washington.
A Responsible Legislative Proposal
WAAFHA urges the Legislature to consider legislation that would:
- Make eight residents the standard maximum capacity for homes meeting clearly defined safety, space, staffing, and evacuation requirements.
- Establish a firm deadline for DSHS to approve or deny a complete capacity-increase application.
- Permit experienced providers with strong compliance records to use verified self-reporting for routine safety requirements.
- Authorize remote or virtual verification when an on-site visit is unnecessary.
- Maintain random audits and immediate inspections based on complaints or safety concerns.
- Impose serious consequences for false certifications or concealed violations.
- Require DSHS to publish information concerning pending applications, inspection delays, and average processing times.
- Protect residents by requiring appropriate staffing and individualized care based on residents’ assessed needs—not merely the number of licensed beds.
Regulation Should Protect Residents, Not Obstruct Responsible Care
The choice is not between regulation and safety. The real question is whether Washington can regulate more intelligently.
A well-designed eight-bed and self-reporting system would maintain strong safety protections while increasing care capacity, reducing administrative delays, and rewarding providers who consistently comply with the law.
Adult family home providers are not asking the state to abandon oversight. They are asking for a system that recognizes experience, rewards compliance, uses technology, and directs limited inspection resources toward the homes presenting the greatest risk.
Washington’s vulnerable adults need more safe homes. Qualified providers are prepared to serve them. The Legislature should remove unnecessary obstacles and allow responsible adult family homes to become part of the solution.
Washington Association of Adult Family Home Providers (WAAFHA)
Provider-centered and resident-conscious.