NoHLA Budget Summary 2017 Legislature
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Northwest Health Law Advocates
Health Care Access in the 2017 Washington Legislature
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2017-19 Biennial Budget: Selected Provisions of Interest
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Note: This chart does not include funding for enacted bills that are included in the NoHLA 2017 Legislative Summary, with limited exceptions. See the Summary for information on those items.
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ItemDescription6/30/17 Biennial Budget
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Change in State Funds (NGF-P)Change in Total Funds
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HEALTH CARE AUTHORITY
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Hepatitis C Treatment costsExpands treatment for HCV to Medicaid clients with less severe liver disease as required by court order.40,941,000173,300,000
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Oral Health Pilot ProgramFunding for pilot program in conjunction with Washington Dental Service Foundation to serve diabetic and/or pregnant patients in Yakima, Adams and Cowlitz Counties; includes enhanced reimbursement rates and increase in the allowable number of periodontal treatments. 2SSB 5540 had different provisions for such a pilot program; the bill did not pass. 500,0001,000,000
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Health HomesContinuation of the health home care coordination program for dual eligible Medicaid/Medicare beneficiaries.4,901,0004,901,000
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HBE Infrastructure ReplacementReplace hardware, upgrade security for Healthplanfinder.04,254,000
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HPF Operational ImprovementsUpdates and improved customer experience for QHP and Medicaid enrollees.04,012,000
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Collaborative CareBilling codes to enable primary care providers to bill for collaborative care and integrated behavioral health services.1,102,0004,001,000
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Managed Care DentalBeginning 7/1/18, funding is provided to transition dental service from fee for service to managed care. The successful bidder will be required to increase dental reimbursement, dental utilization, and reduce emergency department utilization within funding provided. (Note this is not integrated with existing Apple Health Managed Care.) See below for assumed savings.276,0001,740,000
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Dental Emergency Department AvoidanceBeginning 7/1/18, funding is reduced to reflect savings achieved through reduced emergency department utilization as a result of managed dental care.-6,103,000-16,375,000
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Prescription Drug CostsBeginning 1/1/18, HCA shall implement a single standard preferred drug list and serve as the single pharmacy benefits manager under the prescription drug purchasing consortium.-41,635,000-142,287,000
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Managed Care Staff ReductionThird party liability now handled through managed care - decreased staffing need.-2,170,000-6,202,000
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Medicaid Transformation WaiverFunding to align the budget with projected Medicaid transformation waiver expenditures as approved by CMS, which includes 3 initiatives. 0676,473,000
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ACA Employer Shared ResponsibilityImprove data collection required for ACA reporting on the employer shared responsibility provision.0472,000
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Pain Management Call CenterTelephone clinical consultation line to support primary care providers re pain medication management and medication-assisted treatment for Medicaid clients. 608,0001,216,000
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Nurse Case Managers10 NCMs to coordinate medically assisted treatment and movement to medical homes for those being treated for opioid use disorder.900,0001,958,000
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I-1433 Minimum wageMedicaid caseload decrease due to higher minimum wage.-22,946,000-183,316,000
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Children's Mental HealthAnnual depression screenings for children 12-16 and mothers with children 0-6 (E2SHB 1713).494,0001,098,000
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HBE Outreach and MarketingOutreach and marketing to potential QHP enrollees.01,500,000
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Inpatient Hospital Cost AvoidanceAssumed savings from increased access to skilled nursing in adult family homes and group homes which will result in prompt hospital discharges and prevent hospital inpatient admissions.-2,342,000-4,556,000
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IMD Federal WaiverAssumes HCA/DSHS are granted a federal waiver beginning 7/1/17 to allow federal Medicaid matching funds for stays in Institutions of Mental Disease involving substance abuse and mental health treatment. -5,147,0000
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Medication Assisted TreatmentPilot program for substance abuse treatment for inmates at the Snohomish County Jail.200,000200,000
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MICP Rate IncreaseIncrease reimbursement for skilled nursing by LPNs and RNs who serve medically intensive children living in a group home setting.1,782,0003,436,000
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DEPARTMENT OF SOCIAL AND HEALTH SERVICES
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Long Term Care
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Medicaid transformation Waiver funding (LTSS services)Funding is provided for new services and supports for unpaid family caregivers that help people stay at home and avoid the need for more intensive services. 043,588
