A review of HCA decision packages to the governor

The Office of Financial Management (OFM) has made available the state agency “Decision Packages” submitted for consideration in the 2020 supplemental budget. These packages are a set of “asks” made by agencies to the governor’s office.


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At the end of September, Health Care Authority (HCA) Director Sue Birch sent a letter to OFM outlining “26 maintenance-level and 17 performance level initiatives” included in the agency’s funding proposal. The letter includes the following HCA budgetary requests:

  • Savings Restoration: HCA’s proposal includes several funding requests to make up for savings assumptions in the HCA’s current budget that are not attainable — this includes restoration related to the implementation of a Medicaid single preferred drug list and assumed Healthier Washington savings. One of the decision packages also requests $3.4 million to correct a technical error that “inadvertently omitted a portion of the emergency room dental savings restored in the 2019-21 Operating Budget.”
  • Behavioral Health: The proposal asks for additional funding to support the state’s community behavioral health system. This includes funding for the state’s psychiatric inpatient treatment system, along with $1.5 million in funding for three new peer respite centers, $5 million to support administrative costs associated with implementing the 1115 Mental Health Institute of Mental Disease (MH IMD) waiver, and $221,000 for Program of Assertive Community Treatment (PACT) teams.
  • Public Employees Benefits/School Employee Benefits: The HCA is asking for $20.2 million to improve the PEBB and SEBB programs’ basic long term disability benefit. HCA is proposing a $1,500 monthly maximum benefit for both programs. Additional funding is also needed to successfully continue the launch of the SEBB Program.
  • Agency Investments: Additional funding is requested to assist the HCA with BH staff integration and other investments in the HCA workforce.

Individual policy-related decision packages include $721,000 and 2 FTEs to support planning and procurement efforts for the state’s public option, $298,000 and 2 FTEs to develop, implement, and maintain the new prescription drug price transparency program, and $1.24 million to fully fund the mental health drop-in center pilot established through HB 1394.

The proposals now go to Governor Jay Inslee’s office for consideration in the development of his 2020 supplemental budget to the legislature.