Department of Social and Health Services
| Average Annual FTEs | Near General Fund State | Other Funds | Total Funds | |
|---|---|---|---|---|
| (Dollars in Thousands) | ||||
| Current Budget | 18,429.2 | 10,133,195 | 10,618,837 | 20,752,032 |
| 2023-25 Maintenance Level | 18,509.4 | 10,346,461 | 10,633,633 | 20,980,094 |
| Difference from 2023-25 Original | 80.2 | 213,266 | 14,796 | 228,062 |
| % Change from 2023-25 Original | 0.44% | 2.1% | 0.14% | 1.1% |
2024 Policy Other Changes |
||||
| Maple Lane Phase 1 | 0.0 | 15,558 | 0 | 15,558 |
| TJC Response | 0.0 | 4,842 | 0 | 4,842 |
| Clinical Contracted Staffing | 0.0 | 36,346 | 0 | 36,346 |
| Olympic Heritage Behavioral Health | 437.1 | 140,924 | 0 | 140,924 |
| DSH Reduction Delay | 0.0 | (72,814) | 72,814 | 0 |
| Trueblood Case Judgment | 0.0 | 100,318 | 0 | 100,318 |
| Forensic Beds at WSH and ESH | 101.6 | 29,826 | 1,233 | 31,059 |
| Recruit & Retain Qualified Staff | 3.5 | 1,904 | 0 | 1,904 |
| Maple Lane Maintenance Transfer | 0.0 | 671 | 0 | 671 |
| Critical IT Pharmacy System | 0.0 | 1,188 | 0 | 1,188 |
| Caseload Ratio Reduction – Year 1 | 18.3 | 2,946 | 2,279 | 5,225 |
| Facility Maintenance Costs | 0.0 | 100 | 100 | 200 |
| Parent Support Programs | 0.0 | 400 | 0 | 400 |
| Facility Costs | 0.0 | 3,662 | 3,758 | 7,420 |
| RCS Certification Program | 0.50 | 88 | 88 | 176 |
| Nursing Facility Rate Methodology | 0.0 | 0 | 6,693 | 6,693 |
| Dementia Care Stability | 0.0 | 2,264 | 2,584 | 4,848 |
| WCF Operations | 4.4 | 0 | 2,599 | 2,599 |
| Senior Nutrition Funding | 0.0 | 7,093 | 0 | 7,093 |
| WCF Information Technology | (19.9) | 0 | 4,908 | 4,908 |
| Tribal Kinship Navigator Equity | 0.0 | 510 | 0 | 510 |
| GOSH Housing Expansion | 0.50 | 6,459 | 2,100 | 8,559 |
| Transitional Care Center | 0.0 | (6,050) | (6,162) | (12,212) |
| ACES Mainframe as a Service | 0.0 | 8,674 | 8,334 | 17,008 |
| Address Phone and Lobby Wait Times | 21.1 | 3,603 | 1,329 | 4,932 |
| Asset Verification System | 1.9 | 1,600 | 1,599 | 3,199 |
| Summer Electronic Benefit Transfer | 1.8 | 9,624 | 9,625 | 19,249 |
| ACES M&O Increase | 0.0 | 5,510 | 5,293 | 10,803 |
| Expand TANF Time Limit | 0.90 | 4,621 | 0 | 4,621 |
| Skimmed Benefits Replacement | 0.30 | 893 | 21 | 914 |
| State Supplemental Payment Increase | 0.0 | 50 | 0 | 50 |
| ORIA Support Services and Staffing | 0.50 | 5,000 | 0 | 5,000 |
| Fiscal Responsibility Act Impacts | 1.3 | 1,945 | 193 | 2,138 |
| Broaden Focus of LPAs | 1.0 | 99 | 63 | 162 |
| Apple Health for Uninsured | 1.0 | 229 | 0 | 229 |
| IE&E Roadmap Continuation | 8.3 | 5,543 | 12,088 | 17,631 |
| Reduce Wait Times Technology | 0.0 | 6,538 | 4,180 | 10,718 |
| Pandemic Emergency Assistance | 0.20 | 201 | 2,490 | 2,691 |
| Poverty Reduction Support | 0.80 | 349 | 99 | 448 |
| Time & Attendance Staff | 6.5 | 731 | 599 | 1,330 |
| Behavioral Health Study | 0.0 | 100 | 0 | 100 |
| Community Assemblies | 0.0 | 0 | 1,000 | 1,000 |
| Office of Justice and Civil Rights | 0.0 | 390 | 110 | 500 |
| SILAS Implementation | 0.0 | 4,876 | 2,961 | 7,837 |
| Community Discharge | 0.0 | 2,325 | 0 | 2,325 |
| 2024 Policy Other Changes Total | 591.6 | 339,136 | 142,978 | 482,114 |
2024 Policy Comp Changes |
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| State Employee Benefits | 0.0 | 885 | 401 | 1,286 |
| Compression and Inversion | 0.0 | 835 | 561 | 1,396 |
| Pension Rate Month of Death Bill | 0.0 | 405 | 180 | 585 |
| Pension Rate PSERS Bill | 0.0 | 51 | 10 | 61 |
| 2024 Policy Comp Changes Total | 0.0 | 2,176 | 1,152 | 3,328 |
2024 Policy Central Services Changes |
||||
| Archives/Records Management | 0.0 | 7 | 4 | 11 |
| Audit Services | 0.0 | 10 | 6 | 16 |
| Legal Services | 0.0 | 110 | 43 | 153 |
| Administrative Hearings | 0.0 | 54 | 81 | 135 |
| CTS Central Services | 0.0 | 1,381 | 773 | 2,154 |
| DES Central Services | 0.0 | 53 | 23 | 76 |
| OFM Central Services | 0.0 | 21,306 | 159 | 21,465 |
| GOV Central Services | 0.0 | 131 | 60 | 191 |
| 2024 Policy Central Services Changes Total | 0.0 | 23,052 | 1,149 | 24,201 |
| Total Policy Changes | 591.6 | 364,364 | 145,279 | 509,643 |
| 2024 Policy Level | 19,101.0 | 10,710,825 | 10,778,912 | 21,489,737 |
| Difference from 2023-25 Original | 671.8 | 577,630 | 160,075 | 737,705 |
| % Change from 2023-25 Original | 3.6% | 5.7% | 1.5% | 3.6% |
Policy Changes
Facility Maintenance Costs
Funding is provided to replace the Clear Lake dock at Lakeland Village to ensure it meets ADA and safety standards, as well as the needs of the residents. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - State, other funds)
Maple Lane Phase 1