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Transformation Waiver - MAC savingsSavings anticipated from new MAC program to support caregivers, reducing use of traditional LTSS.-2,200-5,000
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Transformation Waiver - TSOA savingsSavings anticipated from new TSOA program to support caregivers, reducing use of traditional LTSS.-1,100-2,500
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Developmental Disabilities Administration
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Increase in Basic Health Plus waivers slots Adds ~600 slots for Transition students (exiting high school) to the waiver, provides them Medicaid and access to employment supports and other DDA services.738,0001,963,000
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Behavioral Health Administration
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Tribal Fee-for-Service StaffingFunding for an American Indian/Alaska Native Fee-for-Service Medicaid program to allow access to Medicaid behavioral services without being enrolled in a managed care program.296,000492,000
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DEPARTMENT OF HEALTH
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Increase Newborn Screening FeeThe department will increase the newborn screening fee by (Senate budget $4.05, House budget $10) per baby screened in order to add X-linked adrenoleukodystrophy (X-ALD) to the mandatory newborn screening panel. X-ALD is a genetic disease that affects one in 18,000 boys. Early diagnosis of X-ALD, through newborn screening, can increase the likelihood of survival and also postpone the onset of extreme symptoms.01,118,000
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Expand Targeted Case ManagementThe department will increase targeted case management for high-risk populations with health disparities in the HIV program. High-risk populations include minorities, people with HIV who are over the age of 50, and intravenous drug users. High-risk behavior includes not adhering to medications, skipping medical appointments, dropping out of care, or utilizing an ineffective treatment regimen. This expansion will provide targeted case management for an additional 800 clients.06,096,000
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Lead/Environments of ChildrenOne-time funding to test water fixtures in schools across the state, with an emphasis on testing older schools first, and for screening, case management, and an electronic data reporting system to identify nad track children who are at the highest risk of having elevated lead levels in their blood.3,000,0003,000,000
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Foundational Public Health Service (FPHS) DOH FundingOne-time funding is provided to DOH as part of foundational public health services, to implement strategies to control the spread of communicable diseases and other health threats. This may include the maintenance, updating, or replacement of equipment in the state public health laboratory; addressing inequities among state residents; reporting on the root cause analyses of adverse events at medical facilities; preventing adverse health consequences of hepatitis C; or assessing IT system consolidation and modernization opportunities for statewide public health data systems. The DOH must develop a statewide government public health plan by November 30, 2018.2,000,0002,000,000
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HIV: One-Time FundingFour projects are funded on a one-time basis:
-Health DIsparity Project to increase access to dental, mental health and housing for persons with HIV and to increase services for Latino individuals in central WA with HIV
-Building Provider Capacity to support the MAX clinic at Harborview and expansion into Pierce County and statewide training
-Peer Navigation Project to establish a peer-to-peer network in which navigators will link individuals living with HIV to medical care, housing support, training and other services.
-Central Eligibility Database - a single eligibility portal for statewide usage and streamlined case management of individuals living with HIV and receiving public health services
Funding is also provided for etracking and evaluating the above projects.
09,000,000
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Address Medical Quality Assurance Commission (MQAC) Staff ShortagesFunding is provided for the Medical Quality Assurance Commission (MQAC) to increase the number of FTEs to respond to increased workload and to respond more quickly to issues that impact potential patient harm. 02,604,000
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First Responders/DisabilityPursuant to Substitute House Bill 1258 (first reponders/disability), funding is provided for the Department of Health, the Criminal Justice Training Commission, and the Military Department, in collaboration with others, to review and design training programs and to notify first responders and law enforcement regarding emergency situations where a person with a disability is present at the scene. 36,00036,000
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Medication Assisted TreatmentFunding is provided for a pilot program for substance abuse treatment for inmates at the Snohomish County Jail who are undergoing detoxification from heroin and other opioids and for connecting them with treatment providers in the community upon their release. 200,000200,000
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Suicide PreventionFunding is provided to the Department of Health to increase capacity to respond to calls to the suicide prevention hotline using existing contracts for crisis lines. 700,000700,000
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Breast, Cervical and Colon Health ProgramIncrease in program funding.260,000260,000
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Northwest Health Law Advocates | 206.325.6464 | nohla@nohla.org
August 3, 2017
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