Details of the governor’s 2022 supplemental budget

Gov. Jay Inslee released his proposed 2022 supplemental budget Dec. 16. See WSHA’s Dec. 16 edition of Inside Olympia for the overall budget highlights. Below are budget details for the governor’s 2022 supplemental budget.

WSHA’s Highlights

Health Care Workforce Investments

• $6 million state to establish a nurse preceptor grant program for nurses who are willing to supervise nursing students in health care settings.
• $3.6 million state + $3.6 million state + $5.8 million state ($13 million total) to administer grants for nursing programs to purchase and upgrade simulation lab equipment to help expand capacity and serve more nursing students.
• $8 million state to administer grants to incentivize students to enter the health workforce. This includes up to one year of college and access to tutoring, career advising, emergency childcare and more.
• $7.8 million state Nurse Staffing Crisis for Long Term Care (LTC). Funding to conduct health workforce survey of LTC workers and pilot grant funded program to improve retention and “job quality” in LTC facilities.
• $2.5 million state to improve health care credentialing performance.
• $0 state ($2 million total) to fund 10 additional FTE licensing staff for faster processing for nurse licenses.
• $0 state ($761,000 total) for NQAC to expand nursing assistant training to reduce the time an individual needs to complete the nurse certification exam and create an apprenticeship pathway for nurse assistants and LPNs.

Difficult to Discharge

• $0 state ($3.4 million total) for COVID-positive units in nursing homes.
• $0 state ($3.24 million total) in incentive payments to long-term care settings to accept non-acute patients from acute care hospitals.
• $0 state ($840,000 total) for incentive payments to skilled nursing facilities to take Medicaid clients discharged from inpatient care.
• $39.8 million in local match and federal funds to renew Initiative 2 (long term supports for older adults) for 5 additional years under the state’s Medicaid Transformation Project, subject to federal approval. This proposal includes funding for two WSHA priorities: guardianships for low-income people through the Office of Public Guardian and presumptive eligibility for patients discharging from acute care hospitals who need long term services and supports.
• $10.9 million state ($22.3 million total) for a new contract at the Transitional Care Center of Seattle (TCCS): a DSHS-owned nursing home created to accept difficult-to-place residents from acute care hospitals. The new contract includes a higher daily rate, smaller total client capacity and elimination of the rate to hold empty beds. WSHA is disappointed TCCS is reducing capacity.
• $116.5 state ($321.6 million total) to continue the COVID-19 rate enhancements to contracted long-term care providers, with reductions over fiscal years 2023 & 2024.
• $4.8 million state ($8.5 million total) to help developmentally disabled patients transition care settings – including creating transition coordination teams, mobile diversion and rapid response teams, and enhanced support for providers.
• $1.9 million state ($3.8 million total) for rate add-on of $153 per day for specialized behavior support contracts to increase residential setting options to deliver long-term care services and supports to a growing number of clients who are registered sex offenders.
• $0 state ($30.9 million total) to reduce the threshold for occupancy penalties for skilled nursing facilities for purposes of the July 1, 2022, rate development.

Behavioral Health

• $300,000 state funds for the prenatal-to-25 behavioral health facilitation to help facilitate the Children and Youth Behavioral Health Workgroup and develop a strategic plan for behavioral health services for children and youth ages prenatal to 25.
• $15 million state ($30 million total) to increase the number of community contracted Children’s Long-Term Inpatient Program (CLIP) beds.
• $10.7 million state funds ($30.46 million total funds) for a 4.5-percent increase in Medicaid reimbursement rates for community behavioral health providers contracted through managed care organizations. This is in addition to the 2-percent increase provided in the current 2021-2023 budget. The Children and Youth Behavioral Health Work Group and Behavioral Health Workforce Advisory Committee both recommended a 7-percent increase.
• $50 million one-time state funds to assist behavioral health providers that serve Medicaid and state-funded clients and experienced revenue losses or increased expenses due to the COVID-19 epidemic.
• $4.6 million state ($5.5 million total funds) for youth inpatient navigators to help support families and children that need, but are unable to find, long-term inpatient beds.
• $115,000 state funds ($333,000 total) for coordination and collaboration with MCOs and BH ASOs on discharge of patients from inpatient involuntary treatment programs.
• $3.2 million state ($6.4 million total) to reduce caseloads and transition patients from state hospitals to home and community settings.
• $10 million state funds to supply Naloxone kits distributed by hospitals and providers and expand Naloxone distribution programs.
• $5.5 million state ($8.9 million total) to expand intensive habilitation services and out-of-home services for children and youth with significant behavioral issues need, including adding six, three-bed facilities in licensed intensive habilitation services and six, three-bed facilities for long-term enhanced out-of-home services.
• $84,000 state ($168,000 total) for DSHS and $48,000 state ($97,000 total) for a continuum of care across state agencies and providers for children and youth with complex behavioral needs. Includes establishment of a 32-bed, short-term Residential Crisis Stabilization Program for youth with severe behavioral health diagnoses.
• $1.7 million state for the mental health access project for youth behavioral response teams to conduct behavior health therapy and trauma-focused cognitive behavioral health therapy, screening and assessments for youth.
• $90,000 state to hire staff to lead a new youth behavioral health program, which includes the mental health access project and youth suicide prevention efforts.
• $1.4 million state for youth suicide prevention efforts, including strategies to prevent youth suicide and staff to implement youth suicide prevention campaigns.
• $3 million state ($4.27 million total) to manage and contract for 32 beds at the regional treatment facility in Vancouver and beds planned for the regional treatment facility in Snohomish County.

