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Home » Budget » State budgets » 2021-23 Gov. Inslee's proposed budgets » Agency recommendation summaries » Washington State Health Care Authority

Washington State Health Care Authority

  Annual FTEs General Fund State Other Funds Total Funds
  (Dollars in Thousands)
Estimated Expenditures 1,431.0 6,047,285 16,296,030 22,343,315
2021-23 Maintenance Level 1,429.3 6,132,990 15,827,004 21,959,994
Difference from 2019-21 (1.7) 85,705 (469,026) (383,321)
% Change from 2019-21 (0.1%) 1.4% (2.9%) (1.7%)

2021-23 Policy Other Changes

Healthier WA Savings Restoration 0.0 61,584 80,848 142,432
Restore Program Integrity Savings 0.0 143,000 321,000 464,000
Low-Income Health Care I-502 0.0 (65,478) 65,478 0
1115 IMD Waiver Costs 1.0 207 1,868 2,075
Initiative 3 FCS Extension 0.0 0 17,102 17,102
SHB 2728 Telehealth Lines 1.0 803 0 803
Behavioral Health Provider Rate 0.0 7,428 12,584 20,012
Administrative Reduction 0.0 (3,636) (5,376) (9,012)
SSB 5181 - Firearms Restrictions (0.5) 0 (36) (36)
Extend MTP Initiative 3 1.5 0 (25,499) (25,499)
Scheduling Tool Replacement 0.0 0 300 300
Trueblood Phase 2 Implementation 0.0 17,155 2,619 19,774
UMP Member Support 1.0 0 261 261
WRHAP Pilot Program Evaluation 0.0 120 0 120
Youth Mobile Crisis Teams 0.0 7,848 2,622 10,470
Child Assessment & Diagnosis 0.0 3,062 66 3,128
Inpatient Treatment Capacity 0.0 13,500 0 13,500
BH Employment Barriers Task Force 0.0 100 0 100
Bed Tracker System 1.0 220 620 840
Mobile Crisis Response Enhancements 0.0 8,000 0 8,000
Co-Responder Grants 0.0 2,000 0 2,000
BH Teaching Clinics Enhancement 0.0 150 0 150
Child Care Sponsorship Pilot 3.0 390 590 980
Health Homes - Tribal Affairs 0.0 (302) 1,960 1,658
Tribal Residential SUD Rates 0.0 0 15,733 15,733
Covered Lives Tax 0.0 34,139 59,798 93,937
Interoperability (Health Care) 0.0 394 2,106 2,500
Primary Care Case Mgmt - Tribal 0.0 26 232 258
MH Referral Service for Children 0.0 1,480 220 1,700
ECHO Project (ID/DD) 0.0 600 0 600
MQIP Extension 0.0 0 342,321 342,321
Benefit Programs Customer Support 3.0 0 626 626
ALTSA Extension 48.8 0 53,676 53,676
PEBB My Account Ongoing Support 2.0 0 1,221 1,221
Performance Audits and Requests 1.0 0 292 292
Pharmacy Point of Sale 3.0 435 3,913 4,348
DSH Delay 0.0 (69,617) 179,562 109,945
Trueblood FTEs 7.0 2,245 0 2,245
MTP Extension 0.0 0 (393,424) (393,424)
Family Planning Rate Enhancement 0.0 5,129 15,526 20,655
Community Health Centers - I-502 0.0 590 (590) 0
HBE Sponsorship Program Improvement 0.0 0 908 908
Modernizing Healthplanfinder 0.0 0 4,064 4,064
HBE Business and Worker Outreach 0.0 0 600 600
HBE Enhanced Data Analysis 0.0 0 1,408 1,408
Enhanced Security Program 0.0 0 325 325
GF-State Reduction 0.0 (1,554) 1,554 0
Language Access Providers Agreement 0.0 79 109 188
Backfill Medicaid Fraud Account 0.0 19,103 (19,103) 0
2021-23 Policy Other Changes Total 72.8 189,200 748,084 937,284

