Department of Social and Health Services
| Annual FTEs | General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Estimated Expenditures | 12,613.2 | 6,418,005 | 7,723,795 | 14,141,800 |
2017-19 Maintenance Other Changes |
||||
| Facility Maintenance Costs | 0.0 | 98 | 0 | 98 |
| Mandatory Caseload Adjustments | (18.9) | (7,403) | (6,593) | (13,996) |
| DES Mileage Rate Increase | 0.0 | 37 | 19 | 56 |
| Hospital Revenue Adjustment | 0.0 | 3,034 | (3,034) | 0 |
| Maintain Safe Secure Facilities | 1.5 | 951 | 246 | 1,197 |
| Trueblood Fines | 0.0 | 47,017 | 0 | 47,017 |
| Decertification Revenue Adjustment | 0.0 | 53,218 | (53,218) | 0 |
| Technical Corrections | 7.2 | 5,812 | (5,059) | 753 |
| Forecast Cost Utilization | 0.0 | (16,317) | (9,202) | (25,519) |
| Utilization of Residential Services | 0.0 | (6,073) | (5,340) | (11,413) |
| Utilization of Respite Services | 0.0 | 353 | 332 | 685 |
| RHC Compliance | 33.0 | 9,031 | 8,914 | 17,945 |
| Leased Facilities One-Time Costs | 0.0 | 433 | 160 | 593 |
| Continuing ESAR Project | 0.0 | 1,065 | (4,233) | (3,168) |
| ABD Recovery Variance | 0.0 | 9,238 | 0 | 9,238 |
| Families Forward Washington Grant | 0.50 | 0 | 412 | 412 |
| TALX Wage Verification | 0.0 | 727 | 297 | 1,024 |
| Eligibility Staff 50/50 Split | 0.0 | 1,983 | (1,983) | 0 |
| HIU Position Reclassification | 0.0 | 400 | 171 | 571 |
| TANF Caseload Adjustment | 0.0 | 5,297 | 0 | 5,297 |
| WSH Federal Funding Loss | 0.0 | 578 | 0 | 578 |
| SILAS - Leave Attendance Scheduling | 3.6 | 104 | 30 | 134 |
| 2017-19 Maintenance Other Changes Total | 26.9 | 109,583 | (78,081) | 31,502 |
2017-19 Maintenance Transfers Changes |
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| 2017-19 Maintenance Transfers Changes Total | 0.0 | 0 | 0 | 0 |
| Total Maintenance Changes | 26.9 | 109,583 | (78,081) | 31,502 |
| 2017-19 Maintenance Level | 12,640.1 | 6,527,588 | 7,645,714 | 14,173,302 |
2017-19 Policy Other Changes |
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| Reduce Assaults in JR Facilities | 18.9 | 3,108 | 0 | 3,108 |
| BHA Administration Support | 3.2 | 893 | 0 | 893 |
| ESH Office Relocation | 0.0 | 296 | 0 | 296 |
| State Hospital Operations | 196.0 | 43,102 | 0 | 43,102 |
| Trueblood Fines | 0.0 | (28,000) | 0 | (28,000) |
| Psychiatric Intensive Care Unit | 9.4 | 2,460 | 0 | 2,460 |
| WSH Safety Response | 10.7 | 3,551 | 0 | 3,551 |
| Ross Lawsuit Compliance | 6.7 | 1,797 | 0 | 1,797 |
| Forensic Competency Restoration | 0.0 | 1,282 | 0 | 1,282 |
| SILAS Implementation | 0.80 | 260 | 0 | 260 |
| Leased Facilities One-Time Costs | 0.0 | 901 | 48 | 949 |
| Electronic Visit Verification | 0.0 | (2,198) | 2,198 | 0 |
| Asset Verification Pilot | 0.0 | 70 | 69 | 139 |
| Automatic Voter Registration | 0.30 | 45 | 19 | 64 |
| Digital Marketing DCS Award | 1.0 | 0 | 500 | 500 |
| Safety, Compliance & Accountability | 11.5 | 1,707 | 510 | 2,217 |
| Electronic Storage | 0.0 | 474 | 158 | 632 |
| Community Expansion | 0.50 | 156 | 0 | 156 |
| Transport and Hospital Watch Staff | 3.3 | 571 | 0 | 571 |
| 2017-19 Policy Other Changes Total | 262.3 | 30,475 | 3,502 | 33,977 |
2017-19 Policy Transfers Changes |
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| Domestic Violence Unit Transfer | 2.5 | 6,131 | 3,195 | 9,326 |
| 2017-19 Policy Transfers Changes Total | 2.5 | 6,131 | 3,195 | 9,326 |
| Total Policy Changes | 264.8 | 36,606 | 6,697 | 43,303 |
| 2017-19 Policy Level | 12,904.9 | 6,564,194 | 7,652,411 | 14,216,605 |
Policy Changes
Facility Maintenance Costs
The Department of Social and Health Services (DSHS) is responsible for maintaining and repairing four secure juvenile residential facilities and eight community facilities. One-time funding is provided to purchase equipment, goods and services to resolve building component and grounds deficiencies beyond the scope of ordinary maintenance, but lower than the threshold for capital projects.
