Department of Health
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 2,087.2 | 245,030 | 2,789,020 | 3,034,050 |
| 2023-25 Maintenance Level | 2,004.9 | 206,919 | 1,289,871 | 1,496,790 |
| Difference from 2023-25 Original | (82.3) | (38,111) | (1,499,149) | (1,537,260) |
| % Change from 2023-25 Original | (3.9%) | (15.6%) | (53.8%) | (50.7%) |
2023 Policy Other Changes |
||||
| Adjust Budget Driven Revenue | 0.0 | 0 | 142 | 142 |
| Sustain Watch Me Grow Program | 3.6 | 2,768 | 0 | 2,768 |
| Care-a-Van & Mobile Health Services | 3.0 | 1,462 | 0 | 1,462 |
| Comprehensive Planning Climate | 0.0 | 0 | 50 | 50 |
| Climate Resilience Strategy | 0.0 | 0 | 72 | 72 |
| Improve Newborn Screening Timelines | 5.2 | 0 | 1,600 | 1,600 |
| HIV Pharmaceutical Drug Rebates | 9.0 | 0 | 100,749 | 100,749 |
| Healthy Environment for All Act | 23.7 | 4,767 | 4,389 | 9,156 |
| DWSRF Set Asides Allotment Increase | 10.5 | 0 | 7,146 | 7,146 |
| Climate & Health Program Expansion | 15.4 | 0 | 7,503 | 7,503 |
| Drinking Water Consolidation Grants | 0.0 | 0 | 808 | 808 |
| Options for Tainted Drinking Water | 0.80 | 1,624 | 0 | 1,624 |
| Drinking Water Technical Services | 4.2 | 0 | 1,044 | 1,044 |
| COVID-19 Funding Gap | 0.0 | 0 | 20,000 | 20,000 |
| Behavioral Health Agency Regulation | 1.3 | 580 | 214 | 794 |
| Medical Test Site Fees | 3.1 | 0 | 1,865 | 1,865 |
| Upgrade Medical Cannabis Registry | 6.4 | 1,758 | 1,758 | 3,516 |
| Workplace Safety for Climate Impact | 0.0 | 0 | 10,000 | 10,000 |
| Clear Hospital Complaint Backlog | 6.0 | 2,039 | 680 | 2,719 |
| Maintain Core Public Health Systems | 65.3 | 23,066 | 0 | 23,066 |
| Master Person Index Expansion | 10.1 | 2,991 | 0 | 2,991 |
| Continue Public Health Technology | 24.5 | 17,752 | 0 | 17,752 |
| WMCC Implementation Plan | 0.0 | 200 | 0 | 200 |
| Address Increase Demand for Nurses | 8.0 | 0 | 2,276 | 2,276 |
| Adjust 988 Funding Levels | 0.0 | 0 | (21,330) | (21,330) |
| Cancer Screening & Prevention | 0.0 | 3,298 | (3,298) | 0 |
| EHDDI Data System Modernization | 0.40 | 237 | 0 | 237 |
| Birth Equity Project | 3.0 | 3,166 | 0 | 3,166 |
| Early Hearing Detection for Infants | 2.9 | 988 | 0 | 988 |
| Secure Reproductive Health Services | 3.2 | 15,010 | 0 | 15,010 |
| Reproductive Rights Awareness | 0.0 | 1,000 | 0 | 1,000 |
| Maternal Infant Health | 0.90 | 400 | 0 | 400 |
| Statewide Medical Logistics Center | 6.5 | 7,355 | 7,022 | 14,377 |
| Shellfish Biotoxin Testing | 4.6 | 993 | 379 | 1,372 |
| Settlement Data and Evaluation | 0.0 | 0 | 1,346 | 1,346 |
| Settlement Stabilization Support | 0.0 | 0 | 3,768 | 3,768 |
| Settlement Maternal Health | 0.0 | 0 | 2,692 | 2,692 |
| Settlement Drug User Health Hubs | 0.0 | 0 | 6,730 | 6,730 |
| Technical Corrections | 13.1 | 985 | 2,885 | 3,870 |
| Uniform Facilities Enforcement | 4.0 | 376 | 1,277 | 1,653 |
| Washington Medical Commission | 10.6 | 0 | 2,293 | 2,293 |
| 2023 Policy Other Changes Total | 249.3 | 92,815 | 164,060 | 256,875 |
2023 Policy Comp Changes |
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| State Employee Benefits | 0.0 | 56 | 112 | 168 |
| WFSE General Government | 0.0 | 5,055 | 19,174 | 24,229 |
| Rep Employee Health Benefits | 0.0 | 157 | 622 | 779 |
| Non-Rep Recruitment/Retention | 0.0 | 136 | 277 | 413 |
| Non-Rep General Wage Increase | 0.0 | 2,004 | 3,982 | 5,986 |
| SEIU 1199 General Government | 0.0 | 211 | 2,365 | 2,576 |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 101 | 322 | 423 |
| Vaccine Booster Incentive | 0.0 | 117 | 240 | 357 |
| 2023 Policy Comp Changes Total | 0.0 | 7,837 | 27,094 | 34,931 |
2023 Policy Central Services Changes |
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| Shared Tenant M365 to CSM | 0.0 | (419) | (2,045) | (2,464) |
| State Data Center | 0.0 | (3) | (7) | (10) |
| Archives/Records Management | 0.0 | 11 | 54 | 65 |
| Audit Services | 0.0 | 6 | 27 | 33 |
| Legal Services | 0.0 | 223 | 1,171 | 1,394 |
| Administrative Hearings | 0.0 | 0 | 1 | 1 |
| CTS Central Services | 0.0 | 632 | 3,079 | 3,711 |
| DES Central Services | 0.0 | 123 | 773 | 896 |
| OFM Central Services | 0.0 | 1,228 | 3,120 | 4,348 |
| GOV Central Services | 0.0 | 170 | 831 | 1,001 |
| 2023 Policy Central Services Changes Total | 0.0 | 1,971 | 7,004 | 8,975 |
| Total Policy Changes | 249.3 | 102,623 | 198,158 | 300,781 |
| 2023-25 Policy Level | 2,254.2 | 309,542 | 1,488,029 | 1,797,571 |
