Preliminary ALTSA Reduction Proposals for State Fiscal Year 2021

Preliminary ALTSA Reduction Proposals for State Fiscal Year 2021

Aging and Long-Term Support Administration has released their preliminary budget reduction proposals.  On May 13th the Office of Financial Management directed all state agencies to submit reductions to their General Fund-State expenditures by 15%.  This is due to the impacts on state revenue due to the COVID-19 pandemic.  The cuts that ALTSA has proposed are as follows –

  1. Client Eligibility: Elimination of the optional Medicaid Personal Care (MPC) state plan program. Increasing the level of functional need required to meet Nursing Facility Level of Care in Washington’s Medicaid state plan and waivers will decrease the number of Medicaid clients in home and community residential settings by approximately 20,500 people; nursing home clients by approximately 680 people; and a corresponding reduction of a significant number of ALTSA staff and AAA full-time equivalent positions. ($129.8M GF-S; $282.3M total funds)
  2. Eliminate client service programs: Includes eliminating state funded non-citizens and Senior Drug Education programs, Medicaid funded Adult Day Health and Day Care services, reducing Adult Family Home Meaningful Day programs. ($15.5M GF-S; $2.7M)
  3. Rental Subsidies to Assist Nursing Home clients who request transitions: To assist clients in nursing homes to transition to their own residence with in-home care supports, ALTSA proposes paying for rental subsidies so that clients can afford to relocate to their own home. Even though the subsidy is state-only funding, the cost is still less than paying half of a nursing home rate, thus saving money. ($1.0M GF-S; $1.0M Total Funds)
  4. Provider Rates: Savings is achieved by assuming an across–the-board three percent rate reduction for all ALTSA providers, including those who collectively bargain wages and benefits and capturing the additional 6.2 percent of Medicaid matching from July through September as savings. ($60.6M GF-S; $9.4M total funds)
  5. Staffing costs:  Including unpaid furlough days. ($15.0M GF-S; $25.8M total funds)

Please be assured that we are working on your behalf to stave off these cuts.  We have joined a broad coalition of health care related organizations that includes unions, consumer groups, and provider groups.  We are hopeful that together, we will be able to limit the impacts of these proposed budget reductions that increase service eligibility criteria for all programs and cut rates.  We will continue to push for the federal government to increase the enhanced FMAP through the 21/23 biennium.  This would help to limit the need for state general fund cuts by back filling state program dollars with federal money. 

Look for key messaging information from us in the coming weeks so you too can advocate against these draconian cuts denying needed health care, services and supports to seniors and persons with disabilities. 




David Carter | Director, Health Care Finance & Policy

C 360.888.5702