Washington State agencies submitted their budget requests to the Governor’s office this month, documents which generally highlight their priorities for the coming fiscal year and into the future. This year’s budget requests were no different, and the Wire selected some specific asks from three departments to kick off our budget coverage. 

COVID spending will be with us for a long time

The state’s COVID-19 budget isn’t going away next year, or even in 2023. Washington’s Department of Health is planning on spending a total of $212 million over the next two years in pandemic response ranging from funding testing, contact tracing and investigation, care coordination and outbreak response, to name a few. 

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This means that COVID-19 is here to stay for the foreseeable future, and state and local agencies should plan accordingly. Let’s take a look at the numbers, as presented in the budget request: 

While the Legislature gave the Department of Health authority to spend up to $1.1 billion in federal funding to fight the pandemic through 2023, it’s unclear whether that will be enough to cover expenses. This additional $212 million is designed to make sure the department can continue its work. 

In the 2021 state budget, the Department of Health received $900 million in federal spending authority. Beginning this July, the Department identified the $212 million shortfall, mostly due to FEMA scaling back its reimbursement at the end of this year. Right now, FEMA is covering the Department’s COVID-19 costs for activities like testing and outbreak response in their entirety. It will be reducing this to 75% beginning in January. 

Since the CARES Act passed, insurance companies have been required to pay for COVID-19 testing without charging patients for the service, but it’s not certain if the federal government will continue to require this. Health insurance doesn’t usually pay for asymptomatic testing — which has been a crucial part of the pandemic mitigation strategy. The Department of Health estimated it would need $435 million for diagnostic and screening tests through June 30, 2023. 

Also of interest is that the Department is planning on providing funding for vaccinations through 2024, at the least. 

“Vaccine hesitancy and the increasing threat of variants, present significant obstacles for the state to resume normal business operations and move beyond the pandemic,” the Department’s budget request states. 

A breakdown of vaccination funding requests can be seen below: 

Washington State reached its goal of getting 70% of those eligible for a vaccine at least one dose by mid-July. But vaccinations aren’t equal across the state or among demographic groups. While the Department of Health’s vaccine work has received significant federal funding, the scale of the need has outpaced funding, the report states. 

This means that the Department is settling in for a long war with COVID-19, and gives credence to the idea that it’s here to stay, and likely endemic. 

Dispute Resolution Centers

The Department of Commerce is asking for more funding for Dispute Resolution Centers around the state, which have been chronically underfunded in recent years. These centers provide programs to communities to support housing and family stability, and youth and community restorative practices with a focus on equity. 

The 2021-23 operating budget provided $6 million over two years to fund these centers. While the Department’s ask notes it’s an increase from previous years, it’s still well below the $17.1 million per biennium envisioned by state law. The 2021-23 supplemental budget request asks for an additional $4.1 million to fund these centers, which have seen an increase in demand during the pandemic. 

Demand is expected to increase further as eviction moratoriums come to an end and people begin to face eviction. 

“This request will not address the complete funding gap but it will ensure more Washingtonians have access to low-or no-cost dispute resolution services,” the request states. 

There are 21 Dispute Resolution Centers across the state that in 2020 served nearly 60,000 people, mediated 2,562 cases and trained 7,721 community members on mediation. 

Improving prison health care

The Department of Corrections is requesting $27.6 million to implement a new health care model to care for prisoners with chronic health conditions, provide preventative care and expand care for high-risk patients. 

The Washington State Department of Corrections’ outdated and underfunded health care delivery system has significant gaps, the request states. 

A screenshot of the budget request can be viewed below:

Nationwide, the request states that Washington ranks 20th in the nation for health care spending per inmate, less than states like North Carolina, New York, Alaska and Nebraska. The Department of Corrections delivers on demand health care based on a combination of emergency appointment requests and intermittent visits by on-site and external medical care providers. 

“These episodes of care are delivered sporadically, and do not provide for a comprehensive model of primary care delivery. Specifically, they can lack essential key elements related to preventative service or identification and management of conditions such as diabetes, kidney and heart disease. Reactive health care does not address the on-going needs of DOC’s population and puts its patients, staff, and the state of Washington at risk,” the request states. 

The patient-center care model allows prisoners to have an ongoing relationship with a primary clinician and support team to provide continuous and comprehensive care. The care team will be led by an Advanced Nurse Practitioner or physician that leads a medical team. The budget request will also increase medical staffing. 

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