| Difference from 2021-23 | 167.0 | 64,512 | (1,300,991) | (1,236,479) |
| % Change from 2023-25 Original | 8.0% | 26.3% | (46.6%) | (40.8%) |
Policy Changes
Adjust Budget Driven Revenue
This technical adjustment in budget driven revenue is due to the enactment of E2SSB 5796 (cannabis revenue appropriations) in 2022. (Dedicated Cannabis Account - State)
Sustain Watch Me Grow Program
Funding is provided to sustain core functions of the Watch Me Grow Washington program that provides health and safety information to parents of young children. (General Fund - State)
Care-a-Van & Mobile Health Services
Funding is provided to maintain vehicles purchased with federal funding and provide operational support for the Care-a-Van Mobile Health program. This will increase the department's ability to provide mobile health services in areas with limited access to health clinics and will maintain the ability to quickly respond to future public health emergencies and disasters. (General Fund - State)
Comprehensive Planning Climate
Governor Inslee will introduce legislation in 2023 requiring local governments to plan for climate resiliency while reducing contributions to the climate crisis. The bill will require cities and counties to update their land use plans to reduce greenhouse gas emissions, reduce single-occupancy transportation, and establish a new climate change and resiliency goal that integrates equity considerations. Multiple state agencies will work with the Department of Commerce in assisting local governments with implementation, including providing technical assistance and guidance materials. Funding is provided to implement this bill. (Climate Commitment Account - State)
Climate Resilience Strategy
The Department of Ecology will propose legislation to lead a collaborative effort to produce an updated climate change response strategy by July 1, 2024, with updates every four years thereafter. Ecology will coordinate with the Department of Commerce and other state agencies in the development of the strategy. Funding is provided to the Department of Health for its role in the interagency work group created in the bill. (Natural Climate Solutions Account - State)
Improve Newborn Screening Timelines
Funding is provided for a courier service to quickly transport newborn testing specimens to the public health laboratory. (General Fund - Private/Local, General Fund - Local)
HIV Pharmaceutical Drug Rebates
Legislation will be proposed to create a new account for revenue from the medical rebate program for clients living with human immunodeficiency virus (HIV). This will provide additional flexibility and better planning to improve health outcomes and reduce racial disparities for clients living with HIV. (HIV Pharmaceutical Rebates - Non-Appropriated)
Healthy Environment for All Act
The department will implement the Healthy Environment for All (HEAL) Act under chapter 70A.02 RCW. This will provide staff to support the Environmental Justice Council, including participation grants, and will help maintain and update the environmental health disparities map. (Climate Commitment Account - State, General Fund - State)
DWSRF Set Asides Allotment Increase
Expenditure authority is provided to fund technical assistance for small water systems. (Drinking Water Assistance Account - Federal)
Climate & Health Program Expansion
Funding is provided to implement the Climate Commitment Act under RCW 70A.65.010. This will fund staff to meet the requirements of the act, distribute climate plus grants to schools, and support the climate and health adaptation initiative. (Climate Investment Account - State, Climate Commitment Account - State)
Drinking Water Consolidation Grants
Expenditure authority is provided to expand the water system consolidation grant program to consolidate smaller water systems with larger water systems that can offer technical, managerial, and financial capacity. (Drinking Water Assistance Admin - State)
Options for Tainted Drinking Water
This funding will assist people who have contaminated ground water in their individual well or who are served by small public water systems that are contaminated. The department will work with these homes and businesses to provide access to safe drinking water through testing and treatment, while longer term solutions are pursued. (General Fund - State)
Drinking Water Technical Services
