Department of Social and Health Services - Developmental Disabilities
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 1,528.2 | 1,942,471 | 2,415,664 | 4,358,135 |
| 2021-23 Maintenance Level | 1,564.1 | 1,911,282 | 2,400,183 | 4,311,465 |
| Difference from 2021-23 Original | 35.9 | (31,189) | (15,481) | (46,670) |
| % Change from 2021-23 Original | 2.3% | (1.6%) | (0.6%) | (1.1%) |
2022 Policy Other Changes |
||||
| Community Supports for Children | 0.50 | 5,510 | 3,390 | 8,900 |
| In-Home Provider PPE | 1.9 | 2,001 | 2,509 | 4,510 |
| Community Residential Services | 2.0 | 308 | 237 | 545 |
| Agency Provider Tax Rate Adjustment | 0.0 | 123 | 156 | 279 |
| Transitional Care Management | 19.2 | 4,791 | 3,674 | 8,465 |
| CDE Transition Costs | 0.0 | 298 | 378 | 676 |
| Continuum of Care | 0.50 | 84 | 84 | 168 |
| Financial Eligibility Staff | 11.2 | 1,413 | 1,084 | 2,497 |
| HCBS Provider Development | 0.50 | 1,850 | 994 | 2,844 |
| DDA Waiver and SOLA Forecasting | 1.5 | 205 | 205 | 410 |
| Enhanced Case Management | 25.0 | 3,671 | 2,696 | 6,367 |
| Personal Needs Allowance | 0.0 | 99 | 62 | 161 |
| Network Risk Mitigation | 0.0 | 353 | 359 | 712 |
| Personal Protective Equipment | 0.0 | 0 | 2,816 | 2,816 |
| DCYF Reimbursement Gap | 0.0 | 306 | 199 | 505 |
| SEIU and Liang Settlements | 0.0 | 18,506 | 23,553 | 42,059 |
| Public Health Emergency FMAP | 0.0 | (50,516) | 50,516 | 0 |
| Youth Inpatient Navigators | 0.50 | 82 | 82 | 164 |
| Targeted Provider Rates | 0.0 | 64,394 | 113,379 | 177,773 |
| Transform Services for DDA Clients | 1.0 | 160 | 0 | 160 |
| 2022 Policy Other Changes Total | 63.8 | 53,638 | 206,373 | 260,011 |
2022 Policy Comp Changes |
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| Adult Family Homes CBA | 0.0 | 1,389 | 1,278 | 2,667 |
| State Employee Benefits | 0.0 | 4 | 3 | 7 |
| WFSE General Government | 0.0 | 10,004 | 8,194 | 18,198 |
| Rep Employee Health Benefits | 0.0 | 54 | 45 | 99 |
| Coalition of Unions | 0.0 | 44 | 35 | 79 |
| Non-Rep General Wage Increase | 0.0 | 656 | 453 | 1,109 |
| SEIU 1199 General Government | 0.0 | 724 | 582 | 1,306 |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 172 | 138 | 310 |
| SEIU 775 Agency Providers Parity | 0.0 | 953 | 1,214 | 2,167 |
| SEIU 775 In Home Providers | 0.0 | 8,764 | 11,156 | 19,920 |
| 2022 Policy Comp Changes Total | 0.0 | 22,764 | 23,098 | 45,862 |
| Total Policy Changes | 63.8 | 76,402 | 229,471 | 305,873 |
| 2022 Policy Level | 1,627.9 | 1,987,684 | 2,629,654 | 4,617,338 |
| Difference from 2021-23 Original | 99.7 | 45,213 | 213,990 | 259,203 |
| % Change from 2021-23 Original | 6.5% | 2.3% | 8.9% | 5.9% |
Policy Changes
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 - Federal, General Fund - Medicaid Federal, General Fund - State, other funds)
Coalition of Unions
The collective bargaining agreement includes a general wage increase of 3.25% for fiscal year 2023 and a lump sum payment for all employees hired before July 1, 2022. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
SEIU 1199 General Government
The collective bargaining agreement includes a general wage increase of 3.25% for fiscal year 2023 and a retention bonus payable in two equal installments. (General Fund - Medicaid Federal, General Fund - State, General Fund - Federal, other funds)
Community Supports for Children
Families caring for children and youth with significant behavioral issues need extra support. This funding will expand intensive habilitation services and out-of-home services for children and youth from ages eight to 21. This includes adding six three-bed facilities in licensed intensive habilitation services and six three-bed facilities for long-term enhanced out-of-home services. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
In-Home Provider PPE
In-home care providers provide personal care to Medicaid clients in the client's home. Personal protective equipment maintains the safety of the provider and client. Funding is provided to purchase, store, and distribute PPE to in-home providers. This assumes that Federal Emergency Management Agency (FEMA) funding expires in March 2022. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Community Residential Services
Funding is provided to monitor services delivered to over 4,500 clients served in contracted residential programs. Two staff will verify that Medicaid clients receive services authorized on Core and Community Protection waivers and meet assurance with the federal Centers for Medicare & Medicaid Services. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Agency Provider Tax Rate Adjustment
Funds are provided to adjust the employer tax rate paid to home care agencies. An exemption lowered the tax rate used to calculate the tax costs paid on behalf of clients. This created a gap between the tax rate provided to the agencies and the employer tax paid by clients. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Transitional Care Management
Funding is provided to coordinate transitions of care for 2,100 clients who move from one type of care setting to a new one. This includes ramping up staffing from 38 FTEs in fiscal year 2023 to 104 FTEs in fiscal year 2025 to create transition coordination teams, mobile diversion and rapid response teams, and enhanced support for providers. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
CDE Transition Costs
In April 2022, the Consumer Directed Employer (CDE) will become the new employer for over 45,000 individual providers who serve clients in their home. The department will provide funds for administrative costs, including premiums for paid family leave, to the new CDE in April. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Continuum of Care
Children and youth with complex behavioral issues need a continuum of care across state agencies and local providers. Funding is provided for 32 beds and agency administration costs 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 of a new facility that is anticipated to open in fiscal year 2024. This funding also will hire a program manager to begin planning for services in this facility. In the 2023-25 biennium, DDA will have additional staffing costs to provide case management, resources and other services for children and youth served in the facility. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Financial Eligibility Staff
