Washington State Health Care Authority
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 1,528.6 | 6,607,701 | 19,379,582 | 25,987,283 |
| 2021-23 Maintenance Level | 1,528.6 | 6,908,391 | 20,665,546 | 27,573,937 |
| Difference from Original | 0.0 | 300,690 | 1,285,964 | 1,586,654 |
| % Change from Original | 0.0% | 4.6% | 6.6% | 6.1% |
2021-23 Policy Other Changes |
||||
| Low-Income Health Care - I-502 | 0.0 | 18,727 | (18,727) | 0 |
| FMAP Changes | 0.0 | (44,142) | 44,142 | 0 |
| Civil Conversion Bed Capacity | 0.0 | 9,312 | 1,114 | 10,426 |
| Cascade Care | 0.0 | 0 | (30,000) | (30,000) |
| COVID FMAP Extension | 0.0 | (19,488) | 19,488 | 0 |
| COVID FMAP Increase | 0.0 | (207,614) | 207,614 | 0 |
| Improve Newborn Screening Timeline | 0.0 | 50 | 122 | 172 |
| Backfill Block Grant Funds | 0.0 | 0 | 5,729 | 5,729 |
| FCS Admin Support | 0.0 | 0 | 226 | 226 |
| Interpreter Services Program Costs | 0.0 | 129 | 186 | 315 |
| Pharmacy Point of Sale Replacement | 0.0 | 446 | 2,834 | 3,280 |
| Community Long-Term Inpatient Beds | 0.0 | 12,382 | 9,177 | 21,559 |
| Community Health Centers - I-502 | 0.0 | 3,961 | (3,961) | 0 |
| Behavioral Health Ombuds | 0.0 | 272 | (272) | 0 |
| Uninsured transfer | 0.0 | (1,000) | 0 | (1,000) |
| 2021-23 Policy Other Changes Total | 0.0 | (226,965) | 237,672 | 10,707 |
| Total Policy Changes | 0.0 | (226,965) | 237,672 | 10,707 |
| Policy Level | 1,528.6 | 6,681,426 | 20,903,218 | 27,584,644 |
| Difference from Original | 0.0 | 73,725 | 1,523,636 | 1,597,361 |
| % Change from Original | 0.0% | 1.1% | 7.9% | 6.1% |
Policy Changes
Interpreter Services Program Costs
Funding is adjusted for the interpreter services program at the Health Care Authority to pay the employer premiums required by the Department of Labor and Industries. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Low-Income Health Care - I-502
Initiative 502, approved by voters in 2012, directed a portion of the revenue from taxes on the sale of marijuana into the Basic Health Trust Account. Those dollars are used in lieu of General Fund-State dollars for capitation payments for Medicaid clients enrolled in managed care plans. Funding is adjusted to reflect updated estimates of marijuana-related revenue. (General Fund - State, Basic Health Plan Trust Account - Non-Appropriated)
FMAP Changes
Federal and state funding are adjusted to account for Federal Medical Assistance Percentage (FMAP) changes in the federal contribution for caseloads and rates. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Civil Conversion Bed Capacity
Funding is provided to add 60 contracted beds to increase community civil conversion bed capacity, which will address growing waitlists for forensic beds at Western State Hospital. (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
COVID FMAP Extension
The federal Families First Coronavirus Relief Act authorized additional Federal Medical Assistance Percentage (FMAP) funds for the duration of the public health emergency. State funds are reduced and Medicaid spending is increased to reflect an additional 6.2 percent federal Medicaid matching rate from April through June 30, 2023. (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)
COVID FMAP Increase
The federal Families First Coronavirus Relief Act authorized additional Federal Medical Assistance Percentage (FMAP) funds for the duration of the public health emergency. State funds are reduced, and Medicaid spending is increased to reflect an additional 6.2 percent federal Medicaid matching rate from January through June 30, 2023. (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)
Improve Newborn Screening Timeline
The Washington State Department of Health is increasing newborn screening fees to cover costs related to specimen transit time. Reducing specimen transit time will reduce the time for physicians to diagnose newborns. Funding is provided to cover infant screening fees for infants covered by Apple Health. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Backfill Block Grant Funds
Federal expenditure authority is provided to reflect grants from the American Rescue Plan Act (ARPA) based on the Substance Abuse and Mental Health Services Administration's (SAMHSA) approved plan. (General Fund - American Rescue Plan Act (ARPA))
FCS Admin Support
Funds are provided for the administrative support necessary to continue the foundational community supports (FCS) initiative that is part of Washington state's Medicaid transformation waiver. (General Fund - Private/Local, General Fund - Local, General Fund - Federal)
Pharmacy Point of Sale Replacement
The pharmacy point of sale module in Provider One, Washington's Medicaid payment system, adjudicates pharmacy claims for the medical assistance population. It is essential to replace this system with a program that can meet the state's changing business requirements and improve transparency in how pharmacy payments are paid for. Funding is provided to replace the aging pharmacy point of sale sub-system in ProviderOne. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Community Long-Term Inpatient Beds
Funding is adjusted for changes in utilization and the cost of providing long-term involuntary inpatient treatment in a community setting. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Community Health Centers - I-502
Funds are provided to adjust the Dedicated Marijuana Account to align with revenues. (General Fund - State, Dedicated Cannabis Account - State)
Behavioral Health Ombuds
Funding is adjusted to shift funds from federal to state funds to reflect updated guidance from the Centers for Medicare and Medicaid Services. (General Fund - State, General Fund - Cash, General Fund - Local CRC Oregon, other funds)
