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April 22, 2020
Dear Interested Stakeholder,
On Friday, April 3rd, Governor Inslee signed the 2020 Supplemental Budget. This budget makes modest changes to our current two-year budget that the Governor signed last May. We are pleased to see a budget that continues to reflect a commitment to better outcomes for our clients, ongoing support for our staff and funding to pay our service providers.
Due to the COVID-19 pandemic, the Governor also used his line item veto authority to trim a combined $445 million from the state’s 2020 supplemental operating budget and the next two-year biennial budget. As the Governor mentioned in his recent veto address, these were all very difficult, but necessary, decisions that were made to protect Washington residents, conserve the financial resources we need right now to continue this fight, and to help in the eventual recovery from this pandemic.
Listed below are some of the significant budget items that are included in the Governor’s supplemental budget as well as the list of line item vetoes that impact ALTSA:
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Nursing Home Medicaid Rates: There have been an increasing number of nursing home closures over the last year, just as our state’s population of seniors is dramatically increasing. Funding is provided to better align nursing facility Medicaid payment rates with facility operating costs. ($15.3M GF-S; $30.5M Total Funds)
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Consumer Directed Employer: DSHS continues implementation of ESSB 6199, an act relating to the Consumer Directed Employer (CDE) program. This bill was enacted by the Legislature during the 2018 Regular Session and DSHS has contracted with one CDE vendor to be the legal employer of individual providers (IPs) for the purposes of performing administrative functions. ($14.7M GF-S; $30.5M Total Funds)
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Agency Provider Parity update: Funding is provided for employer taxes for home care agency providers, this funding is tied to agency request legislation that changed the agency parity methodology to ensure sufficient funding to home care agencies for required employer taxes. ($439,000 GF-S; $1.0M Total Funds)
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Restore Nursing Home Discharge Reduction: Funding restores a reduction taken in the biennial budget to the Medicaid nursing home caseload forecast. ($9.5M GF-S; $17.7M Total Funds)
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Asset Verification System: This is a continuation of the implementation of a federally-compliant asset verification system for asset-based Medicaid eligibility decisions. ($500,000 GF-S; $1.0M Total Funds; 2.6 FTE)
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Service Plan Signatures: DSHS is required by federal rule to ensure compliance with federal requirements to collect provider signatures on all service care plans. ($3.0M GF-S; $6.1M Total Funds)
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Restore Workload/Lease Funding: The staffing levels identified in the Mandatory workload adjustments for the 2019-21 Biennial Budget were not fully funded. Most significantly, full funding is required to meet the demands of a growing abuse and neglect investigations caseload and to provide office space for our growing staff. ($9.4M GF-S; $14.9M Total Funds; 49.7 FTE)
The Governor’s line item vetoes impacting ALTSA are as follows:
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Agency Provider Administrative Rate: The administrative rate will not be increased by $0.05 per hour and will remain at $5.52 per hour.
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Dementia Action Collaborative: funding for a Dementia Action Collaborative staff position and specialized dementia services in two AAA areas will not be provided.
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Specialty Dementia Care Rate Add-On: There will not be a $10 per day rate increase for assisted living facilities who contract with the Department specifically to provide care for individuals with dementia.
The full economic impact that the COVID-19 pandemic is having on our state is still unknown, but we can expect to experience significant budget challenges in this and future budget cycles. It will require creativity and flexibility in our resource use that we may have not exercised in the past. As we work through this difficult economic time, we will keep you informed of budget activities.
We recognize that this is a difficult time for you as well. Thank you for the continued support you provide to individuals in need throughout our state.
Sincerely,
 Bill Moss, Assistant Secretary
Aging and Long-Term Support Administration
DSHS: Transforming Lives
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