The 2023-25 budget assumed that operations at Oak Cottage at Maple Lane would be eligible for Medicaid. After further review, it was determined that the facility is an Institution of Mental Diseases (IMD), and therefore, falls under the IMD exclusion in the 1965 Social Security Act. Funding is provided to backfill the federal funding assumed in the underlying budget. (General Fund - State)
TJC Response
Funding is provided for one-time facility improvements, equipment, and contracted staffing needed to mitigate an audit finding from The Joint Commission's (TJC) on-site visit to Eastern State Hospital. (General Fund - State)
Clinical Contracted Staffing
Funds are provided for the increased need for contracted nursing staff caused by extraordinary vacancy rates at the state's psychiatric hospitals. (General Fund - State)
Olympic Heritage Behavioral Health
Funding is provided for the operation of Olympic Heritage Behavioral Health (formerly Cascade Hospital) in Tukwila, adding 72 additional inpatient psychiatric beds for civil conversion patients currently residing at Western State Hospital in forensic beds. (General Fund - Medicaid Federal, General Fund - Local CRC Oregon, General Fund - State, other funds)
DSH Reduction Delay
This item adjusts funds for the continued delay in the expiration of Disproportionate Share Hospital (DSH) payments from the federal Medicaid program. (General Fund - Cash, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Trueblood Case Judgment
Funding is provided to pay contempt fines ordered by the federal district court on July 7, 2023, related to the Trueblood, et. al. v. DSHS class action lawsuit. (General Fund - State)
Forensic Beds at WSH and ESH
Funding is provided to add 30 forensic beds at Western State Hospital and eight forensic beds at Eastern State Hospital. (General Fund - Medicaid Federal, General Fund - Cash, General Fund - State, other funds)
Recruit & Retain Qualified Staff
This item continues education reimbursement, provides clinical training to competency restoration staff, and hires nurse recruiters. In addition, sufficient funding is provided to create a postdoctoral program in psychology at Western State Hospital and to create a nursing residency program at Western State Hospital and Eastern State Hospital. (General Fund - State)
Maple Lane Maintenance Transfer
Funding is provided for DSHS to maintain the facility, property, and assets at Maple Lane that was previously maintained by the Department of Corrections. (General Fund - State)
Critical IT Pharmacy System
Funds are provided for licensing costs required for the new IT Pharmacy System utilized by Behavioral Health Administration facilities. (General Fund - State)
State Employee Benefits
Funding is provided to increase the retiree health insurance subsidy, adjusting the cap from $183 to $193 per month and raising the base subsidy percentage from 50 percent to 60 percent. The insurance funding rates are set at $1,145 per month for fiscal year 2024 and $1,158 per month for fiscal year 2025. (General Fund - State, General Fund - Medicaid Federal, General Fund - Federal, other funds)
Compression and Inversion
Funding is provided to address salary inversion and compression issues arising from recent recruitment and retention adjustments made in Chapter 475, Laws of 2023 (ESSB 5187). (General Fund - Medicaid Federal, General Fund - State, General Fund - Cash, other funds)
Pension Rate Month of Death Bill
Funding is provided for contribution rate impacts associated with proposed legislation that ensures the continuation of benefit payments through the end of the month in which a retiree or beneficiary dies. (General Fund - Medicaid Federal, General Fund - State, General Fund - Federal, other funds)
Pension Rate PSERS Bill
Funding is provided for contribution rate impacts associated with proposed legislation to include staff of residential treatment facilities and the Special Commitment Center in the Public Safety Employees’ Retirement System. (General Fund - Medicaid Federal, General Fund - State, General Fund - Local CRC Oregon, other funds)
Caseload Ratio Reduction – Year 1
This item provides information technology staff to support the increase in case management positions in the Developmental Disabilities Administration. (General Fund - Cash, General Fund - State, General Fund - Medicaid Federal, other funds)
Parent Support Programs
This funding increases contracts for parent support programs, including the Parent-to-Parent Coalition and the Informing Parents program, to provide emotional support services and information to families of children with special needs. Services include information and referrals to community resources, trained 'helping parents' who are matched with other parents, and public awareness and outreach for people with special needs. (General Fund - State)
