Department of Social and Health Services
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 11,488.0 | 6,393,519 | 7,413,236 | 13,806,755 |
| 2019-21 Maintenance Level | 11,657.0 | 6,448,655 | 7,335,198 | 13,783,853 |
| Difference from 2017-19 | 169.0 | 55,136 | (78,038) | (22,902) |
| % Change from 2017-19 | 1.5% | 0.86% | (1.1%) | (0.2%) |
2019-21 Policy Other Changes |
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| Ward Psychologists | 2.5 | 879 | 0 | 879 |
| State Hospital Telephone Service | 1.4 | 1,037 | 0 | 1,037 |
| Behavioral Health Tribal Liaison | 0.50 | 141 | 0 | 141 |
| DSH Adjustment | 0.0 | (28,621) | 28,621 | 0 |
| Hospital Safety: Recruitment Team | 11.7 | 3,732 | 0 | 3,732 |
| Hospital Safety: ACIT Training | 16.3 | 2,908 | 0 | 2,908 |
| Hospital Safety: NEO Training | 7.9 | 1,635 | 0 | 1,635 |
| Hospital Safety: Jail Consultation | 1.5 | 659 | 0 | 659 |
| Hospital Safety: Direct Care Staff | 33.0 | 8,161 | 0 | 8,161 |
| Essential IT Service Impacts | 0.0 | 1,826 | 796 | 2,622 |
| Consumer Directed Employer Program | 5.2 | 20,019 | 21,677 | 41,696 |
| Restore Workload/Lease Funding | 57.9 | 10,736 | 6,449 | 17,185 |
| Asset Verification System | 2.8 | 549 | 547 | 1,096 |
| Service Plan Signatures | 16.9 | 3,938 | 3,743 | 7,681 |
| Agency Provider Parity Definitions | 0.0 | 514 | 655 | 1,169 |
| DD Continuum of Care Workgroup | 1.2 | 180 | 120 | 300 |
| Dan Thompson Community Investments | 0.0 | 0 | 1,000 | 1,000 |
| Family Mentorship Program | 0.0 | 225 | 0 | 225 |
| Cross Agency Complex Youth | 14.6 | 1,858 | 1,598 | 3,456 |
| Expanded SOLA Options | 16.2 | 1,723 | 1,636 | 3,359 |
| Restore NH Discharge Reduction | 0.0 | 9,489 | 8,213 | 17,702 |
| Nursing Home Rate Increase | 0.0 | 15,255 | 15,254 | 30,509 |
| ABD Supplied Shelter Grant | 0.0 | 0 | 2,500 | 2,500 |
| Eliminate ABD Mid-Cert Review | 0.0 | 0 | 228 | 228 |
| Continue Asset Verification System | 6.1 | 2,155 | 797 | 2,952 |
| AVS Funding and FTE Adjustment | (5.0) | (248) | (498) | (746) |
| DCS Intergovernmental Demonstration | 1.0 | 0 | 500 | 500 |
| Economic & Social Mobility | 0.0 | 38 | 0 | 38 |
| PWA Supplied Shelter Grant | 0.0 | 6 | 0 | 6 |
| RCA Supplied Shelter Grant | 0.0 | 0 | 44 | 44 |
| TANF/SFA Supplied Shelter Grant | 0.0 | 0 | 1,439 | 1,439 |
| WorkFirst Fund Balance | 0.0 | (5,500) | 5,500 | 0 |
| WorkFirst Services Reduction | 0.0 | (2,284) | 0 | (2,284) |
| High Acuity Resident Supervision | 2.5 | 475 | 0 | 475 |
| Correct Funding Gap | 0.0 | 1,400 | 600 | 2,000 |
| 2019-21 Policy Other Changes Total | 194.2 | 52,885 | 101,419 | 154,304 |
2019-21 Policy Comp Changes |
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| PERS & TRS Plan 1 Benefit Increase | 0.0 | 285 | 128 | 413 |
| 2019-21 Policy Comp Changes Total | 0.0 | 285 | 128 | 413 |
2019-21 Policy Central Services Changes |
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| Archives/Records Management | 0.0 | 43 | 15 | 58 |
| Audit Services | 0.0 | 80 | 29 | 109 |
| Attorney General | 0.0 | 222 | 47 | 269 |
| Administrative Hearings | 0.0 | 2 | 2 | 4 |
| CTS Central Services | 0.0 | 2 | 0 | 2 |
| DES Central Services | 0.0 | 173 | 60 | 233 |
| OFM Central Services | 0.0 | 2,833 | 984 | 3,817 |
| 2019-21 Policy Central Services Changes Total | 0.0 | 3,355 | 1,137 | 4,492 |
| Total Policy Changes | 194.2 | 56,525 | 102,684 | 159,209 |
| 2019-21 Policy Level | 11,851.2 | 6,505,180 | 7,437,882 | 13,943,062 |
| Difference from 2017-19 | 363.2 | 111,661 | 24,646 | 136,307 |
| % Change from 2017-19 | 3.2% | 1.7% | 0.33% | 0.99% |
Policy Changes
Ward Psychologists
Psychologists serve as one of the first lines of defense in identifying triggers and developing behavioral support plans to assist in violence reduction. Increased violence at the hospital can result when the forensic population receives services from a psychologist only when referred. Currently, there are seven psychologist positions to support 11 wards. To meet the needs of each ward and increase safety at the hospital, funding is provided for four additional psychologist positions and one Director of Psychology position. (General Fund - State)
State Hospital Telephone Service
The existing telecommunications system at Western State Hospital and Eastern State Hospital are outdated and failing, and replacement parts are no longer manufactured for the existing hardware. Funding is provided to continue replacing the telecommunications system at the state hospitals and fund dedicated project management and IT staff. (General Fund - State)
Behavioral Health Tribal Liaison
