Washington State Health Care Authority
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 1,503.4 | 6,366,988 | 18,126,938 | 24,493,926 |
| 2021-23 Maintenance Level | 1,503.4 | 6,330,167 | 18,019,130 | 24,349,297 |
| Difference from 2021-23 Original | 0.0 | (36,821) | (107,808) | (144,629) |
| % Change from 2021-23 Original | 0.0% | (0.6%) | (0.6%) | (0.6%) |
2022 Policy Other Changes |
||||
| Naloxone Distribution | 0.0 | 10,000 | 0 | 10,000 |
| Launch Opioid Awareness Marketing | 0.0 | 1,000 | 0 | 1,000 |
| Expand Drug Checking Services | 0.0 | 1,877 | 0 | 1,877 |
| Establish Mobile Opioid Treatment | 1.0 | 8,114 | 2,708 | 10,822 |
| Low-Income Health Care I-502 | 0.0 | 41,583 | (41,583) | 0 |
| Trueblood Diversion Programs | 0.0 | 8,632 | 219 | 8,851 |
| ABCD Outreach | 0.0 | 30 | 0 | 30 |
| 1115 IMD Waiver Costs | 0.0 | 1,601 | (59) | 1,542 |
| Enhanced FMAP for HCBS | 0.0 | (2,330) | 2,330 | 0 |
| Behavioral Health Personal Care | 0.0 | 11,667 | 0 | 11,667 |
| Behavioral Health Provider Relief | 0.0 | 50,000 | 0 | 50,000 |
| Behavioral Health Provider Rates | 0.0 | 10,749 | 20,711 | 31,460 |
| Bree Collaborative | 0.0 | 600 | 0 | 600 |
| Trueblood Crisis Stabilization | 0.0 | 3,999 | 2,430 | 6,429 |
| Child Assessment & Diagnosis | 0.0 | 0 | 450 | 450 |
| Continous Enrollment | 0.0 | 7,807 | 7,819 | 15,626 |
| FMAP Increase | 0.0 | (161,219) | 161,219 | 0 |
| Trueblood Data | 0.0 | 250 | 250 | 500 |
| Acute Care Hospital Capacity | 0.0 | 0 | 840 | 840 |
| Periodic Screening | 0.0 | 220 | 132 | 352 |
| Electronic Consent Management | 2.5 | 3,080 | 0 | 3,080 |
| Bundle Opioid Treatment Payments | 0.0 | 4,550 | 12,300 | 16,850 |
| Fertility Study | 0.0 | 200 | 0 | 200 |
| ALTSA Renewal of MTP | (23.3) | 0 | 39,805 | 39,805 |
| Community Information Exchange | 3.0 | 2,210 | 262 | 2,472 |
| FCS Administration/Waiver Renewal | 1.5 | 0 | 793 | 793 |
| Problem Gambling | 0.0 | 28 | 63 | 91 |
| PACT Team Rates | 0.0 | 3,870 | 0 | 3,870 |
| FCS Renewal of MTP | 0.0 | 0 | (40,226) | (40,226) |
| Customer Service Staff | 4.5 | 0 | 1,208 | 1,208 |
| Procurement Resources | 0.0 | 0 | 2,734 | 2,734 |
| Mental Health Parity | 0.0 | 0 | 700 | 700 |
| SEBB Maintenance and Operations | 3.2 | 0 | 971 | 971 |
| Problem Gambling Treatment | 0.0 | 0 | 150 | 150 |
| MSP Asset Test Removal | 0.0 | 1,213 | 1,202 | 2,415 |
| SBHS Funding | 0.0 | 4,152 | (4,152) | 0 |
| CBH Sustainability CCBHC Model | 0.0 | 300 | 300 | 600 |
| Community Long-Term Inpatient Beds | 0.0 | 6,354 | (18,106) | (11,752) |
| Community Health Centers - I-502 | 0.0 | 4,159 | (4,159) | 0 |
| MQIP Renewal | 2.0 | 0 | 102,429 | 102,429 |
| Continuum of Care | 0.20 | 48 | 49 | 97 |
| Expand PCCM Programs | 1.0 | 136 | 11,892 | 12,028 |
| Outreach/Intensive Case Management | 0.0 | 5,000 | 0 | 5,000 |
| Renewal of MTP | 0.0 | 0 | 35,734 | 35,734 |
| Tribal Advisory Board | 0.0 | 200 | 0 | 200 |
| Children's Dental Rate Increase | 0.0 | 7,460 | 8,222 | 15,682 |
| UPL Overpayment | 0.0 | 2,252 | (2,252) | 0 |
| Children’s Long-Term Inpatient Prog | 0.0 | 15,040 | 15,040 | 30,080 |
| Tribal Crisis Responders | 0.0 | 137 | 0 | 137 |
| Legal and Contracts Staff | 3.3 | 408 | 409 | 817 |
| Rural CHART Support | 0.50 | 81 | 2,082 | 2,163 |
| EHR Expansion | 1.5 | 22,126 | 5,461 | 27,587 |
| Quality Assurance Fee Program | 1.2 | 0 | 37,154 | 37,154 |
| Total Cost of Insulin | 0.80 | 363 | 0 | 363 |
| Support for Recent BH Initiatives | 7.5 | 1,090 | 1,005 | 2,095 |
| IMD Federal Waiver | 0.0 | 53,148 | 0 | 53,148 |
| Remote Patient Monitoring | 0.0 | 352 | 869 | 1,221 |
| Language Access Providers Agreement | 0.0 | 211 | 291 | 502 |
| ITA Civil Discharge Monitoring | 1.0 | 115 | 218 | 333 |
| Medicaid Caseload | 0.0 | 193,037 | 680,032 | 873,069 |
| Master Person Index M&O | 1.5 | 47 | 420 | 467 |
| Prenatal to 25 BH Facilitation | 0.0 | 300 | 0 | 300 |
| Eliminating ABD/HEN Review | 0.0 | 130 | 11 | 141 |
| Parent Warmline | 0.0 | 500 | 0 | 500 |
| Regional Treatment Facilities | 6.6 | 2,995 | 1,283 | 4,278 |
| Youth Inpatient Navigators | 1.0 | 4,603 | 891 | 5,494 |
| UIHP Enhanced FMAP | 0.0 | 14,940 | (14,940) | 0 |
| Health Care for Undocumented Adults | 10.0 | 3,720 | 0 | 3,720 |
| Glidepath for Supported Employment | 0.0 | 2,387 | 0 | 2,387 |
| Expand Housing & Employment Access | 0.0 | 16,596 | 0 | 16,596 |
| Expand Medical Respite Care for BH | 2.0 | 5,441 | 5,712 | 11,153 |
| Specialized Landlord Support | 0.0 | 2,110 | 0 | 2,110 |
| Invest in Master Leasing Incentive | 0.0 | 490 | 0 | 490 |
| Provide Crisis Response | 0.0 | 3,679 | 1,226 | 4,905 |
| Expand Housing First Opportunities | 0.50 | 6,027 | 2,009 | 8,036 |
| Reduce Discharge to Homelessness | 0.50 | 775 | 0 | 775 |
| Wraparound with Intensive Services | 0.0 | 1,206 | 0 | 1,206 |
| 2022 Policy Other Changes Total | 33.5 | 391,846 | 1,046,558 | 1,438,404 |
2022 Policy Comp Changes |
||||
| State Employee Benefits | 0.0 | 8 | 15 | 23 |