2021-23 Policy Comp Changes

Pension Adjustments, nonrate 0.0 80 145 225
State Employee Benefits 0.0 (120) (209) (329)
WFSE General Government 0.0 (1,285) (2,637) (3,922)
Temporary Layoffs and Other Savings 0.0 (3,070) (5,245) (8,315)
Rep Employee Health Benefits 0.0 (71) (141) (212)
Non-Rep General Wage Increase 0.0 (1,664) (2,392) (4,056)
2021-23 Policy Comp Changes Total 0.0 (6,130) (10,479) (16,609)

2021-23 Policy Central Services Changes

Archives/Records Management 0.0 5 8 13
Audit Services 0.0 (39) (63) (102)
Legal Services 0.0 (109) (143) (252)
Administrative Hearings 0.0 (37) (35) (72)
CTS Central Services 0.0 117 189 306
DES Central Services 0.0 47 76 123
OFM Central Services 0.0 1,587 172 1,759
Self-Insurance Liability Premium 0.0 21 35 56
2021-23 Policy Central Services Changes Total 0.0 1,592 239 1,831
Total Policy Changes 72.8 184,662 737,844 922,506
2021-23 Policy Level 1,502.1 6,317,652 16,564,848 22,882,500
Difference from 2019-21 71.1 270,367 268,818 539,185
% Change from 2019-21 5.0% 4.5% 1.6% 2.4%

Policy Changes

Healthier WA Savings Restoration

Healthier Washington is a project that allows the Health Care Authority and the Department of Social and Health Services to establish integrated clinical models of physical and behavioral health care to improve the effectiveness of health care purchasing and delivery. Savings assumed in the current budget will not be realized this biennium. Funding is provided to restore a portion of the assumed savings. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Restore Program Integrity Savings

Program integrity activities help ensure that state and federal dollars are spent appropriately on delivering high-quality, necessary care and on preventing fraud and waste. The savings assumed in the current budget will not be realized in the 2021-23 biennium. Funding is provided to restore assumed savings. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)

Low-Income Health Care I-502

Initiative 502, approved by voters in 2012, directed a portion of the revenue from taxes on the sale of marijuana into the Basic Health Trust Account. Those dollars are used in lieu of General Fund-State dollars for capitation payments for Medicaid clients enrolled in managed care plans. Funding is adjusted to reflect updated estimates of marijuana-related revenue. (General Fund - State, Basic Health Plan Trust Account - Non-Appropriated)

1115 IMD Waiver Costs

The federal Centers for Medicare & Medicaid Services (CMS) requires significant health information technology (HIT) commitments to meet milestones associated with the 1115 Institutions for Mental Disease (IMD) waiver. There also are reporting and evaluation requirements related to the waiver. To ensure all required assessment, IT, budget neutrality and evaluation elements are met, funding is provided for increased HIT costs necessary for the implementation of the waiver. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - Cash, other funds)

Initiative 3 FCS Extension

Funding is provided to align with anticipated spending for the Medicaid Transformation Project (MTP) Initiative 3 (Foundational Community Supports). The transformation project is a five-year agreement between Washington state and the Centers for Medicare and Medicaid Services that provides federal investment to promote innovative, sustainable, and systemic changes that improve the overall health of Washingtonians. (General Fund - Federal, General Fund - Private/Local, General Fund - Local)

SHB 2728 Telehealth Lines

Funding is provided to implement Substitute House Bill 2728, which requires HCA to calculate and administer a carrier assessment to fund the Partnership Access Line and the Psychiatric Consultation Line. (General Fund - State)

Behavioral Health Provider Rate

Funding is provided to maintain and increase access for behavioral health services for Medicaid patients through increased provider rates. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)

Administrative Reduction

The Health Care Authority will reduce expenditures on non-mission critical contracts and by maintaining a higher than usual vacancy rate. (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)

SSB 5181 - Firearms Restrictions

Substitute Senate Bill 5181, enacted in the 2019 legislative session, imposed restrictions on firearms possession by individuals receiving involuntary behavioral health treatment, which created work for the Health Care Authority's firearms compliance unit. The actual workload has been less than anticipated in the enacted budget. Funding is reduced to align with projected expenditures. (General Fund - State, General Fund - Cash, General Fund - Local CRC Oregon, other funds)

