Department of Social and Health Services
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 17,363.5 | 7,645,314 | 10,326,047 | 17,971,361 |
| 2023-25 Maintenance Level | 17,624.4 | 8,920,304 | 9,395,629 | 18,315,933 |
| Difference from 2023-25 Original | 260.9 | 1,274,990 | (930,418) | 344,572 |
| % Change from 2023-25 Original | 1.5% | 16.7% | (9.0%) | 1.9% |
2023 Policy Other Changes |
||||
| Facility Maintenance Costs | 0.0 | 666 | 102 | 768 |
| WiFi Services | 0.0 | 270 | 0 | 270 |
| Disproportionate Share Hospital | 0.0 | (75,144) | 75,144 | 0 |
| Competency Evaluations | 26.0 | 7,646 | 0 | 7,646 |
| KC Forensic Evaluation Pilot Site | 3.0 | 1,474 | 0 | 1,474 |
| Neuropsychological Evaluations | 2.0 | 976 | 0 | 976 |
| Maple Lane Campus | 46.7 | 7,717 | 5,964 | 13,681 |
| DSHS RTF - Vancouver Campus | 161.1 | 47,391 | 0 | 47,391 |
| Barriers to Discharge | 21.0 | 6,351 | 297 | 6,648 |
| Restore WSH Civil Ward | 61.9 | 15,725 | 0 | 15,725 |
| Violence Reduction Team | 66.0 | 17,618 | 924 | 18,542 |
| Savings from STAR Ward Closure | (65.5) | (19,134) | 0 | (19,134) |
| Jail-based Behavioral Health | 3.0 | 10,364 | 0 | 10,364 |
| Personal Protective Equipment | 0.0 | 5,931 | 2,238 | 8,169 |
| State Hospital Direct Care Staffing | 80.1 | 13,831 | 1,042 | 14,873 |
| Phase 2 Trueblood | 6.0 | 2,484 | 0 | 2,484 |
| Phase 3 Trueblood | 19.0 | 5,656 | 0 | 5,656 |
| Trueblood Court Monitor | 0.0 | 830 | 0 | 830 |
| Facility One-time Costs | 0.0 | 4,642 | 2,747 | 7,389 |
| Assessment Tool Study | 0.0 | 485 | 484 | 969 |
| Financial Eligibility Staff | 25.5 | 3,001 | 2,302 | 5,303 |
| Expand High School Transition | 0.0 | 2,618 | 2,108 | 4,726 |
| Continue Klamath Cottage | 24.5 | 4,540 | 0 | 4,540 |
| Adjust CDE Rates | (20.6) | 282,989 | 360,173 | 643,162 |
| Funded Program Implementation | 4.0 | 4,549 | 3,776 | 8,325 |
| Employment/Community Inclusion | 3.0 | 24,100 | 19,402 | 43,502 |
| Translation Service Rates | 1.0 | 1,806 | 1,360 | 3,166 |
| Children and Adults in Hospitals | 4.0 | 6,018 | 5,890 | 11,908 |
| Specialty Adult AFH | 7.0 | 6,062 | 7,197 | 13,259 |
| Expand Behavior Stabilization | 4.0 | 6,825 | 4,137 | 10,962 |
| Community Trust | 0.0 | 0 | 35,438 | 35,438 |
| Non-citizen Program | 0.0 | 5,839 | 0 | 5,839 |
| Agency Parity | 0.0 | 62,439 | 79,466 | 141,905 |
| CDE Administrative Component | 0.0 | 6,832 | 8,694 | 15,526 |
| Residential PNA | 0.0 | 2,191 | 1,209 | 3,400 |
| Medicaid Provider Rates | 0.0 | 430 | 500 | 930 |
| Assisted Living Provider Rates | 0.0 | 70,172 | 78,078 | 148,250 |
| Medical Escort Settlement | 0.0 | 569 | 723 | 1,292 |
| Adult Abuse Registry | 0.90 | 525 | 215 | 740 |
| Acute Care Hospital Rapid Response | 0.0 | 17,400 | 17,400 | 34,800 |
| Transitional Care Center of Seattle | 1.0 | 41,059 | 41,061 | 82,120 |
| Institutional Transitions | 16.7 | 10,895 | 2,058 | 12,953 |
| Kinship Navigator | 0.50 | 601 | 66 | 667 |
| LTSS Operations | 22.9 | 0 | 12,663 | 12,663 |
| LTSS Technology | 17.0 | 0 | 13,118 | 13,118 |
| Medicaid Program Integrity | 8.1 | 1,061 | 1,061 | 2,122 |
| Medicaid Provider Rates | 0.0 | 80,575 | 73,146 | 153,721 |
| Skilled Nursing Facility Rates | 0.0 | 55,380 | 55,382 | 110,762 |
| Medicare-Medicaid Integration Grant | 1.2 | 0 | 443 | 443 |
| Residential Complaints & Licensing | 7.1 | 860 | 1,052 | 1,912 |
| Traumatic Brain Injury Facility | 0.0 | 1,518 | 1,435 | 2,953 |
| Eliminate ABD Recoveries | (2.6) | 39,519 | 0 | 39,519 |
| IE&E Status Tracker & Platform | 19.0 | 9,049 | 21,115 | 30,164 |
| IE&E Discovery and Innovation | 4.0 | 3,564 | 8,318 | 11,882 |
| TANF - Diaper-related Assistance | 0.0 | 0 | 13,966 | 13,966 |
| Expanding OAR | 0.30 | 1,142 | 0 | 1,142 |
| Federal SAVES Grant | 1.0 | 0 | 485 | 485 |
| Federal Refugee Funding Increase | 0.0 | 0 | 49,446 | 49,446 |
| Refugee Housing Program Manager | 1.0 | 0 | 299 | 299 |
| TANF Time Limit Extension | 2.5 | 0 | 25,332 | 25,332 |
| Unaccompanied Children Supports | 1.0 | 1,000 | 0 | 1,000 |
| IT Realignment Resources | 2.0 | 609 | 171 | 780 |
| Zero Emission Staffing | 3.0 | 0 | 815 | 815 |
| Language Access Providers Agreement | 0.0 | 27 | 14 | 41 |
| Office of Justice and Civil Rights | 2.0 | 616 | 174 | 790 |
| Critical Wi-Fi Connectivity | 0.0 | 485 | 0 | 485 |
| 2023 Policy Other Changes Total | 591.3 | 812,644 | 1,038,630 | 1,851,274 |
2023 Policy Comp Changes |
||||
| State Employee Benefits | 0.0 | 665 | 312 | 977 |
| WFSE General Government | 0.0 | 182,775 | 81,650 | 264,425 |
| Rep Employee Health Benefits | 0.0 | 4,352 | 1,961 | 6,313 |
| Non-Rep Recruitment/Retention | 0.0 | 1,642 | 769 | 2,411 |
| Coalition of Unions | 0.0 | 8,331 | 571 | 8,902 |
| Non-Rep General Wage Increase | 0.0 | 20,854 | 9,358 | 30,212 |
