NoHLA Proposed Budget Comparison 2017
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Northwest Health Law Advocates
Health Care Access in the Washington Legislature
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2017-19 Biennial Budget Proposal: Selected Provisions of Interest
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ItemDescriptionSenate passed 3 23 17House passed 3 31 17
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Change in State Funds (NGF-P)Change in Total FundsChange in State Funds (NGF-P)Change in Total Funds
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HEALTH CARE AUTHORITY
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Hospital Safety Net Assessment - MaintainExtends expiration date of this hospital assessment from 2019 to 2021. (HB 1766)00033,372,000
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Access to Autism Svces.A non-profit provider is funded to assist clients with autism to navigate the healthcare system3,000,0003,000,00000
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Hepatitis C Treatment costsExpands treatment for HCV to Medicaid clients with less severe liver disease as required by court order41,069,000172,837,00040,941,000173,300,000
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Oral Health Pilot ProgramImplementing 2SSB 5540 (oral health pilot program) - statewide (Senate), pilot regions (House)3,408,00012,695,000500,0001,000,000
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Health HomesContinuation of the health home care coordination program for dual eligible Medicaid/Medicare beneficiaries1,400,0001,400,0001,000,0001,000,000
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HBE Infrastructure ReplacementReplace hardware, upgrade security for Healthplanfinder04,254,00004,254,000
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HPF Operational ImprovementsUpdates and improved customer experience for QHP and Medicaid enrollees04,012,00004,012,000
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Collaborative CareBilling codes to enable primary care providers to bill for collaborative care and integrated behavioral health services1,102,0004,001,0001,102,0004,001,000
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Hearing Instrument CoverageRestore coverage of hearing instruments for adults on Medicaid and PEBB (2SSB 5179)1,004,0004,096,00000
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Managed Care Dental5% reduction in dental funding to be achieved by contracting for dental managed care-5,827,000-14,635,00000
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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-32,121,000-108,548,000-32,121,000-108,548,000
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Managed Care Staff ReductionThird party liability now handled through managed care - decreased staffing need.-2,584,000-5,168,000
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WSHIP AssessmentImplementing ESHB 1338 extending the high risk insurance pool through December 20225,577,00018,507,0005,577,00018,507,000
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Medicaid Transformation WaiverHouse: funding to align the budget with Medicaid transformation waiver as approved by CMS, which includes 3 initiatives. Senate Proviso: HCA shall not accept or expend any federal funds received under a Medicaid transformation demonstration waiver under Healthier Washington unless specifically approved and appropriated by the legislature. (Note: Senate proposal does not specifically approve funds except as noted below in DSHS budget.)000676,470
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Healthier WA Savings Restoration2016 supplemental budget overstated initial years' savings. HCA does not expect savings this biennium. This restores the unmet savings for 2017-19 biennium.0061,028,000136,922,000
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ACA Employer Shared ResponsibilityImprove data collection required for ACA reporting on the employer shared responsibility provision.000472,000
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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. 00608,0001,216,000
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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.00900,0001,958,000
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Managed Care CY 2018 & 2019 (2%)2% rate increase in CYs 2018-19 for Apple Health Family, Blind and Disabled, and Expansion programs as assumed in expenditure forecast.0058,764213,590
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I-1433 Minimum wageMedicaid caseload decrease due to higher minimum wage00-22,946,000-183,316,000
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Children's Mental HealthAnnual depression screenings for children 12-16 and mothers with children 0-6 (E2SHB 1713)00494,0001,098,000
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Pacific Islander Health CarePremium payments for purchasing QHPs for those eligible under SHB 1291.001,898,0001,898,000
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HBE Outreach and MarketingOutreach and marketing to potential QHP enrollees.0003,000,000
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Chiropractors: Manipulative TherapyFor chiropractic services to eligible Medicaid clients.008133,572,000
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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. 041,388043,588
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Transformation Waiver - MAC savingsSavings anticipated from new MAC program to support caregivers, reducing use of traditional LTSS -2,200-5,000-1,700-3,900
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Transformation Waiver - TSOA savingsSavings anticipated from new TSOA program to support caregivers, reducing use of traditional LTSS-1100-2500-200-400
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Developmental Disabilities Administration
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Increase in Basic Health Plus waivers slots Adding 600 slots for Transition students (exiting high school) to the waiver, provides them Medicaid plus access to employment supports and other DDA services
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Economic Security Administration
