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 Original | 0.0 | 172,181 | 388,160 | 560,341 |
| % Change from Original | 0.0% | 2.1% | 1.6% | 1.7% |
2023-25 Policy Other Changes |
||||
| Hospital Safety Net Assessment | 0.0 | 0 | 246,863 | 246,863 |
| MQIP Payments | 0.0 | 0 | (66,352) | (66,352) |
| Acupuncture and Chiropractic | 0.0 | (984) | (2,981) | (3,965) |
| Upper Payment Limit | 0.0 | 229 | (289) | (60) |
| Cannabis Revenue Distributions | 0.0 | 25,046 | (25,046) | 0 |
| Overdose Prevention/Harm Reduction | 0.0 | (2,928) | 2,928 | 0 |
| CBHS 1915i | 0.0 | 8,261 | 9,021 | 17,282 |
| PPW Residential | 0.0 | (1,135) | (568) | (1,703) |
| Community Beds at OHBH | 0.0 | (1,368) | 0 | (1,368) |
| Controlled Sub.Treatment Admin | 0.0 | 0 | (300) | (300) |
| Prescription Opioid Education | 0.0 | 0 | (350) | (350) |
| MOUD in Jails Technical Support | 0.0 | 0 | (403) | (403) |
| MTP 2.0 Long-Term Supports Services | 3.5 | 0 | (47,970) | (47,970) |
| BH Personal Care - 1915i Waiver | 0.0 | 5,982 | 0 | 5,982 |
| Medicaid Transformation Project 2.0 | 0.0 | 0 | 33,440 | 33,440 |
| Contract Increases | 0.0 | 0 | 594 | 594 |
| Stanwood Commitment Facility Beds | 0.0 | (341) | (386) | (727) |
| Health Home Shared Federal Savings | 0.0 | (13,500) | 0 | (13,500) |
| Blake Projects/Programs | 0.0 | 250 | 0 | 250 |
| Behavioral Health Application | 0.0 | (561) | 0 | (561) |
| Foundational Community Supports | 0.0 | 0 | 28,406 | 28,406 |
| Long-Acting OUD Medication | 0.0 | 0 | (750) | (750) |
| SUD Prev., Outreach, Tx, Recovery | 0.0 | 0 | (250) | (250) |
| Rapid Methadone Induction Pilot | 0.0 | 0 | (875) | (875) |
| UW 90/180 Beds | 0.0 | 0 | 1,245 | 1,245 |
| Long-term Civil Commitment Beds | 0.0 | (6,331) | (2,740) | (9,071) |
| 2023-25 Policy Other Changes Total | 3.5 | 12,620 | 173,237 | 185,857 |
| Total Policy Changes | 3.5 | 12,620 | 173,237 | 185,857 |
| Policy Level | 1,662.7 | 8,284,029 | 24,642,381 | 32,926,410 |
| Difference from Original | 3.5 | 184,801 | 561,397 | 746,198 |
| % Change from Original | 0.21% | 2.3% | 2.3% | 2.3% |
Policy Changes
Controlled Sub.Treatment Admin
Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - 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)
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)
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)
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)
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)
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)
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)
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)
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)
Prescription Opioid Education
Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)
MOUD in Jails Technical Support
Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)
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)
BH Personal Care - 1915i Waiver
Funding is provided for projected cost increases related to Behavioral Health Personal Care services. (General Fund - State)
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)
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)
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)
Health Home Shared Federal Savings
Shared savings from the federal government by operating the health home program. (General Fund - State)
Blake Projects/Programs
Funding is provided to fully implement SB 5536. (General Fund - State)
Behavioral Health Application
Funding is adjusted due to delays in implementing an application-based behavioral health pilot program. (General Fund - 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)
Long-Acting OUD Medication
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)
Rapid Methadone Induction Pilot
Funding is adjusted to align with projected expenditures. (Opioid Abatement Settlement Account - State)
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)
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)
