Department of Social and Health Services - Long Term Care
|Annual FTEs||General Fund State||Other Funds||Total Funds|
|(Dollars in Thousands)|
|Total Maintenance Changes||0.0||0||0||0|
|2019-21 Maintenance Level||2,336.5||2,677,134||3,692,079||6,369,213|
2019-21 Policy Other Changes
|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|
|Personal Protective Equipment||0.0||521||415||936|
|COVID Testing for Nursing Homes||0.0||17,160||9,240||26,400|
|Shared Benefit Adjustment||0.0||3,744||4,766||8,510|
|2019-21 Policy Other Changes Total||1.7||41,423||29,578||71,001|
|Total Policy Changes||1.7||41,423||29,578||71,001|
|2019-21 Policy Level||2,338.2||2,718,557||3,721,657||6,440,214|
Funding is reduced due to changes in the projected costs and utilization of long-term services and supports.
Mandatory Caseload Adjustments
Funding is reduced due to a decrease in the projected number of clients receiving long-term care services and supports based off of the November, 2020 forecast.
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.
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.
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.
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.
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.
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.
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.
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)
Personal Protective Equipment
Funding is provided to reflect the increased costs incurred 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)
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)
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)