Analysis of the governor’s 2020 supplemental budget

December 18, 2019

Gov. Jay Inslee released his proposed 2020 supplemental budget today. Highlights of the budget include addressing the homelessness crisis, expanding early learning and combatting climate change. The governor’s proposal would utilize all of the forecasted revenue and does not propose to raise any new revenue.

The good news for hospitals and health systems is that there are no major funding cuts to health care and no new taxes proposed. There are modest investments in health care in this supplemental budget, including the continued support of the governor’s 5-year plan to decentralize long-term civil commitment patients. 

In a 60-day legislative session starting on Jan. 13, the supplemental budget makes spending adjustments to the 2019-2021 biennial budget. Supplemental budgets typically do not include new large spending increases – referred to as policy-level changes. Given that the bulk of the state revenue has already been appropriated in the 2019 budget, this budget is a typical supplemental budget. The House and Senate will also release their versions of the budget during the legislative session (in February) before working together to craft a final budget. The last day of regular session is Thursday, March 12.

Here are some of the highlights from the governor’s expenditure budget, as they impact WSHA’s legislative priorities.

Modest investments in behavioral health, which include:

  • $582,000 in state funds and $657,000 in federal funds to cover the full estimated cost of a mental health drop-in center pilot that was established by the Legislature in 2019.
  • $221,000 in state funds only to cover ramp-up costs associated with adding eight additional Program for Assertive Community Treatment (PACT) teams.
  • $328,000 in state funds only for Behavioral Health – Administrative Service Organizations to pay ambulance providers transporting Ricky’s law patients to secure withdrawal management and stabilization facilities for treatment.
  • $746,000 in state funds to support the Department of Health in its effort to provide technical assistance and conduct more frequent inspections of new freestanding psychiatric hospitals.
  • $6.1 million in state funds only for a 5 percent increase to behavioral health Administrative Service Organizations for services not covered by the Medicaid program (including ITA court costs, community inpatient services, crisis and commitment services, and residential services).
  • $2.0 million to enhance the state’s suicide prevention program.
  • $11.9 million for increased staffing at the state psychiatric hospitals.

WSHA is disappointed the governor’s budget does not appropriate funding for WSHA’s key budget priorities, including difficult-to-discharge patients needing memory care, the Medicaid long-term mental health rate increase, and intensive outpatient and partial hospitalization programs.
Other budget items include:

  • $8.4 million in state funds only to replace lost federal funding to maintain family planning services across the state (Title X services)
  • $32 million in state funds and $93 million in federal funds to restore savings assumed through Medicaid program integrity review. This restores unrealistic savings that were not realized from fraud and abuse audits.
  • $10.5 million in funding for foundational public health services.
  • $15 million for a Medicaid nursing home rate increase.
  • $15.4 million to provide 1,200 slots in supportive housing.
  • $2.2 million in state and other funds to continue addressing the opioid crisis, including through the state’s prescription drug monitoring program, a fentanyl prevention campaign and the state’s secure drug take back program.
  • $558,000 in state funds to support the implementation of Cascade Care (public option plans).
  • $300,000 in state and other funds for a developmental disability work group.
  • $1.7 million in state funds and $1.6 in federal funds for an additional nine slots in three locations for patients with developmental disabilities.
  • $76,000 in state funds and $473,000 in other funds in additional newborn screening fees to hospitals to add spinal muscular atrophy to the state’s mandatory newborn screening panel in 2019.
  • $1.4 million in state funds and $1.3 million in federal funds for an actuarial analysis to support a rate increase for health home lead and care coordination organizations serving dually eligible Medicare-Medicaid clients.
  • $991,000 in state funds and $991,000 in federal funds to maintain Children’s Health Insurance Program coverage as a secondary payer for eligible child dependents of employees eligible for school employee or public employee benefit coverage.
  • Restored Disproportionate Share Hospital payment reductions from the congressional DSH delay. WSHA strongly advocated for this at the federal level.
  • $989,000 to support youth smoking cessation and $1.97 million for the Department of Health to implement a new program to track vapor products that are sold to consumers.

Join us for our Legislative Session Kickoff webinar Jan. 15

Please join us at noon Wednesday, Jan. 15 for our annual Legislative Session Kickoff webinar for members. The webinar will cover what to expect during the 2020 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 and add the webinar to your calendar.

Join us for Hospital Advocacy Day in Olympia Jan. 29-30

Please join us in Olympia for Hospital Advocacy Day Jan. 29-30! This will be our second-annual Advocacy Day, and we will spend the time advocating for our priorities, talking with legislators and telling the hospital story. The events kickoff the evening of Wednesday, Jan. 29 with a legislative briefing, advocacy training and networking dinner. On Jan. 30, we will have a second legislative briefing followed by legislative visits throughout the day. We look forward to working with our elected leaders to advance legislation that benefits Washingtonians and helps them live the healthiest lives they can.

Register at See you in Olympia!


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