Department of Social and Health Services
| Annual FTEs | General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Estimated Expenditures | 11,711.6 | 6,469,997 | 7,406,933 | 13,876,930 |
| Total Maintenance Changes | 0.0 | 0 | 0 | 0 |
| 2019-21 Maintenance Level | 11,619.5 | 6,321,814 | 7,465,838 | 13,787,652 |
2019-21 Policy Other Changes |
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| Civil Ward Reductions | (22.2) | (3,562) | (1,060) | (4,622) |
| Delay San Juan Cottage Opening | (17.4) | (1,604) | (2,144) | (3,748) |
| Trueblood Lawsuit Fines | 0.0 | 3,988 | 0 | 3,988 |
| Contract Rate Increases | 0.0 | 850 | 0 | 850 |
| Leased PCs for Telework | 0.0 | 178 | 0 | 178 |
| COVID-19 Screening Stations | 16.0 | 4,831 | 0 | 4,831 |
| Continue Safety Initiatives at WSH | 7.5 | 1,836 | 0 | 1,836 |
| Personal Protective Equipment | 0.0 | 6,248 | 2,451 | 8,699 |
| COVID-19 Client Services/Facility | 0.50 | 2,064 | 46 | 2,110 |
| Shared Benefit Adjustment | 0.0 | 6,131 | 7,805 | 13,936 |
| Rental Subsidies | 1.7 | (683) | (1,052) | (1,735) |
| Continue COVID Crisis Response | 0.0 | 8,800 | 5,820 | 14,620 |
| Transitional Care Center of Seattle | 0.0 | 9,304 | 8,494 | 17,798 |
| COVID Client Services/Facility | 0.0 | 2,577 | 1,895 | 4,472 |
| COVID Testing for Nursing Homes | 0.0 | 17,160 | 9,240 | 26,400 |
| Delay BFET Enhancement | 0.0 | (1,576) | 0 | (1,576) |
| Continue Disaster Cash Assistance | 0.0 | 9,000 | 0 | 9,000 |
| ESAR Closeout | (4.5) | (446) | (1,045) | (1,491) |
| Maximum Benefit Issuance - FAP | 0.0 | 6,725 | 0 | 6,725 |
| SNAP Fraud Framework Implementation | 0.80 | 0 | 315 | 315 |
| ACES Stabilization | 0.0 | 2,450 | 2,950 | 5,400 |
| Hiring Freeze Savings | (58.5) | (6,039) | (3,978) | (10,017) |
| WA Immigrant Relief Fund | 0.0 | 10,000 | 0 | 10,000 |
| Extension of Certification Reviews | 0.0 | 2,210 | 2,553 | 4,763 |
| National Clearinghouse - SNAP | 0.70 | 342 | 342 | 684 |
| Administrative Underspend | 0.0 | (6,343) | (4,051) | (10,394) |
| Reallocate TANF Funds | 0.0 | (15,207) | 15,207 | 0 |
| WorkFirst Services Underspend | 0.0 | (16,740) | 0 | (16,740) |
| Administrative Savings | 0.0 | (2,700) | 0 | (2,700) |
| Electronic Health Records | 1.0 | 318 | 135 | 453 |
| Wage Increase Savings | 0.0 | (516) | (146) | (662) |
| Furlough Savings | 0.0 | (1,044) | (303) | (1,347) |
| SCC: Close Birch Unit | (5.7) | (908) | 0 | (908) |
| SCTF Siting & Expansion Reduction | (2.9) | (462) | 0 | (462) |
| Fund Central Services Charges | 0.0 | 1,590 | 672 | 2,262 |
| 2019-21 Policy Other Changes Total | (83.0) | 38,772 | 44,146 | 82,918 |
2019-21 Policy Comp Changes |
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| Agency Savings in FY 2021 | (7,031) | (3,343) | (10,374) | |
| General Wage Increase Savings | (1,458) | (410) | (1,868) | |
| 2019-21 Policy Comp Changes Total | 0.0 | (8,489) | (3,753) | (12,242) |
| Total Policy Changes | (83.0) | 30,283 | 40,393 | 70,676 |
| 2019-21 Policy Level | 11,536.5 | 6,352,097 | 7,506,231 | 13,858,328 |
Policy Changes
Hospital Revenue Adjustment
State, federal, and local appropriations are adjusted to reflect variation in expected federal and local revenues. Revenue projections of inpatient contributions and Medicaid earnings are based on a 12-month average.
Utility Rate Adjustments
Funding is provided for increasing utility costs for the state hospitals and the Office of Forensic Mental Health Services (OFMHS).