Facility Costs
Funding is provided for one-time relocation and project costs to support the Department of Social and Health Services' leased facilities strategic plan. (General Fund - State, General Fund - Medicaid Federal, General Fund - Federal, other funds)
RCS Certification Program
Funds are provided to create a new certification program in Residential Care Services (RCS) for residential settings that provide short-term, non-intermediate care to individuals with intellectual and developmental disabilities. This new program will conduct facility inspections, investigate complaints, and protect the safety of clients living in this type of facility. (General Fund - Local CRC Oregon, General Fund - Medicaid Federal, General Fund - State, other funds)
Nursing Facility Rate Methodology
Funding is provided to transition to a new rate methodology called the Patient Driven Payment model, as required by the federal Centers for Medicare and Medicaid Services. This data is used to adjust for the level of patient acuity in a nursing facility that serves Medicaid clients. Funding is provided to minimize the effects of rate changes on nursing facility payments during this transition. This will help ensure that no nursing facility experiences large swings in payments when the new methodology is deployed. (Nursing Fac Qual Enhance Account - Non-Appropriated, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
Dementia Care Stability
Funds are provided to adjust the rate add-on for specialty dementia care from $43.48 per client per day to $55.00. Currently, the rate add-on is less than other comparable rates, which creates a disincentive for facilities to accept dementia care patients. This rate adjustment will ensure that Medicaid dementia care patients are prioritized and accepted at long-term care facilities. (General Fund - State, General Fund - Local CRC Oregon, General Fund - Medicaid Federal, other funds)
WCF Operations
This item provides staffing resources to continue implementation of the Washington Cares Fund Program . Beginning in July 2026, this program will provide long-term services and supports benefits to qualified individuals who have been assessed as needing assistance with daily living activities. The department will administer this program and authorize an estimated $1.1 billion in benefits in its first year of implementation in fiscal year 2027. (Long-Term Servs & Sup Trust Account - State)
Senior Nutrition Funding
Funding is provided to maintain access to senior nutrition and food programs provided through community sites, senior food pantries, mobile food pantries, meals on wheels and other nutrition services. Federal funding expanded senior nutrition and food programs during the pandemic. This funding replaces the loss of federal funding to provide more than one million meals to approximately 18,686 senior citizens. (General Fund - State)
WCF Information Technology
Funds are provided to continue developing the technology solutions for the WA Cares Fund (WCF) program. (Long-Term Servs & Sup Trust Account - State)
Tribal Kinship Navigator Equity
Funding is provided for the tribal kinship navigator program at the same level as the Area Agency on Aging kinship navigator program. The Tribal kinship navigator program operates in seven tribes. The funding for the tribal programs was not included in the 2023-25 budget due to an error. (General Fund - State)
GOSH Housing Expansion
Funding is provided to expand the Governor's Opportunity for Supportive Housing program (GOSH) by 175 slots. This program serves Medicaid clients who are ready to discharge from the state's behavioral health hospitals or community behavioral health facilities and prefer to live independently. GOSH allows these clients to live in their own apartment rather than in a residential setting, like an adult family home, nursing home or assisted living facility. The program provides rental subsidies, supportive social work and personal care for clients who need help with day-to-day activities. (General Fund - State, General Fund - Medicaid Federal, General Fund - Local CRC Oregon, other funds)
Transitional Care Center
Funding is reduced for the transitional care center of Seattle due to a slower ramp-up of clients than was originally estimated in the 2023-25 biennial budget. (General Fund - Local CRC Oregon, General Fund - Cash, General Fund - Medicaid Federal, other funds)
ACES Mainframe as a Service