| SEIU 1199 General Government | 0.0 | 51,848 | 12,446 | 64,294 |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 2,069 | 891 | 2,960 |
| Vaccine Booster Incentive | 0.0 | 1,433 | 668 | 2,101 |
| Adult Family Home Award/Agreement | 0.0 | 153,325 | 185,632 | 338,957 |
| 2023 Policy Comp Changes Total | 0.0 | 427,294 | 294,258 | 721,552 |
2023 Policy Central Services Changes |
||||
| Shared Tenant M365 to CSM | 0.0 | (7,218) | (3,274) | (10,492) |
| State Data Center | 0.0 | (1,720) | 0 | (1,720) |
| Archives/Records Management | 0.0 | 116 | 53 | 169 |
| Audit Services | 0.0 | 150 | 74 | 224 |
| Legal Services | 0.0 | 1,979 | 777 | 2,756 |
| Administrative Hearings | 0.0 | 1,231 | 1,847 | 3,078 |
| CTS Central Services | 0.0 | 9,721 | 4,487 | 14,208 |
| DES Central Services | 0.0 | 1,925 | 705 | 2,630 |
| OFM Central Services | 0.0 | 24,184 | 1,068 | 25,252 |
| GOV Central Services | 0.0 | 3,984 | 1,806 | 5,790 |
| 2023 Policy Central Services Changes Total | 0.0 | 34,352 | 7,543 | 41,895 |
| Total Policy Changes | 591.3 | 1,274,290 | 1,340,431 | 2,614,721 |
| 2023-25 Policy Level | 18,215.7 | 10,194,594 | 10,736,060 | 20,930,654 |
| Difference from 2021-23 | 852.2 | 2,549,280 | 410,013 | 2,959,293 |
| % Change from 2023-25 Original | 4.9% | 33.3% | 4.0% | 16.5% |
Policy Changes
Facility Maintenance Costs
Funding is provided to contract for fire damper inspections at the state hospitals in accordance with RCW 19.27.720. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
WiFi Services
Funding is appropriated for Wi-Fi services from WaTech and other equipment necessary to provide reliable coverage at the state hospitals. (General Fund - State)
Disproportionate Share Hospital
Payments made to states under the Disproportionate Share Hospital grant program are intended to offset the costs of uncompensated care for Medicaid and uninsured patients. Enacted federal legislation has directed changes in federal grants to states for Disproportionate Share Hospitals (DSH). State and federal appropriations are adjusted to reflect estimated changes in this federal revenue. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - Local CRC Oregon, other funds)
Competency Evaluations
Funding is provided to perform more competency evaluation referrals to respond to recent increases in demand. (General Fund - State)
KC Forensic Evaluation Pilot Site
Funding is appropriated to create a forensic evaluation pilot site at the King County Correctional Facility to reduce delays and create efficiencies for Trueblood class members requiring competency evaluations. (General Fund - State)
Neuropsychological Evaluations
Funds are provided to increase the timeliness and availability of neuropsychologist assessments at the state hospitals. (General Fund - State)
Maple Lane Campus
The department will use this funding to support the expansion of the Maple Lane campus. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
DSHS RTF - Vancouver Campus
This funding will provide direct care and operation of the Vancouver Residential Treatment Facility (RTF) campus, including the delivery of services by the department for all 48 beds at this site. (General Fund - State)
Barriers to Discharge
Funding is appropriated to reduce barriers for hard-to-place patients residing at the state hospitals who are ready and appropriate for discharge to a community setting. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Restore WSH Civil Ward
Funding is restored for a civil ward at Western State Hospital previously used for the Specialized Treatment Assessment and Recovery (STAR) ward. The department's strategy for violence reduction and prevention has evolved, making this resource available for civil populations. (General Fund - State)
Violence Reduction Team
Funds are provided to implement a violence reduction and prevention strategy at the state hospitals. (General Fund - State, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Savings from STAR Ward Closure
Savings are captured for the closure of the Specialized Treatment Assessment and Recovery (STAR) ward. Funds are reinvested to reopen a civil ward at Western State Hospital and implement a new violence reduction team to reduce and prevent violence. (General Fund - State)
Jail-based Behavioral Health
This funding will support behavioral health and stabilization services at the King County South Correctional Entity (SCORE). (General Fund - State)
Personal Protective Equipment
Funds are provided to cover the increased costs incurred for personal protective equipment (PPE) during the COVID-19 pandemic. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
State Hospital Direct Care Staffing
