Operating Budget for DDA 2019-2021

update from Evelyn Perez on the DDA Budget for 2019-2021

Developmental Disabilities Administration Update May 22, 2019

Dear Interested Stakeholder, Yesterday, Governor Inslee signed into law the operating budget bill for the 2019-21 biennium. You can find more detailed information about the budget on the Legislative Evaluation & Accountability Program (LEAP) website. When the Department of Social and Health Services, Developmental Disability Administration (DDA) submitted our agency request last fall, our top priority was to fund critical or emergent issues required to comply with state and federal laws. We also requested funding for several other program priorities, and many of these are reflected in the final budget. Highlights from the enacted 2019-21 (2-year) budget that impact DDA include: Vendor Rate Increases: There are several key areas where the Governor made targeted investments for key Medicaid service providers. Enhance Community Residential Rate: Community residential service providers, including supported living, group homes and licensed staffed residential homes receive a 13.5 percent rate increase effective January 1, 2020. ($62.2M GF-S; $123.2M Total Funds) Community Respite Rate Increase: Rates for Overnight Planned Respite Services and Emergency Respite Services (ERS) are increased to $400-$150 for OPRS and to $450-$550 for ERS for children. ($12.2M GF-S; $27.6M Total Funds) Nursing Services Rates: Rates are increased ten percent for in-home Medicaid nursing services and adult family home private duty nursing. ($0.6M GF-S; $1.2M Total Funds) Assisted Living Rates: The Assisted Living Facility Medicaid rate is increased and funding is provided for the impact of the 2021 rate rebase. ($0.5M GF-S; $1.2M Total Funds) Agency Provider Admin Rate: Home care agencies receive a $0.05 per hour administrative rate increase. ($0.1M: GF-S; $0.2M Total Funds) Collective Bargaining Agreements: New collective bargaining agreements that affect DDA employees and providers, including: Washington Federation of State Employees General classified state employees ($21.5M GF-S; $39.9M Total Funds) SEIU 1199 State employee nurses ($1.3M GF-S; $2.5M Total Funds) SEIU 775 NW Individual Provider in-home care workers ($23.6M GF-S; $53.6M Total Funds) Agency Parity While not bargained separately, in-home care agencies receive comparable changes to the SEIU 775 Individual Provider bargaining agreement. ($3.3M GF-S; $7.5M Total Funds) Adult Family Home Council Owners of Adult Family Homes (AFH) bargain with the state for daily rates and special programs. ($8.4M GF-S; $18.8M Total Funds) State Operate Living Alternative (SOLA) Expansion: New SOLA programs are created for a variety of specific groups: Complete 47 SOLA Placements General classified state employees ($6.4M GF-S; $12.6M Total Funds; 74.8 FTE) SOLA Community Options   Fifteen SOLA placements, phased-in through FY 2020 to serve Rainier PAT A residents who wish to transition to the community and DDA clients who are discharged from hospitalization. ($4.2M GF-S; $8.4M Total Funds; 51.5 FTE) Residential Habilitation Centers (RHC) There are several budget steps specifically addressing RHCs: RHC Medicaid Compliance: Funding supports compliance with Centers for Medicare and Medicaid Services (CMS) certification standards for RHC Intermediate Care Facilities. Beginning in FY 2019, 63 Rainier School residents who are assessed to no longer need or benefit from "active treatment" are transitioning to other RHCs with skilled nursing facilities or to community placements such as SOLAs. ($11.5M GF-S: $22.9 Total Funds; 131.2 FTE) Rainier PAT A: On March 6, 2019, Rainer School Program Area Team (PAT) A lost its federal Intermediate Care Facilities certification from CMS. Funding is provided to move remaining Rainier PAT A residents to appropriate placements in other PATs and RHCs. ($0.6M GF-S: $0.5 Total Funds; 2.8 FTE) High School Transition Students: Approximately 350 DDA clients leaving high school not currently receiving services under a Medicaid waiver will receive employment services through this funding. ($2.2M; $4.0M Total Funds) Behavioral Health Enhanced Discharge Placements: Six state-operated behavioral health training home beds are established for short-term placements for DDA clients with behavioral health issues. Staffing begins in FY2021, and clients will be placed beginning in FY2022. ($1.0M GF-S; $1.0M Total Funds; 5.8 FTE) Enhanced Discharge Ramp-Up: An additional 24 SOLA beds are added in a continuation of the transitions of DDA-eligible state hospital residents to enhanced SOLAs. ($5.4 GF-S; $10.5M Total Funds; 62.3 FTE) If you have questions regarding the 2019-21 biennial budget or other results of the legislative session, please contact Luisa Parada Estrada. Thank you for the work you do each day to advocate for individuals in need throughout our state. Sincerely, Evelyn Perez Assistant Secretary DSHS: Transforming Lives