Funding is provided to transition the Automated Client Eligibility System (ACES) mainframe hardware operations to cloud technologies, using a WaTech enterprise contracted service, called Mainframe as a Service. This transition is necessary because the existing mainframe will no longer be serviceable or supported as of December of 2024, which creates risk of critical system failure. (General Fund - Federal, General Fund - Medicaid Federal, General Fund - State, other funds)
Address Phone and Lobby Wait Times
This item provides staffing to help reduce the wait times experienced by customers of the Community Services Division when they call or come into a community service office. (General Fund - State, General Fund - Federal)
Asset Verification System
Funding and staff are provided to fully integrate the Asset Verification System (AVS) into the Automated Client Eligibility System (ACES) to move toward automated asset verification during Medicaid eligibility determinations. (General Fund - Federal, General Fund - State)
Summer Electronic Benefit Transfer
Funding is provided for the administrative expenses associated with implementing the Summer Electronic Benefit Transfer (Summer EBT) program by the summer of 2024. This program will increase food benefits by $40 per child during the summer months for families that are under 185 percent of the federal poverty level and who have school-aged children that would typically receive free or reduced priced meals during the school year. This funding will increase food security for roughly 800,000 children in Washington during the three-month summer break each year. (General Fund - Federal, General Fund - State)
ACES M&O Increase
Funding is provided to help cover the increased costs associated with the maintenance and operations of the Automated Client Eligibility System (ACES). Cost increases include a one-time expense for a vendor transition and other new ongoing maintenance and operation (M&O) services. (General Fund - Medicaid Federal, General Fund - Federal, General Fund - State, other funds)
Expand TANF Time Limit
This funding will expand the 60-month time limit in the Temporary Assistance for Needy Families program to households that are exempt from WorkFirst participation, are experiencing a temporary situation that prevents them from working, or that are actively participating in WorkFirst activities. (General Fund - State)
Skimmed Benefits Replacement
Funding and staffing are provided to replace skimmed or cloned cash assistance benefits up to two times each federal fiscal year effective July 1, 2024. In addition, this funding covers the replacement of Food Assistance Program benefits to ensure alignment with the replacement efforts outlined in the Consolidated Appropriations Act of 2023 for the Supplemental Nutrition Assistance Program. (General Fund - State, General Fund - Federal)
State Supplemental Payment Increase
Funding is provided to increase the State Supplemental Payment (SSP) from $45.36 per month to $70 per month for clients receiving Supplemental Security Income (SSI) and who are served in medical institutions or in residential settings, effective July 1, 2023. This funding also estimates an annual cost-of-living adjustment beginning on January 1, 2024 to align with inflation adjustments made to benefits under Old-Age, Survivors, and Disability Insurance provided by the Social Security Administration. The cost-of-living adjustment on January 1, 2024 brings the SSP payment to $73.20. This funding is necessary in order to align the SSP program with changes made in Chapter 201, Laws of 2023. (General Fund - State)
ORIA Support Services and Staffing
Funds are provided to the Office of Refugee and Immigrant Assistance (ORIA) to expand support services for individuals newly arriving to the United States and Washington who do not qualify for federal refugee resettlement program services. Funding also includes staffing to cover the administrative expenses of coordinating a statewide approach to these support services. (General Fund - State)
Fiscal Responsibility Act Impacts
The federal Fiscal Responsibility Act of 2023 made several changes to the Supplemental Nutrition Assistance Program (SNAP) work requirements for Able-Bodied Adults Without Dependents (ABAWDs). The changes include a phased-in age expansion and new work participation exemptions. Funding is provided to implement these changes and to support IT enhancements, staffing to serve increased SNAP and Food Assistance Program (FAP) caseloads, and food benefits associated with an increased FAP caseload. (General Fund - Federal, General Fund - State)
Broaden Focus of LPAs
