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Home » Budget » State budgets » 2024 Gov. Inslee's proposed supplemental budgets » Agency recommendation summaries » Agency recommendation summaries » Department of Social and Health Services - Long Term Care

Department of Social and Health Services - Long Term Care

  Average Annual FTEs Near General Fund State Other Funds Total Funds
  (Dollars in Thousands)
Current Budget 2,720.2 4,587,718 5,848,771 10,436,489
2023-25 Maintenance Level 2,794.7 4,591,896 5,908,488 10,500,384
Difference from 2023-25 Original 74.5 4,178 59,717 63,895
% Change from 2023-25 Original 2.7% 0.09% 1.0% 0.61%

2024 Policy Other Changes

Caseload Ratio Reduction – Year 1 0.30 43 44 87
RCS Certification Program 0.50 88 88 176
Nursing Facility Rate Methodology 0.0 0 6,693 6,693
Dementia Care Stability 0.0 2,264 2,584 4,848
WCF Operations 4.4 0 2,599 2,599
Senior Nutrition Funding 0.0 7,093 0 7,093
WCF Information Technology (19.9) 0 4,908 4,908
Tribal Kinship Navigator Equity 0.0 510 0 510
GOSH Housing Expansion 0.50 6,459 2,100 8,559
Transitional Care Center 0.0 (6,050) (6,162) (12,212)
Facility Costs 0.0 0 1,643 1,643
2024 Policy Other Changes Total (14.2) 10,407 14,497 24,904

2024 Policy Comp Changes

State Employee Benefits 0.0 104 86 190
Compression and Inversion 0.0 591 493 1,084
Pension Rate Month of Death Bill 0.0 57 47 104
2024 Policy Comp Changes Total 0.0 752 626 1,378
Total Policy Changes (14.2) 11,159 15,123 26,282
2024 Policy Level 2,780.5 4,603,055 5,923,611 10,526,666
Difference from 2023-25 Original 60.3 15,337 74,840 90,177
% Change from 2023-25 Original 2.2% 0.33% 1.3% 0.86%

Policy Changes

Caseload Ratio Reduction – Year 1

This item provides information technology staff to support the increase in case management positions in the Developmental Disabilities Administration. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)

RCS Certification Program

Funds are provided to create a new certification program in Residential Care Services (RCS) for residential settings that provide short-term, non-intermediate care to individuals with intellectual and developmental disabilities. This new program will conduct facility inspections, investigate complaints, and protect the safety of clients living in this type of facility. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)

Nursing Facility Rate Methodology

Funding is provided to transition to a new rate methodology called the Patient Driven Payment model, as required by the federal Centers for Medicare and Medicaid Services. This data is used to adjust for the level of patient acuity in a nursing facility that serves Medicaid clients. Funding is provided to minimize the effects of rate changes on nursing facility payments during this transition. This will help ensure that no nursing facility experiences large swings in payments when the new methodology is deployed. (Nursing Fac Qual Enhance Account - Non-Appropriated, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Dementia Care Stability

Funds are provided to adjust the rate add-on for specialty dementia care from $43.48 per client per day to $55.00. Currently, the rate add-on is less than other comparable rates, which creates a disincentive for facilities to accept dementia care patients. This rate adjustment will ensure that Medicaid dementia care patients are prioritized and accepted at long-term care facilities. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

WCF Operations

This item provides staffing resources to continue implementation of the Washington Cares Fund Program . Beginning in 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. The department will administer this program and authorize an estimated $1.1 billion in benefits in its first year of implementation in fiscal year 2027. (Long-Term Servs & Sup Trust Account - State)

Senior Nutrition Funding

Funding is provided to maintain access to senior nutrition and food programs provided through community sites, senior food pantries, mobile food pantries, meals on wheels and other nutrition services. Federal funding expanded senior nutrition and food programs during the pandemic. This funding replaces the loss of federal funding to provide more than one million meals to approximately 18,686 senior citizens. (General Fund - State)

WCF Information Technology

Funds are provided to continue developing the technology solutions for the WA Cares Fund (WCF) program. (Long-Term Servs & Sup Trust Account - State)

Tribal Kinship Navigator Equity

Funding is provided for the tribal kinship navigator program at the same level as the Area Agency on Aging kinship navigator program. The Tribal kinship navigator program operates in seven tribes. The funding for the tribal programs was not included in the 2023-25 budget due to an error. (General Fund - State)

GOSH Housing Expansion

Funding is provided to expand the Governor's Opportunity for Supportive Housing program (GOSH) by 175 slots. This program serves Medicaid clients who are ready to discharge from the state's behavioral health hospitals or community behavioral health facilities and prefer to live independently. GOSH allows these clients to live in their own apartment rather than in a residential setting, like an adult family home, nursing home or assisted living facility. The program provides rental subsidies, supportive social work and personal care for clients who need help with day-to-day activities. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)

Transitional Care Center

Funding is reduced for the transitional care center of Seattle due to a slower ramp-up of clients than was originally estimated in the 2023-25 biennial budget. (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)

Facility Costs

Funding is 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

Funding is provided to increase the retiree health insurance subsidy, adjusting the cap from $183 to $193 per month and raising the base subsidy percentage from 50 percent to 60 percent. The insurance funding rates are set at $1,145 per month for fiscal year 2024 and $1,158 per month for fiscal year 2025. (General Fund - State, General Fund - Medicaid Federal, General Fund - Federal, other funds)

Compression and Inversion

Funding is provided to address salary inversion and compression issues arising from recent recruitment and retention adjustments made in Chapter 475, Laws of 2023 (ESSB 5187). (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)

Pension Rate Month of Death Bill

Funding is provided for contribution rate impacts associated with proposed legislation that ensures the continuation of benefit payments through the end of the month in which a retiree or beneficiary dies. (General Fund - Medicaid Federal, General Fund - State, General Fund - Federal, other funds)