Federal Funding Adjustment
Federal funding is adjusted to reflect planned expenditures and to reduce federal funds the Department will not be able to draw down in the 19-21 biennium.
Transfers
The department will shift FTE staff and funding to align them with the programs where the costs are incurred for Fiscal Year 2021. The net impact is zero.
Hep C Adjustment
Funding is provided for medical treatment for state hospital patients who have Hepatitis C (Hep C).
Leased PC's
Funding is provided for increased rates for personal computers leased through the Department of Enterprise Services.
Disproportionate Share Hospital
Payments made to states under the Disproportionate Share Hospital grant program are intended to offset the costs of uncompensated care for Medicaid and uninsured patients. State and federal appropriations are adjusted to reflect changes in federal DSH revenue.
Citrix and VPN Charges
Funding is provided to reflect the increased costs incurred by the Department of Social and Health Service's for Citrix and Virtual-Private-Network (VPN) due to the rise in the number of staff working remotely as a result of the COVID-19 pandemic.
Technical Corrections
Funding is provided 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.
Civil Ward Reductions
As part of the Governor's plan to transform behavioral health and to move care for individuals on long-term inpatient commitments to community settings, the future civil census at the two state psychiatric hospitals will decrease. Funding in fiscal year 2021 is reduced to reflect the closure of one civil ward at Eastern State Hospital. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - Local CRC Oregon, other funds)
Delay San Juan Cottage Opening
The 2017-19 biennial budget included capital funding for a new 18-bed children's long term inpatient program cottage at the Child Study and Treatment Center. Current law assumed that the staff for the San Juan Cottage would be hired in January 2021 and patients admitted in April 2021. Delays in the capital construction project mean that the new cottage will be ready for occupancy in May 2021. Funding is adjusted to reflect the savings resulting from the delay in occupancy. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Trueblood Lawsuit Fines
A settlement agreement was reached between the parties of the Trueblood, et al. v. DSHS lawsuit in August 2018 which proposes the suspension of fines beginning in December 2018, provided the state maintains substantial compliance with the terms laid out in the settlement agreement approved by the U.S. District Court (Western District) on December 11, 2018. However, the federal court did not suspend outpatient contempt fines and DSHS is liable for plaintiff attorney fees and court monitor expenses. Funding is provided for outpatient contempt fines, plaintiff attorney fees and court monitor costs related to the Trueblood lawsuit. (General Fund - State)
Contract Rate Increases
These funds will provide rate increases for contracted essential services for Behavioral Health Administration facilities. (General Fund - State)
Leased PCs for Telework
Funding is provided for increased costs for personal computers leased through the Department of Enterprise Services resulting from the need for greater telework capabilities due to COVID-19. These new PCs will take the place of outdated work stations when individuals return to the workplace. (General Fund - State)
COVID-19 Screening Stations
Funding is provided for COVID-19 staffing and visitor screening stations for Behavioral Health Administration facilities. (General Fund - State)
Continue Safety Initiatives at WSH
To increase safety at Western State Hospital, funding is provided for a permanent recruitment and hiring team. This team is necessary to fill vacant funded and essential direct care and support positions to operate the hospital at a safe level for both patients and staff. (General Fund - State)
Personal Protective Equipment
Funding is provided to cover the increased need for personal protective equipment (PPE) as a result of the COVID-19 pandemic. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Agency Savings in FY 2021
Agency savings were achieved by implementing the governor's directive to furlough staff. (Veteran Estate Management Account - Federal, General Fund - Local, General Fund - Private/Local, other funds)
General Wage Increase Savings
Agency savings were achieved by implementing the governor's directive to withhold the general wage increase scheduled for July 1, 2020. (Veteran Estate Management Account - Federal, General Fund - Local, General Fund - Private/Local, other funds)
Forecast Cost/Utilization
Funding is reduced due to changes in the projected costs and utilization of long-term services and supports.
Mandatory Caseload Adjustments
Funding is adjusted to reflect forecasted caseload for the Special Commitment Center total confinement facility, the secure community transition facilities and the less restrictive alternative non-contracted populations based on the November 2020 caseload forecast.
Consumer Directed Employer
Funding is reduced due to a change in the applicable Business and Occupation (B&O) tax from 1.5 percent to 1.75 percent, an implementation timing change, and changes in the Individual Provider caseload.
Utilization of Residential Services
Funding is reduced as a result of projected changes in the caseload and cost of community residential services in the November, 2020 forecast.
