Washington legislators wrap up final supplemental budget negotiations


Nicole Pasia


After closed-door budget negotiations concluded on Wednesday afternoon, the Senate and House Democrats released their proposed supplemental operating budget for 2022. The budget proposal would add an additional $5 billion to the 2021-2023 operating budget, bringing the total to $64.1 billion. Total budgeted funds for the 2021-2023 biennium and 2023-25 are $130.9 billion and $64.9 billion, respectively. 


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“Our state is in a strong fiscal position and this budget makes smart, targeted investments to increase prosperity across the state,” Sen. Christine Rolfes (D-Bainbridge Island), chair of the Senate Ways and Means Committee, said in a statement. “We meet immediate needs by supporting schools and families, addressing the climate crisis and helping people who are struggling to afford basic needs like food, shelter and medical care.”

The budget includes several new health-related funding allocations for behavioral health, COVID-19 mitigation, and Medicaid.

To stabilize the behavioral health workforce, $100 million from the Coronavirus State Fiscal Recovery Fund will go toward one-time payments for community-based, Medicaid-contracting behavioral health providers. An additional $86 million will be used for a 7% behavioral health provider rate increase for Medicaid MCOs, which will be effective Jan. 1, 2023. 

To address the ongoing opioid epidemic, the legislature appropriated $37 million over both the 2021-23 and 2023-25 bienniums. This includes funding for the Health Care Authority to apply a Medicare rate and bundled payment approach to opioid treatment provider reimbursements. 

Approximately $71 million is slated to support nursing and health care education programs at four-year higher education institutions, along with community and technical colleges. The funding will also support apprenticeship grants for licensed practical nurses who will specifically work in long-term care settings. Other bills passed this session have addressed the nursing shortage, such as House Bill 2007, which establishes and funds the Nurse Educator Loan Repayment Program through the Washington Health Corps program. 

The budget proposal includes $46 million to “streamline eligibility process” for Medicaid enrollees. Specifically, it would ensure continuous coverage for children between ages zero to six, and eliminate certain eligibility certifications. This is part of the state’s continued effort to redetermine nearly 300,000 Medicaid beneficiaries that have enrolled during the pandemic. 

Long-term care and developmental disability services will receive significant funding from the proposals—$351 million from 2021-23 and $344 million from 2023-25. This includes extending temporary vendor rate increases through June 2022, increasing base rates for assisted living facilities, and adjusting home care agency tax rates.

An additional $28 million will support long-term services for certain populations, including people aged 12-21 after they are discharged from inpatient care.

Several budget provisions focus on Covid response, including $144 million for testing, transitioning patients from acute care to community-based services, and personal protective equipment. An additional $42 million will go to the Department of Corrections to support Covid-related health care costs and social distancing measures in correctional facilities. 

The supplemental budget proposal awaits a final vote from each chamber during the last day of session on Thursday.