State Operating Budget Includes Significant Health Care Investments

May 5, 2021

We are very pleased the 2021-2023 Operating Budget enacted by the legislature provides significant investments in health care, including many of WSHA’s budget priorities. For more information see our recent Inside Olympia and detailed budget comparison document. WSHA is still gathering information on some of funding and payment increases. We will get more information out to members as it becomes available. The highlights are below.

Difficult to discharge:

  • Includes $2.3 million state ($5.25 million total) for a $60-a-day add on payment specific to 120 patients in acute care hospitals and $2.4 million state ($5.99 million total) for a general rate increase for specialty dementia care. The increased payments will make it easier to transfer patients that do not require inpatient care to an appropriate non-hospital setting.
  • Other difficult-to-discharge investments:
    • $7.9 million for 20 long-term care slots for individuals who stuck in hospitals and are ineligible for Medicaid due to citizenship status.
    • $22.3 million state ($46.2 million total) for the Transitional Care Center of Seattle, a DSHS-owned nursing home for difficult-to-place patients.
    • $7 million state ($14.6 million total) to support transitioning patients from state and community psychiatric hospitals to community settings.
    • $25.9 million state ($26.3 million total) to support increased personal care for clients whose need is due to psychiatric disability.

COVID-19 Response and Other Health Care

  • $46 million total for primary care provider and pediatric professional intensive care rate increase.  Effective October 1, payment for adult primary care services will increase by up to 15 percent and pediatric primary care and intensive care services will increase by 21 percent.  Applies to same primary care provider and service categories as received the temporary increases under the Affordable Care Act.
  • $1.1 billion federal for vaccine deployment, recruitment of public health workers, contact tracing and testing.
  • $147 million state for foundational public health services.
  • $35 million federal for uninsured and underinsured care through rural health centers, federally qualified health centers and free clinics.

Behavioral Health

  • Establishes a feasible and sustainable rate methodology and funding for hospitals caring for long-term civil commitment patients. This reflects a multi-year effort by WSHA and our hospital members.
  • $130 million total to expand substance use disorder services and supports (including outreach, treatment and recovery)
  • $39 million total for behavioral health mobile crisis teams for children and adults
  • $62 million total to support a 2% rate increase for Medicaid and non-Medicaid behavioral health services.
  • $7 million total to help transition civil commitment patients in state and local psychiatric hospitals to community settings, including specialized dementia and enhanced adult residential care placements.
  • Rate increase for community behavioral health providers paid on Medicaid professional fee schedule – up to 15% increase effective October 1, 2021. (Andrew Busz,


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Washington State Hospital Association
999 Third Avenue
Suite 1400
Seattle, WA 98104

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206.283.6122 fax

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