Washington’s adult family home providers deserve bargaining leadership that is aggressive, transparent, legally prepared and controlled by providers.

By Nathaniel Manny Ballantyne
Director of Community Outreach, Washington Association of Adult Family Home Providers (WAAFHA)

SIX THOUSAND PROVIDERS. ONE STATEWIDE VOICE.
PROVIDER-LED. PROVIDER-CONTROLLED. PROVIDER-STRONG.

Representation Must Be Earned

For too long, Washington’s adult family home providers have been told that the Adult Family Home Council speaks for them. But representation is not merely a title. It is a responsibility, and the Council’s performance must be judged by results. Washington has approximately 6,000 adult family home providers. These providers operate small businesses, employ caregivers, prepare meals, administer medications, manage emergencies, comply with extensive regulations, and care for some of the state’s most vulnerable residents 24 hours a day.

Yet providers continue to struggle with inadequate Medicaid reimbursement, delayed managed-care payments, rising labor costs, caregiver overtime liability, regulatory burdens, resident nonpayment, and limited access to legal representation. If the Council has held exclusive bargaining power for years, why are providers still fighting so many of the same battles? The time has come for WAAFHA to become the new exclusive bargaining representative.

Exclusive Power Demands Accountability

Under Washington law, Medicaid-participating adult family home providers form one statewide bargaining unit. The exclusive representative negotiates with the governor over economic compensation, reimbursement, health and welfare benefits, training, labor-management committees, grievance procedures, and other economic matters. That is enormous power. The exclusive representative occupies the only official seat across the bargaining table from the state. It therefore has a duty to be aggressive, transparent, accessible and accountable to every provider whose economic future is being negotiated. In WAAFHA’s judgment, the Council has failed that test.

The Council Has Not Negotiated Strongly Enough

The current Medicaid reimbursement system remains disconnected from the actual cost of operating an adult family home. Providers must pay for caregivers around the clock, food, utilities, insurance, transportation, training, licensing, maintenance, supplies, bookkeeping and regulatory compliance. They also absorb overtime exposure, vacant beds and unpaid resident participation amounts.

The Council promotes the 2025–2027 agreement as a major accomplishment. Any real financial improvement should be acknowledged. But the proper measure of bargaining success is not the size of a press release or the total amount announced by the state. The real measure is whether an individual provider can pay caregivers fairly, maintain the home, comply with state mandates and remain financially sustainable. Too many providers say the answer is still no.

The state will always arrive at bargaining concerned about its budget. The providers’ representative must arrive concerned about the survival of adult family homes. Providers do not need a representative that merely reports what the state is prepared to give. They need one that fights for what care actually costs.

The Failure to Intervene in Bolina Was Unacceptable

WAAFHA believes the Council’s failure to intervene or otherwise take a sufficiently visible and forceful role in the Bolina litigation is one of the clearest examples of inadequate representation.

That litigation raised issues with potentially enormous consequences for adult family homes, particularly regarding caregiver compensation and overtime liability. When a case threatens the operating model of an entire industry, the exclusive representative should retain experienced counsel, seek intervention or amicus participation where legally appropriate, educate the court about how adult family homes operate, and explain the consequences for providers, caregivers and residents.

Even if intervention might ultimately be denied, providers should see a timely, public and coordinated legal strategy. A bargaining organization cannot wait until precedent is established and then merely explain what the decision means. Representation requires appearing while the law is being made.

WAAFHA will not treat major litigation affecting providers as someone else’s problem. Providers need an organization prepared to lawyer up and defend the adult family home model before courts, agencies and the Legislature.

Silence Is Not Representation

An exclusive representative should maintain a constant relationship with the entire bargaining unit not merely with dues-paying members, insiders or conference attendees. Providers should receive bargaining reports, proposed priorities, explanations of state offers, financial analyses and meaningful opportunities to comment before major agreements are finalized.

Instead, many providers report that they hear little until decisions have already been made. They often learn about payment problems, legal developments and regulatory changes through informal provider groups. That is not meaningful statewide representation.

