The Adult Family Home Council is pleased to welcome Visakha Som, MPA, as our new Education Coordinator. With more than 20 years of experience in training, quality improvement, and long-term care programs, Visakha brings a strong background in developing practical, provider-focused education and resources.

In her new role, she will lead AFHC conferences, webinars, trainings, and educational materials, working closely with providers, chapters, and state partners to ensure our education programs are timely, relevant, and responsive to the needs of adult family homes.

Visakha is passionate about turning complex regulations and requirements into clear, easy-to-use tools that help providers succeed. We are excited to have her on board and look forward to the new learning opportunities, resources, and support she will bring to the AFHC community.

CBHS Billing Corrections Underway

The Health Care Authority (HCA) is working with Managed Care Organizations (MCOs) and providers to correct certain Community Behavioral Health Support (CBHS) claims that may have been submitted with billing errors. Identified issues include provider taxonomy information and atypical provider identifiers.

Affected Adult Family Homes will be contacted directly by their MCO with instructions on any required corrections. This may include completing an attestation form or taking other steps to ensure claims are processed correctly.

Providers are encouraged to closely monitor their email and mail for communications from MCOs and respond promptly to avoid potential payment delays or compliance issues.

Update on Proposed TB Rule Changes

The Adult Family Home Council continues to advocate on behalf of providers as the state moves forward with proposed updates to tuberculosis (TB) screening requirements for long-term care settings, including adult family homes.

While the original goal of the rulemaking was to modernize TB requirements and make certain processes easier for providers, the current proposal includes additional screening, education, and documentation requirements that could significantly impact AFHs. Proposed changes include new baseline screening requirements for staff, annual TB education, updated procedures for positive TB tests, and an expanded timeframe for completing new-hire screening.

The Council has raised concerns about the complexity of the proposed rules, potential staffing challenges, limited access to testing and chest X-rays in some communities, and the risk of creating additional compliance burdens without meaningful improvements to resident safety.

The department has acknowledged stakeholder concerns and plans to revise the draft language, seek additional input, and release an updated proposal before moving forward.

Extended Timelines For HCA Certifications

The Washington State Department of Health has adopted permanent rules extending the timeline for Home Care Aide (HCA) certification and clarifying training requirements and exemptions for long-term care workers, including staff in adult family homes. These changes take effect July 3, 2026, and remain in place through December 31, 2027.

Under the updated rules, workers will have additional time to complete certification, while core training requirements remain unchanged. Basic training (generally 75 hours) must still be completed within 120 days of hire. However, the timeline to obtain full HCA certification has been extended to 365 days from the date of hire, and up to 425 days for workers with provisional certification.

For AFH providers, this extension offers more flexibility in a challenging workforce environment, but employers are still responsible for tracking training milestones and certification deadlines to ensure compliance.

The rules also clarify when caregivers may begin working before full certification, outline stricter expectations for timely application submission (within 14 days of hire), and detail updated provisions for limited-English-proficient workers receiving provisional certificates.

These changes are temporary and tied to ongoing legislative authority, with current timelines set to revert after December 31, 2027, unless extended by the legislature.

New Regulatory Authority for Nursing Assistants

Beginning July 1, 2026, oversight of nursing assistants in Washington will transition from the Secretary of Health to the Washington State Board of Nursing (WABON) under Senate Bill 5051. This change brings nursing assistant regulation in line with the same board that oversees RNs and LPNs.

For Adult Family Home providers, most day-to-day processes will remain the same. Nursing assistant applications, renewals, complaints, and credential verification will continue to be handled through the Department of Health’s HELMS system and Provider Credential Search. No new applications, exams, or fees are required as a result of this transition.

What is changing is the regulatory authority behind the process. WABON will now be responsible for credentialing and disciplinary decisions for nursing assistants, and the profession will be regulated under a more formal nursing practice framework. The Board will also expand to include nursing assistant representation and additional nursing expertise.