Funding is provided to phase in the Hospital Acuity Resource Tool (HART), an acuity-based direct care staffing model, at Western State Hospital. Direct care staff include registered nurses, mental health technicians, psychiatric security attendants, and licensed practical nurses. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - State, other funds)
Phase 2 Trueblood
Funding is appropriated for costs incurred in King County for Trueblood et. al v. DSHS lawsuit. (General Fund - State)
Phase 3 Trueblood
This item funds costs incurred for phase 3 of the Trueblood et. al v. DSHS lawsuit, including the expansion to the Thurston/Mason and Salish regions. (General Fund - State)
Trueblood Court Monitor
Ongoing funding is provided for court monitor costs related to the Trueblood et. al v. DSHS lawsuit. (General Fund - State)
Facility One-time Costs
Funds are provided for one-time relocation and project costs to support the Department of Social and Health Services' leased facilities strategic plan. (General Fund - State, General Fund - Medicaid Federal, General Fund - Federal, 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 $1,160 per employee per month for fiscal year 2024 and $1,233 per employee per month for fiscal year 2025. (General Fund - State, General Fund - Federal, General Fund - Medicaid Federal, other funds)
WFSE General Government
Funding is provided for a general wage increase of 4%, effective July 1, 2023; a general wage increase of 3%, effective July 1, 2024; targeted job classification base range increases; recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023; shift premium increase for eligible shifts from $1 to $2.50 per eligible hour; a COVID-19 booster incentive of $1,000; supplemental shift premium increases for nurse classifications; 5% premium pay for employees who are assigned to a facility that provides direct care to residents, patients and/or clients and whose duties are required to be performed on location; and an increase of $250 to the annual lump sum payment for Labor and Industries risk classes 7200/7201. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Rep Employee Health Benefits
This provides health insurance funding 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 $1,160 per employee per month for fiscal year 2024 and $1,233 per employee per month for fiscal year 2025. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Non-Rep Recruitment/Retention
Funding is provided for recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023. (General Fund - Federal, General Fund - State, General Fund - Medicaid Federal, other funds)
Coalition of Unions
Funding is provided for a general wage increase of 4%, effective July 1, 2023; a general wage increase of 3%, effective July 1, 2024; targeted job classification base range increases; recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023; shift premium increase for eligible shifts from $1 to $2.50 per eligible hour; and a COVID-19 booster incentive of $1,000. The agreement also includes a supplemental shift premium increases for nurse classifications; 5% premium pay for employees who are assigned to a facility that provides direct care to residents, patients and/or clients and whose duties are required to be performed on location; and a $500 annual lump sum payment for L&I codes 7200/7201. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Non-Rep General Wage Increase
Funding is provided for wage increases 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. It is sufficient for a general wage increase of 4 percent, effective July 1, 2023 and a general wage increase of 3 percent, effective July 1, 2024. This item includes both general government and higher education workers. (General Fund - State, General Fund - Federal, General Fund - Medicaid Federal, other funds)
SEIU 1199 General Government
Funding is provided for a general wage increase of 4%, effective July 1, 2023; a general wage increase of 3%, effective July 1, 2024; targeted job classification base range increases; recognition and retention lump sum payments for employees employed on or before July 1, 2022 and continuously employed through July 1, 2023; shift premium increase for eligible shifts from $1 to $2.50 per eligible hour; and a COVID-19 booster incentive of $1,000. The agreement includes supplemental shift premium increases for nurse classifications; 5% premium pay for employees who are assigned to a facility that provides direct care to residents, patients and/or clients and whose duties are required to be performed on location; and an ARNP ANCC Board certification incentive of $2,500. In addition, this agreement includes preceptor premium pay increase, increase in training dollars, additional retention incentive of $1,500, and $500 annual lump sum payment for L&I codes 7200/7201. (General Fund - State, General Fund - Medicaid Federal, General Fund - 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. (General Fund - Federal, General Fund - Medicaid Federal, General Fund - State, other funds)
