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Opinion >  Guest Opinion

Vicki Lowe and Jeremy Norden-Paul: Bill would strengthen state’s commitment to equitable and compassionate care

By Vicki Lowe and Jeremy Norden-Paul

By Vicki Lowe and Jeremy Norden-Paul

In 2019, the Washington state Legislature passed the Long-Term Care Trust Act, creating a new public benefit that has already become a model for other states on how to meet the long-term care needs of their aging and disabled populations. The trust was passed to help Washingtonians access long-term care and alleviate some of the growing stress on the state’s Medicaid budget, and is the first publicly funded long-term care program outside of Medicaid.

There was just one problem: the original bill did not include tribes or people with developmental disabilities (and others who acquire a disability before the age of 18).

This year, the state Legislature is considering House Bill 1323, an update to the original Trust Act that solves this problem by expanding eligibility to include employees of the Tribal Sovereign Nations and people with developmental disabilities, and also seeks to clarify opt-out provisions to close a tax avoidance loophole that could leave the trust low on funding in the future.

As the executive director of the American Indian Health Commission, and the executive director of the Washington State Developmental Disabilities Council, we are pleased that Washington state leads the nation in long-term care benefits and that the Legislature is considering extending those benefits to tribes and people who acquire disabilities before the age of 18. This is who we can and should be as a state: bold, innovative, diverse, and inclusive.

The arguments in opposition to this legislation are not responsive to the needs of the 70% of Washingtonians who will one day need long-term care. However, advocates in support of this bill understand those needs and have provided constructive input to identify solutions to the long-term care crisis we are facing and will increasingly face. The private business and insurance sectors also have an important role to play in the future of the long-term care system in Washington state – providing low-cost long-term care insurance that supplements the benefits provided by the trust and is affordable for working families. We are cautiously optimistic that stakeholders – including those with diverse and sometimes competing interests – can join forces to create solutions for aging and disabled Washingtonians.

Tribes and Indigenous people have long-held, deep-rooted values around providing dignified care to elders in our homes and communities. People with developmental disabilities and their families understand the incredible dedication and selflessness it takes to care for someone with a long-term disability. We believe the passage of HB 1323 would have a positive impact on these communities and would continue strengthening the state’s commitment to equitable policy for long-term, compassionate care.

Vicki Lowe ( is executive director of the American Indian Health Commission for Washington state. Jeremy Norden-Paul ( is executive director of the Washington State Developmental Disabilities Council.

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