DDA Children Residential Education
Funding is provided to pay for increased costs of approximately 80 school aged children in residential settings who need more service hours as a result of school being conducted virtually and not in-person.
Utilization of Respite Services
Funding is reduced for projected decreases in the caseload and cost of respite services based off of the November, 2020 forecast.
Enhanced FMAP Offset
During the Public Health Emergency (PHE) CMS provided an additional 6.2% in FMAP match for Medicaid services. The agency maximized the increase in federal funding to provide enhanced rates to providers in long-term care settings. The increased FMAP allowed the agency to offset GF-S that would ordinarily be used for services for clients and return GF-S to reserve.
COVID-19 Client Services/Facility
Funding and 1.0 FTE staff are provided to address increased costs resulting from the COVID-19 pandemic, including a state-operated COVID-19 specific facility and temporary financial eligibility staff. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - State, other funds)
Shared Benefit Adjustment
Funding is provided to cover the estimated claims for the variance between services provided under the shared benefit equation and the full amount of the benefit while rulemaking takes place. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Mandatory Workload Tech Correction
The agency discovered an error in the Mandatory Workload Step data for Adult Protective Services (APS) investigations, which drives the number of FTE allotted to the APS program. As a result, funding is reduced along with 186.0 FTEs.
Rental Subsidies
The COVID-19 pandemic is requiring nursing facilities to move many clients who no longer need nursing levels of care into community settings. The cost of the state-only rental subsidies, in-home services, and ALTSA staff requires less GF-State dollars than the state portion of the nursing home Medicaid rate, if clients continued to wait in nursing facilities. Savings are achieved utilizing state-only rental subsidies of no more than $750/month. To support this effort, 3.3 FTE staff are provided. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - Local CRC Oregon, other funds)
Continue COVID Crisis Response
Funds are provided for continuing strike teams and COVID-specific units in long-term care facilities. Strike teams are trained personnel who are able to travel where needed to temporarily assist long-term care facilities that cannot care for their vulnerable clients due to a COVID outbreak that depletes the facility's own staff. The COVID specific facilities are paid a higher rate for more intensive staffing and infection disease control procedures in order to provide care in a wing or entire facility dedicated to serving COVID-positive clients who do not need hospital care, but require ongoing nursing support during their recovery. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Transitional Care Center of Seattle
Funds are provided for nursing home services and emergent building costs at the Transitional Care Center of Seattle (TCCS). As part of the COVID-19 response, DSHS purchased this building to provide care for difficult-to-place residents from acute care hospitals. This will create more hospital capacity to treat COVID-19 patients. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
COVID Client Services/Facility
Funding is provided to address increased costs resulting from the COVID-19 pandemic, including a state-operated COVID-19 specific facility and temporary financial eligibility staff. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
COVID Testing for Nursing Homes
This item supports the ongoing costs of testing at nursing facilities. CDC guidelines direct nursing facilities to test for COVID-19 at an increased frequency, and the price of tests continues to fluctuate. Additional funding will support the cost of the increased testing count. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - State, other funds)
TANF Caseload Adjustment
Funding is adjusted to reflect the November 2020 caseload forecast and per capita costs for the Temporary Assistance for Needy Families (TANF) program.
Fund Balance
The state general-fund is reduced one-time in fiscal year 2021 due to a contribution of federal funds that covered the cost of COVID related policy changes including the Temporary Assistance for Needy Families (TANF) 60-month time limit extension, a waiver of TANF work requirements and sanction, and to offer the maximum food benefit to recipients of the state's Food Assistance Program in order to mirror a federal Supplemental Nutrition Assistance Program waiver.