| WFSE General Government | 0.0 | 850 | 1,705 | 2,555 |
| Rep Employee Health Benefits | 0.0 | 5 | 9 | 14 |
| Non-Rep General Wage Increase | 0.0 | 1,091 | 1,863 | 2,954 |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 47 | 84 | 131 |
| 2022 Policy Comp Changes Total | 0.0 | 2,001 | 3,676 | 5,677 |
2022 Policy Central Services Changes |
||||
| Archives/Records Management | 0.0 | 3 | 5 | 8 |
| Audit Services | 0.0 | 18 | 29 | 47 |
| Legal Services | 0.0 | 62 | 81 | 143 |
| Administrative Hearings | 0.0 | 46 | 43 | 89 |
| CTS Central Services | 0.0 | 148 | 239 | 387 |
| DES Central Services | 0.0 | 8 | 14 | 22 |
| OFM Central Services | 0.0 | 1,423 | 265 | 1,688 |
| Self-Insurance Liability Premium | 0.0 | 1 | 2 | 3 |
| 2022 Policy Central Services Changes Total | 0.0 | 1,709 | 678 | 2,387 |
| Total Policy Changes | 33.5 | 395,556 | 1,050,912 | 1,446,468 |
| 2022 Policy Level | 1,536.9 | 6,725,723 | 19,070,042 | 25,795,765 |
| Difference from 2021-23 Original | 33.5 | 358,735 | 943,104 | 1,301,839 |
| % Change from 2021-23 Original | 2.2% | 5.6% | 5.2% | 5.3% |
Policy Changes
Outreach/Intensive Case Management
Funding is provided to continue first-year appropriations for the Recovery Navigator program outlined Engrossed Senate Bill 5476 (Chapter 311, Laws of 2021) that addressed the State v. Blake decision. This will ensure that funding for service delivery is consistent and stable between fiscal years to support planning activities and implementation efforts as required by the bill. (General Fund - State)
Audit Services
Adjustments are made for each agency’s anticipated cost of audits performed by the State Auditor’s Office. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
Legal Services
Adjustments are made for each agency's anticipated cost of Attorney General's Office legal services based on a three-year average. Because legal services costs are based on usage, funding provided in the central service model is not all inclusive. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
Administrative Hearings
Adjustments are made for each agency’s anticipated cost of administrative hearings conducted by the Office of Administrative Hearings. (St Health Care Authority Admin Acct - State, General Fund - State, General Fund - Federal)
DES Central Services
Adjustments are made to reflect each agency’s anticipated share of charges from the Department of Enterprise Services for campus rent, parking, security and contracts; capital project surcharges; financing cost recovery; public and historic facilities; real estate services; risk management services; personnel service rates; the Perry Street and Capitol Campus child care centers; small agency services; and the department’s enterprise applications. See the 2021-23 Budget Instructions for allocation methodologies. (General Fund - State, School Employees' Insur 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 applications, the One Washington program, and other central services provided by the Office of Financial Management. See the 2021-23 Budget Instructions for allocation methodologies. (St Health Care Authority Admin Acct - State, General Fund - State, General Fund - Federal, other funds)
WFSE General Government
The collective bargaining agreement includes a general wage increase of 3.25% for fiscal year 2023 and a lump sum payment for employees who were employed continuously starting on or before July 1, 2021 through June 30, 2022. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Naloxone Distribution
Opioid intoxication and overdose can be treated with the drug naloxone. Funding is provided for every Washingtonian in substance use disorder treatment to receive a naloxone kit, provide 40,000 kits to expand naloxone distribution, and supply 2,000 free naloxone kits in 20 vending machines located in strategic parts of the state each year. (General Fund - State)
Launch Opioid Awareness Marketing
This item will fund an opioid awareness campaign targeted at youth to increase the awareness of fentanyl. (General Fund - State)
Expand Drug Checking Services
Funding is provided for fentanyl and benzodiazepine test strips and for community and mail-based spectrometer testing that can be used to inform drug users and public health officials about the content of the street-level drug supply. (General Fund - State)
Establish Mobile Opioid Treatment
Funding is provided for 10 mobile units to fill treatment gaps and increase access to medications for opioid use disorder for underserved populations that do not have a treatment provider within a reasonable distance. These mobile units bring treatment to the client and benefit rural areas in particular. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, 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)
Trueblood Diversion Programs
One-time bridge funding is provided to support some of the diversion programs funded by Trueblood settlement agreement contempt fines while sustainability and data collection efforts continue. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
