Department of Health
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 2,351.0 | 374,845 | 1,582,358 | 1,957,203 |
| 2025-27 Maintenance Level | 2,184.6 | 276,118 | 1,416,667 | 1,692,785 |
| Difference from 2025-27 Original | (166.4) | (98,727) | (165,691) | (264,418) |
| % Change from 2025-27 Original | (7.1%) | (26.3%) | (10.5%) | (13.5%) |
2025 Policy Other Changes |
||||
| Fruit & Vegetable Incentive Program | 0.0 | 6,000 | 0 | 6,000 |
| Ambulance Services | 0.0 | 1,000 | 0 | 1,000 |
| Cannabis Revenue Distribution | 0.0 | 0 | 881 | 881 |
| Behavioral Health Workforce | 0.0 | 3,000 | 0 | 3,000 |
| Climate Resilience Adaptation | 1.0 | 0 | 382 | 382 |
| 988 Call Centers | 8.4 | 0 | 35,693 | 35,693 |
| Modern Cloud Environment | 0.0 | 8,592 | 0 | 8,592 |
| Drinking Water Dedicated Funds | 2.6 | 0 | 3,231 | 3,231 |
| Environmental Justice Council Staff | 1.0 | 0 | 888 | 888 |
| HEAL Capacity Grant | 0.0 | 0 | 4,000 | 4,000 |
| Native Youth Sports Programs | 0.0 | 750 | 0 | 750 |
| Health Disparities Council | 0.0 | 64 | 0 | 64 |
| Healthy Environment of All Act | 1.0 | 0 | 1,124 | 1,124 |
| Newborn Screening Fee Increase | 1.3 | 0 | 223 | 223 |
| Reproductive Health Services | 0.0 | 617 | 0 | 617 |
| Remove Psylocibin | 0.0 | (1,340) | 0 | (1,340) |
| Protecting Workers from Pesticide | 0.0 | 0 | 267 | 267 |
| General Admin Savings | 0.0 | (5,000) | 0 | (5,000) |
| Priv Detention Delay | 0.0 | (1,316) | 0 | (1,316) |
| Dedicated Water Fund Swap | 0.0 | (3,947) | 3,947 | 0 |
| Indirect Reduction | 0.0 | (4,738) | 0 | (4,738) |
| Reduce Climate Impact Workforce | 0.0 | 0 | (5,000) | (5,000) |
| School Based Health Centers | 0.0 | 2,410 | 0 | 2,410 |
| Tele-buprenophine Hotline | 0.0 | 0 | 3,150 | 3,150 |
| Perinatal OUD Services | 0.0 | 0 | 410 | 410 |
| WA Health M&O | 4.0 | 1,976 | 0 | 1,976 |
| WMC Operations | 4.0 | 0 | 2,029 | 2,029 |
| 2025 Policy Other Changes Total | 23.3 | 8,068 | 51,225 | 59,293 |
2025 Policy Comp Changes |
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| WFSE General Government | 0.0 | 3,377 | 19,166 | 22,543 |
| Non-Rep General Wage Increase | 0.0 | 1,688 | 5,036 | 6,724 |
| Non-Rep Targeted Pay Increases | 0.0 | 287 | 1,259 | 1,546 |
| SEIU 1199 General Government | 0.0 | 192 | 1,260 | 1,452 |
| Updated PEBB Rate | 0.0 | (157) | (732) | (889) |
| PERS & TRS Plan 1 Benefit Increase | 0.0 | 76 | 335 | 411 |
| Pension Benefit Amortization | 0.0 | (279) | (1,217) | (1,496) |
| 2025 Policy Comp Changes Total | 0.0 | 5,184 | 25,107 | 30,291 |
2025 Policy Transfers Changes |
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| Transfers | 0.0 | 0 | 0 | 0 |
| 2025 Policy Transfers Changes Total | 0.0 | 0 | 0 | 0 |
2025 Policy Central Services Changes |
||||
| Archives/Records Management | 0.0 | 5 | 22 | 27 |
| Audit Services | 0.0 | 4 | 17 | 21 |
| Legal Services | 0.0 | 159 | 838 | 997 |
| WTS Central Services | 0.0 | 95 | 470 | 565 |
| DES Central Services | 0.0 | 19 | 124 | 143 |
| OFM Central Services | 0.0 | 1,691 | 4,072 | 5,763 |
| GOV Central Services | 0.0 | 8 | 40 | 48 |
| 2025 Policy Central Services Changes Total | 0.0 | 1,981 | 5,583 | 7,564 |
| Total Policy Changes | 23.3 | 15,233 | 81,915 | 97,148 |
| 2025-27 Policy Level | 2,207.9 | 291,351 | 1,498,582 | 1,789,933 |
| Difference from 2023-25 | (143.1) | (83,494) | (83,776) | (167,270) |
| % Change from 2025-27 Original | (6.1%) | (22.3%) | (5.3%) | (8.5%) |
Policy Changes
Fruit & Vegetable Incentive Program
Poor nutrition affects overall health and is a significant risk factor for chronic disease. Increased access to fresh fruit and vegetables is associated with better outcomes for chronic diseases such as hypertension, cardiovascular disease, diabetes, and stroke. This enables low-income households to increase access to fresh fruits and vegetables and contributes to overall food security and diet quality. (General Fund - State)
Ambulance Services
Ambulance services in the Benton-Franklin Health District are operated primarily through volunteers and serves the Coyote Ridge Corrections Center. Costs to transport individuals in need of emergency care have exceeded the resources available through local funding. This funding ensures current needs can continue to be met. (General Fund - State)
Cannabis Revenue Distribution
The Department of Health (DOH) manages a cannabis, vapor product, and tobacco education and public health program. To maintain the education and program operating costs, the department receives a portion of the revenue from cannabis product sales based on distribution criteria included in chapter 169, Laws of 2022. Revenue is adjusted each budget cycle based on the latest revenue forecast. This technical adjustment is necessary to align with the November 2024 revenue forecast. (Dedicated Cannabis Account - State)
Behavioral Health Workforce