A tribal liaison position is funded to support the requirements of chapter 43.376 RCW and DSHS Administrative Policy No 07.01. The tribal liaison position will represent the two state psychiatric hospitals, statewide forensic services and the Special Commitment Center with the 29 recognized tribes in Washington state. (General Fund - State)
DSH Adjustment
Under current law, there is a scheduled reduction in the funding expected through the Medicaid Disproportionate Share Hospital (DSH) grant program. This reduction was originally scheduled to go into effect several years ago and has been delayed several times. It is assumed that the reduction will continue to be delayed by the federal government, reducing the need for state funds for the operation of Eastern State Hospital. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Hospital Safety: Recruitment Team
To increase safety at Western State Hospital, funding is provided to open a permanent recruitment and hiring center supported by 15 FTEs. The center will be used to immediately fill vacant funded direct care positions and maintain a rate of hiring commensurate with the rate of attrition on an ongoing basis. (General Fund - State)
Hospital Safety: ACIT Training
This funding is provided to train direct care staff on the day and night shifts at Western State Hospital in Advanced Crisis Intervention Training. Funding is provided to increase ACIT trainers by 5 FTEs for the immediate effort to train all direct care staff and then maintain biennial refreshers on an ongoing basis. (General Fund - State)
Hospital Safety: NEO Training
New employee orientation (NEO) trainings are increased from once monthly to twice monthly. Funding is provided for 10 additional trainers to accommodate the increase in NEO trainings and quicker onboarding of new staff. (General Fund - State)
Hospital Safety: Jail Consultation
Funding is provided for a community-based forensic psychiatry consultation team to offer medication and behavioral health treatment to underserved jails. (General Fund - State)
Hospital Safety: Direct Care Staff
To increase patient and staff safety, direct care staffing at Western State Hospital is increased by 66 FTEs to reach the staffing levels recommended in the Washington state staffing model. (General Fund - State)
Essential IT Service Impacts
One time funding is provided to maintain current information technology service levels and avoid adverse impacts to clients. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
PERS & TRS Plan 1 Benefit Increase
For eligible Public Employees' and Teachers' Retirement Systems Plan 1 members, this item provides an increase of 1.5 percent, up to a maximum of $22 per month. (General Fund - Federal, General Fund - State)
Consumer Directed Employer Program
Funding is provided to continue the implementation of ESSB 6199, an act relating to the Consumer Directed Employer (CDE) program. This bill was enacted during the 2018 legislative regular session and requires DSHS to contract with up to two CDE vendors to be the legal employer of individual providers (IPs) for the purpose of performing administrative functions. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Restore Workload/Lease Funding
Funding is provided to fully fund increased staff and lease costs associated with caseload growth as projected in the November forecasts. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Asset Verification System
Funding and FTEs are provided to continue the implementation of a federally-compliant Asset Verification System for asset-based Medicaid eligibility decisions. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Service Plan Signatures
Funding is provided to implement new processes necessary to ensure compliance with federal requirements to collect provider signatures on all service care plans. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Agency Provider Parity Definitions
Funding is provided for employer taxes for home care agency providers. This item supports agency request legislation which seeks to change agency parity methodology so that future parity will provide sufficient funding to home care agencies to pay required employer taxes rather than an award calculated for individual providers (IP) who have a lower tax liability. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
DD Continuum of Care Workgroup
Funding is provided solely for the department to advance the recommendations of the "Rethinking Intellectual Disability Policy to Empower Clients, Develop Providers and Improve Services" Ruckelshaus report. The purpose of this work is to design and implement a modern, community-focused, person-centered and individualized service delivery system for individuals who currently reside in residential habilitation centers, with an emphasis on investments in community residential service options, including services and options for those with complex behavioral needs. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Dan Thompson Community Investments
