Washington State Health Care Authority
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 1,674.8 | 8,123,128 | 24,105,687 | 32,228,815 |
| 2025-27 Maintenance Level | 1,643.7 | 8,737,681 | 28,394,792 | 37,132,473 |
| Difference from 2025-27 Original | (31.1) | 614,553 | 4,289,105 | 4,903,658 |
| % Change from 2025-27 Original | (1.9%) | 7.6% | 17.8% | 15.2% |
2025 Policy Other Changes |
||||
| Hospital Safety Net Assessment | 0.0 | (75,000) | (294,929) | (369,929) |
| MTP - MQIP Payments | 0.0 | 0 | (81) | (81) |
| Acupuncture and Chiropractic | 0.0 | (11,812) | (34,693) | (46,505) |
| AHE Service Delivery Change Cost | 12.5 | (20,237) | (8,706) | (28,943) |
| Young Adult Discharge Program | 0.0 | 6,000 | 0 | 6,000 |
| Cannabis Revenue Distributions | 0.0 | 52,566 | (52,566) | 0 |
| CBHS 1915i | 0.0 | 54,344 | 52,051 | 106,395 |
| PPW Residential | 0.0 | (2,270) | (1,136) | (3,406) |
| Community Beds at OHBH | 0.0 | (11,395) | 2,850 | (8,545) |
| CMS Eligibility Solution | 0.0 | 2,299 | 13,319 | 15,618 |
| MTP 2.0 Long-Term Supports Services | 18.7 | 0 | (1,276) | (1,276) |
| BH Personal Care - 1915i Waiver | 0.0 | 32 | 0 | 32 |
| PEBB/SEBB Third Party Administrator | 0.0 | 0 | 25,129 | 25,129 |
| Streamlined Elgblty Determination | 4.0 | 660 | 786 | 1,446 |
| Medicaid Transformation Project 2.0 | 0.0 | 0 | 265,592 | 265,592 |
| HHS 988-BH Intgrtd Clnt Referrl Sys | 24.0 | 0 | 41,137 | 41,137 |
| Contract Increases | 0.0 | 866 | 2,190 | 3,056 |
| Newborn Screening Fee Increase | 0.0 | 48 | 50 | 98 |
| WA Cares Implement/Maintenance | 0.0 | 0 | 9,514 | 9,514 |
| Non-Native SUD at Tribal Facilities | 0.0 | 70,907 | 0 | 70,907 |
| Stanwood Commitment Facility Beds | 0.0 | (1,802) | (452) | (2,254) |
| MAGI Post Eligibility Reviews | 0.0 | 292 | 708 | 1,000 |
| PEBB/SEBB IT Resrce/Benefit Accts | 9.0 | 0 | 4,058 | 4,058 |
| HBE General Wage Increase | 0.0 | 35 | 1,715 | 1,750 |
| Contract Procurement of P1 M&O | 0.0 | 234 | 666 | 900 |
| PEBB/SEBB Hospital Participation | 0.50 | 0 | 374 | 374 |
| Trueblood Phase 4 | 0.0 | 59,083 | 0 | 59,083 |
| Certified Comm BH Clinics Develpmnt | 2.0 | 1,236 | 0 | 1,236 |
| Blake Projects/Programs | 3.8 | 17,781 | 1,348 | 19,129 |
| Language Access Providers Agreement | 0.0 | 993 | 1,238 | 2,231 |
| HHS Master Person Index M&O | 1.0 | 578 | 475 | 1,053 |
| Reentry Pre-Release Services | 0.0 | 12,805 | 81,498 | 94,303 |
| MC Acctability/Medicare Alignmnt | 0.0 | 490 | 490 | 980 |
| Foundational Community Supports | 0.0 | 0 | 149,444 | 149,444 |
| Cascade Care Savings | 0.0 | 0 | 30,000 | 30,000 |
| CSC and SI Procurement Costs | 0.0 | 20 | 2,620 | 2,640 |
| Expanding Access/Focused Engagement | 0.0 | 7 | 844 | 851 |
| HPF & Customer Support | 0.0 | 16 | 3,652 | 3,668 |
| Response to ACA Changes | 0.0 | 18 | 4,653 | 4,671 |
| Emergency Dept MOUD | 0.0 | 0 | 758 | 758 |
| Traditional Health Care Practices | 0.0 | 165 | 165 | 330 |
| Tribal Opioid Prevention | 0.0 | 0 | 16,381 | 16,381 |
| UW 90/180 Beds | 0.0 | 0 | 18,538 | 18,538 |
| Long-term Civil Commitment Beds | 0.0 | (5,408) | 3,080 | (2,328) |
| 2025 Policy Other Changes Total | 75.5 | 153,551 | 341,484 | 495,035 |
2025 Policy Comp Changes |
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| WFSE General Government | 0.0 | 1,442 | 2,749 | 4,191 |
| Non-Rep General Wage Increase | 0.0 | 4,340 | 5,944 | 10,284 |
| Non-Rep Targeted Pay Increases | 0.0 | 2,652 | 2,927 | 5,579 |
| Updated PEBB Rate | 0.0 | (223) | (336) | (559) |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 100 | 147 | 247 |
| Non-Rep Salary Schedule Revision | 0.0 | 11 | 15 | 26 |
| Pension Benefit Amortization | 0.0 | (357) | (533) | (890) |
| 2025 Policy Comp Changes Total | 0.0 | 7,965 | 10,913 | 18,878 |
2025 Policy Central Services Changes |
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| Archives/Records Management | 0.0 | 2 | 2 | 4 |
| Audit Services | 0.0 | 35 | 57 | 92 |
| Legal Services | 0.0 | 104 | 135 | 239 |
| Administrative Hearings | 0.0 | 267 | 247 | 514 |
| WTS Central Services | 0.0 | 98 | 156 | 254 |
| DES Central Services | 0.0 | 39 | 60 | 99 |
| OFM Central Services | 0.0 | 2,744 | 397 | 3,141 |
| GOV Central Services | 0.0 | 10 | 16 | 26 |
| 2025 Policy Central Services Changes Total | 0.0 | 3,299 | 1,070 | 4,369 |
| Total Policy Changes | 75.5 | 164,815 | 353,467 | 518,282 |
| 2025-27 Policy Level | 1,719.2 | 8,902,496 | 28,748,259 | 37,650,755 |
| Difference from 2023-25 | 44.4 | 779,368 | 4,642,572 | 5,421,940 |
| % Change from 2025-27 Original | 2.7% | 9.6% | 19.3% | 16.8% |
Policy Changes
Hospital Safety Net Assessment
Funding to increase the hospital safety net contribution to the general fund. (General Fund - Federal, General Fund - Local, General Fund - Private/Local, other funds)
MTP - MQIP Payments
Medicaid Quality Improvement Program (MQIP) will be used to support the 1115 Medicaid Transformation Project (MTP) waiver. Apple Health managed care organizations and their partnering providers will receive MQIP payments as they meet designated milestones. Funding is adjusted to reflect anticipated program expenditures. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)
Acupuncture and Chiropractic