For AFHs, this shift may bring a stronger clinical focus in areas such as resident safety, care plan compliance, medication assistance, and allegations of abuse or neglect. Providers are encouraged to review internal policies and training materials to ensure references are updated and supervision and documentation practices are clearly aligned with expectations.

Spring 2026 RCS Provider Forum

The Adult Family Home Council, in partnership with the Home and Community Living Administration’s Residential Care Services (RCS), is hosting the Spring 2026 Adult Family Home Provider Forum. This virtual session offers providers a direct opportunity to hear from RCS leadership, including regional administrators and field managers, and participate in discussion on key regulatory topics.

The forum will focus on what a successful inspection looks like, including preparation, onsite visits, exit conferences, and post-inspection follow-up. Participants will also receive updates from RCS and gain a clearer understanding of provider and regulator roles during inspections, as well as how to connect with regional field managers.

Attendees will receive 1.5 continuing education units (CEUs).

Event Details:

• Date: June 10, 2026

• Time: 1:00 PM – 2:30 PM

• Location: Virtual

• Registration: Free and open to all AFH providers

Updated Worker Safety Awareness Program

The Adult Family Home Council is launching an updated version of the Worker Safety Awareness Program on June 16, 2026. This free statewide training is designed to help adult family homes identify, prevent, and respond to common workplace hazards while supporting compliance with Washington State Labor & Industries (L&I) requirements and strengthening overall safety practices in care settings.

The redesigned e-course is more flexible and user-friendly, featuring 43 short interactive modules that can be completed in segments of 15 minutes or less. The training is accessible on desktop, tablet, and mobile devices and includes quizzes, videos, games, and supplemental resources to support learning.

Participants will explore key topics such as PPE use, ergonomics, hazardous drug exposure, and bloodborne pathogen safety. Educational materials will also be available in multiple languages, including Spanish and several additional community languages, along with ADA-accessible formats.

To earn continuing education credit, participants must complete all modules and pass four quizzes with a score of 75% or higher. The training is self-paced, can be paused and resumed at any time, and allows unlimited quiz retakes.

The program was developed with support from the Washington State Department of Labor & Industries Safety & Health Investment Projects (SHIP) grant program and is intended to make workplace safety training more practical, accessible, and engaging for AFH providers and caregivers.

Ship Grant: Hepatitis B Virus

Hepatitis B (HBV) is a highly infectious, vaccine-preventable liver infection spread through contact with infected blood or certain body fluids. Because HBV can survive in dried blood for over a week, adult family home staff should follow strict infection control practices to reduce exposure risk.

How it spreads
HBV is transmitted through exposure to infected blood or body fluids, including needlestick injuries, sharing needles, unprotected sex, contact with open wounds or contaminated surfaces, and from mother to child during birth.

Symptoms
Symptoms may be mild or severe and include fatigue, fever, nausea, abdominal pain, joint pain, dark urine, and jaundice. Infection can be short-term (acute) or long-term (chronic).

Prevention

• A safe and effective vaccine is available and highly protective for most adults.

• Employers must offer the HBV vaccine at no cost to staff with occupational exposure risk.

• Consistent use of PPE (gloves, masks, eye/face protection, gowns, and resuscitation devices) is required when exposure to blood or other potentially infectious materials is possible.

If exposure occurs
Staff should immediately wash and flush the affected area, report the incident to a supervisor, and seek medical evaluation as soon as possible. Employers are required to ensure access to post-exposure care and vaccination when needed.

Key reminder for AFHs
Follow standard bloodborne pathogen precautions at all times and ensure staff are trained in PPE use and exposure response procedures to protect both employees and residents.

Emergency Preparedness Considerations for Summer Hazards

Residential Care Services (RCS) is reminding adult family homes to prepare for seasonal risks that commonly occur during summer months, including extreme heat, wildfires, wildfire smoke, and planned or unexpected power outages.

These events can have serious impacts on vulnerable residents, so providers are encouraged to review and strengthen emergency plans now rather than waiting for an active incident.

