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Department of Health

  Average Annual FTEs Near General Fund State Other Funds Total Funds
  (Dollars in Thousands)
Current Budget 1,881.8 147,968 1,133,924 1,281,892
2019-21 Maintenance Level 1,890.3 148,963 1,134,846 1,283,809
Difference from 2017-19 8.5 995 922 1,917
% Change from 2017-19 0.45% 0.67% 0.08% 0.15%

2019-21 Policy Other Changes

Prescription Drug Monitoring 0.0 1,125 0 1,125
Preserve Title X Program 0.0 8,400 0 8,400
Foundational Public Health Services 0.0 10,528 0 10,528
Child Profile Health System 0.0 1,000 0 1,000
Maintain HEAL-WA Web Portal 0.10 0 964 964
Medical Test Site Inspections 1.0 0 530 530
Comply with HIV Reinvest Rule 0.0 0 8,000 8,000
Communicable Disease Modernization 0.0 51 0 51
Lower Vape/Tobacco Use-Age 18 to 20 0.0 989 0 989
Conduct Mandated Newborn Screening 1.2 6 360 366
Eliminate Hepatitis C 0.30 228 0 228
Reduce Suicide Rates 1.3 2,046 0 2,046
Attorney General Costs 0.0 0 1,623 1,623
Ensuring Access to Women's Health 0.0 159 0 159
Fentanyl Prevention Campaign 0.0 60 0 60
Psychiatric Hospital Enforcement 1.8 746 0 746
Reproductive Health Act 0.0 49 0 49
Secure Drug Take Back Program 0.0 0 1,008 1,008
Vapor Product Labeling 4.2 1,674 0 1,674
2019-21 Policy Other Changes Total 9.9 27,061 12,485 39,546

2019-21 Policy Comp Changes

PERS & TRS Plan 1 Benefit Increase 0.0 9 45 54
2019-21 Policy Comp Changes Total 0.0 9 45 54

2019-21 Policy Central Services Changes

Archives/Records Management 0.0 3 13 16
Attorney General 0.0 24 195 219
DES Central Services 0.0 5 22 27
OFM Central Services 0.0 76 376 452
2019-21 Policy Central Services Changes Total 0.0 108 606 714
Total Policy Changes 9.9 27,178 13,136 40,314
2019-21 Policy Level 1,900.2 176,141 1,147,982 1,324,123
Difference from 2017-19 18.4 28,173 14,058 42,231
% Change from 2017-19 0.98% 19.0% 1.2% 3.3%

Policy Changes

Attorney General

Adjustments are made to reflect each agency's anticipated share of legal service charges from the Attorney General’s Office. (General Fund - Local, General Fund - State, Health Professions Account - State, other funds)

DES Central Services

Adjustments are made to reflect each agency’s anticipated share of charges from the Department of Enterprise Services (DES) for campus rent, utilities, parking, and contracts; capital project surcharges; financing cost recovery; public and historic facilities; real estate services; risk management services; personnel service rates; the Perry Street child care center; small agency services; and the department’s enterprise applications. (General Fund - Federal, General Fund - State, Health Professions Account - State, other funds)

OFM Central Services

Adjustments are made to reflect each agency’s anticipated share of charges from the Office of Financial Management (OFM) for statewide financial applications, One Washington, and other OFM central services. (General Fund - Federal, General Fund - State, Health Professions Account - State, other funds)

Prescription Drug Monitoring

Federal grants are no longer available to support the prescription drug monitoring program. General Fund-State funds are provided to continue supporting the initiative to reduce prescription drug abuse and misuse. (General Fund - State)

Preserve Title X Program

This item replaces lost federal funding to maintain family planning services across the state. The U.S. Department of Health and Human Services' new rule changes federal Title X regulations. This rule, which conflicts with state law, no longer allows the state to use Title X funds for its Family Planning Program, which offers pharmaceuticals, supplies, health education, training for providers and staff, and reimbursement to providers. (General Fund - State)

Foundational Public Health Services

Estimated revenue from vapor distribution taxes will be insufficient to cover the Foundational Public Health Services Account appropriation in the 2019-21 biennium. Ongoing funding is provided from the state general fund for foundational public health services. (General Fund - State)

Child Profile Health System

The federal revenue provided through the Core Immunization Grant has remained stagnant over the years, yet the expenditure requirements placed on the grant have grown. This grant, which helped cover the state's Child Profile Health Promotion System, is not able to sustain its historical support of this statewide communication tool. Funding is provided to DOH to maintain the Child Profile Health Promotion System. (General Fund - State)

Maintain HEAL-WA Web Portal

The operational costs of the University of Washington Health Electronic Resource for Washington (HEAL-WA) web portal are increasing as the number of users increase. Funding is provided to cover the increased costs to maintain this valuable tool which allows health care providers to access professional literature and clinical resources. (Health Professions Account - State)