Reduction due to agency halting implementation of new Acupuncture and Chiropractic benefit. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
AHE Service Delivery Change Cost
Funding provided to convert Apple Health Expansion service delivery from managed care to fee for service (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Young Adult Discharge Program
Funding is provided for implementing a post-inpatient housing program for young adults in accordance with the provisions of Chapter 175, Laws of 2024 (2SHB 1929). (General Fund - State)
Cannabis Revenue Distributions
Appropriations from the Dedicated Cannabis Account are adjusted pursuant to chapter 169, Laws of 2022 (E2SSB 5796) and the November 2024 revenue forecast. (Basic Health Plan Trust Account - Non-Appropriated, Dedicated Cannabis Account - State, General Fund - State)
CBHS 1915i
Funding is provided for increased costs related to the Community Behavioral Health Supports program. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
PPW Residential
Funding is eliminated due to a lack of provider interest in operating a 16-bed, pregnant and parenting women Residential Treatment program in Grays Harbor County. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Community Beds at OHBH
Funding is reduced to match updated cost projections for a community provider to offer behavioral health services in two wards of Olympic Heritage Behavioral Health. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
CMS Eligibility Solution
Funding to improve Healthplanfinder (HPF) communication with ACES (Automated Client Eligibility) and provide an eligibility pathway for Non-MAGI (Modified Adjusted Gross Income) clients. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
MTP 2.0 Long-Term Supports Services
Funding to provide additional rental subsidies and respite care for waiver participants. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)
BH Personal Care - 1915i Waiver
Funding is provided for projected cost increases related to Behavioral Health Personal Care services. (General Fund - State)
PEBB/SEBB Third Party Administrator
The Washington State Health Care Authority requests additional financial resources in the 2025-2027 biennium budget to cover increased costs in the Public Employees Benefits Board and School Employees Benefits Board Uniform Medical Plan, and Uniform Dental Plan third party administrator (TPA) fees. Additional funding is needed to address TPA costs increases and large enrollment shifts. (SEBB Dental Benefits Admin Acct - Non-Appropriated, SEBB Medical Benefits Admin Acct - Non-Appropriated, Uniform Medical Plan Benefits Acct - Non-Appropriated)
Streamlined Elgblty Determination
Funding is provided for administrative support to amend rules and Medicaid state plan to comply with new federal guidelines on client eligibility. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Medicaid Transformation Project 2.0
Funding is provided through MQIP to align appropriation authority with anticipated MTP expenditures for Accountable Communities of Health, Initiative 1. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)
HHS 988-BH Intgrtd Clnt Referrl Sys
Funding to develop a behavioral health integrated client referral system to comply with the 988 crisis response legislation. (General Fund - Cash, General Fund - Medicaid Federal, Stw988BehavHealth&SuicidePrevLine - State, other funds)
Contract Increases
Funding is provided to pay for increased utilization of service contracts. (General Fund - State, School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State, other funds)
Newborn Screening Fee Increase
Funding to pay for increased Department of Health newborn screenings. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
WA Cares Implement/Maintenance
Funding for provider enrollment, claim processing assistance, and administrative support for the WA Cares Fund implementation. (Long-Term Servs & Sup Trust Account - State)
Non-Native SUD at Tribal Facilities
Funding is provided to match federal funds for Tribal substance use treatment claims. (General Fund - State)
Stanwood Commitment Facility Beds
Funding is adjusted for civil commitment beds at the Stanwood facility. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
MAGI Post Eligibility Reviews
Funding provided for maintenance and operations for the Robotic Processing Automation and Text message service for clients renewing their Medicaid eligibility. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
PEBB/SEBB IT Resrce/Benefit Accts
The Washington State Health Care Authority requests additional staffing and financial resources in the 2025-2027 biennium to support its new enrollment system for the Public Employees Benefits Board and School Employees Benefits Board programs. The new system, Benefits 24/7, requires additional member service and IT staffing to stabilize the system and address additional system development needs. (School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State)
HBE General Wage Increase
Funding to support a wage increase that mirrors increases for state workers. (General Fund - Cash, General Fund - Medicaid Federal, Health Benefit Exchange Account - State, other funds)