Expenditure authority is provided to cover the gap between program costs and available revenue in the drinking water technical services program. (Safe Drinking Water Account - State)
COVID-19 Funding Gap
Funding is provided to continue COVID-19 public health and response activities, including the distribution of testing supplies to agricultural workers and Tribal governments. These funds may only be allocated and expended after approval of the spending plan by the Office of Financial Management. The department must maximize the use of federal reimbursements, including seeking Federal Emergency Management Agency (FEMA) reimbursement for eligible activities. (Coronavirus St Fiscal Recovery Fund - Federal)
Behavioral Health Agency Regulation
There is an increase in licensure and regulatory activities in the department's behavioral health agency (BHA) program. This funding will help cover the gap between fee revenue and the program costs. (General Fund - Local, General Fund - State, General Fund - Private/Local)
Medical Test Site Fees
Expenditure authority is provided to meet increased workload demands in laboratory inspection work. (Medical Test Site Licensure Account - State)
Upgrade Medical Cannabis Registry
Funding is provided to complete the medical cannabis authorization system project upgrades to improve reporting functions and accessibility by the end of the 2023-25 biennium. (Dedicated Cannabis Account - State, General Fund - State)
Workplace Safety for Climate Impact
Funds are provided for the Climate Impact Worker Safety program. This includes pass-through grants to community-based organizations to support workplace health and safety for workers who are burdened by the intersection of their work and climate impacts, including extreme heat and cold, wildfire smoke, drought, and flooding. Five percent of the total amount can be used for administration costs. (Climate Commitment Account - State)
Clear Hospital Complaint Backlog
Funding is provided to investigate hospital complaints more quickly and clear a backlog that developed during the COVID-19 pandemic. (General Fund - State, General Fund - Local, General Fund - Private/Local)
Maintain Core Public Health Systems
Funds are provided to maintain core public health systems that are used to collect, track and report public health information; were critical during the COVID-19 pandemic; and will be essential in future public health emergencies. (General Fund - State)
Master Person Index Expansion
Funding is provided to onboard new systems, cover maintenance and operations of the Master Person Index (MPI) Initiative, and coordinate with the Health and Human Services Coalition MPI Initiative. The Coalition MPI is a system that matches identifiers across a defined set of demographic data and provides a single common identifier across the systems. (General Fund - State)
Continue Public Health Technology
Funding is provided to sustain information technology infrastructure, tools, and solutions developed to respond to the COVID-19 pandemic. The department shall submit a plan to the Office of Financial Management by September 15, 2023, that identifies a new funding strategy to maintain these information technology investments within the department's existing state, local and federal funding. (General Fund - State)
WMCC Implementation Plan
Funding is provided for the department, in collaboration with the Washington Medical Coordination Center (WMCC), to create an implementation plan for real-time bed capacity and tracking for hospitals, excluding behavioral health hospitals and facilities and skilled nursing facilities. The department will provide the implementation plan and estimated costs for an information technology system and implementation costs to the Office of Financial Management by September 15, 2023 for the bed capacity and tracking tool. (General Fund - State)
Address Increase Demand for Nurses
Expenditure authority is provided for the Nursing Care Quality Assurance Commission (NCQAC) to increase staffing levels to meet the increased demand for nursing licensure and updates to policies and regulatory framework. (Health Professions Account - State)
Adjust 988 Funding Levels
Funding is adjusted to reflect projected expenditures. (Stw988BehavHealth&SuicidePrevLine - State)
Cancer Screening & Prevention