ABCD Outreach
Funding is provided to the Authority to contract with the Office of Equity to provide equity training for the local Access to Baby Child Dentistry (ABCD) coordinators. (General Fund - State)
1115 IMD Waiver Costs
Subject to oversight by the Office of the Chief Information Officer, funding is provided for technology costs required to implement a Section 1115 Medicaid demonstration waiver for services provided at institutions of mental disease (IMD). (General Fund - State, General Fund - Federal)
Enhanced FMAP for HCBS
Funding is adjusted for utilization changes with respect to the federal government's increased FMAP for Medicaid Home and Community Based Services (HCBS). (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Behavioral Health Personal Care
Funding is adjusted for behavioral health wraparound services for individuals with long-term care and behavioral health needs (including those discharged from the state hospitals) to safely reside in a community setting. The Health Care Authority is seeking a 1915(i) waiver from the federal Centers for Medicare and Medicaid Services to potentially transfer the existing behavioral health personal care program to managed care. (General Fund - State)
Behavioral Health Provider Relief
Funding is provided on a one-time basis solely for the Authority to provide assistance payments to behavioral health providers that serve Medicaid and state-funded clients and have experienced revenue loss or increased expenses as a result of the COVID-19 pandemic. This amount supplements the provider relief that was provided in the 2021-23 biennial budget. (General Fund - State)
Behavioral Health Provider Rates
Funds are provided for a 4.5 percent increase in Medicaid reimbursement for community behavioral health providers contracted through managed care organizations, effective January 2023. This item is recommended by the Children and Youth Behavioral Health Work Group. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)
Bree Collaborative
Additional funding is provided for the Bree collaborative to focus additional attention on surgical bundles and incentivize quality outcomes for patients. (General Fund - State)
Trueblood Crisis Stabilization
Pursuant to the Trueblood v. DSHS settlement agreement, funding is provided to operate the recently opened crisis stabilization facility in Spokane and for two facilities in King County that received appropriations in the 2021-23 capital budget. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Child Assessment & Diagnosis
These funds will increase provider training to teach them to use the current version of the diagnostic classification: 0-5 classification system of mental health and developmental disorders of infancy and early childhood as established in Section 2(11), Chapter 126, Laws of 2021. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - Local CRC Oregon)
Continous Enrollment
Funding is provided to implement continuous enrollment for Medicaid-eligible children ages zero to six with income at or below 215% of the federal poverty level upon receipt of a 1115 waiver approval from the Centers for Medicare and Medicaid Services. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
FMAP Increase
The federal Families First Coronavirus Relief Act authorized additional Federal Medical Assistance Percentage (FMAP) funds for the duration of the public health emergency. State funds are reduced and Medicaid spending is increased to reflect an additional 6.2 percent federal Medicaid matching rate from January through June 30, 2022. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - Cash, other funds)
Trueblood Data
Funding is provided to support Health Care Authority activities required by the Trueblood settlement agreement. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Acute Care Hospital Capacity
Funding is provided for incentive payments to skilled nursing facilities to take Medicaid clients discharged from inpatient care. (Coronavirus St Fiscal Recovery Fund - Federal)
Periodic Screening
This funding will update the well child visit periodicity schedule for Apple Health clients to align with Bright Futures recommendations for ages <1 to 20. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - State, other funds)
Electronic Consent Management
Funding is provided to procure an electronic consent management (ECM) solution to enable patients and health care providers to exchange sensitive health-related information easily, securely and legally. (General Fund - State)
Bundle Opioid Treatment Payments
To increase access to Food and Drug Administration (FDA)-approved medications and improve care, funding is provided to implement bundled payments based on current Medicare Part B rates for opioid disorder treatment services. Opioid treatment programs are the only facilities legally able to offer all three medications and this rate increase is expected to increase the number of providers operating in Washington state. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)