Extend MTP Initiative 3

The Medicaid Transformation Project (MTP) is a five-year agreement between the state and the Centers for Medicare and Medicaid Services (CMS) that provides federal investment to promote innovative, sustainable, and systemic changes that improve the overall health of Washingtonians. Funding is provided to extend the MTP Initiative 3 (Foundational Community Supports) for an additional year. This extension year will provide additional services for supportive housing and supported employment with community partners during the pandemic. (General Fund - Local, General Fund - Federal, General Fund - Private/Local)

Scheduling Tool Replacement

This funds the replacement of a scheduling tool in the customer service center because the existing tool (Pipkins Software) is no longer updated or technically supported. A maintainable and supported workforce scheduling tool will enable the Employees and Retirees Benefits (ERB) Division customer service unit to more effectively manage resources and meet increasing customer service needs through calls and document processing. (St Health Care Authority Admin Acct - State, School Employees' Insur Admin Acct - Non-Appropriated)

Trueblood Phase 2 Implementation

A settlement agreement has been approved in the Trueblood, et. al. v. DSHS lawsuit. Implementation of the agreement will occur in phases in different regions of the state. The first phase, funded in the 2019-21 budget, included Pierce and Spokane counties and the southwest region. The second phase will include King County. The agreement outlines five key areas of investments: competency evaluations, competency restoration, forensic Housing and Recovery through Peer Services (HARPS), forensic Projects for Assistance in Transition from Homelessness (PATH), crisis diversion and supports, education, training and workforce development. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)

UMP Member Support

This provides resources to help manage members’ issues and support the contract management of the Uniform Medical Plan (UMP) after unexpected significant enrollment increases. (School Employees' Insur Admin Acct - State)

WRHAP Pilot Program Evaluation

Funding is needed in fiscal year 2022 to perform a required evaluation of the Washington Rural Health Access Preservation pilot (WRHAP) pilot. The WRHAP pilot includes 13 rural critical access hospitals that received payments for achieving certain quality metrics in the delivery of behavioral and care coordination services. The Centers for Medicare & Medicaid Services (CMS) required HCA to perform a program evaluation as part of the approval for provision of federal funding for these services. (General Fund - State)

Youth Mobile Crisis Teams

Youth mobile crisis teams respond to youth in crisis either in their own homes, community locations where a child is referred and in crisis, or in hospital emergency departments. They work closely with first responders so that police, firefighters, and paramedics can contact youth mobile crisis teams to assist the youth in crisis and divert psychiatric hospital admissions when possible. Currently, only four of the ten regions in the state have youth-specific mobile crisis units. Funding for six additional youth mobile crisis teams is provided to expand services statewide. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Child Assessment & Diagnosis

This item will reduce diagnosis and treatment disparities by providing children, aged birth to 5 years old (particularly boys of color), with up to five sessions of intake and assessment in their own home or other natural setting. It includes provider reimbursement for traveling to the child as well as training on the appropriate diagnosis classification criteria to diagnose children in this age range. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)

Inpatient Treatment Capacity

Funds are provided to develop and implement a plan to increase inpatient treatment capacity in community behavioral health settings. (General Fund - State)

BH Employment Barriers Task Force

The Health Care Authority will convene a task force to identify ways to reduce barriers to behavioral health employment related to background checks. (General Fund - State)

Bed Tracker System

The current psychiatric inpatient system has 1,038 beds certified by the Department of Health to provide involuntary treatment. This number is comprised of beds in a variety of settings and serves different treatment modalities. However, there is no system to identify available beds by type or setting for patient referral. Funding is provided for a statewide behavioral health treatment bed registry system to provide up-to-date availability of beds to first responders and emergency medical service personnel, hospital emergency room services, crisis responders, mental health centers, Medicaid managed care organizations, behavioral health administrative service organizations and others that may need to find an inpatient bed or offer a continuum of care for an individual. Development and implementation of this registry system will facilitate coordinated referrals to get patients to the right treatment bed in a more timely manner, avoiding errors and prolonged delays in transferring to an appropriate treatment bed. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)