Funds are provided to address a federal grant shortfall. This funding would enable the department to maintain existing services, enhance data systems, and increase work in addressing inequities around services related to cancer treatment. (General Fund - Federal, General Fund - State)
EHDDI Data System Modernization
Funding is provided to improve the data system for the early hearing, detection, diagnosis, and intervention (EHDDI) program. An improved data system will help increase the number of newborn hearing screenings and follow-up rates. (General Fund - State)
Birth Equity Project
The department will expand the Birth Equity Project and other initiatives that support prenatal and perinatal health, with a focus on culturally appropriate, community-led, evidence-based projects that enhance health and parent social support for communities experiencing the most extreme perinatal health disparities. (General Fund - State)
Early Hearing Detection for Infants
Funds are provided for the early hearing detection program for infants due to loss of federal funding and more restrictive uses of federal funding. This program ensure that all infants who are deaf or hard of hearing receive appropriate early interventions. (General Fund - State)
Secure Reproductive Health Services
The department will reimburse abortion clinics for reproductive care for people who are unable to afford these services and for reimbursement of travel expenses, including, but not limited to, childcare, meals and lodging. Additionally, the department will provide grant funding to public four-year institutions of higher education that offer advanced degrees in nursing, medicine, or pharmacy to develop and offer abortion care training for students and licensed providers. (General Fund - State)
Reproductive Rights Awareness
Funding is provided for a comprehensive public education and awareness campaign about abortion access and reproductive health rights. The campaign will focus on providing information to the public on where to access abortion services; how to distinguish between clinics offering abortion services and crisis pregnancy centers, or other limited service clinics; and patient rights regarding abortion and sexual health related information. The campaign may also provide information to health care providers about their rights and responsibilities related to providing abortion and reproductive health services. (General Fund - State)
Maternal Infant Health
Funding was provided in the 2021 legislative session to support strategies identified in the state opioid response plan that address the needs of pregnant and parenting individuals with opioid use disorder and for the treatment of infants born with neonatal abstinence syndrome. Program implementation delays prevented full use of funds within the funding timeline. (General Fund - State)
Statewide Medical Logistics Center
Funding is provided to support the statewide medical logistics center. This is a leased warehouse that houses personal protective equipment and a 60-day inventory of supports for public health and health care response. (General Fund - State, Coronavirus St Fiscal Recovery Fund - Federal)
Shellfish Biotoxin Testing
This item will pay for shellfish biotoxin testing. (General Fund - Local, General Fund - State, General Fund - Private/Local)
Settlement Data and Evaluation
This funding will create an overdose public health dashboard and develop a state opioid and overdose response plan. The plan would include data collection, evaluation, and opioid usage data to support the department's ability to monitor opioid usage and track progress on plan activities. Legislation will be proposed to create the new account. (Distributor Opioid Abatement Settle - State)
Settlement Stabilization Support
The department will increase access to harm reduction programs and supplies, including the purchase of naloxone and safe usage supplies. Legislation will be proposed to create the new account. (General Fund - State, Distributor Opioid Abatement Settle - State)
Settlement Maternal Health
Funding is provided to coordinate a work group on pregnant, parenting and families with children to analyze services and outcomes by community to identify service gaps. Funding will also provide housing supports for pregnant, parenting and families with children who have substance abuse disorders. Pass-through funding is provided to help critical access hospitals integrate data systems and to support improvements to safe care plans for infants who are born with substance exposure in coordination with the Department of Children, Youth, and Families. Legislation will be proposed to create the new account. (General Fund - State, Distributor Opioid Abatement Settle - State)
