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Agency Recommendation Summaries

Department of Social and Health Services - Long Term Care

  Average Annual FTEs Near General Fund State Other Funds Total Funds
  (Dollars in Thousands)
Current Budget 3,010.6 5,572,216 7,334,886 12,907,102
2025-27 Maintenance Level 3,117.5 5,715,830 7,643,645 13,359,475
Difference from 2025-27 Original 106.9 143,614 308,759 452,373
% Change from 2025-27 Original 3.6% 2.6% 4.2% 3.5%

2026 Policy Other Changes

AAA Case Management 0.0 (2,517) 0 (2,517)
Administrative Reduction 0.0 (364) 0 (364)
Assisted Living Rebase Delay 0.0 (21,221) (24,242) (45,463)
Enhanced Dementia Care Pilot 0.0 (305) (358) (663)
Facility One-Time Costs 0.0 700 528 1,228
HR1 Eligiblity Reductions 0.0 7,642 0 7,642
IP Training Penalty 0.0 3,800 0 3,800
Nursing Home Rebase Delay 0.0 (48,645) (53,576) (102,221)
Transitional Care Center Seattle 0.0 (2,852) (2,852) (5,704)
WA Cares IT 0.0 0 (6,801) (6,801)
WA Cares M&O 0.0 0 22,793 22,793
2026 Policy Other Changes Total 0.0 (63,762) (64,508) (128,270)

2026 Policy Transfers Changes

Reimagine DSHS 580.2 1,343,972 1,420,463 2,764,435
2026 Policy Transfers Changes Total 580.2 1,343,972 1,420,463 2,764,435
Total Policy Changes 580.2 1,280,210 1,355,955 2,636,165
2026 Policy Level 3,697.7 6,996,040 8,999,600 15,995,640
Difference from 2025-27 Original 687.1 1,423,824 1,664,714 3,088,538
% Change from 2025-27 Original 22.8% 25.6% 22.7% 23.9%

Policy Changes

AAA Case Management

Savings are achieved by reducing funding for AAA case management. This brings the total reduction to 5%. (General Fund - State)

Administrative Reduction

Funding is reduced to reflect a reduction in administrative services. (General Fund - State)

Assisted Living Rebase Delay

Funding for the increased cost and utilization of assisted living and adult residential care services is delayed until fiscal year 2028. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Enhanced Dementia Care Pilot

Savings are achieved by ending the enhanced dementia care pilot. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Facility One-Time Costs

One-time funding is provided to decommission and relocate the Lacey Aging and Long-Term Support Administration office into a state-owned facility in Olympia. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

HR1 Eligiblity Reductions

Funding is provided to address the impacts of federal changes to Medicaid eligibility tied to immigration status. Beginning in October 2026, many lawfully residing noncitizens will lose access to Medicaid. This funding adds 500 noncitizen services slots for clients currently receiving long-term care and developmental disability services. (General Fund - State)

IP Training Penalty

Funding is provided to address penalties assessed by the Center for Medicaid and Medicare Services for inadequate staff training of individual providers of in-home care services. (General Fund - State)

Nursing Home Rebase Delay

Funding for the increased cost and utilization of nursing home facilities is delayed until fiscal year 2028. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Reimagine DSHS

Funds are transferred between programs to align appropriations with the new Department of Social and Health Services organizational structure. (General Fund - Cash, General Fund - Federal, General Fund - Local, other funds)

Transitional Care Center Seattle

Savings are achieved by reducing beds at the Transitional Care Center of Seattle from 80 to 60 to align with the provider's staffing model. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

WA Cares IT

Funding is adjusted for the WA Cares technology project, expected to be complete by the end of fiscal year 2026. (Long-Term Servs & Sup Trust Account - State)

WA Cares M&O

Funding is provided for ongoing maintenance and operating costs of the WA Cares technology platform expected to go live in fiscal year 2027. (Long-Term Servs & Sup Trust Account - State)