Fertility Study
Funds are provided for a study to determine the utilization and cost impact of adding a fertility treatment benefit for Medicaid clients. (General Fund - State)
ALTSA Renewal of MTP
Funding is provided to align appropriation authority with anticipated Medicaid Transformation Project (MTP) spending and renew Initiative 2 for five additional years. This renewal is funded through the MQIP Initiative 2 and provides support options that enable older adults to remain in their home and receive services. (General Fund - Local, General Fund - Federal, General Fund - Private/Local)
Community Information Exchange
Funds are provided to study the cost and implementation impacts of a statewide community information exchange to serve community-based organizations, health plans, accountable communities of health, and safety net providers. Upon completion of that study and its acceptance by the Office of Financial Management, the Health Care Authority can begin implementation in fiscal year 2023. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)
FCS Administration/Waiver Renewal
Funds are provided for the administrative support necessary to continue the foundational community supports (FCS) initiative that is part of Washington state's Medicaid transformation waiver. This item is dependent upon renewal of that waiver. (General Fund - Local, General Fund - Federal, General Fund - Private/Local)
Problem Gambling
Funding is provided to add problem gambling treatment coverage to the Apple Health program beginning in fiscal year 2023. Expanding problem gambling treatment will expand service delivery and access for individuals seeking treatment for problem gambling. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
PACT Team Rates
This funding will align rates between existing and new providers for the Program of Assertive Community Treatment (PACT). Rates for the 13 existing providers are lower than the amounts appropriated for the eight new teams created in the 2021-23 biennial budget. (General Fund - State)
FCS Renewal of MTP
Funding is provided to align appropriation authority with anticipated Medicaid Transformation Project (MTP) spending and renew Initiative 3 for five additional years. This renewal is funded through the MQIP Initiative 3 and provides clients with supports to stay in their home or maintain employment. (General Fund - Private/Local, General Fund - Federal, General Fund - Local)
Customer Service Staff
Funding is provided for 9.0 FTE staff to address customer service responsiveness through phone calls and navigation with Public Employees Benefits Board (PEBB) and School Employees Benefits Board (SEBB) My Accounts, open enrollments, and the new PEBB My Account (PMA) navigation starting in 2022. This item also covers the additional complexity and expansion of administering medical Flexible Spending Account (FSA) and Dependent Care Assistance Program (DCAP) benefits in recent years. (School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State)
Procurement Resources
Funds are provided to maintain and enhance member benefits, replace outdated contracts, create a new accountable care program (ACP) contract and new dental contracts, and comply with executive orders, implement PEBB and SEBB decisions, and conduct several key procurements. (St Health Care Authority Admin Acct - State, SEBB Medical Benefits Admin Acct - Non-Appropriated, Uniform Medical Plan Benefits Acct - Non-Appropriated, other funds)
Mental Health Parity
Funding is provided to complete an analysis of mental health benefits administered by the Uniform Medical Plan (UMP) third party administrator and to implement changes necessary to comply with federal requirements for access to care. (SEBB Medical Benefits Admin Acct - Non-Appropriated, Uniform Medical Plan Benefits Acct - Non-Appropriated)
SEBB Maintenance and Operations
The Health Care Authority will use this funding to support basic maintenance and operations and to develop capacity for future enhancements for the School Employees Benefits Board (SEBB) Program My Account system. (School Employees' Insur Admin Acct - State)
Problem Gambling Treatment
This funding will expand problem gambling and gambling disorder specialized treatment. (Problem Gambling Account - State)
MSP Asset Test Removal
Funding is provided to remove the asset test from the Medicare savings plan. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
SBHS Funding
Funding is provided to support school-based health services by removing the financial contribution requirement for school districts. (General Fund - Private/Local, General Fund - Local, General Fund - State)
CBH Sustainability CCBHC Model