Vaccine Booster Incentive
Funding is provided for a $1,000 lump sum COVID-19 booster incentive for non-represented employees. This funding does not cover institutions of higher education. (General Fund - Medicaid Federal, General Fund - Federal, General Fund - State, other funds)
Assessment Tool Study
Funding is provided to contract for an evaluation of the Comprehensive Assessment Reporting Evaluation (CARE) tool. This evaluation will result in a feasibility report that documents algorithmic processes, assessment calculations, process mapping, and workflow mapping for the CARE tool. The report will inform how the tool can be simplified, modified or replaced to meet the obligations of Medicaid match, be more person-centered and easily understood, reduce the need for manual notations, and capture client strengths, capacities, needs and desired outcomes for care. (General Fund - State, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Financial Eligibility Staff
Funding is provided for 25.5 FTE staff to complete financial eligibility determinations and perform case maintenance activities to help clients obtain or stay connected to vital services, medical coverage, cash, and food assistance. This funding will improve DDA's ability to meet the 45-day application processing requirement specified in WAC 182-503-0060. (General Fund - State, General Fund - Medicaid Federal, General Fund - Cash, other funds)
Expand High School Transition
Students with intellectual and developmental disabilities become eligible for employment and community inclusion services from the DSHS-DDA at the age of 21. Funding is provided for students who are served on the Individual and Family Services waiver or who are not on a waiver, but are eligible for employment and community inclusion services. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Continue Klamath Cottage
Funds are provided to continue operating the Klamath Cottage at Rainier School, a short-term transition option for individuals in acute care hospitals and state hospitals who no longer require medical treatment but are waiting for community placements. (General Fund - State)
Adjust CDE Rates
Funding is provided for a new rate for the consumer directed employer (CDE) contracted individual providers as set by the Consumer Directed Employer Rate Setting Board in accordance with RCW 74.39A.530. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Funded Program Implementation
The department will continue the phase-in and expansion of programs that serve children and youth with co-occurring behavioral health and intellectual/developmental disabilities. This includes the continued phase-in of youth inpatient navigators to participate in case management for children and youth with behavioral health needs. Additionally, funding is provided to expand intensive habilitation and enhanced out-of-home placements for youth. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Employment/Community Inclusion
This item funds rate increases for supported employment and community inclusion services. These programs provide meaningful employment, volunteer and other community activities for people with intellectual and developmental disabilities who are eligible for these programs. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Translation Service Rates
Funding is provided for contracted services that provide translation services to clients in federally required languages through a contracted vendor. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Children and Adults in Hospitals
The department will increase the capacity of direct support providers to better meet the needs of individuals with complex support needs. A new pilot program will be created that provides an enhanced rate to providers who take specialized training to better serve clients. This will help reduce unnecessary hospitalization of children and adults with intellectual and developmental disabilities. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Specialty Adult AFH
Funding is provided for a new enhanced adult family home pilot for adult family home (AFH) providers who specialize in serving individuals with intellectual or developmental disabilities (I/DD), who may also have a co-occurring health or behavioral diagnosis, in their communities rather than in an acute care setting. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Expand Behavior Stabilization
