5 Things Washington: Q&A w/ Rep. Joe Schmick, HCA budget request, WA Cares Fund


Emily Boerger


Want to hear something crazy? We now have 7 full time reporters covering health policy, not counting me. We cover health policy in 15 states, making us one of the most comprehensive outlets for news and information on state-level health policy in the country.

And, if you know us and our story over these last 11 years, you know that this is because of your support. We started here in Washington State.. We live here in Washington State. And, we’re now taking that same non-partisan, policy agnostic approach that grew out of our state to other parts of the country.

So, thank you for you help and encouragement. We appreciate it very much.





With help from Emily Boerger

1. Keynote Video: AG Bob Ferguson

Washington State Attorney General Bob Ferguson joined us as our Morning Keynote speaker at the State of Reform Conference last week, where he touched on a broad range of issues including his office’s response to Texas’s new abortion law, the Purdue opioid lawsuit settlement, and mask mandate enforcement.

He also discussed his office’s anti-trust work, noting that the office has quadrupled the number of attorneys working in this space. “The AG’s office had not historically been involved in reviewing potential mergers and acquisitions in the health care industry or any other industry, for that matter. [Our presence] was very small … I’m not a health care expert, and I’m not an anti-trust expert, but my job is to make sure that there’s a level playing field for consumers in our state.” Video of his full comments is available here.

2. Q&A: Rep. Joe Schmick on the 2022 session

Rep. Joe Schmick has served in the legislature since 2007 and is the Ranking Member of the House Health Care and Wellness Committee. In this Q&A, Schmick outlines the legislation he has been preparing during the interim and his health policy priorities for the upcoming session.

His priorities include: addressing low Medicaid reimbursement rates, ensuring adequate 988 implementation in rural parts of the state, and evaluating barriers to licensure. “There’s always a balance between patient safety and getting folks more focused in the workforce to provide services. And I think we’ve always got to be very cautious when we do stuff in the legislature, that we are not adding more barriers to helping people out.”


3. HCA Agency budget request

In anticipation of 2022 supplemental budget conversations, state agencies were required to submit their Agency Budget Requests to OFM by Monday. During our “Update from the HCA” panel at the conference on Thursday, Interim Medicaid Director Dr. Charissa Fotinos outlined the priorities included in HCA’s request.

Fotinos says support for the community information exchange (CIE) will be critical in meeting social determinant needs of individuals. She also says the agency is focused on improving conditions for the primary care workforce and expanding behavioral health resources. HCA’s funding request includes a placeholder request to cover health care costs for youth with severe BH diagnoses and ongoing funding for increased Medicaid reimbursement rates for Opioid Treatment Program providers.


4. Changes to the WA Cares Fund?

Lawmakers from both sides of the aisle expect to see changes to the WA Cares Fund in the 2022 session as they work to ensure the program’s financial viability and fairness. Rep. Nicole Macri describes the new payroll tax as a “safety net” for Washingtonians, but notes that there will likely be recommendations coming to the legislature to fine tune eligibility elements of the program.

Sen. Mike Padden, who represents Spokane Valley, says he’s particularly concerned about employees who live in Idaho who won’t be able to access the benefits from the tax, but will still be required to pay it. The tax, which is set to go into effect January 2020, has gained attention in recent weeks as long-term care insurance companies have been flooded with applications by those wishing to avoid the tax ahead of the Nov. 1 opt-out deadline. The rush has overloaded insurance companies, and led some to stop selling policies.

5. Solutions for the long-term care workforce crisis

With a rapidly aging population and a diminishing number of workers entering the field, Washington’s existing long-term care workforce shortage is being made worse by the pandemic. “We did have workforce shortages prior to COVID. They were nothing like they have been now, and things are truly reaching a crisis stage at this point,” says Bill Moss from the Aging and Long-Term Support Administration (ALTSA) at DSHS.

State of Reform’s newest reporter, Soraya Marashi, caught up with ALTSA’s Moss and Bea Rector for a conversation on some of the initiatives DSHS is pursing to support and engage the long-term care workforce. Their strategies focus on increasing wages and benefits, early recruitment, and finding ways to change the perception of these jobs as being “unskilled” or undervalued.