The General Assembly Raised Bill No. 498 seeks to enhance protections for personal care attendants and improve access to state programs, effective July 1, 2026. It establishes a new framework for self-directed home care programs funded by Medicaid, requiring the Department of Social Services (DSS) to publish quarterly reports on financial statements, timesheet processing, customer service performance, and penalties against the fiscal intermediary responsible for payroll. The bill also mandates a cost-benefit analysis by the Secretary of the Office of Policy and Management regarding the potential transfer of fiscal intermediary duties from private contractors to state management, with a report due by October 1, 2026.

Additionally, the bill introduces provisions for financial penalties in contracts for fiscal intermediary services entered into or renewed after August 31, 2026, specifically for late payroll processing. Personal care attendants can claim damages for documented tardy pay, including late fees on rent or utilities. The bill emphasizes accountability through annual compliance audits by the Auditors of Public Accounts and mandates that penalties for late payments be enforced. It also requires that all communications from state agencies and contractors comply with effective communication standards and be provided in the appropriate language for the municipality, ensuring accessibility and clarity for personal care attendants and consumers.