Department of Social and Health Services - Developmental Disabilities
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 4,679.7 | 2,069,285 | 2,695,591 | 4,764,876 |
| 2023-25 Maintenance Level | 4,837.4 | 2,409,050 | 2,454,207 | 4,863,257 |
| Difference from 2023-25 Original | 157.7 | 339,765 | (241,384) | 98,381 |
| % Change from 2023-25 Original | 3.4% | 16.4% | (9.0%) | 2.1% |
2023 Policy Other Changes |
||||
| Facility Maintenance Costs | 0.0 | 102 | 102 | 204 |
| Assessment Tool Study | 0.0 | 485 | 484 | 969 |
| Financial Eligibility Staff | 25.5 | 3,001 | 2,302 | 5,303 |
| Expand High School Transition | 0.0 | 2,618 | 2,108 | 4,726 |
| Continue Klamath Cottage | 24.5 | 4,540 | 0 | 4,540 |
| Personal Protective Equipment | 0.0 | 2,105 | 1,743 | 3,848 |
| Adjust CDE Rates | (8.9) | 88,916 | 113,163 | 202,079 |
| Funded Program Implementation | 4.0 | 4,549 | 3,776 | 8,325 |
| Employment/Community Inclusion | 3.0 | 24,100 | 19,402 | 43,502 |
| Translation Service Rates | 1.0 | 1,212 | 836 | 2,048 |
| Children and Adults in Hospitals | 4.0 | 6,018 | 5,890 | 11,908 |
| Specialty Adult AFH | 7.0 | 6,062 | 7,197 | 13,259 |
| Expand Behavior Stabilization | 4.0 | 6,825 | 4,137 | 10,962 |
| Community Trust | 0.0 | 0 | 35,438 | 35,438 |
| Non-citizen Program | 0.0 | 5,839 | 0 | 5,839 |
| Agency Parity | 0.0 | 12,512 | 15,924 | 28,436 |
| CDE Administrative Component | 0.0 | 779 | 991 | 1,770 |
| Residential PNA | 0.0 | 727 | 476 | 1,203 |
| Medicaid Provider Rates | 0.0 | 430 | 500 | 930 |
| Assisted Living Provider Rates | 0.0 | 1,008 | 1,256 | 2,264 |
| Medical Escort Settlement | 0.0 | 144 | 181 | 325 |
| Facility One-time Costs | 0.0 | 372 | 308 | 680 |
| 2023 Policy Other Changes Total | 64.1 | 172,344 | 216,214 | 388,558 |
2023 Policy Comp Changes |
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| Adult Family Home Award/Agreement | 0.0 | 20,383 | 25,053 | 45,436 |
| State Employee Benefits | 0.0 | 93 | 72 | 165 |
| WFSE General Government | 0.0 | 48,035 | 39,700 | 87,735 |
| Rep Employee Health Benefits | 0.0 | 1,007 | 830 | 1,837 |
| Non-Rep Recruitment/Retention | 0.0 | 226 | 177 | 403 |
| Coalition of Unions | 0.0 | 266 | 212 | 478 |
| Non-Rep General Wage Increase | 0.0 | 2,824 | 2,232 | 5,056 |
| SEIU 1199 General Government | 0.0 | 5,326 | 4,277 | 9,603 |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 386 | 314 | 700 |
| Vaccine Booster Incentive | 0.0 | 193 | 152 | 345 |
| 2023 Policy Comp Changes Total | 0.0 | 78,739 | 73,019 | 151,758 |
| Total Policy Changes | 64.1 | 251,083 | 289,233 | 540,316 |
| 2023-25 Policy Level | 4,901.5 | 2,660,133 | 2,743,440 | 5,403,573 |
| Difference from 2021-23 | 221.8 | 590,848 | 47,849 | 638,697 |
| % Change from 2023-25 Original | 4.7% | 28.6% | 1.8% | 13.4% |
Policy Changes
Facility Maintenance Costs
Funding is provided to contract for fire damper inspections at the state hospitals in accordance with RCW 19.27.720. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Assessment Tool Study
Funding is provided to contract for an evaluation of the Comprehensive Assessment Reporting Evaluation (CARE) tool. This evaluation will result in a feasibility report that documents algorithmic processes, assessment calculations, process mapping, and workflow mapping for the CARE tool. The report will inform how the tool can be simplified, modified or replaced to meet the obligations of Medicaid match, be more person-centered and easily understood, reduce the need for manual notations, and capture client strengths, capacities, needs and desired outcomes for care. (General Fund - State, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Financial Eligibility Staff
Funding is provided for 25.5 FTE staff to complete financial eligibility determinations and perform case maintenance activities to help clients obtain or stay connected to vital services, medical coverage, cash, and food assistance. This funding will improve DDA's ability to meet the 45-day application processing requirement specified in WAC 182-503-0060. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)
Expand High School Transition
Students with intellectual and developmental disabilities become eligible for employment and community inclusion services from the DSHS-DDA at the age of 21. Funding is provided for students who are served on the Individual and Family Services waiver or who are not on a waiver, but are eligible for employment and community inclusion services. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Continue Klamath Cottage
Funds are provided to continue operating the Klamath Cottage at Rainier School, a short-term transition option for individuals in acute care hospitals and state hospitals who no longer require medical treatment but are waiting for community placements. (General Fund - State)
Personal Protective Equipment
Funding is provided to cover the increased costs incurred for personal protective equipment (PPE) during the COVID-19 pandemic. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Adjust CDE Rates