HB 2247 established a stipend program to increase participation in supervised experience requirements and is set to begin July 1, 2025. This encourages entry into a behavioral health field which is suffering from workforce shortages. More applicants can meet this requirement by reducing the economic barriers. (General Fund - State)
Climate Resilience Adaptation
The legislature requested an update to the state's Integrated Climate Response Strategy. DOH is one of several agencies coordinating on the impacts of climate related events on human and animal health. This position will focus on extreme heat and wildfire smoke and assist with coordination. (Climate Commitment Account - State)
988 Call Centers
Increased call volumes to the in-state 988 Suicide & Crisis Lifeline centers have increased operating costs. Currently, Washington state has three regional 988 call centers, which must maintain a 90% call answer rate. Increased funding will allow call centers to maintain appropriate staffing levels and avoid disruption to service. (Stw988BehavHealth&SuicidePrevLine - State)
Modern Cloud Environment
Public health systems were moved from the physical agency data center to a modern cloud environment to increase efficiency and flexibility. Funding will maintain critical systems and operate cloud computing storage. (General Fund - State)
Drinking Water Dedicated Funds
DOH must maintain drinking water data systems, certify water system operators, implement the federal Safe Drinking Water Act, and administer safe drinking water loans. Funds are provided to continue current programs and complete migration of the current Sentry drinking water database to the federally maintained Safe Drinking Water Information System. (Drinking Water Assistance Account - Federal, Drinking Water Assistance Admin - State, Waterworks Operator Certification - State, other funds)
Environmental Justice Council Staff
The Environmental Justice Council is responsible for researching issues and engaging communities and Tribes around environmental justice priorities. The council has experienced an increased volume of work that is not sustainable without additional support. An additional Operations Manager will lead and oversee council strategy, policy, and operations and additional funding is provided to support translation services. (Climate Commitment Account - State)
HEAL Capacity Grant
Funding is provided to continue availability of grants to overburdened communities and vulnerable populations to provide guidance to the seven state agencies identified in the HEAL Act. (Climate Commitment Account - State)
Native Youth Sports Programs
Native youth face disproportionate challenges that lead to over representation in the juvenile justice system. This offers indigenous children and adolescents with culturally relevant, sports-based programs to encourage engagement and belonging to prevent youth from entering the juvenile justice system. (General Fund - State)
Health Disparities Council
Funding is provided for the council to expand membership by eight members. (General Fund - State)
Healthy Environment of All Act
The Healthy Environment for All (HEAL) Act relies on the Environmental Health Disparities Map to assess community needs across the state. Currently the map sits on an aging platform and must be migrated to maintain stability and flexibility. Additional operating staff to implement HEAL and complete environment justice assessments will enable the department to fulfill HEAL requirements. (Climate Commitment Account - State)
Newborn Screening Fee Increase
The Healthy Environment for All (HEAL) Act relies on the Environmental Health Disparities Map to assess community needs across the state. Currently the map sits on an aging platform and must be migrated to maintain stability and flexibility. Additional operating staff to implement HEAL and complete environment justice assessments will enable the department to fulfill HEAL requirements. (General Fund - Local, General Fund - Private/Local)
Reproductive Health Services
Grants are provided for providers of abortion care who participate in the department’s sexual and reproductive health program to purchase state-acquired mifepristone. (General Fund - State)
Remove Psylocibin
This estimated cost pertains to an earlier bill version. The bill that was passed did not require this work and is no longer necessary. (General Fund - State)
Protecting Workers from Pesticide
The Pesticide Application Safety Committee was created in 2018 to develop policy recommendations to protect farm workers, farmers, and other community members from pesticide exposure and is set to expire June 30, 2025. Due to the COVID-19 pandemic response, the committee was unable to complete the work mandated. This two-year extension is to enhance coordination between DOH, the Washington State Department of Agriculture, and the Department of Labor & Industries to complete an analysis and develop effective strategies against pesticide-related injury. (Model Toxics Control Operating Acct - State)