Funding is provided to explore alternate service delivery models, such as Certified Community Behavioral Health Clinics (CCBHCs) and to develop behavioral health comparison rates. The CCBHC program has demonstrated significantly improved access to quality mental health and substance use care in community-based settings. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Community Long-Term Inpatient Beds
Funding is adjusted for changes in utilization and the cost of providing long-term involuntary inpatient treatment in a community setting. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - State, other funds)
Community Health Centers - I-502
Funds are provided to adjust the Dedicated Marijuana Account to align with revenues. (General Fund - State, Dedicated Marijuana Acct - State)
MQIP Renewal
Funding is provided to align Medicaid Quality Improvement Project (MQIP) appropriation authority with anticipated Medicaid Transformation Project (MTP) spending and to align with the renewal of the MTP waiver. (General Fund - Federal, General Fund - Private/Local, General Fund - Local)
Continuum of Care
Children and youth with complex behavioral issues need a continuum of care across state agencies and local providers. Funding is provided in the outlook for rates for 32 beds and agency administration at the Health Care Authority to create a short-term Residential Crisis Stabilization Program (RCSP) for youth with severe behavioral health diagnoses. The capital budget includes appropriations for design and construction, and this funding will hire a program manager to begin planning for services in this facility, which is assumed to open in fiscal year 2024. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Expand PCCM Programs
Funding is provided to expand the primary care coordination management (PCCM) program with Indian Health Service clinics to improve care coordination and client outcomes. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - Cash, other funds)
Renewal of MTP
This funding will align appropriation authority with anticipated Medicaid Transformation Project (MTP) spending and renew Initiative 1 for five additional years. This renewal is funded through the MQIP Initiative 1 and supports regional accountable communities of health in transforming the Medicaid delivery system to serve the whole person and use Medicaid resources wisely. (General Fund - Federal, General Fund - Private/Local, General Fund - Local)
Tribal Advisory Board
Funding is provided for the Tribal Centric Behavioral Health Advisory Board to continue planning efforts and implementation activities for inpatient behavioral health facilities operated by Tribes statewide, including the development of a Tribal freestanding evaluation and treatment center. (General Fund - State)
Children's Dental Rate Increase
Funds are provided to increase child dental rates to equal respective adult dental rates. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
UPL Overpayment
Funding is provided to shift federal expenditures that were disallowed by the Centers for Medicare and Medicaid Services to state funds to cover the costs that exceed the Medicaid Inpatient Upper Payment Limit (UPL). (General Fund - State, General Fund - Cash, General Fund - Local CRC Oregon, other funds)
Children’s Long-Term Inpatient Prog
Funds are provided to expand the availability and access of long-term inpatient beds in contracted settings for children requiring intensive supports statewide through the Children Long-term Inpatient Program (CLIP). (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Tribal Crisis Responders
Funding is provided to support implementation of the Tribal Designated Crisis Responder program statewide. Tribal-designated crisis responders are appointed by the Health Care Authority and provide culturally appropriate evaluations of American Indians and Alaskan Natives. They have the same authority as other designated crisis responders within the Superior Court system for tribal and non-tribal members. (General Fund - State)
Legal and Contracts Staff
This item will enable the Authority to hire essential contracts and legal staff. (School Employees' Insur Admin Acct - State, General Fund - Federal, General Fund - State, other funds)
Rural CHART Support
The Health Care Authority (HCA) is granted expenditure authority in anticipation of a federal grant award, effective October 2021, and for staffing needs beginning in January 2023, to implement and achieve the goals of the Community Health Access and Rural Transformation (CHART) model. In May 2021, HCA applied to be the CHART lead organization for the state. As lead organization, HCA will be awarded a federal grant to partner with rural hospitals and community stakeholders to reduce the disparities in health care access and quality that exist between rural and urban settings. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - Cash, other funds)
EHR Expansion