Key focus areas include:

• Wildfire readiness: Update evacuation plans, maintain emergency go-bags, clear vegetation near structures, and ensure staff know multiple evacuation routes and destinations. Plans should account for residents with mobility or medical equipment needs.

• Extreme heat safety: Monitor indoor temperatures, support hydration, and recognize early signs of heat exhaustion and heat stroke. Providers are reminded that fans should not be used when indoor temperatures exceed 90°F due to safety concerns.

• Power outages and PSPS events: Utility-related shutoffs may occur during wildfire risk periods. AFHs should ensure backup power plans are in place, especially for residents who rely on electrically powered medical equipment.

• Wildfire smoke exposure: Monitor air quality daily during fire season, limit outdoor exposure when air quality worsens, and improve indoor air quality through filtration, sealing gaps, and keeping windows and doors closed.

Recommended actions for AFHs:

Providers should update emergency preparedness and evacuation plans, conduct staff drills, restock emergency supplies, identify residents with high medical vulnerability, and review procedures for prolonged power outages. Staff should also be trained to recognize and respond to heat-related illness and smoke exposure risks.

RCS emphasizes that early preparation is key to maintaining safety and continuity of care during summer emergencies.

Potential Delay with Medicaid Financial Applications

The Department recently reorganized Intake and Financial Workers into a separate division from Home and Community Services (HCS). As a result of this transition, some early delays have been identified that may affect how quickly Medicaid service authorizations are processed.

For Adult Family Home providers, this is especially important for residents transitioning from private pay to Medicaid. Providers are strongly encouraged to ensure applications are submitted at least 45 days in advance, with 60–90 days preferred whenever possible.

If you are experiencing delays with a resident’s Medicaid application or authorization process, the Council encourages providers to reach out as soon as possible so staff can assist in addressing the issue with the Department.

Mental Health Disorders;: Complex Diagnoses and Advanced Intervention Strategies
June 10  |  9:00AM – 11:00AM

This training builds on the foundations and focuses on more complex mental health diagnoses, including schizophrenia, psychotic disorders, personality disorders, and neurocognitive conditions.

2.0 CEU available to all  who attend.

Room and Care: Listing and Managing Vacancies  
June 10  |  10:30AM – 12:00PM

This training provides practical, step-by-step guidance on using the Room and Care application to list current Medicaid vacancies. Participants will learn how to create and manage listings, keep vacancy information accurate and up to date, and ensure their home appears in searches used by case managers and referral sources. The session will also cover common errors to avoid, best practices for maintaining listings, and how effective use of Room and Care can support timely placements and stable occupancy.

1.5 CEU available to all AFH Council members who attend.

Spring 2026 Adult Family Home Forum
June 10  |  1:00PM – 2:30PM

Please join us for a conversation with your local RCS staff. We have scheduled these meetings with the intention of improving communication and giving you an opportunity to meet your Field Manager and get your questions answered.

1.5 CEU available to all  who attend.

Mornings with Member Support  
June 11  |  8:30AM – 9:30AM

Join us on the second and fourth Thursday of each month for Mornings With Member Support, an open conversation space led by Maleia Press, AFHC’s Regulatory Support Director, together with our Member Support team.  These informal Q&A sessions give Adult Family Home providers the opportunity to ask questions, gain clarity on regulatory requirements, and talk through real-world compliance scenarios with AFHC’s in-house experts. While the focus is on regulatory compliance and understanding both state and federal rules, no topic is off limits bring any question related to AFH operations, resident rights, documentation, surveys, or day-to-day challenges. Whether you’re navigating a complex situation, seeking guidance on best practices, or simply wanting reassurance that you’re on the right track, this twice-monthly space offers supportive, practical answers in a welcoming environment.

Looking for Education Opportunities?

Check Out Our Events Page

Need Support?

Reach Out to Our Staff

Are You a Member Yet?

Learn About Membership Benefits