The bill defines “agency with choice services” as personal care services for older adults, individuals with physical disabilities, and individuals with behavioral health needs that are provided under self-directed service delivery model of co-employment for direct support workers. The measure requires the Department of Human Services (DHS) and the Oregon Health Authority (OHA) to adopt rules for the licensing of organizations that provide agency with choice services and to contract with up to two agencies by January 1, 2026. The measure specifies requirements and responsibilities of licensed agencies, clients’ rights, employment conditions, reimbursement structures, and contract provisions.
HB 4129 would create a new homecare “option” by requiring the state to contract with private vendors to take over certain administrative aspects of the state’s Medicaid-funded homecare program. The SEIU-backed bill also includes provisions virtually guaranteeing these new entities would be unionized. By doing so, the new model — dubbed “agency with choice” — would provide a roundabout way for SEIU 503 to reshuffle homecare workers into the realm of private-sector labor law outside the protections of the Harris decision by the Supreme Court in 2014.
Stripping caregivers of their rights is bad enough, but HB 4129 will also come at a significant cost to taxpayers. The bill is awaiting fiscal analysis, but a similar version introduced last year was projected to cost over $388 million in just the first four years after passage. Is the enormous cost — not to mention the disruptions to client care caused by adding new entities into an already complex system — worth it just to allow one of the state’s biggest special interest groups to skirt a U.S. Supreme Court ruling and reach back into the pockets of in-home caregivers?
Why aren’t lawmakers ensuring that caregivers’ rights remain protected by the Harris decision under the new employment model?