Delay BFET Enhancement
Funding for a Basic Food Education and Training (BFET) program enhancement is reduced one-time in fiscal year 2021 to reflect a delay in implementation. (General Fund - State)
Continue Disaster Cash Assistance
Pursuant to the Governor's Proclamation 20-18, 20.52 et seq., and 20-63 et seq., the Department of Social and Health Services continues to provide assistance through the Disaster Cash Assistance Program (DCAP) to individuals and families without children during the COVID-19 pandemic. Funding is provided to continue DCAP in fiscal year 2021 contingent upon the extension of the specified proclamations. (General Fund - State)
ESAR Closeout
Due to the termination of the Eligibility Services ACES Remediation (ESAR) project in fiscal year 2021, funding is reduced to reflect the unspent appropriation. (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Maximum Benefit Issuance - FAP
The Department of Social and Health Services has received monthly waivers from the federal Food and Nutrition Service (FNS), allowing it to offer the maximum food benefit to recipients of the Supplemental Nutrition Assistance Program (SNAP) to address food insecurity during the COVID-19 pandemic. Contingent upon the department continuing to receive this federal waiver in January 2021 through June 2021, funding is provided to allow the department to issue the maximum food benefit to recipients of the state's Food Assistance Program (FAP), which mirrors the SNAP requirements. (General Fund - State)
SNAP Fraud Framework Implementation
One-time federal funding is awarded to the Economic Services Administration to create an automated fraud prevention dashboard and database system to detect criminal fraud or other fraudulent activities in the Supplemental Nutrition Assistance Program. (General Fund - Federal, General Fund - State)
ACES Stabilization
Funding is provided to extend the life of the Automated Client Eligibility System (ACES), the state’s financial eligibility and enrollment system for safety net programs, including Medicaid, basic food, and cash assistance. This funding is specifically for database modernization activities to address current stability issues and to mitigate known risks. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Hiring Freeze Savings
Agency savings were achieved by implementing the governor’s directive to freeze non-essential hiring. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
WA Immigrant Relief Fund
Funding is provided to continue offering a one-time benefit to undocumented immigrants who have experienced a hardship due to the COVID-19 pandemic. (General Fund - State)
Extension of Certification Reviews
In response to the COVID-19 pandemic and pursuant to the federal Continuing Appropriations Act of 2021 (H.R. 8337 (Sec. 4603)), the Department of Social and Health Services has opted to suspend the mid-certification reviews and extend eligibility reviews temporarily between November 2020 and June 2021 for the Supplemental Nutrition Assistance Program (SNAP), the state's Food Assistance Program (FAP), the Temporary Assistance for Needy Families Program (TANF), the State Family Assistance Program (SFA), and the Aged, Blind or Disabled Program (ABD). This allows the department to smooth out the spike in the certification review workload and ensure that eligible households maintain access to assistance during the COVID-19 pandemic. (General Fund - State, General Fund - Federal Dedicated, General Fund - Temporary Assist for Needy Families)
National Clearinghouse - SNAP
Funding is provided to the Economic Services Administration to implement a federally mandated interstate data matching system for the Supplemental Nutrition Assistance Program (SNAP). The funding covers IT enhancements, national clearinghouse fees, and staffing. (General Fund - State, General Fund - Federal)
Administrative Underspend
Agency savings were achieved through a reduction in administrative expenses including training, travel, capital outlays, and contracts. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Reallocate TANF Funds
Unallocated state general funds are offset by using available federal Temporary Assistance for Needy Families (TANF) funds during the 2019-21 biennium. These funds are reallocated to other Temporary Assistance for Needy Families services, caselaod, and poverty reduction items. (General Fund - Federal Dedicated, General Fund - State, General Fund - Temporary Assist for Needy Families)
WorkFirst Services Underspend
As a result of underspending in WorkFirst services, funding is reallocated to other Temporary Assistance for Needy Families services and poverty reduction items. (General Fund - State)
Administrative Savings
Funding and staffing are reduced in fiscal year 2021 to reflect an underspend due to staffing vacancies, reduced travel, and fewer clients seeking services. (General Fund - State)
Electronic Health Records
Funding is provided to replace obsolete and failing switching equipment at facilities. (General Fund - State, General Fund - Federal)
Wage Increase Savings
Agency savings were achieved by implementing the governor's directive to withhold the general wage increase scheduled for July 1, 2020. (General Fund - Federal, General Fund - State)
Furlough Savings
Agency savings were achieved by implementing the governor's directive to furlough staff. (General Fund - Federal, General Fund - State)
Less Restrictive Alternatives
Funding is adjusted to reflect forecasted caseload for less restrictive alternative contracted bed populations based on the November 2020 caseload forecast.
SCC: Close Birch Unit
Due to a declining census at the Special Commitment Center Total Confinement Facility, the Department of Social and Health Services was able to consolidate residents between living units. Individuals previously housed in the Birch Unit have been moved into other living units while maintaining appropriate support. Funding is reduced to align with the savings achieved through this closure. (General Fund - State)
SCTF Siting & Expansion Reduction
To maintain social distancing measures in response to the COVID-19 pandemic, the Department of Social and Health Services has delayed moving individuals into the new King County Secure Community Transition Facility expansion wing. Funding is reduced to account for the savings associated with the delay in staffing and services. (General Fund - State)
Fund Central Services Charges
Funding is provided to the Department of Social and Health Services to accommodate increased costs associated with payments to the Attorney General's Office, Office of Financial Management and Office of Administrative Hearings. (General Fund - Federal, General Fund - State)