Mandatory Caseload Adjustments
An adjustment is made to reflect the forecasted changes to the Special Commitment Center total confinement facility, the secure community transition facilities and the less restrictive alternative populations based on the November 2018 caseload forecast.
DES Mileage Rate Increase
Funding is provided for the Department of Enterprise Services' (DES) fleet management mileage rate increase, effective October 1, 2018.
Transfers
A net zero program transfer is made to align expenditure authority with the correct agency program where the work and responsibilities occur.
Reduce Assaults in JR Facilities
The interim Prison Rape Elimination Act (PREA) audit issued in October 2018 found that Juvenile Rehabilitation (JR) failed to meet PREA standard 115.313 (c) which requires each secure juvenile facility to maintain staffing ratios of a minimum of 1:8 during waking hours and 1:16 during sleeping hours. Funding is provided to maintain the existing staffing levels necessary to bring the three JR facilities into compliance with this standard.
Hospital Revenue Adjustment
An annual adjustment is made to maintain funding levels based on 12-month average annual revenue projections of inpatient contributions and Medicaid earnings.
Maintain Safe Secure Facilities
Funding is provided to improve the Consolidated Maintenance & Operations' (CMO) ability to provide safe living environments for clients by replacing failing building infrastructure at state-owned facilities.
Trueblood Fines
A settlement agreement was reached in the Trueblood et. al v. DSHS lawsuit in August 2018 which proposes the suspension of fines beginning December 2018, provided the state maintains substantial compliance with the terms in the settlement agreement. The agreement was approved by the U.S. District Court - Western District on December 11, 2018. Appropriations are adjusted to reflect the suspension of fines beginning in December 2018.
Decertification Revenue Adjustment
In May 2018, the Centers for Medicaid and Medicare Services decertified Western State Hospital due to noncompliance with four of 26 conditions of participation. Appropriations are adjusted to reflect the loss of federal revenue due to the decertification of Western State Hospital.
Technical Corrections
Adjustments are made for variances found in the reconciliation of multiple budget steps to correct the federal funding source, provide additional federal and local authority, and net zero category transfers between agency programs.
BHA Administration Support
Funding is provided to adequately staff the core business functions and processes of the Behavioral Health Administration (BHA). This includes oversight of daily operations, tribal relations, policy development and analysis, and records management.
ESH Office Relocation
Funding is provided to relocate staff at Eastern State Hospital (ESH) from wards that are currently being renovated for forensic placements.
State Hospital Operations
Funding is provided to maintain the current level of spending at the state psychiatric hospitals.
Psychiatric Intensive Care Unit
Funding is provided for a Psychiatric Intensive Care Unit (PICU) to serve assaultive patients at Eastern State Hospital. The PICU will house high acuity patients for short-term stays with a transition back to a standard ward after stabilization. These patients will receive specialized patient care and treatment.
WSH Safety Response
Funding is provided to implement a multi-faceted approach to reduce violence and increase patient and staff safety at Western State Hospital. A STAR and Step Up unit will open to serve up to 20 of the highest acuity patients with evidence-based best practices. Other initiatives include increased security and staff training and enclosed nurses stations.
Ross Lawsuit Compliance
As part of the settlement agreement in Ross v. Lashway, funding is provided to improve the quality and timeliness of treatment for patients found not guilty by reason of insanity.
Forensic Competency Restoration
Funding is increased to cover the cost of operating the Yakima Competency Restoration Program and the Maple Lane Competency Restoration Program. These two facilities provide 54 beds for the statewide forensic competency restoration system.
SILAS Implementation
Funding is provided to integrate a scheduling, time, and leave system that will standardize and modernize staff management processes at Western State Hospital in Lakewood.
Leased Facilities One-Time Costs
Funding is provided for one-time costs related to relocation and facility upgrades necessary to efficiently utilize work space.
Forecast Cost Utilization
This item reflects changes in the utilization of long-term care services by nursing homes, area agencies on aging services, and home and community-based services.
Utilization of Residential Services
Funding is provided to address greater utilization of the Developmental Disabilities Administration (DDA) residential services in Adult Supported Living, Child Supported Living, Group Homes, Community Protection, and Intermediate Care for the Intellectually Disabled.