COVID-19 Response

• $1.3 million state to support the Washington Medical Coordination Center.
• $173.2 million state ($198.4 million total) for COVID-19 Contain the Spread. Funds to continue supporting statewide efforts for diagnostic testing, case investigation and contact tracing, care coordination, outbreak response, disease surveillance, public communications, and other necessary operational support.
• $99.9 million state to expand COVID-19 vaccinations.

Other Health Care

The budget also makes other health care investments:

• $102.4 million in local match and federal funds to align appropriation authority for the Medicaid Quality Improvement Project (MQIP) with anticipated Medicaid Transformation Project spending and waiver renewal.
• $15.9 million state ($19.1 million total) to maintain core public health systems.
• $7.8 million state ($15.6 total) to provide continuous enrollment or Medicaid-eligible children with family income less than 215 percent of the federal poverty level through 6 years of age under a 1115 waiver filed with the Centers for Medicare and Medicaid Services.
• $3.7 state to expand Apple Health to undocumented Washingtonians who do not qualify for other state-funded health care assistance programs, beginning January 2024.
• $520,000 state to implement the universal developmental screening system statewide, to improve childhood screening and referral activities.
• $2 million state to maintain the Watch Me Grow program delivering health information to parents such as well-child visits, immunization reminders and other health information.
• $35.8 million in local match and federal funds to renew Initiative 1 (accountable communities of health) for 5 additional years under the state’s Medicaid Transformation Project, subject to federal approval.
• $102,000 state to increase access to doulas who serve Medicaid patients.
• $814,000 state to expand grants for new school-based health centers and add behavioral health capacity for existing school-based health centers.
• $7.5 million state ($15.7 million total) to increase Medicaid payment rates for dental services to children to align with rates for adult dental services.
• $81,000 ($2.16 million total) to implement the Community Health Access and Rural Transformation (CHART) model.
• $22.1 million state ($27.6 million total) to procure Electronic Health Record (EHR) software and procure services of a lead organization to set up, operate and maintain EHR services for providers that do not have EHR capability.

Other Important Areas

• $0 state ($1.4 million total) to support survivors of sexual assault through the transition to virtual/remote services and to support their increased emergency needs.
• $0 state ($1.9 million total) to increase access to COVID-19 testing and vaccines for domestic violence shelters and programs to mitigate the spread of the virus and increase supports for domestic violence survivors.

Join us for our Legislative Session Kickoff webinar Jan. 11

Please join us at noon Tuesday, Jan. 11 for our annual Legislative Session Kickoff webinar for members. The webinar will cover what to expect during the 2022 legislative session and give an overview of WSHA’s legislative priorities and hot topics. It will also include an opportunity to ask questions of WSHA’s Government Affairs leaders. We will record the webinar for our members to watch at their convenience. Register now.

Join us for Hospital Advocacy Days Jan. 24-28

WSHA will host our annual Hospital Advocacy Days Jan. 24-28, 2022. The event activities and meetings will be virtual once again, and attendees will partner with WSHA staff to meet with state lawmakers to advocate for health care priorities and to tell the hospital story. This is your chance to be a voice for your hospital patients and community. We ask that you register as soon as possible — and hold the time on your calendar — so our team can schedule meetings with legislators. Register online at wsha.org/advocacydays and contact Joanna Castellanos at joannac@wsha.org with questions.