Notes from the Private Duty Advisory Council

NAHC’s Private Duty Advisory Council monthly meeting this week, featuring an update on NAHC’s advocacy efforts as well as potential policies being monitored from Co-chair Brittnei Salerno of La Jolla Nurses Homecare and Executive Director of Private Duty at NAHC Kristen Wheeler. Legislation being watched by the NAHC Advocacy Team includes:

NAHC President William A. Dombi reminded the group that these bills will need to be reintroduced next year for the new Congress. We are very unlikely to see any movement on this legislation during the lame duck session of the current Congress.

Council Co-Chair Brittnei Salerno of La Jolla Nurses Homecare and Private Duty Executive Director Kristen Wheeler shared updates on these items, as well as a regulatory update that may potentially affect providers in the Southeast United States. The US Department of Labor (DOL) announced a new initiative to better enforce violations of the Fair Labor Standards Act (FLSA). The campaign aims to improve compliance in Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

“The US DOL is determined to ensure these workers are not denied any of their hard-earned wages. Our current initiative combines compliance assistance and enforcement to decrease violations by employers in the care industries,” said DOL’s Wage & Hour Division Regional Administrator Juan Coria. The initiative will focus on resources to educate care workers in the industry along with targeting the misclassification of workers as independent contractors. A public webinar hosted by the DOL on Thursday, November 17, 2022, will review the protections for care workers so that employers and workers alike will understand their rights and responsibilities currently protected by the FLSA. The states being targeted are a result of division investigators identifying violations in nearly 89 percent of investigations completed in home and nursing care completed between 2020 and 2022.

During the state share portion of the meeting, the Council discussed the recently passed $15 minimum wage for Medicaid direct service providers in Florida. Council member Maxine Hochhauser of LHC Group told the group that the Medicaid fee schedule increase simply does not cover the cost of providing services. Expectations are that many Medicaid recipients will no longer have access to care unless the reimbursement rates are increased. The Home Care Association of Florida has joined the Florida Assisted Living Association and the Florida Ambulance Association in challenging the state’s Agency for Healthcare Administration on this requirement, maintaining that the agency did not use a proper rule-making process to define “direct care” workers who would be affected by the wage change. Further information will be shared as it becomes available.

Council members that sit on various workgroups of the Home Care Action Alliance updated the group on the efforts of those groups. Meetings are in their final stages and Project Manager Pat Kelleher is compiling recommendations of the groups. An early December release of these recommendations and action items is on track.

NAHC’s Private Duty Summit is expected to come to fruition in 2023 as a “conference within a conference” at the Annual Conference & Expo in October. The summit will feature robust educational sessions and will be individually branded to ensure attendees understand the separation. However, attendees will also be allowed access to the keynote general sessions as well as the lively trade show hall.

Bill Dombi rounded out the meeting with an update on what’s happening on Capitol Hill with home care legislation.

Interested in being a part of the Private Duty Advisory Council in 2023? Let us know!

Notes from the Private Duty Advisory Council

NAHC’s Private Duty Advisory Council monthly meeting, on Wednesday, September 21,  featured an update on NAHC’s advocacy efforts as well as potential policies being monitored from Co-chair Brittnei Salerno of La Jolla Nurses Homecare and Executive Director of Private Duty at NAHC Kristen Wheeler. Included among those are:

  1. S. 2210 /HR 4131Better Care Better Jobs Act
  2. HR 2898Home Care Services for Seniors Act
  3. HR 2954Enhancing American Retirement Act
  4. HR 4826Domestic Workers Bill of Rights
  5. HR 6000CURES 2.0 Act
  6. S. 2562Choose Home Care Act of 2021
  7. HR 5094Nursing Home Workforce Support and Expansion Act of 2021
  8. HR 1909Citizenship for Essential Workers Act

Council member Jeff Salter of Caring Senior Service shared his experience at last week’s Advocacy Day on Capitol Hill. NAHC hosted well over of 80 attendees representing 27 states that met in person and virtually with over 150 individual congressional meetings. Further Council discussion included NAHC’s collaborative efforts on the Home Care Workforce Action Alliance, which launches meetings of the four individual workgroups focused on home care aides and nurses next week, as well as NAHC’s upcoming Annual Conference & Expo.

Notes from the Private Duty Advisory Council

A meeting earlier this week of the Private Duty Home Care at NAHC Advisory Council produced some interesting discussion on a variety of topics. Below is a brief summary of the discussion.

Legislation & Regulation

  • HR 2898Home Care Services for Seniors Act, NAHC has been involved since the beginning (September 2018). This would allow people to use funds in their Health Savings Accounts to pay for home care. In May of this year, the Joint Committee on Taxation released an estimated cost of $202 million over 10 years. NAHC has and continues to support the passage of this bill. Take action now!
  • HR 2954Enhancing American Retirement Act or “Securing a Strong Retirement Act of 2022”. Introduced in May 2021 and would allow people to use their IRA to pay for long-term care insurance premiums.
  • Department of Labor New Independent Contractor Rule – The Initial Final Rule was withdrawn in May 2021 and, in June 2022, the DOL announced its intention to release a new proposed rule. We do not know when that proposed new rule will be released, but we will update you when more information becomes available.


  • The Home Care Workforce Action Alliance is meeting in DC on August 3rd with key NAHC staff involved (I’ll be there!). More information to follow but we expect a call for volunteers willing to work with one of the Alliance’s subgroups.