Utilization of Respite Services
Funding is provided to address greater utilization of respite services in the November 2018 developmental disabilities forecast.
RHC Compliance
Funding is provided to add required staff at the Residential Habilitation Centers (RHCs) and State Operated Living Alternatives (SOLAs) during the 2017-19 biennium. This complies with active treatment, health and safety, client rights, and other Centers for Medicare and Medicaid Services (CMS) requirements for Intermediate Care Facilities (ICFs).
Electronic Visit Verification
This reduction is due to a delay in the implementation of the federal “21st Century Cures Act.” The enacted 2018 supplemental budget replaced a reduction in federal funds anticipated under this act with GF-State funds for fiscal year 2019. The loss of federal funds will not occur due to the delayed implementation date.
Asset Verification Pilot
Funding is provided for a pilot program to test an asset verification system (AVS), which is a federal requirement for the Medicaid financial eligibility process.
Continuing ESAR Project
Due to the A-87 waiver expiring in December 2018, fund sources are being adjusted to ensure the Economic Services Administration is able to continue its Automated Client Eligibility System (ACES) complex remediation efforts focused on database modernization and mainframe rehosting.
ABD Recovery Variance
Since the creation of the Aged, Blind, or Disabled (ABD) program in November 2011, the budget has assumed that the Economic Services Administration will recover 70 percent of ABD - Presumptive SSI (PSSI) expenditures in the first year of the biennium, and 60 percent in the second year. However, actual recoveries have not kept pace with these assumptions, resulting in a budget shortfall. This item provides additional funding to ESA to cover the variance in recoveries so the ABD program remains fully funded.
Families Forward Washington Grant
One-time federal expenditure authority is increased to allow the Economic Services Administration to implement the Families Forward Washington grant, a multi-year grant that the Division of Child Support (DCS) received through the W.K. Kellogg Foundation. This demonstration project allows DCS to test strategies through contracting with local partners to provide occupational skills training, financial education and asset building, and case management services to non-custodial parents in Benton and Franklin counties who owe child support and have difficulty meeting their obligations due to low earnings.
TALX Wage Verification
TALX is a nationwide online income verification system which provides real-time employment and salary information; however, the usage and costs have both increased since 2013. Funding is provided to cover increased contracted costs.
Eligibility Staff 50/50 Split
The federal Center for Medicare and Medicaid Services (CMS) no longer offers the 75/25 percent matching rate for certain Economic Services Administration eligibility staff. This funding covers the new state contribution for the eligibility staff at a 50/50 percent matching rate.
HIU Position Reclassification
The office assistant class series in the customer service contact center's hub imaging unit (HIU) in the Community Services Division changed in June 2017 to a forms and records analyst series. Funding is provided to ensure the agency is able to cover the increased salary and related costs supported by the position reclassification.
TANF Caseload Adjustment
Funding is adjusted to reflect the November 2018 caseload forecasts and per capita costs for the Temporary Assistance for Needy Families (TANF) program.
Automatic Voter Registration
Funding is provided for staffing and information technology impacts associated with the implementation of automatic voter registration, consistent with Chapter 110, Laws of 2018.
Digital Marketing DCS Award
One-time federal expenditure authority is increased to allow DSHS's Division of Child Support (DCS) to participate in a federal demonstration project using digital marketing to increase participation in the child support program.
Domestic Violence Unit Transfer
This is a net zero transfer wherein FTEs and funding for the Domestic Violence Unit and its associated programs are transferred from the Department of Children, Youth and Families to the Department of Social and Health Services.
WSH Federal Funding Loss
Funding is provided to replace lost federal revenue due to the decertification of Western State Hospital (WSH).
SILAS - Leave Attendance Scheduling
Funding is provided to continue the work on an automated staff scheduling system for Western State Hospital (WSH).
Safety, Compliance & Accountability
Funds are provided to maintain safety, internal audit, human resources, emergency management, travel, payroll, and financial compliance resources at levels necessary to ensure safe, compliant, and accountable public service operations.
Electronic Storage
Funds are provided to replace server hosting storage which has reached maximum capacity. Current server hosting storage has reached its end of life and will no longer be supported by the vendor as of May 2019.
Community Expansion
One program administrator is provided to assist in the siting process for new secure community transition facilities, as proposed in the 2019-21 capital budget (project 30003577).
Transport and Hospital Watch Staff
As the Special Commitment Center (SCC) residential population ages, the department continues to experience an increase in medical demands for off-island specialty and hospital services. This item provides funding for 6.5 security guards to assist the SCC transport teams in performing hospital watches for residents who are admitted into local area hospitals as required by state law and to safeguard the public and residents.
