Upcoming Conference | 2019 Re-Wire Policy Conference, Dec 10, 2019 Register

Differences in how the House & Senate plan to fund DSHS

The operating budget bill House Democrats passed off the floor last week totaled $52.8 billion, while the Senate’s proposing a slightly smaller package, at $52.2 billion.

In the graphic showing funding-by-agency in the budgets below, the blue bars represent the House budget that passed off the floor, and the gray bars represent the Senate’s proposed budget.

Image: fiscal.wa.gov

At first blush, the two budgets largely mirror each other in the way the largest amounts of spending are apportioned by agency. The biggest difference between the two, at least in percentage of total funding directed toward a particular agency, is in the way the two chambers fund the Department of Social and Health Services: The House allocates $13.91 billion, while the Senate allocates $13.52 billion.

The House spends roughly $390.2 million more than the Senate on policy changes within DSHS, total; both chambers plan to increase spending overall.

Notable differences between the two chambers’ funding for DSHS include:

  • The House allocates $31.2 million more to DSHS than the Senate, for a total of $86.2 million, on state hospital operations;
  • On a related note: The House allocates $38.5 million more than the Senate toward community placements that prioritize patients being discharged from state psychiatric hospitals;
  • The House provides for a $39.8 million, one-time rebase of Medicaid nursing home rates, which usually happens only the second year of a biennium, according to the proposal documents — the Senate does not;
  • The House includes nearly $31 million for federal appropriation authority to “continue expanding the five-year Medicaid Transformation Waiver” approved by CMS and appropriated in the 2017-19 biennium — the Senate doesn’t;
  • The House spends $87.1 million more on assisted living facility rates than the Senate;
  • The House budget increases the Personal Needs Allowance for Medicaid in-home services clients from 100 percent of the Federal Poverty Level to 120 percent of the FPL, which requires $24.7 million in funding — the Senate doesn’t; and
  • The House spends $133.5 million more than the Senate on enhancing the rate for Developmental Disabilities Administration community residential service providers like group homes and supported living. The rates are set to increase yearly through 2021.

While the number isn’t big, comparatively, it’s also worth noting that the House allocates almost $2.7 million to DSHS to prepare for the introduction of the Long-Term Care Trust Act, while the Senate doesn’t allocate any.

Also notable is that the Senate funds some things the House doesn’t and cuts funds in a couple places the House doesn’t cut them. For instance, the Senate cuts $22.7 million in indirect staff funding and $29.5 million in nursing home discharge — the House does not.

To dig deeper into the differences in funding for agencies between the two chambers, usethis tool on fiscal.wa.gov.