Timely and accurate eligibility determinations are critical to improving access to services for clients with intellectual or developmental disabilities. Funding is provided for 22.3 FTE staff to complete financial eligibility determinations within the required 45-day timeframe, reduce the backlog of clients waiting for eligibility determination, and reduce wait times on the call center. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
HCBS Provider Development
Home and community-based services (HCBS) providers help connect clients with disabilities to supportive community resources, provide supportive parenting services, and offer short-term respite support to caregivers. Funding is provided to increase the hourly rates paid to providers of waiver services on April 1, 2022. Additionally, funding is provided for an assistive technology program manager to provide advice, conduct evaluations and make recommendations to clients, families, providers and case managers on the type of assistive technology that may help clients maintain independence. (General Fund - State, General Fund - Federal)
DDA Waiver and SOLA Forecasting
Funding is provided for 3.0 FTE staff to determine appropriate methods to forecast services to clients with intellectual and developmental disabilities. Currently, the number of clients served under the individual family services, basic plus waivers and state-operated living alternatives (SOLA) is capped. The 2021-23 biennial budget directed the program to estimate the number of clients who need these services. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
Enhanced Case Management
Funding is provided to expand access to the enhanced case management program from 700 to 1500 clients. This will include 50 FTE case managers to increase the program's capacity and reduce caseload ratios to one case manager per 30 clients. It also will enhance the Comprehensive Assessment Reporting and Evaluation system to provide automatic nursing referrals for clients in this program. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Personal Needs Allowance
Funds are provided to increase the personal needs allowance (PNA) for Medicaid clients in residential and institutional settings. The PNA is the amount of income retained by the Medicaid client to pay for personal needs, including housing costs, utilities, food, and personal incidentals. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Network Risk Mitigation
Funding is provided to replace aging hardware and bring network assets up to current security best practices in order to reduce the risk of service interruption. (General Fund - State, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Personal Protective Equipment
Personal protective equipment helps contain the spread of COVID-19 and reduce infection rates. Funding is provided to purchase, store, and distribute PPE to DSHS employees. This assumes that Federal Emergency Management Agency (FEMA) funding expires in March 2022. (General Fund - Medicaid Federal, General Fund - Cash, Coronavirus St Fiscal Recovery Fund - Federal, other funds)
DCYF Reimbursement Gap
Funds are provided to maintain current information technology (IT) service levels as the Department of Children, Youth, and Families moves to an internally managed network from a DSHS-managed network. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
SEIU and Liang Settlements
Funds are provided to settle the cases of Liang, et al, v. Washington DSHS, et al, and SEIU 775 v. Washington DSHS, et al. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
Public Health Emergency FMAP
The federal Families First Coronavirus Relief Act authorized additional federal matching funds (FMAP) for the duration of the public health emergency. State funds are reduced and Medicaid is increased to reflect an additional 6.2 percent federal Medicaid matching rate from January through June 30, 2022. This includes appropriations related to unanticipated receipt number 0025. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - Local CRC Oregon, other funds)
Youth Inpatient Navigators
Funding is provided for 7.0 FTE, including a project manager and social and health program consultants, to participate in youth inpatient navigator meetings, in coordination with the Health Care Authority. This will help coordinate care and services for individuals experiencing a mental health crisis. New regional teams will convene key stakeholders, including MCOs, hospitals, educational districts and community providers, to find the right services for youth in crisis. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Targeted Provider Rates
Funding is provided to continue the COVID-19 rate enhancements to contracted providers that expired on December 31, 2021. The rate enhancements are reduced by 20 percent every two quarters in fiscal year 2023 and fiscal year 2024. This includes appropriations related to unanticipated receipt number 0024. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Transform Services for DDA Clients
The department will use this funding to forecast the need for community and residential services (including respite beds and crisis stabilization services), study Medicaid rates, and develop metrics for community residential providers and additional DDA services for a new caseload forecast. (General Fund - State)
Adult Family Homes CBA
Funding is provided for implementation of an agreement reached between the governor and the adult family home council under the provisions of chapter 41.56 RCW for fiscal year 2023. (General Fund - State, General Fund - American Rescue Plan Act (ARPA), General Fund - Medicaid Federal, other funds)
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 - Federal, General Fund - Medicaid Federal, General Fund - State, 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 - Federal, 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 - Federal, General Fund - Medicaid Federal, General Fund - State, 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. (General Fund - Medicaid Federal, General Fund - State, General Fund - Federal, other funds)
SEIU 775 Agency Providers Parity
Funding is provided to for the homecare agency parity impacts of the agreement between the governor and the service employees international union healthcare 775nw. (General Fund - Medicaid Federal, General Fund - American Rescue Plan Act (ARPA), General Fund - State, other funds)
SEIU 775 In Home Providers
Funding is provided for the implementation of an agreement reached between the governor and the adult family home council under the provisions of chapter 41.56 RCW for fiscal year 2023. (General Fund - Medicaid Federal, General Fund - American Rescue Plan Act (ARPA), General Fund - State, other funds)