This item funds family support and/or employment/day services for eligible persons with developmental disabilities who can be served by community-based developmental disability services. (Developmental Dis Comm Trust Acct - State)
Family Mentorship Program
Funding is provided to increase the family mentorship program by 50 percent, which will help connect families with loved ones in institutional settings with families who have successfully transitioned into a community setting. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - State, other funds)
Cross Agency Complex Youth
This item adds two new children's state-operated living alternative (SOLA) homes to serve youth age 20 and younger. These individuals are no longer eligible for residential habilitation center admission and are not able to successfully transition to out-of-home residential placements because suitable community options do not exist. These SOLA homes will house six children and be phased in by June 30, 2021. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Expanded SOLA Options
This funding will provide nine community residential placements in three (SOLAs) for adults seeking a community placement. Placements will be phased in by June 30, 2021. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Restore NH Discharge Reduction
Funding is provided to fully fund the expected cost of nursing home services as projected in the November forecasts. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
Nursing Home Rate Increase
Funding is provided to better align nursing facility Medicaid payment rates with facility operating costs by moving to an annual rate rebase and adding an economic inflation factor. (General Fund - Cash, General Fund - Medicaid Federal, General Fund - State, other funds)
ABD Supplied Shelter Grant
The Aged, Blind or Disabled (ABD) assistance program currently issues a reduced grant to recipients with no shelter costs, referred to as the supplied shelter grant standard. This funding allows the Economic Services Administration to eliminate the supplied shelter grant standard and covers the projected increase in the per capita cost associated with issuing up to the maximum grant standard. Removing this provision allows recipients to meet more of their foundational needs, such as securing a safe and healthy home. (Home Security Fund Account - State)
Eliminate ABD Mid-Cert Review
The Aged, Blind or Disabled assistance program requires participants to complete a mid-certification review every six months to verify program eligibility. A number of aged participants receiving ABD grant assistance experience challenges submitting the mid-certification review due to their age, income, transportation and housing status and, as a result, lose their access to the $197 monthly grant and the state-funded Medical Care Services program. DSHS will eliminate the review requirement for this population. Funding is provided to restore the caseload of aged participants who have lost this benefit. (Home Security Fund Account - State)
Continue Asset Verification System
Funding and FTE staff are provided to continue the implementation of a federally-compliant Asset Verification System for asset-based Medicaid eligibility decisions. (General Fund - Federal, General Fund - State, Home Security Fund Account - State)
AVS Funding and FTE Adjustment
The Economic Services Administration's Asset Verification System (AVS) implementation expenditures in fiscal year 2020 are less than originally projected. This adjusts the funding and FTE staff to reflect new projections. (General Fund - Federal, General Fund - State)
DCS Intergovernmental Demonstration
One-time federal expenditure authority is increased to allow the Division of Child Support (DCS) to participate in a federal demonstration project to develop and test innovations to increase child support payments in intergovernmental cases. (General Fund - Federal)
Economic & Social Mobility
One-time funding is provided for the Economic Services Administration to develop and implement training for its employees and interested partnering agency employees that touch on the lives of people experiencing poverty. This training will address implicit bias, trauma-informed care, diversity, equity, and inclusion. This funding also covers the Poverty Reduction Work Group's steering committee travel costs. (General Fund - Federal, General Fund - State)
PWA Supplied Shelter Grant