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Pacific Islander health care (HB 1291)Cost to add coverage for Pacific Islanders not now eligible for Medicaid00119119
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DEPARTMENT OF HEALTH
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PMP and Opioid Prescription RulesPursuant to Substitute Senate Bill 5248 (addressing the use and misuse of opioids), funding is provided for the analytical work and increased reporting associated with an expansion of organizations eligible to receive information from the Prescription Monitoring Program. Funding is also provided for one-time rulemaking regarding the management of acute pain that has been caused by an injury or a surgical procedure.624,0001,397,000
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Children's Mental HealthPursuant to Second Substitute Senate Bill 5749 (children's mental health), funding is provided for the coordination of site visits and on-site inspection work for seven facilities that are dually inspected by both the Department of Social and Health Services and the Department of Health.0277,000
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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.560,0001,118,00001,880,000
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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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Diabetes Planning and ReportingFunding is provided for the implementation of SB 5689 (diabetes epidemic in Washington), which requires the Department of Health to report to the legislature action plans to address the prevalence of diabetes in the Washington state population.82,00082,000
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Lead Directive - School ExposureFunding is provided to sample and test drinking water and drinking water fixtures in public schools across the state. The Department of Health, in collaboration with the Educational School Districts, must prioritize elementary schools where drinking water and drinking water fixtures have not yet been tested for contaminants, and elementary schools where drinking water and drinking water fixtures have not been tested within the past three years. House Budget emphasizes testing older schools first.2,365,0002,365,0003,490,0003,490,000
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Lead Directive - Community ExposureFunding is provided for screening, case management, and an electronic data reporting system to identify and track children who are at the highest risk of having elevated levels of lead in their blood.2,397,0002,397,000
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Health Outcomes PregnancyPursuant to Engrossed Substitute House Bill 1796 (pregnancy accommodations), funding is provided for the Department of Health to establish and chair the Healthy Pregnancy Advisory Committee.00187,000187,000
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Foundational Public Health Service (FPHS) DOH FundingFunding is provided to the Department of Health as part of foundational public health services, to implement strategies to control the spread of communicable diseases and other health threats, including the maintenance, updating, or replacement of equipment in the state public health laboratory; to address health inequities among state residents; for the reporting and investigation of root cause analyses of adverse events at medical facilities; to prevent the adverse health consequences of hepatitis C; to assess IT system consolidation and modernization opportunities for statewide public health data systems; and to develop a governmental public health improvement plan. Funding is also provided to DOH to support the local health jurisdictions to improve their ability to address communicable disease monitoring and prevention and chronic disease and injury prevention. 0040,000,00040,000,000
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Expand HIV Program EligibilityFunding is provided to allow the Department of Health to expand financial eligibility and to target its efforts toward populations with health disparities in the HIV Early Intervention Program. 0008,096,000
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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. 0002,604,000
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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. 0036,00036,000
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Language of Public NoticesPursuant to Second Substitute House Bill 1540 (language of public notices), funding is provided for state agencies and emergency management departments to provide health and safety-related notices and communications in languages other than English or in a manner that non-English speaking persons can understand. 00976,000976,000
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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. 00200,000200,000
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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. 00700,000700,000
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BH: Integration TransferThe Licensing and Certification Program at the Department of Social and Health Services is transferred to the Department of Health (DOH), as part of behavioral health integration. The DOH must license and certify behavioral health treatment programs and regulate treatment agencies providing services for chemical dependency, community mental health and problem and pathological gambling. 002,115,0005,086,000
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Pilot program to address health disparities in rural communitiesDepartment must contract with a nongovernmental entity that has experience in adapting global health strategies to underserved communities for a pilot program to develop strategies to address health disparities in rural communities. The program should engage marginalized communities in order to identify barriers and social determinants that most impact health, including access to housing and food and economic stability. The department must report to the legislature by December 1, 2018 regarding identified barriers and any recommendations for interventions.00500,000500,000
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Northwest Health Law Advocates | 206.325.6464 | nohla@nohla.org
August 7, 2017
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