This item will expand capacity for both bed-based and mobile diversion services, as well as increase the rate for service providers. This is necessary to maintain a viable provider network to prevent unnecessary hospitalizations and out-of-state placements for clients with difficult-to-serve behaviors. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Community Trust
Appropriation authority is provided to continue funding projects that will enhance and expand Home and Community Based Services (HCBS) for individuals with intellectual and developmental disabilities. (Developmental Dis Comm Service Acct - State)
Non-citizen Program
The department will create a program for people with developmental disabilities who are not eligible for federally funded programs due to their immigration status. This new program will provide personal care for people who need to step down from hospital care but require long-term care supports. The Health Care Authority will provide ongoing medical services for these clients. (General Fund - State)
Agency Parity
This item provides homecare agency parity consistent with the rates set by the Consumer Directed Employer Rate Setting Board in accordance with RCW 74.39A.530. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
CDE Administrative Component
This item covers administrative costs set by the Consumer Directed Employer Rate Setting Board in accordance with RCW 74.39A.530. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Residential PNA
If proposed legislation is enacted, this item will increase the personal needs allowance (PNA) for clients residing in institutions and residential facilities from $75.36 to $100.00 per month. The PNA is an amount of their own income clients retain to pay for their personal needs, including clothing, personal hygiene supplies, cell phone data, non-covered facility activities, additional grooming, and small treats. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Medicaid Provider Rates
Funding is provided to increase rates for providers of home and community-based services who serve Medicaid clients. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Assisted Living Provider Rates
Funds are provided to increase rates for assisted living facilities that serve Medicaid clients. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Medical Escort Settlement
Funds are provided for the unfair labor practice settlement in the case of the Adult Family Home Council v. Office of Financial Management. If the settlement agreement is not reached by June 30, 2024, the funds shall lapse. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Adult Family Home Award/Agreement
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 the 2023-25 biennium. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
Adult Abuse Registry
Funding is provided to implement proposed legislation to create a process to remove names from the vulnerable adult abuse registry. Currently, there is no provision that allows a provider's case to be reviewed or removed from this registry. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
Acute Care Hospital Rapid Response
This item will continue the rapid response nursing team program in fiscal year 2024. This program provides staffing teams for long-term care facilities facing workforce shortages and helps address hospital capacity issues that have affected the health sector during the COVID-19 pandemic. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Transitional Care Center of Seattle
Funding is provided for the ongoing operation and projected cost increases of nursing facility services in Transitional Care Center of Seattle (TCCS). One FTE position is provided for complex transition planning to help TCCS residents transition to home and community-based settings. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Institutional Transitions
Funding is provided to help Medicaid patients transition from acute care hospitals, state hospitals and community psychiatric hospitals into settings in the community with more appropriate levels of care. (General Fund - Local CRC Oregon, General Fund - State, General Fund - Medicaid Federal, other funds)
Kinship Navigator
This funding will be used to continue the case management kinship navigator pilot. Initial findings of a study, begun in 2018 in cooperation with the Department of Children, Youth, and Families and the University of Washington, show improved utilization of resources, client satisfaction, and health and well-being of pilot participants. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
LTSS Operations
