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December 15, 2023
Dear colleagues—
Wednesday, Governor Inslee released his proposed 2024 Supplemental Budget for consideration by the Washington State legislature. The Department of Social and Health Services was thankful to see over $737.7 million in operating budget investments for Washingtonians served by our agency. Among investments made in the Aging and Long-Term Support Administration, we are pleased to highlight:
GOSH Housing Expansion – The Governor’s Opportunity for Supportive Housing is expanded by an additional 175 slots to serve people ready to discharge from the state behavioral health hospitals or community behavioral health facilities. GOSH allows people to live in their own residence rather than a facility such as a nursing home, adult family home or assisted living facility. ($8.6M total funds; $6.5M general fund-state)
Dementia Care Stability – The rate add-on for specialty dementia care is increased from $43.48 per day to $55.00 per day as an incentive for clients with dementia who rely on Medicaid to have better access to assisted living facilities that have a Specialized Dementia Care contract. ($4.8M total funds; $2.3M general fund-state)
Senior Nutrition – This funding will help maintain access to a variety of senior food and nutrition programs including senior food pantries, mobile food pantries, meals on wheels, and other nutrition services. This will provide over one million meals to approximately 19,000 senior citizens. ($7.1M general fund-state)
WA Cares Fund Operations and Information Technology – The WA Cares program will use this additional funding to continue developing the technology and infrastructure to begin providing long-term services and supports for eligible Washingtonians beginning July 2026. ($5.4M LTSS Trust Account)
RCS Certification Program – This new Residential Care Services program will conduct facility inspections, investigate complaints, and protect the safety of clients living in residential settings that provide short-term, non-intermediate care to individuals with a developmental disability. ($176,000 total funds; $88,000 general fund-state)
Tribal Kinship Navigator Equity – The tribal kinship navigator program operates in seven tribes. This funding corrects an error in the 23-25 budget to fund the tribal programs at the
same level as the kinship programs administered by Area Agencies on Aging. ($510,000 general fund-state)
Facility One-Time Costs – This supports the ALTSA space for office locations being remodeled or moved to new locations throughout the state. ($1.6M total funds)
Electronic Health Records – In the WaTech agency budget, the statewide EHR project covering DSHS, the Health Care Authority, Department of Health and Department of Corrections received funding that will begin the work of bringing a modern electronic health records system for Medicaid clients that will integrate state and private health care provider medical records in a secure manner.
State Employee Benefits – The base subsidy retiree health insurance percentage is increased from 50 to 60 percent, increasing the cap from $183 to $193 per month. ($190,000 total funds; $104,000 general fund-state)
ALTSA Agency Request Legislation – The Governor’s proposal also includes funding for one piece of ALTSA Agency Request Legislation. The change to the new federally mandated Patient Driven Payment Model adjusts rates to patient acuity differently. This funding will minimize the effects of rate changes during the transition period to ensure that no facility experiences large swings in their Medicaid payment rates while the new system is rolled out. ($6.7M Nursing Facility Quality Enhancement Account)
ALTSA also received approval by the Governor’s office to run two other pieces of Agency Request Legislation that do not have a financial impact to the budget:
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Expanding the definition of family member for the purpose of individual provider training, certification and continuing Education – This legislation is a technical fix for a bill passed in the 2023 legislative session (E2SHB 1694). Due to a drafting error, E2SHB 1694 missed adding parents and children when related by marriage or domestic partnership—so fathers-in-law or daughters-in-law (as two examples) do not currently qualify for the lower training and certification requirements extended to other family members. This request legislation aims to correct this error. It also re-instates the Continuing Education requirement for an individual provider caring only for their relative when the relative is not a biological, step, or adoptive child.
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Clarifying employment standards for long-term care individual providers – This legislation seeks to incorporate federal guidance into the state’s minimum wage law that clarifies the employment relationship when the individual provider is a family or household member.
The Governor’s budget is just the first step in the legislative process. The legislature will consider the proposals, introduce new legislative priorities, and pass a final budget during the 2024 session that balances expenditures with revenue projections. As we continue to move through this process, the Department of Social and Health Services will work to support the legislature and the Governor’s office in their decision-making process, forwarding our important mission of Transforming Lives.
For additional details on the Governor’s budget, please visit https://ofm.wa.gov/budget/state-budgets/gov-inslees-proposed-2024-supplemental-budgets.
Sincerely,
 Bea Rector
Assistant Secretary
Aging and Long-Term Support Administration
Washington State Department of Social and Health Services
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