Mobile Crisis Response Enhancements

A robust crisis care continuum can divert individuals from intersecting with the criminal justice system. Enhanced mobile crisis response services are a preferred strategy for individuals in distress that focuses on resolving mental health and substance use crisis. Funding is provided for the Behavioral Health Administrative Services Organizations (BHASOs) to add mobile crisis response teams throughout the 10 regional service areas to ensure minimum standards and enhancements to move toward best practices. BHASOs ensure that Black, Indigenous, and People of Color (BIPOC) can access treatment and resources in their own region. Enhancements to MCR teams may add certified peer counselors to the service continuums, provide warm handoffs between the individual in crisis and the treatment community, assertive outreach, and engagement with individuals who have had frequent contact with the crisis service delivery system. (General Fund - State)

Co-Responder Grants

Including a mental health practitioner on the team of personnel responding to an emergency involving an individual experiencing behavioral health crisis can result in diverting individuals from the legal system or state hospitals to less restrictive alternatives. Grant funding is provided to add these resources to communities throughout the state, particularly in BIPOC communities. (General Fund - State)

BH Teaching Clinics Enhancement

Funding is provided for the Health Care Authority to convene a work group to develop a recommended teaching clinic enhancement rate for behavioral health training and supervision of students and others seeking their certification or license. (General Fund - State)

Child Care Sponsorship Pilot

Administrative support is required to pay carriers on behalf of eligible participants in a two-year health care sponsorship pilot for employees working in a licensed child care facility. (General Fund - State, Health Benefit Exchange Account - State, General Fund - Federal)

Health Homes - Tribal Affairs

Funding is provided to expand Health Homes services to the American Indian (AI) and Alaska Native (AN) populations. This will be achieved through incentives for lead organizations to contract with Indian Health Service providers. By engaging IHS providers, the Health Homes program can help mitigate the health disparities affecting the AI/AN population. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - Cash, other funds)

Tribal Residential SUD Rates

Apple Health reimburses all substance use disorder (SUD) resident treatment facilities (RTFs) for adults and youth intensive inpatient resident treatment at rates that do not cover the cost of the treatment and support provided by tribal RTFs to Indian Health Service-eligible American Indian and Alaska Native Medicaid clients. Higher, cost-based rates can be negotiated with the Centers for Medicare & Medicaid Services (CMS). (General Fund - Cash, General Fund - Medicaid Federal, General Fund - Local CRC Oregon)

Covered Lives Tax

Funding is provided to pay the per-member, per-month assessment for lives covered under the Medicaid program. This assessment will fund foundational public health in Washington. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)

Interoperability (Health Care)

Funding is provided to procure a technology solution to meet the patient health record access requirements of the Centers of Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)

Primary Care Case Mgmt - Tribal

Primary Care Case Management payments are used by tribal providers to coordinate and monitor Medicaid health care services for the population assigned to their care. Funding is provided to increase the Primary Care Case Management rate from $3.00 to $6.00. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

MH Referral Service for Children

The Washington State Mental Health Referral Service for Children and Teens connects patients and families with evidence-supported outpatient mental health services in their community. This service is free to those who use it, but is scheduled to end at the close of the 2019-21 biennium. Funding is provided to continue this telephone-based referral service. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)

ECHO Project (ID/DD)

Funding is provided to continue funding with the University of Washington for facilitation of the Extension for Community Healthcare Outcomes (ECHO) project for providers who deliver services to intellectually disabled/developmentally disabled (ID/DD) clients. (General Fund - State)

MQIP Extension

The Medicaid Quality Improvement Program (MQIP) allows states to design quality improvement programs for the Medicaid population in ways that support the state's quality goals. In Washington, the MQIP will be used to support the Medicaid Transformation Waiver. Apple Health managed care organizations and their partnering providers will receive MQIP program payments as they meet designated milestones. Funding is provided to increase the appropriation for the MQIP program as the transformation waiver is extended for one year. (General Fund - Private/Local, General Fund - Local, General Fund - Federal)