Funding is provided to continue implementation of the long-term services and supports (LTSS) trust program, now called WA Cares Fund, as directed by chapter 50B RCW. Beginning July 2026, this program will provide long-term services and supports benefits to qualified individuals who have been assessed as needing assistance with daily living activities. This investment will be funded solely from worker contributions to the Long-Term Services and Supports Trust Account. (Long-Term Servs & Sup Trust Account - State)
LTSS Technology
Funding is provided for technology solutions necessary to operate the WA Cares Fund program. This investment will be funded solely from worker contributions to the Long-Term Services and Supports (LTSS) Trust Account. (Long-Term Servs & Sup Trust Account - State)
Medicaid Program Integrity
This item will enable the department to meet reporting, auditing, and dispersal requirements of Medicaid funds used in Aging and Long-Term Support Administration (ALTSA) and Developmental Disabilities Administration (DDA) programs. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Skilled Nursing Facility Rates
This item will increase rates for skilled nursing facilities that serve Medicaid clients. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Medicare-Medicaid Integration Grant
Expenditure authority is provided for the Advancing Medicare and Medicaid Initiative grant that was previously approved through the unanticipated receipt approval process. (General Fund - Private/Local, General Fund - Local)
Residential Complaints & Licensing
Funding is provided for complaint investigations and licensing efforts to keep up with the current and estimated future growth in the volume of complaints regarding care in long-term care facilities. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Traumatic Brain Injury Facility
This item will fund one 16-bed facility in a community-based residential setting. This facility will provide specialized medical behavioral supports, specialized inpatient care, and long-term residential services to individuals experiencing a traumatic brain injury with complex medical and behavioral needs so they can reside in Washington. The Health Care Authority will also help fund the service delivery in this new program. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Eliminate ABD Recoveries
Funds are provided to eliminate the department's garnishment of a portion of the Social Security Income (SSI) lump sum payment received by recipients of the Aged, Blind or Disabled (ABD) program, effective October 1, 2023. Recipients will no longer have to pay back ABD cash benefits received during months in which they also received a backdated SSI payment. (General Fund - State)
IE&E Status Tracker & Platform
The department will continue building the foundation of an integrated eligibility and enrollment (IE&E) system across health and human services programs, including Medicaid, basic food, child care, and cash assistance. This funding covers the continuation of phase 1, including the status tracker and the selection of a technical platform. (General Fund - State, General Fund - Federal)
IE&E Discovery and Innovation
Funding is provided to continue building the foundation of an integrated eligibility and enrollment (IE&E) system across health and human services programs, including Medicaid, basic food, child care, and cash assistance. This funding covers phase 2, including discovery and innovation work and customer experience. (General Fund - Federal, General Fund - State)
TANF - Diaper-related Assistance
Funds are provided to increase the cash benefit by $80 per month for households with a child under the age of three that are receiving Temporary Assistance for Needy Families (TANF) or State Family Assistance. The funding is intended to assist with the cost of diapers as described in Chapter 100, Laws of 2022 (SSB 5838). The cash benefit increase is effective November 1, 2023. (General Fund - State, General Fund - Temporary Assist for Needy Families, General Fund - Federal Dedicated)
Expanding OAR
The department will expand the Ongoing Additional Requirements (OAR) program that assists participants receiving cash assistance with unmet expenses if needed to continue living independently. The funding increases the payment standard for existing services; modernizes benefits to include transportation, internet service, care for service animals, and certain medical and dental services if not covered by Medicaid; and extends eligibility to those on the Housing and Essential Needs Referral program. (General Fund - State)
Federal SAVES Grant
Expenditure authority and staffing are provided to the Division of Child Support for a multi-year federal grant intended to increase safe access to child support and parenting services for domestic violence victims and survivors. (General Fund - Federal)