Funds are provided for a new rate for the consumer directed employer (CDE) contracted individual providers as set by the Consumer Directed Employer Rate Setting Board in accordance with RCW 74.39A.530. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Funded Program Implementation
The department will continue the phase-in and expansion of programs that serve children and youth with co-occurring behavioral health and intellectual/developmental disabilities. This includes the continued phase-in of youth inpatient navigators to participate in case management for children and youth with behavioral health needs. Additionally, funding is provided to expand intensive habilitation and enhanced out-of-home placements for youth. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Employment/Community Inclusion
This item funds rate increases for supported employment and community inclusion services. These programs provide meaningful employment, volunteer and other community activities for people with intellectual and developmental disabilities who are eligible for these programs. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Translation Service Rates
Funding is provided for contracted services that provide translation services to clients in federally required languages through a contracted vendor. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Children and Adults in Hospitals
The department will increase the capacity of direct support providers to better meet the needs of individuals with complex support needs. A new pilot program will be created that provides an enhanced rate to providers who take specialized training to better serve clients. This will help reduce unnecessary hospitalization of children and adults with intellectual and developmental disabilities. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Specialty Adult AFH
Funding is provided for a new enhanced adult family home pilot for adult family home (AFH) providers who specialize in serving individuals with intellectual or developmental disabilities (I/DD), who may also have a co-occurring health or behavioral diagnosis, in their communities rather than in an acute care setting. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Expand Behavior Stabilization
This item will expand capacity for both bed-based and mobile diversion services, as well as increase the rate for service providers. This is necessary to maintain a viable provider network to prevent unnecessary hospitalizations and out-of-state placements for clients with difficult-to-serve behaviors. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Community Trust
Appropriation authority is provided to continue funding projects that will enhance and expand Home and Community Based Services (HCBS) for individuals with intellectual and developmental disabilities. (Developmental Dis Comm Service Acct - State)
Non-citizen Program
The department will create a program for people with developmental disabilities who are not eligible for federally funded programs due to their immigration status. This new program will provide personal care for people who need to step down from hospital care but require long-term care supports. The Health Care Authority will provide ongoing medical services for these clients. (General Fund - State)
Agency Parity
Funds are provided for homecare agency parity consistent with the rate set by the Consumer Directed Employer Rate Setting Board in accordance with RCW 74.39A.530. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
CDE Administrative Component
Funding is provided for administrative costs as set by the Consumer Directed Employer Rate Setting Board in accordance with RCW 74.39A.530. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Residential PNA
This item will increase the personal needs allowance (PNA) for clients residing in institutions and residential facilities from $75.36 to $100.00 per month. The PNA is an amount of their own income they retain to pay for their personal needs, such as clothing, personal hygiene supplies, cell phone data, non-covered facility activities, additional grooming, and small treats. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Medicaid Provider Rates
Funding is provided to increase rates for providers of home and community-based services who serve Medicaid clients. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)
Assisted Living Provider Rates
This item will increase rates for assisted living facilities that serve Medicaid clients. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Medical Escort Settlement
Funding is provided for the unfair labor practice settlement in the case of Adult Family Home Council v. Office of Financial Management. If the settlement agreement is not reached by June 30, 2024, the funds shall lapse. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Facility One-time Costs
Funding is provided for one-time relocation costs and projects that support the DSHS Six-Year Facilities Plan that supports 106 leased offices and client service centers statewide. (General Fund - State, General Fund - Medicaid Federal, General Fund - Federal, other funds)