Contract Procurement of P1 M&O
Funding is provided to reprocure the contract to maintain and operate the state's ProviderOne payment system. The current contract expires June 30, 2026. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
PEBB/SEBB Hospital Participation
The Health Care Authority (HCA) projects a decrease in required revenue and projected expenditures in the PEBB and SEBB programs in the 2025-27 and 2027-29 biennium. These impacts are projected to result from impacts of legislatively mandated caps on facility inpatient and outpatient reimbursement, as detailed in agency request legislation Z0050.2, and the resulting downstream impacts to future projected Uniform Medical Plan (UMP) plan expenditures and resulting Employer Medical Contribution (EMC) state expenditures. All impacts are estimated based on the bill as written; if assumptions deviate from drafted analysis, the results of this decision package will change. (School Employees' Insur Admin Acct - State, St Health Care Authority Admin Acct - State)
Trueblood Phase 4
Funding is provided to implement phase 4 of the Trueblood settlement agreement. (General Fund - State)
Certified Comm BH Clinics Develpmnt
Funding is provided to continue implementation of Certified Community Behavioral Health Clinics. (General Fund - State)
Blake Projects/Programs
Funding is provided to fully implement SB 5536. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Language Access Providers Agreement
Funding is adjusted for interpreter services based upon the language access providers' collective bargaining agreement for the 2025-27 biennium. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
HHS Master Person Index M&O
Funding to support staff to carry out critical operations and maintenance activities for the Master Person Index initiative, which includes data management, development support, and program leadership. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Reentry Pre-Release Services
Funding to provide targeted reentry prerelease services for the adult population. The justice-involved prerelease and reentry services initiative was approved by the Centers for Medicare and Medicaid Services in its renewal of the MTP (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
MC Acctability/Medicare Alignmnt
Funding to implement and maintain new managed care and access rules and to create and operate the new Medicaid Advisory Committee and the Beneficiary Advisory Council. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Foundational Community Supports
Funding to increase rates for Supportive Housing and Supported Employment services and assist additional clients with receiving services. (General Fund - Federal, General Fund - Local, General Fund - Private/Local)
Cascade Care Savings
Funding to continue the Cascade Care premium payment program through calendar year 2026. (State Health Care Affordability Acc - State)
CSC and SI Procurement Costs
Funding to procure a customer support center vendor and the system integrator to support HPF maintenance and operations activities and enhancement services. (General Fund - Cash, General Fund - Medicaid Federal, Health Benefit Exchange Account - State, other funds)
Expanding Access/Focused Engagement
Funding to improve access to affordable health care by expanding language access and reaching underserved and rural communities via direct mail correspondences. (General Fund - Cash, General Fund - Medicaid Federal, Health Benefit Exchange Account - State, other funds)
HPF & Customer Support
Funding to improve critical software development capabilities, stabilize IT structures, and expand customer service quality management. (General Fund - Cash, General Fund - Medicaid Federal, Health Benefit Exchange Account - State, other funds)
Response to ACA Changes
Funding to continue Washinton Healthplanfinder maintenance and operations capacity to address system functionality related to federal rules changes and mandates, including Affordable Care Act compliance updates. (General Fund - Cash, General Fund - Medicaid Federal, Health Benefit Exchange Account - State, other funds)
Emergency Dept MOUD
Funding is provided for a program that provides all Washington state emergency departments with real-time Medications for Opioid Use Disorder clinical guidance and 24/7 follow-up appointment scheduling. (Opioid Abatement Settlement Account - State)
Traditional Health Care Practices
Funding to apply for a CMS waiver to allow for the payment of claims for Tribal traditional care practices. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Tribal Opioid Prevention
Funding is provided to implement SB 6099. (Tribal Opioid Prev & Treatment Acc - State)
UW 90/180 Beds
Funding is adjusted for civil commitment beds at the University of Washington Behavioral Health Hospital. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal)
Long-term Civil Commitment Beds
Funding is adjusted to align with projected expenditures for individuals on 90-day to 180-day civil commitment orders who are served in community settings. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
