Additional funding is necessary to support the increased cost and utilization of adult residential care services anticipated in fiscal year 2027. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

The new law established by E2SSB 5440 requires DDA provide services to persons with intellectual or developmental disabilities with the goal of improving access to equitable, stable, and successful housing in the community and improve coordination of necessary services and handoffs between county courts, jails, and state hospitals. To meet the unanticipated rate of referrals received, additional staff are provided. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Additional funding is necessary to support increased access to Home and Community-Based Services (HCBS) waiver services, including crisis diversion services for children and adults. A 15% rate increase for both Crisis Diversion Beds (including mobile diversion) and the state-funded Overnight Planned Respite Services for adults and a 30% increase for Enhanced Respite Services for children will match rates of other community residential providers, retain a reliable provider network and quality of care, and stabilize clients in crisis and divert them from hospitals and institutional care settings. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Center for Medicare and Medicaid Services (CMS) issued the Ensuring Access to Medicaid Services Final Rule in April 2024 to improve access to care, quality, and health outcomes and better address health equity issues in the Medicaid program. The rule seeks to increase transparency and accountability, standardize data and monitoring, and create opportunities for states to promote active beneficiary engagement in their Medicaid programs. This funding provides staff dedicated to overseeing DDAs transition and compliance. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Federal expenditure authority is necessary for agencies to utilize awards and grants. Current Medicaid revenue for the Residential Habilitation Centers exceed the agencys current authority. (General Fund - Federal, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Day habilitation services include an array of services including community inclusion, respite, and community employment. A 15% rate increase and four-hour increase to the maximum available hours for community respite is funded to attract a larger pool of providers and offer more hours to eligible individuals. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Lease payments for the nursing facility at the Fircrest residential habilitation center are estimated to begin in April of fiscal year 27. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Additional funding is necessary to support the proposed Consumer Directed Employer (CDE) Rate Setting Board labor and admin rates. This provides adequate funding to pay the 46,000 Individual Providers wages and benefits and administrative duties to ensure that in-home care remains a viable option to allow Medicaid clients to live in their community rather than more restrictive and costly alternatives. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Additional funding is necessary to implement the collective bargaining agreement reached between the state of Washington and the Adult Family Home Council under the provisions of chapter 41.56 RCW for the 202527 biennium. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Additional funding is necessary to support the parity step for agency providers (AP), associated with the proposed CDE Rate Setting Board rates. This provides adequate funding to keep AP rates in alignment with CDE labor rates. This will ensure in-home care remains a viable option to allow Medicaid clients to live in their community rather than more restrictive and costly alternatives. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

The new federal CMS requirements intended to streamline Medicaid enrollment aims to simplify basic Medicaid programs by reducing coverage disruptions, streamlining the process, increasing enrollment and retention, and protecting beneficiaries. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Currently, assisted living facility (ALF) rates are funded below the estimated cost of providing long-term care services and at a lower percentage of estimated costs than rates for long-term care provided in similar settings. This underfunding, combined with recent inflation and unprecedented workforce shortage, has created a threat to the viability of the ALF provider network. This rate increase is intended to support the viability of assisted living providers. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Additional funding is necessary to support projected increases in the costs and utilization of nursing services and supports offered by Supported Living providers to meet the acuity needs of clients and reduce the risk of hospitalization. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Non-Paid Services Caseload currently requires case management services. This reduction would remove the requirement to manage caseloads for clients not receiving services and would not impact paid client services. (General Fund - State)

The Yakima Valley School (YVS) is a Residential Habilitation Center serving individuals with developmental disabilities. YVS is currently set to close when certain criteria are met and is only certified as a Nursing Facility (NF). Services in facilities are much more expensive than care provided in community settings, and the necessary improvements to ensure resident and staff safety are increasingly costly. By closing this site, the administration will be able to focus resources into community services and still retain two facilities in Eastern and Western Washington to serve individuals. (General Fund - Local, General Fund - Local CRC Oregon, General Fund - Private/Local, other funds)

The Rainier School (RS) is a Residential Habilitation Centers serving individuals with developmental disabilities. RS is only certified as an Intermediate Care Facility (ICF) and it is increasingly difficult to maintain certification requirements due to aging buildings with high maintenance costs and renovation demands. Services in facilities are much more expensive than care provided in community settings, and the necessary improvements to ensure resident and staff safety are increasingly costly. By closing this site, the administration will be able to focus resources into community services and still retain two facilities in Eastern and Western Washington to serve individuals. (General Fund - Local, General Fund - Local CRC Oregon, General Fund - Private/Local, other funds)

This funding is intended to support children and youth in Residential Habilitation Centers. There are no eligible residents, and the funding is no longer necessary. (General Fund - State)

Individual and Family Service (IFS) Waiver supports families by providing stabilizing services for family members with a developmental disability who is three years or older. Though a client may be found eligible for services upon assessment, utilization is voluntary and subject to provider availability.This one-time reduction reflects the true cost of the IFS Waiver due to lower utilization. (General Fund - State)

Funding and FTE staff are reduced to reflect position vacancy administrative savings. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)

Additional funding is necessary to support the proposed CDE Rate Setting Board Agency admin rates. This increase will provide adequate funding to keep AP rates in alignment with the administrative cost growth. This will ensure in-home care remains a viable option to allow Medicaid clients to live in their community rather than more restrictive and costly alternatives. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

This funding is to support individual choice for clients transitioning from residential habilitation centers to community settings. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

Funding is provided for a shift premium for state employees who are not represented by a union or are not covered by a bargaining agreement subject to financial feasibility determination. The premium is 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. (General Fund - State)

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 - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)

Funding is provided for staff who are not represented by a union or are not covered by a bargaining agreement that is subject to financial feasibility determination for paid bereavement leave and rest and recovery leave. (General Fund - State)

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: The Fish and Wildlife Captains and Lieutenants Association (FWLCA) receive a general wage increase of 17% effective July 1, 2025, and 2% effective July 1, 2026, and a 5% differential between sergeants and lieutenants, and between lieutenants and captains; 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; a 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, with the premium pay 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 - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

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 - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)

Funding is provided for increases in premium pay for state employees who are not represented by a union or not covered by a bargaining agreement subject to financial feasibility determination. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

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 - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

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; a 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, which premium pay will be in effect for the 2025–27 biennium; three additional steps on the nurse salary schedule; an increase to the annual lump-sum payment for employees in LNI risk codes 7200/7201 from $500 to $750; a 5% assignment pay for RN2s and RN3s at DCYF, Juvenile Rehabilitation Institutions; and $100 standby rate for ARNP and ARNP leads. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

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. (General Fund - Local, General Fund - Private/Local, Traumatic Brain Injury Account - State, other funds)

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 - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

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 - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)

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 - Local, General Fund - Private/Local, Traumatic Brain Injury Account - State, other funds)