Medical Test Site Inspections

The number of inspections and complaint investigations in the Medical Test Sites program is increasing. Current spending authority is insufficient to support the program's current resource needs. Funding is provided for the program to maintain inspection of licensed laboratories and protect patient safety. (Medical Test Site Licensure Account - State)

Comply with HIV Reinvest Rule

The federal Ryan White Care Act requires the state to reinvest all pharmaceutical drug rebate revenue it receives through its AIDS Drug Assistance Program into additional services to support those living with HIV/AIDS. This step provides additional authority from the general fund (local) to comply with the federal requirement to reinvest rebate funds to continue providing community services, medical services, case management, and support services for people living with HIV. (General Fund - Local, General Fund - Private/Local)

Communicable Disease Modernization

In 2017, the HIV Planning Steering Committee, facilitated by the Washington State Department of Health (DOH), recommended actions the state should take to update and modernize state statutes. Proposed legislation will make changes in state law to remove HIV/AIDS exceptionalism, reduce negative HIV stigma, and eliminate barriers to routine HIV testing. A one-time appropriation is needed to cover the costs of stakeholder engagement and rule-making. (General Fund - State)

Lower Vape/Tobacco Use-Age 18 to 20

This item promotes vape and tobacco cessation and provides counseling support and nicotine replacement therapy to 18- to 20-year-olds addicted to tobacco and vapor products. Effective January 2020, a new state law will raise the minimum legal age of sale for tobacco and vapor products from 18 to 21 years of age. This will leave many young people in this group addicted to products to which they will soon no longer have legal access. (General Fund - State)

Conduct Mandated Newborn Screening

In 2019, the State Board of Health added spinal muscular atrophy to the list of diseases screened through the state's mandatory newborn screening panel. Funding is provided to increase the test fee to support the department's Newborn Screening Laboratory to conduct this new, required blood sample testing for this heritable condition. (General Fund - Local, General Fund - Private/Local, General Fund - State)

Eliminate Hepatitis C

Funding is provided to DOH for the Lab Information Management System (LIMS) which will automatically generate case reports in the Washington Disease Reporting System. This item is eligible for a 90/10 federal match and has the matching federal dollars funded in the Health Care Authority. (General Fund - State)

Reduce Suicide Rates

This funding supports the most critical enhancements to the state's suicide prevention system. Substantial investments will provide the department with resources to lead, coordinate and implement the Washington State Suicide Prevention Plan, and to coordinate with a broad group of stakeholders. Grant funding is also provided for tribal nations and for a pilot project on preventing suicides in the agricultural industry. (General Fund - State)

Attorney General Costs

The 2019-21 biennial budget provided the Attorney General's Office (AGO) with funding for increased work related to the Washington Medical Commission and the Chiropractic Quality Assurance Commission, but did not provide a corresponding increase to DOH to pay the increased bills. This item provides the expenditure authority to DOH to cover the cost of legal services required. (Health Professions Account - State)

Ensuring Access to Women's Health

Funding is provided to ensure that all women employed by the state and their families have access to the full range of reproductive health services regardless of individual health plan coverage. Funding is effective January 1, 2020, and is anticipated to be ongoing. (General Fund - State)

Fentanyl Prevention Campaign

Funding is provided for an educational campaign targeting youth to alert them of the dangers of fentanyl use. (General Fund - State)

Psychiatric Hospital Enforcement

This item enhances DOH oversight for psychiatric hospitals by requiring all new facilities to obtain a 24-month provisional license in chapter 71.12 RCW. DOH will provide technical assistance and conduct frequent inspections during this period to ensure the hospital can provide safe care and maintain compliance. This expands the enforcement options available to DOH in chapter 43.70 RCW including license suspension, license conditions, suspension of patient admissions, and civil fines. (General Fund - Local, General Fund - Private/Local, General Fund - State)

Reproductive Health Act

Funding is provided to DOH to cover costs identified in the published fiscal note for Chapter 399, Laws of 2019 (Second Substitute Senate Bill 5602). (General Fund - State)

Secure Drug Take Back Program

Expenditure authority is provided for the Safe Medication Return/ Drug Take-Back Program to match revenue DOH has already received. Starting in July 2020, the department will contract with the Washington Poison Center to conduct a survey of Washington residents to measure whether the drug take-back program has led to statistically significant changes in safe and secure disposal attitudes and in drug abuse or misuse rates. (Secure Drug Take-back Program Acct - State)

Vapor Product Labeling

Funding is provided to the Department of Health to establish a program and information system to collect and process labeling and ingredient tracking of vapor products sold to consumers in the state of Washington. (General Fund - State)

PERS & TRS Plan 1 Benefit Increase

For eligible Public Employees' and Teachers' Retirement Systems Plan 1 members, this item provides an increase of 1.5 percent, up to a maximum of $22 per month. (General Fund - Federal, General Fund - State, Health Professions Account - State, other funds)

Archives/Records Management

Adjustments are made to reflect each agency’s anticipated share of state archiving and state records center costs from the Secretary of State’s Office. (General Fund - Federal, General Fund - State, Health Professions Account - State, other funds)