The Pregnant Women Assistance (PWA) program currently issues a reduced grant to recipients with no shelter costs, referred to as the supplied shelter grant standard. This funding allows the Economic Services Administration to eliminate the supplied shelter grant standard and covers the projected increase in the per capita cost associated with issuing up to the maximum grant standard. Removing this provision allows recipients to meet more of their foundational needs, such as securing a safe and healthy home. (General Fund - State)
RCA Supplied Shelter Grant
The Refugee Cash Assistance (RCA) program currently issues a reduced grant to recipients with no shelter costs, referred to as the supplied shelter grant standard. This funding allows the Economic Services Administration to eliminate the supplied shelter grant standard and covers the projected increase in the per capita cost associated with issuing up to the maximum grant standard. Removing this provision allows recipients to meet more of their foundational needs, such as securing a safe and healthy home. (General Fund - Federal)
TANF/SFA Supplied Shelter Grant
The Temporary Assistance for Needy Families (TANF) and State Family Assistance (SFA) programs currently issue a reduced grant to recipients with no shelter costs, referred to as the supplied shelter grant standard. This funding allows the Economic Services Administration to eliminate the supplied shelter grant standard and covers the projected increase in the per capita cost associated with issuing up to the maximum grant standard. Removing this provision allows recipients to meet more of their foundational needs, such as securing a safe and healthy home. (General Fund - Federal Dedicated, General Fund - Temporary Assist for Needy Families)
WorkFirst Fund Balance
There is a one-time reduction of unallocated General Fund-State fund balance that will be offset by using available federal TANF funds during the 2019-21 biennium. (General Fund - Federal Dedicated, General Fund - State, General Fund - Temporary Assist for Needy Families)
WorkFirst Services Reduction
Funding for WorkFirst services is reduced to reflect under-expenditures in the program resulting from declining caseloads. (General Fund - State)
High Acuity Resident Supervision
The high acuity treatment program at the Special Commitment Center's total confinement facility was established in September 2019 as part of a settlement agreement with Disability Rights Washington. Funding is provided for supervision and direct care to program residents, ensuring they receive equitable treatment and rehabilitation services. (General Fund - State)
Archives/Records Management
Adjustments are made to reflect each agency’s anticipated share of state archiving and state records center costs from the Secretary of State’s Office. (General Fund - Federal, General Fund - State)
Audit Services
Adjustments are made to reflect each agency’s anticipated share of state government audits from the State Auditor’s Office. (General Fund - Federal, General Fund - State)
Attorney General
Adjustments are made to reflect each agency's anticipated share of legal service charges from the Attorney General’s Office. (General Fund - Federal, General Fund - State)
Administrative Hearings
Adjustments are made to reflect each agency's anticipated share of administrative hearings charges from the Office of Administrative Hearings. (General Fund - Federal, General Fund - State)
CTS Central Services
Adjustments are made to reflect each agency’s anticipated share of charges from Consolidated Technology Services (CTS) for the Office of the Chief Information Officer, Office of Cyber Security, state network, enterprise services, small agency IT services, state data center operations, security gateways, and geospatial imaging services. (General Fund - State)
DES Central Services
Adjustments are made to reflect each agency’s anticipated share of charges from the Department of Enterprise Services (DES) for campus rent, utilities, parking, and contracts; capital project surcharges; financing cost recovery; public and historic facilities; real estate services; risk management services; personnel service rates; the Perry Street child care center; small agency services; and the department’s enterprise applications. (General Fund - Federal, General Fund - State)
OFM Central Services
Adjustments are made to reflect each agency’s anticipated share of charges from the Office of Financial Management (OFM) for statewide financial applications, One Washington, and other OFM central services. (General Fund - Federal, General Fund - State)
Correct Funding Gap
Funding is provided for central services in the 2019-21 biennium. (General Fund - Federal, General Fund - State)