Funding is provided to procure Electronic Health Record (EHR) software and procure the services of a lead organization to set up, operate, and maintain EHR services. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Quality Assurance Fee Program
Funding is provided for the Authority to make increased payments to ambulance transport providers and to administer the Quality Assurance Fee program as directed in Chapter 74.70 RCW. (Ambulance Transport Fund - State, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Total Cost of Insulin
This funding will establish the “total cost of insulin” workgroup as prescribed by Engrossed Second Substitute House Bill 2662 (Chapter 346, Laws of 2020). (General Fund - State)
Support for Recent BH Initiatives
Funds are provided to right-size program capacity, managerial structure, and operational capabilities for the Division of Behavioral Health and Recovery to align with the breadth of work that is assigned to the agency. This includes the transformation of community behavioral health, integration of physical and behavioral health, work related to the Trueblood settlement agreement and Blake court decision, and implementation of the 988 suicide prevention hotline, and other workload items. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
IMD Federal Waiver
Funding is adjusted for changes in federal waiver status in fiscal year 2021 and caseload utilization for services in institutions of mental disease (IMD). Of this amount, $19 million is for belated claims for expenses incurred in the previous biennium. (General Fund - State)
Remote Patient Monitoring
Funds are provided to add a remote patient monitoring (RPM) benefit to Apple Health (Medicaid) coverage. (General Fund - State, General Fund - Federal)
Language Access Providers Agreement
Funding is adjusted for interpreter services based upon the language access providers collective bargaining agreement for fiscal year 2023. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
ITA Civil Discharge Monitoring
Funding is provided for coordination and collaboration with managed care and behavioral health administrative service organizations on the handling of inpatient behavioral health care and discharge processes, Involuntary Treatment Act stays, and timely discharge to home and community settings. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Medicaid Caseload
The Families First Coronavirus Response Act (FFCRA) provides enhanced federal Medicaid funding to states meeting certain conditions, including continuous beneficiary enrollment throughout the public health emergency period regardless of changes that might otherwise affect eligibility. The November 2021 forecast prepared by the Caseload Forecast Council assumes that the public health emergency will end in January 2022 and included six months for disenrollment at the conclusion of the public health emergency. This item reflects the incremental cost of disenrollment over a period lasting 12 months. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Master Person Index M&O
Funds are provided for two staff to complete the master person index project. This is a foundational database for multiple health and human services enterprise coalition IT projects being completed in this biennium. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Prenatal to 25 BH Facilitation
This funding will help facilitate the Children and Youth Behavioral Health Workgroup to develop a strategic plan for the delivery of behavioral health services for prenatal to age 25. (General Fund - State)
Eliminating ABD/HEN Review
Funding is provided for the department to eliminate the mid-certification review requirement for blind and disabled recipients of the Aged, Blind or Disabled program and Housing and Essential Needs Referral program. It also will restore the caseload of participants who have lost this benefit, effective July 1, 2022. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Parent Warmline
Funding is provided to expand the new parent phone line that will include longer hours of service and more resources for culturally appropriate service delivery. (General Fund - State)
Regional Treatment Facilities
Funding is provided for the Health Care Authority to manage and contract for 32 beds at the regional treatment facility in Vancouver and beds planned for the regional treatment facility in Snohomish County. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Youth Inpatient Navigators
Funds are provided to partner with Seattle Children's Hospital to help families and caregivers identify alternate, temporary solutions for instances where a long-term inpatient bed for children is not available due to bed capacity or geography issues. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
UIHP Enhanced FMAP
Funding is adjusted for utilization changes with respect to the federal government's increased FMAP for the Urban Indian Health Organization (UIHP) and Native Hawaiian Health Care Systems. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Cash, other funds)