General Admin Savings
This reduction is focused on preserving core services and direct support staff. DOH will reduce or remove administrative costs related to the following projects and executive programs: Be Well WA Campaign; Healthcare Innovation and Strategy Project; Executive Office of Healthcare Innovation & Strategy; Global One Health Office; and Office of Strategic Partnerships - RHO and Partnership Engagement and Planning Programs. (General Fund - State)
Priv Detention Delay
DOH is responsible for inspecting private detention centers operating in Washington state. The department is currently delayed and corresponding funding is held until such time that inspections can be completed. (General Fund - State)
Dedicated Water Fund Swap
DOH proposes to use Dedicated Water funds for eligible expenses in lieu of General Fund-State. This action is intended to be a one-time swap. (General Fund - State, Safe Drinking Water Account - State)
Indirect Reduction
DOH has a standardized calculation for state and federal indirect costs to support programs. This reduction in indirect costs is proportional to the overall reductions proposed in the 2025-27 budget. (General Fund - State)
Reduce Climate Impact Workforce
Funding for the climate impact workforce is removed. (Climate Commitment Account - State)
School Based Health Centers
School-based health centers provide accessible, age-appropriate, and culturally relevant health services to students. These centers provide beneficial physical and mental health wellness examinations, as well as immunization clinics. This supports the current 17 centers operating around the state while administrators seek permanent funding sources. (General Fund - State)
Tele-buprenophine Hotline
Funding is provided to launch a tele-buprenorphine hotline that facilitates access to medications for opioid use disorder treatment. (Opioid Abatement Settlement Account - State)
Perinatal OUD Services
Funding is provided for perinatal opioid use disorder information and services. (Opioid Abatement Settlement Account - State)
WA Health M&O
WA Health is a bed tracking and supply database that supports emergency response functions such as patient placement with available beds and quality of patient care. The system requires staff to maintain the system and funding to continue software licenses. (General Fund - State)
WMC Operations
The Washington Medical Commission is responsible for establishing, monitoring, and enforcing qualifications for licensure, consistent standards of practice, and continuing competency. The commission's workload volume has increased as applications and licensee populations continue to grow. These operational staff will ensure timely review and continued focus on the safety and integrity of the profession. (Health Professions Account - State)
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, Health Professions Account - 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, Health Professions Account - 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. (Foundational Public Health Servs Ac - State, General Fund - Federal, General Fund - State, other funds)
SEIU 1199 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; 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 - Federal, General Fund - Local, Health Professions Account - State, 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. (Public Health Supplemental Account - Private/Local, Secure Drug Take-back Program Acct - State, Temporary Worker Housing Account - 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, Health Professions Account - 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. (Public Health Supplemental Account - Private/Local, Secure Drug Take-back Program Acct - State, Temporary Worker Housing Account - Non-Appropriated, other funds)
Transfers
Transfer to split DOH funding by newly created budget structure by program. (General Fund - Federal, 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 - Federal, General Fund - Local, General Fund - State, other funds)
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, Health Professions Account - 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 - Local, General Fund - State, Health Professions Account - State, other funds)
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 - Local, General Fund - 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, Health Professions Account - 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 - Local, General Fund - State, Health Professions Account - 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 - Local, General Fund - State, other funds)