Funding is provided for the staffing necessary to broaden the focus of Local Planning Area (LPA) partnerships to enhance poverty reduction efforts and to establish a customer voice council to advise the Community Services Division in developing, implementing, and evaluating programs and practices. (General Fund - Federal, General Fund - State)
Apple Health for Uninsured
Funding is provided for the staffing necessary to process additional medical assistance cases resulting from the July 1, 2024 implementation of the Apple Health Expansion program. (General Fund - State)
IE&E Roadmap Continuation
Funds are provided for the continuation of the Integrated Eligibility and Enrollment (IE&E) IT project, including the design and implementation of a human-centered portal for people to use when accessing benefits across multiple health and human service agencies. This item also supports the expansion of the project office for program leadership, project governance, organizational change management, communications, contract and vendor management, and other core program office functions. (General Fund - Federal, General Fund - State)
Reduce Wait Times Technology
Funding is provided for technology enhancements and the project governance necessary to create efficiencies that will reduce call center and lobby wait times for customers of the Community Services Division. Enhancements include chatbot, robotic process automation, interactive voice response, and document upload. (General Fund - Family Support/Child Welfare, General Fund - Federal, General Fund - State, other funds)
Pandemic Emergency Assistance
Federal funding is provided for the administration of an additional one-time cash benefit made available through the Pandemic Emergency Assistance Fund. Federal funds cover the one-time cash benefit for Temporary Assistance for Needy Families and Supplemental Nutrition Assistance Program recipients, whereas state funds cover the benefit for recipients of the State Family Assistance and Food Assistance programs. (General Fund - State, General Fund - Federal)
Poverty Reduction Support
Funding and staff are provided to support the facilitation, outreach, engagement, and communication needed to achieve poverty reduction goals. (General Fund - Federal, General Fund - State)
Time & Attendance Staff
Funds are provided to assist the department with managing the increased payroll workload associated with 24/7 facility premium pay established in 2023-25 collective bargaining agreements. (General Fund - Federal, General Fund - State)
Behavioral Health Study
The department will use this funding to provide a report on felony civil conversion cases by October 1, 2024. (General Fund - State)
Community Assemblies
Funding is provided to create public assemblies hosted by community-based organizations to elevate community solutions and expertise regarding funding and policy solutions related to transitioning Washington toward a sustainable and climate resilient state. (Climate Commitment Account - State)
Office of Justice and Civil Rights
This item supports the Office of Justice and Civil Rights (OJCR) in working through the investigation and administrative justice backlog. (General Fund - Federal, General Fund - State)
SILAS Implementation
Funds are provided to continue the implementation of the System for Integrated Leave, Attendance, and Scheduling (SILAS) project for Developmental Disabilities Administration (DDA) and Behavioral Health Administration (BHA) facilities. (General Fund - State, General Fund - Federal)
Community Discharge
Funding is provided to shift staff from the total confinement facility on McNeil Island to the Special Commitment Center’s community operations. Services are now needed in the community due to an increase in the resident population being court-ordered into less restrictive alternatives throughout the state. (General Fund - State)
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 - State, General Fund - Federal)
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)
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)
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)
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 Cybersecurity, state network, enterprise and small agency IT services, enterprise architecture and data management, Microsoft 365 licenses, and other items. (General Fund - State, General Fund - Federal)
DES Central Services
Adjustments are made to reflect each agency's anticipated share of charges from the Department of Enterprise Services (DES) 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)
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 2023-25 OFM Budget Instructions for allocation methodologies. (General Fund - Federal, General Fund - State)
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 - State, General Fund - Federal)