Health Care for Undocumented Adults
Funding is provided for expansion of Apple Health to undocumented Washingtonians who do not qualify for other state-funded health care assistance programs and have countable incomes below 138 percent of the federal poverty level. This is an important first step toward universal health coverage. Services are assumed to begin in January 2024, and initial funding is provided for program capacity and information technology changes necessary to support this initiative. (General Fund - State)
Glidepath for Supported Employment
This item will enable to the agency to explore opportunities to create a bridge period for Housing and Essential Needs benefits for individuals engaged in supported employment. (General Fund - State)
Expand Housing & Employment Access
Funds are provided for a supported housing and supported employment program to serve individuals who don't qualify for Medicaid or who need an extended time to apply for and obtain Medicaid. This program is comparable to the foundational community supports initiative in the Medicaid transformation waiver. (General Fund - State)
Expand Medical Respite Care for BH
This item will provide funding for medical care professionals to care for individuals with a medical condition who do not have housing with the intent of reducing avoidable hospitalizations and improving medical care for a population that is underserved. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Specialized Landlord Support
Funding is provided to create a regional landlord liaison program to support stability for residents with behavioral health needs. (General Fund - State)
Invest in Master Leasing Incentive
Funding is provided to create a master leasing incentive program with specific emphasis on Trueblood programs and to develop a master leasing toolkit for use by landlords serving special populations. (General Fund - State)
Provide Crisis Response
Funds are provided for regional behavioral health mobile crisis response teams focused on supported housing. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Expand Housing First Opportunities
Funding is provided to expand access to no-barrier, low-barrier, and transitional housing using a 'housing first' model. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Reduce Discharge to Homelessness
Funding is provided to reduce instances where an individual may discharge from a state-operated behavioral health institution to homelessness. (General Fund - State)
Wraparound with Intensive Services
Pursuant to the settlement agreement under AGC v. Washington State Health Care Authority, funding is provided to expand eligibility for Wraparound with Intensive Service (WISe) to undocumented immigrant and refugee children ineligible for federally funded Medicaid benefits. (General Fund - State)
State Employee Benefits
Health insurance funding is provided for state employees who are not covered by the healthcare coalition. The insurance funding rate is $936 per employee per month for fiscal year 2022 and $1,130 per employee per month for fiscal year 2023. (General Fund - State, General Fund - Federal, General Fund - Medicaid Federal, other funds)
Rep Employee Health Benefits
Health insurance funding is provided as part of the master agreements for employees who bargain for health benefits as part of a coalition of unions. The insurance funding rate is $936 per employee per month for fiscal year 2022 and $1,130 per employee per month for fiscal year 2023. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Non-Rep General Wage Increase
A general wage increase of 3.25%, effective July 1, 2022, is provided for state employees who are not represented by a union or who are covered by a bargaining agreement that is not subject to financial feasibility determination. (General Fund - State, St Health Care Authority Admin Acct - State, General Fund - Medicaid Federal, other funds)
PERS & TRS Plan 1 Benefit Increase
For eligible Public Employees' and Teachers' Retirement Systems Plan 1 members, this item provides an increase of 3%, up to a maximum of $110 per month. (St Health Care Authority Admin Acct - State, General Fund - State, General Fund - Medicaid Federal, 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, 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 from Consolidated Technology Services (CTS) for the Office of the Chief Information Officer, Office of Cyber Security, state network, enterprise services, small agency IT services, security gateways, and geospatial imaging services. See the 2021-23 Budget Instructions for allocation methodologies. (St Health Care Authority Admin Acct - State, General Fund - State, General Fund - Federal, other funds)
Self-Insurance Liability Premium
Adjustments are made to reflect each agency's share of the actuarially projected costs of the self-insurance liability premium. (General Fund - State, General Fund - Federal)