Benefit Programs Customer Support

This funding provides additional support for the administration of the Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) programs. This will reduce the time that agencies and school districts wait for technical assistance. (St Health Care Authority Admin Acct - State, School Employees' Insur Admin Acct - State)

ALTSA Extension

Funding is provided to extend the Medicaid Transformation Waiver for an additional year. To finance this extension, Initiative 2 will be funded through the Medicaid Quality Improvement Program (MQIP). (General Fund - Private/Local, General Fund - Local, General Fund - Federal)

PEBB My Account Ongoing Support

This provides support for the maintenance and operation of the Public Employees Benefits Board MyAccount enrollment system. (St Health Care Authority Admin Acct - State)

Performance Audits and Requests

Funding is provided for one FTE staff to facilitate, manage and respond to increased State Auditor's Office performance audits and requests. (Performance Audits of Government - State)

Pharmacy Point of Sale

The pharmacy point of sale module in ProviderOne, Washington's Medicaid payment system, adjudicates pharmacy claims for the medical assistance population. It is essential to replace this system with a program that can meet the state's changing business requirements and improve transparency in how pharmacy payments are paid for. Funding is provided to replace the aging pharmacy point of sale sub-system in ProviderOne. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)

DSH Delay

Under the Affordable Care Act, disproportionate share hospital (DSH) funding was scheduled to be reduced beginning in 2014. The federal government has extended this reduction to federal fiscal year 2021. Funding is adjusted for both the certified public expenditure hold harmless payment and federal DSH appropriation in anticipation of another federal extension. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - Cash, other funds)

Trueblood FTEs

Funding is provided to support the data reporting, contracts, and fiscal work required in the Trueblood settlement agreement. (General Fund - State)

MTP Extension

Funding is provided to the Health Care Authority to extend the 1115 Medicaid Transformation Waiver for an additional year. This extends the Department of Social and Health Services' Aging and Long-Term Support Administration (ALTSA) Initiative 2 and Initiative 3 of the Medicaid Transformation Project (MTP) for an additional year through December 2022. (General Fund - Federal, General Fund - Private/Local, General Fund - Local)

Family Planning Rate Enhancement

Funding is provided to Title X providers to enhance family planning rates. Title X providers offer essential health care services to the medical assistance population. These services help prevent the negative health consequences associated with unintended pregnancies. (General Fund - State, General Fund - Cash, General Fund - Medicaid Federal, other funds)

Community Health Centers - I-502

Funds are provided to adjust the Dedicated Marijuana Account to align with revenues. (Dedicated Marijuana Acct - State, General Fund - State)

HBE Sponsorship Program Improvement

This item improves the ability of private and public sector funders to help more individuals and families afford health coverage through Washington Healthplanfinder. These enhancements to the Exchange’s sponsorship program would also improve the customer experience of those benefiting from sponsored third-party payments. (Health Benefit Exchange Account - State)

Modernizing Healthplanfinder

The Exchange will accelerate its modernization efforts by moving to a new hosting platform and creating a system made up of several smaller applications that are easily changed, tested, secured, and managed. (General Fund - Medicaid Federal, Health Benefit Exchange Account - State, General Fund - Cash, other funds)

HBE Business and Worker Outreach

The Health Benefit Exchange will enhance its support and outreach to small and large businesses and employees to assist with information, ongoing points of contact, and immediate assistance when owners and employees face a potential loss of employer-based health insurance coverage. (General Fund - Medicaid Federal, Health Benefit Exchange Account - State, General Fund - Cash, other funds)

HBE Enhanced Data Analysis

The Health Benefit Exchange will organize and structure its data to more efficiently research, analyze, and turn complex data sets into actionable analyses and information to meet the insurance needs of current and potential customers. (General Fund - Medicaid Federal, Health Benefit Exchange Account - State, General Fund - Local CRC Oregon, other funds)

Enhanced Security Program

Funding is provided for additional staff resources for the Exchange to combat and respond to increasing malicious cyber activity. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, Health Benefit Exchange Account - State, other funds)