Adult Family Home Award/Agreement
Funding is provided for implementation of an agreement reached between the governor and the Adult Family Home Council under the provisions of chapter 41.56 RCW for the 2023-25 biennium. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
State Employee Benefits
Health insurance funding is provided for state employees who are not represented by a union, who are covered by a bargaining agreement that is not subject to financial feasibility determination, or who are not part of the coalition of unions for health benefits. The insurance funding rate is $1,160 per employee per month for fiscal year 2024 and $1,233 per employee per month for fiscal year 2025. (General Fund - State, General Fund - Federal, General Fund - Medicaid Federal, other funds)
WFSE General Government
Funding is provided for a general wage increase of 4%, effective July 1, 2023; a general wage increase of 3%, effective July 1, 2024; targeted job classification base range increases; recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023; shift premium increase for eligible shifts from $1 to $2.50 per eligible hour; a COVID-19 booster incentive of $1,000; supplemental shift premium increases for nurse classifications; 5% premium pay for employees who are assigned to a facility that provides direct care to residents, patients and/or clients and whose duties are required to be performed on location; and an increase of $250 to the annual lump sum payment for Labor and Industries risk classes 7200/7201. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Rep Employee Health Benefits
This provides health insurance funding as part of the master agreements for employees who bargain for health benefits as part of a coalition of unions. The insurance funding rate is $1,160 per employee per month for fiscal year 2024 and $1,233 per employee per month for fiscal year 2025. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Non-Rep Recruitment/Retention
Funding is provided for recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Coalition of Unions
Funding is provided for a general wage increase of 4%, effective July 1, 2023; a general wage increase of 3%, effective July 1, 2024; targeted job classification base range increases; recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023; shift premium increase for eligible shifts from $1 to $2.50 per eligible hour; and a COVID-19 booster incentive of $1,000. The agreement also includes a supplemental shift premium increases for nurse classifications; 5% premium pay for employees who are assigned to a facility that provides direct care to residents, patients and/or clients and whose duties are required to be performed on location; and a $500 annual lump sum payment for L&I codes 7200/7201. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Non-Rep General Wage Increase
Funding is provided for wage increases for state employees who are not represented by a union or who are covered by a bargaining agreement that is not subject to financial feasibility determination. It is sufficient for a general wage increase of 4 percent, effective July 1, 2023 and a general wage increase of 3 percent, effective July 1, 2024. This item includes both general government and higher education workers. (General Fund - State, General Fund - Federal, General Fund - Medicaid Federal, other funds)
SEIU 1199 General Government
Funding is provided for a general wage increase of 4%, effective July 1, 2023; a general wage increase of 3%, effective July 1, 2024; targeted job classification base range increases; recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023; shift premium increase for eligible shifts from $1 to $2.50 per eligible hour; and a COVID-19 booster incentive of $1,000. The agreement includes supplemental shift premium increases for nurse classifications; 5% premium pay for employees who are assigned to a facility that provides direct care to residents, patients and/or clients and whose duties are required to be performed on location; and an ARNP ANCC Board certification incentive of $2,500. In addition, this agreement includes preceptor premium pay increase, increase in training dollars, additional retention incentive of $1,500, and $500 annual lump sum payment for L&I codes 7200/7201. (General Fund - State, General Fund - Medicaid Federal, General Fund - Federal, other funds)
PERS & TRS Plan 1 Benefit Increase
For eligible Public Employees' and Teachers' Retirement Systems Plan 1 members, this item provides an increase of 3%, up to a maximum of $110 per month. (General Fund - Federal, General Fund - Medicaid Federal, General Fund - State, other funds)
Vaccine Booster Incentive
Funding is provided for a $1,000 lump sum COVID-19 booster incentive for non-represented employees. This funding does not cover institutions of higher education. (General Fund - Medicaid Federal, General Fund - Federal, General Fund - State, other funds)