Settlement Drug User Health Hubs
Funding is provided to support the establishment of health engagement hubs to provide health care and social services for people who use drugs. The funding could support six hubs that will offer a range of services, including access to physical and behavioral health care, low barrier buprenorphine, care coordination, reproductive health, and linkages to community recovery supports. Ten percent of this funding will be directed to support Tribal syringe services programs. Proposed legislation will be proposed to create the new account. (General Fund - State, Distributor Opioid Abatement Settle - State)
Technical Corrections
Funds are provided for variances found in the reconciliation of multiple budget steps to correct the federal funding source and provide additional federal and local authority. (Health Professions Account - State, General Fund - State, General Fund - Local, other funds)
Uniform Facilities Enforcement
If proposed legislation is approved, funding is provided and appropriation authority is adjusted to create a uniform enforcement framework for medical facilities. (General Fund - Private/Local, General Fund - State, General Fund - Local, other funds)
Washington Medical Commission
Expenditure authority is adjusted to account for increased fee revenue and related workload increases for the Washington Medical Commission. This funding will provide additional staffing, resources for paper-less processes, and resources to focus on equity issues in policies and complaint processes. (Health Professions Account - State, Public Health Supplemental Account - State)
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 - Federal, General Fund - State, Health Professions Account - State, 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 - State, Health Professions Account - State, General Fund - 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. (Health Professions Account - State, General Fund - Federal, General Fund - State, 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. (Health Professions Account - State, General Fund - State, General Fund - 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 - Federal, General Fund - State, Health Professions Account - State, 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 - Local, General Fund - Federal, Health Professions Account - 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 - Federal, General Fund - State, Health Professions Account - 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 - State, Health Professions Account - State, General Fund - Federal, other funds)
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). (Drinking Water Assistance Account - Federal, Safe Drinking Water Account - State, General Fund - Private/Local, other funds)
State Data Center
Adjustments are made for each agency's share of costs related to the State Data Center. (General Fund - State, General Fund - Local, General Fund - Private/Local, 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, General Fund - Local, 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, General Fund - Federal, General Fund - Local, 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. 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 - State, Health Professions Account - State, General Fund - Local, other funds)
Administrative Hearings
Adjustments are made for each agency's anticipated cost of hearings performed by the Office of Administrative Hearings. (Health Professions Account - 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 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, General Fund - Local, 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, 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, Health Professions Account - State, 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 Chapter 11 of the 2023-25 OFM Budget Instructions for allocation methodologies. (Health Professions Account - State, General Fund - Local, General Fund - State, other funds)
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 - Local, General Fund - State, General Fund - Federal, other funds)