WFSE General Government
Funding for bargaining includes a 3%/2% general wage increase, targeted job classification increases, wildfire disaster leave, expanded bereavement leave, and paid vaccine travel time during pandemic emergencies. The agreement also includes: an additional $1 per hour supplemental shift premium for eligible employees who are assigned to a facility that provides direct care to residents, patients, and/or clients and whose duties are performed on location on evenings and weekends; 5% premium pay for employees who are assigned to a 24/7 facility that provides direct care to residents, patients, at-risk youth, and/or clients and whose duties are required to be performed on location, which will be in effect for the 2025–27 biennium; three additional steps on the nurse salary schedule; and an increase to the annual lump-sum payment for employees in LNI risk codes 7200/7201 from $500 to $750. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
Non-Rep General Wage Increase
Funding is provided for wage increases for state employees who are not represented by a union or are not under a bargaining agreement that is subject to financial feasibility determination. It is sufficient for a general wage increase of 3%, effective July 1, 2025, and a general wage increase of 2%, effective July 1, 2026. This item includes both general government and higher education workers. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
Non-Rep Targeted Pay Increases
Funding is provided for classified state employees who are not represented by a union or not covered by a bargaining agreement subject to financial feasibility determination, for pay increases in specific job classes in alignment with other employees. (General Fund - State, General Fund - Federal, General Fund - Local, other funds)
Updated PEBB Rate
This item adjusts the employer funding rate for public employee insurance benefits to reflect policy-level decision packages. It increases the rate by $8 per month in the first fiscal year and decreases the rate by $34 per month in the second fiscal year, compared to the maintenance-level update, for a total rate of $1,315 in the first year and $1,355 in the second year. (Flexible Spending Admin Account - Non-Appropriated, Opioid Abatement Settlement Account - State, SEBB Flex Spend Dep Care Admin Acct - Non-Appropriated, other funds)
PERS & TRS Plan 1 Benefit Increase
An adjustment is made for pension contribution rates, including to fund a benefit increase of 3%, up to a maximum of $110 per month for eligible Public Employees' and Teachers' Retirement Systems Plan 1 members. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
Non-Rep Salary Schedule Revision
Funding is provided for increases in pay for state employees who are included in a nurse salary restructure and are not represented by a union or are not covered by a bargaining agreement subject to financial feasibility determination. (General Fund - Federal, General Fund - Local, General Fund - State, other funds)
Pension Benefit Amortization
An adjustment is made to the base pension rates, as set out in a proposed bill addressing the calculation of the base rate for the 2025–27 biennium, as well as amortization of Plan 1 benefit increases. (General Fund - Private/Local, Indian Health Improvement Rein Acct - Non-Appropriated, Opioid Abatement Settlement Account - State, 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 - Federal, 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 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 is a two-year average and allows for analysis to incorporate unique agency circumstances. (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 hearings performed by the Office of Administrative Hearings. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State)
WTS Central Services
Adjustments are made to reflect each agency's anticipated share of charges from Washington Technology Solutions for the Office of Cybersecurity, state network, enterprise and small agency IT services, enterprise architecture and data management, Microsoft 365 licenses, and other items. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
DES Central Services
Adjustments are made to reflect each agency's anticipated share of charges from the Department of Enterprise Services for Capitol Campus costs; real estate, risk management, and small agency services; the Perry Street and Capitol Campus child care centers; enterprise applications, and other items. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
OFM Central Services
Adjustments are made to reflect each agency's anticipated share of charges from the Office of Financial Management for existing statewide applications, the One Washington program, and other central services. See Chapter 11 of the 2025–27 OFM Budget Instructions for allocation methodologies. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
GOV Central Services
Adjustments are made to reflect each agency's anticipated share of charges from the Office of the Governor for the Office of Equity. (General Fund - Federal, General Fund - State, St Health Care Authority Admin Acct - State, other funds)
