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Agency recommendation summaries

Washington State Health Care Authority

  Average Annual FTEs Near General Fund State Other Funds Total Funds
  (Dollars in Thousands)
Current Budget 1,659.2 8,099,228 24,080,984 32,180,212
2023-25 Maintenance Level 1,659.2 8,271,409 24,469,144 32,740,553
Difference from 2023-25 Original 0.0 172,181 388,160 560,341
% Change from 2023-25 Original 0.0% 2.1% 1.6% 1.7%

2024 Policy Other Changes

Acupuncture and Chiropractic 0.0 (984) (2,981) (3,965)
BH Personal Care - 1915i Waiver 0.0 5,982 0 5,982
Behavioral Health Application 0.0 (561) 0 (561)
Blake Projects/Programs 0.0 250 0 250
CBHS 1915i 0.0 8,261 9,021 17,282
Cannabis Revenue Distributions 0.0 25,046 (25,046) 0
Community Beds at OHBH 0.0 (1,368) 0 (1,368)
Contract Increases 0.0 0 594 594
Controlled Sub.Treatment Admin 0.0 0 (300) (300)
Foundational Community Supports 0.0 0 28,406 28,406
Health Home Shared Federal Savings 0.0 (13,500) 0 (13,500)
Hospital Safety Net Assessment 0.0 0 246,863 246,863
Long-Acting OUD Medication 0.0 0 (750) (750)
Long-term Civil Commitment Beds 0.0 (6,331) (2,740) (9,071)
MOUD in Jails Technical Support 0.0 0 (403) (403)
MQIP Payments 0.0 0 (66,352) (66,352)
MTP 2.0 Long-Term Supports Services 3.5 0 (47,970) (47,970)
Medicaid Transformation Project 2.0 0.0 0 33,440 33,440
Overdose Prevention/Harm Reduction 0.0 (2,928) 2,928 0
PPW Residential 0.0 (1,135) (568) (1,703)
Prescription Opioid Education 0.0 0 (350) (350)
Rapid Methadone Induction Pilot 0.0 0 (875) (875)
SUD Prev., Outreach, Tx, Recovery 0.0 0 (250) (250)
Stanwood Commitment Facility Beds 0.0 (341) (386) (727)
UW 90/180 Beds 0.0 0 1,245 1,245
Upper Payment Limit 0.0 229 (289) (60)
2024 Policy Other Changes Total 3.5 12,620 173,237 185,857
Total Policy Changes 3.5 12,620 173,237 185,857
2024 Policy Level 1,662.7 8,284,029 24,642,381 32,926,410
Difference from 2023-25 Original 3.5 184,801 561,397 746,198
% Change from 2023-25 Original 0.21% 2.3% 2.3% 2.3%

Policy Changes

Acupuncture and Chiropractic

Reduction due to agency halting implementation of new Acupuncture and Chiropractic benefit. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

BH Personal Care - 1915i Waiver

Funding is provided for projected cost increases related to Behavioral Health Personal Care services. (General Fund - State)

Behavioral Health Application

Funding is adjusted due to delays in implementing an application-based behavioral health pilot program. (General Fund - State)

Blake Projects/Programs

Funding is provided to fully implement SB 5536. (General Fund - State)

CBHS 1915i

Funding is provided for increased costs related to the Community Behavioral Health Supports program. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Cannabis Revenue Distributions

Appropriations from the Dedicated Cannabis Account are adjusted pursuant to chapter 169, Laws of 2022 (E2SSB 5796) and the November 2024 revenue forecast. (Basic Health Plan Trust Account - Non-Appropriated, Dedicated Cannabis Account - State, General Fund - State)

Community Beds at OHBH

Funding is reduced to match updated cost projections for a community provider to offer behavioral health services in two wards of Olympic Heritage Behavioral Health. (General Fund - State)

Contract Increases

The Washington State Health Care Authority requests additional financial resources in the 2025 supplemental to cover the increased costs for various contracts that are necessary to maintain the operations of the Apple Health, Public Employee Benefits Board, and School Employees Benefits Board programs. (School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State)

Controlled Sub.Treatment Admin

Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)

Foundational Community Supports

Funding to increase rates for Supportive Housing and Supported Employment services and assist additional clients with receiving services. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)

Health Home Shared Federal Savings

Shared savings from the federal government by operating the health home program. (General Fund - State)

Hospital Safety Net Assessment

The Hospital Safety Net Assessment (HSNA) program allows the HCA to collect assessments from Washington State hospitals and use the proceeds for payments to hospitals. Funding is adjusted to align with forecasted enrollment increases for the HSNA program. (General Fund - Federal, General Fund - Local, General Fund - Private/Local, other funds)

Long-Acting OUD Medication

Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)

Long-term Civil Commitment Beds

Funding is adjusted to align with projected expenditures for individuals on 90-day to 180-day civil commitment orders who are served in community settings. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

MOUD in Jails Technical Support

Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)

MQIP Payments

Medicaid Quality Improvement Program (MQIP) will be used to support the 1115 Medicaid Transformation Project (MTP) waiver. Apple Health managed care organizations and their partnering providers will receive MQIP payments as they meet designated milestones. Funding is adjusted to reflect anticipated program expenditures. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)

MTP 2.0 Long-Term Supports Services

Funding to provide additional rental subsidies and respite care for waiver participants. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)

Medicaid Transformation Project 2.0

Funding is provided through MQIP to align appropriation authority with anticipated MTP expenditures for Accountable Communities of Health, Initiative 1. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)

Overdose Prevention/Harm Reduction

Funding for Naloxone is shifted from General Fund-State to the Opioid Abatement Settlement Account. (General Fund - State, Opioid Abatement Settlement Account - State)

PPW Residential

Funding is eliminated due to a lack of provider interest is operating a 16-bed, pregnant and parenting women Residential Treatment program in Grays Harbor County. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Prescription Opioid Education

Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)

Rapid Methadone Induction Pilot

Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)

SUD Prev., Outreach, Tx, Recovery

Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)

Stanwood Commitment Facility Beds

Funding is adjusted for civil commitment beds at the Stanwood facility. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

UW 90/180 Beds

Funding is adjusted for civil commitment beds at the University of Washington Behavioral Health hospital. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal)

Upper Payment Limit

Funding is provided to cover costs above the Medicaid Inpatient Upper Payment Limit (UPL) which are disallowed by CMS. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - State, other funds)