Federal Refugee Funding Increase
One-time federal funding is awarded to the Office of Refugee and Immigrant Assistance (ORIA) to provide a variety of services and supports to Afghan and Ukrainian refugees arriving in Washington state. (General Fund - Federal)
Refugee Housing Program Manager
Federal expenditure authority and staffing are provided to assist with the coordination of refugee housing. (General Fund - Federal)
TANF Time Limit Extension
Funds are provided to expand the 60-month time limit in the Temporary Assistance for Needy Families (TANF) program through June 2025 to approximately 1,970 households per month experiencing a hardship. (General Fund - Temporary Assist for Needy Families, General Fund - Federal Dedicated)
Unaccompanied Children Supports
This item provides emergent supports for unaccompanied immigrant children and their sponsors. In addition, funding is provided for the Office of Refugee and Immigrant Assistance (ORIA) to convene a work group to identify long-term services and supports for this population. The work group must submit a report with recommendations by June 30, 2025. (General Fund - State)
IT Realignment Resources
The department will use this funding to support the centralization of information technology (IT) resources and the management of priority IT projects. (General Fund - Federal, General Fund - State)
Zero Emission Staffing
Funding is provided for three FTE staff to support implementation of Executive Order 21-04 (Zero Emission Vehicles). Staff will coordinate with the State Efficiency and Environmental Performance office to collaborate on implementing a strategy for electric vehicles. (Carbon Emissions Reduction Account - State, General Fund - Federal Dedicated, General Fund - Temporary Assist for Needy Families)
Language Access Providers Agreement
Funding is adjusted for interpreter services based upon the language access providers collective bargaining agreement for the 2023-25 biennium. (General Fund - Federal, General Fund - State)
Office of Justice and Civil Rights
The department will establish an Office of Justice and Civil Rights to ensure a unified focus on upholding justice and civil rights for clients and staff. (General Fund - Federal, General Fund - State)
Critical Wi-Fi Connectivity
Funding is provided for infrastructure, services, and labor to expand Wi-Fi coverage at the Special Commitment Center. (General Fund - State)
Shared Tenant M365 to CSM
Agency budgets are reduced by the base budget amounts provided to Consolidated Technology Services for Microsoft 365 licenses so the cost can be added to the central service model allocation in CTS central services (Step 92J). (General Fund - Federal, General Fund - State)
State Data Center
Adjustments are made for each agency's share of costs related to the State Data Center. (General Fund - State)
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)
Audit Services
Adjustments are made for each agency's anticipated cost of audits performed by the State Auditor's Office. (General Fund - State, General Fund - Federal)
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. The methodology to estimate consumption has been updated from a three-year average to a two-year average and allows for analysis to incorporate unique agency circumstances. (General Fund - Federal, General Fund - State)
Administrative Hearings
Adjustments are made for each agency's anticipated cost of hearings performed by the Office of Administrative Hearings. (General Fund - State, General Fund - Federal)
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 Cybersecurity, state network, enterprise services, small agency IT services, security gateways, and geospatial imaging services. This amount now includes the total amount for agencies that use the Microsoft 365 shared tenant. See Chapter 11 of the 2023-25 OFM Budget Instructions for allocation methodologies. (General Fund - Federal, General Fund - State)
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, parking, contracts, and security; 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 Chapter 11 of the 2023-25 OFM Budget Instructions for allocation methodologies. (General Fund - Federal, General Fund - State)
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 Chapter 11 of the 2023-25 OFM Budget Instructions for allocation methodologies. (General Fund - State, General Fund - Federal)
GOV Central Services
A new central service is created to reflect each agency's anticipated share of charges from the Office of the Governor for statewide policy staff and the Office of Equity. (General Fund - State, General Fund - Federal)