The Council’s own stated mission is to improve the lives and well-being of vulnerable adults through the support of adult family homes. Protecting vulnerable adults is honorable, but it is not identical to functioning as a provider-controlled bargaining organization. The Council can return its focus to that mission. Exclusive bargaining authority should be entrusted to an organization created, governed and controlled by providers.

Membership Claims Are Not Democratic Consent

Membership in a private organization is not the same as inclusion in the statewide bargaining unit. The bargaining unit includes eligible providers whether they voluntarily joined the Council. Exclusive status must not be treated as permanent approval from every provider covered by the agreement.

WAAHA estimates that fewer than one-third of the roughly 6,000 providers are active dues-paying Council members, although the Council publicly says it serves more than 2,500 homes. The decisive point is not competing promotional numbers: it is that the actual bargaining unit must be allowed to vote. Providers who are dissatisfied, disconnected or unaffiliated deserve an organized alternative. The Council’s position was never inevitable. It continued for years partly because providers were not presented with a serious statewide alternative. WAAFHA is that alternative.

WAAFHA Is Built and Led by Providers

WAAFHA’s central principle is straightforward: Nothing about providers without providers.

WAAFHA was established to represent adult family homeowners and operators. Its leadership understands what it means to care for residents, supervise caregivers, meet payroll, respond to DSHS, challenge citations and survive on inadequate reimbursement.

WAAFHA will build its bargaining platform through statewide surveys, regional meetings, open forums and provider voting. It will not ask providers to surrender their voices after signing a membership form.

What WAAFHA Will Fight For

• Medicaid rates based on the actual cost of delivering 24-hour care;
• Timely MCO payments with meaningful penalties for unreasonable delay;
• A fair solution to caregiver overtime liability;
• Compensation for extraordinary regulatory mandates;
• Enforceable remedies for unpaid resident participation amounts;
• Meaningful grievance and dispute procedures;
• Legal defense and rapid-response assistance;
• Greater transparency before and during negotiations;
• Stronger protections against arbitrary enforcement; and
• Direct regional communication with providers throughout Washington.

The 2027 Opportunity: Start Organizing Now

The current collective bargaining agreement runs through June 30, 2027. A valid agreement ordinarily creates a “contract bar,” so a change-of-representation petition must be filed during PERC’s statutory window. Under the rule applicable to this bargaining unit, that window is no more than 90 days and no fewer than 60 days before expiration.

If June 30, 2027 remains the controlling expiration date, the anticipated filing period is approximately April 1 through May 1, 2027, subject to confirmation by PERC. March 2027 is therefore a critical final mobilization period not the likely filing window. Providers must not wait until March or April to organize.

What Must Be Done

• Establish WAAFHA as a qualified bargaining organization: WAAFHA’s governing documents, provider control, financial systems and bargaining purpose must be ready for review.
• Secure individual authorization cards: At least 30% of the entire bargaining unit must support the petition. Cards must be individually signed and dated, clearly identify the desired representative, and be current when filed.
• Organize far beyond the minimum: Thirty percent opens the door; it does not guarantee victory. WAAFHA should seek visible support from a clear majority of eligible providers.
• File with PERC during the exact window: A properly prepared change-of-representation petition must be filed on time. Filing too early or too late could result in dismissal.
• Turn out the provider vote: Card-check certification is not available for adult family home providers. PERC must conduct an election, and providers must participate.
• Win certification and prepare to bargain: After providers choose WAAFHA and PERC certifies the result, WAAFHA must arrive ready with economic data, legal counsel, statewide priorities and a disciplined negotiating team.

This Is Not Division. It Is Democracy.

The Council may argue that challenging its authority divides providers. That argument should be rejected. An election is not an attack on collective bargaining; it is collective bargaining democracy in action. No organization owns the bargaining unit. No organization is entitled to permanent control merely because it has occupied the position for years. The authority belongs to providers, and Washington law gives them the power to choose.

The Council has had years to demonstrate what it can accomplish. Providers are entitled to examine the results and decide whether those results are good enough. WAAFHA’s answer is clear: they are not.

PROVIDERS MUST TAKE BACK THEIR VOICE: In 2027, providers must organize, sign authorization cards, vote and choose WAAFHA as their new exclusive bargaining representative.