GF-State Reduction

This item is a net zero fund adjustment in the 2021-23 and 2023-25 biennia to reduce the General Fund-State appropriation by 15 percent ($777,600 GF-State) per year and supplant it with Health Benefit Exchange Account funding. (Health Benefit Exchange Account - State, General Fund - State)

Language Access Providers Agreement

Funding is adjusted for interpreter services based upon the language access providers' collective bargaining agreement for the 2021-23 biennium. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)

Backfill Medicaid Fraud Account

Expenditures from the Medicaid Fraud Penalty Account are shifted to the general fund to align with available revenues. (Medicaid Fraud Penalty Account - State, General Fund - State)

Pension Adjustments, nonrate

This funds the potential impact of Department of Retirement Systems request legislation on pension service credit and benefit calculation. It will prevent budget reductions such as temporary layoffs from negatively affecting employee retirement benefits. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)

State Employee Benefits

Health insurance funding is provided for state employees who are not represented by a union, who are covered by a bargaining agreement that is not subject to financial feasibility determination, or who are not part of the coalition of unions for health benefits. The insurance funding rate is $988 per employee per month for fiscal year 2022 and $1,018 per employee per month for fiscal year 2023. (General Fund - Local, School Employees' Insur Admin Acct - State, General Fund - Private/Local, other funds)

WFSE General Government

This adjustment reflects the impact of the 2021-23 collective bargaining agreement. (General Fund - State, School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State, other funds)

Temporary Layoffs and Other Savings

This item reflects savings achieved from temporary layoffs or similar actions. (General Fund - Local, General Fund - Private/Local, School Employees' Insur Admin Acct - State, other funds)

Rep Employee Health Benefits

This provides health insurance funding for the master agreement for employee benefits as part of a coalition of unions. The insurance funding rate is $988 per employee per month for fiscal year 2022 and $1,018 per employee per month for fiscal year 2023. (General Fund - State, School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State, other funds)

Non-Rep General Wage Increase

This reflects savings from the cancellation of the July 1, 2020 general wage increase for some non-represented, non-classified employees. (Dedicated Marijuana Acct - State, Medicaid Fraud Penalty Account - State, Medical Aid Account - State, other funds)

Archives/Records Management

Adjustments are made for each agency’s anticipated share of charges for archives and records management services provided by the Secretary of State’s Office. (General Fund - State, St Health Care Authority Admin Acct - State, General Fund - Federal, other funds)

Audit Services

Adjustments are made for each agency’s anticipated cost of audits performed by the State Auditor’s Office. (General Fund - State, School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State, other funds)

Legal Services

Adjustments are made for each agency’s anticipated cost of legal services provided by the Attorney General’s Office. Because legal services expenditures are based on consumption, funding provided in the central service model is not all inclusive. (General Fund - Federal, School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State, other funds)

Administrative Hearings

Adjustments are made for each agency’s anticipated cost of administrative hearings from the Office of Administrative Hearings. (General Fund - State, General Fund - Federal, St Health Care Authority Admin Acct - State)

CTS Central Services

Adjustments are made to reflect each agency’s anticipated share of charges for Microsoft 365 G5 licenses contracted for state agencies by the Consolidated Technology Services agency. This contract allows the state to achieve economies of scale and administrative efficiencies in the management of licenses. (General Fund - Federal, St Health Care Authority Admin Acct - State, General Fund - 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 - State, St Health Care Authority Admin Acct - State, General Fund - Federal, other funds)

OFM Central Services

Adjustments are made to reflect each agency’s anticipated share of charges for existing statewide financial applications, One Washington, and other central services provided by the Office of Financial Management. (General Fund - State, St Health Care Authority Admin Acct - State, School Employees' Insur Admin Acct - State, other funds)

Self-Insurance Liability Premium

Adjustments are made to reflect each agency's share of actuarily projected costs of the Self-Insurance Liability Account. This includes adjustments to existing funding levels as well as enhancements for anticipated liabilities in the 2021-23 biennium. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)