Aging and Long-Term Services Administration Releases Information Regarding Budget Decision Package

Aging and Long-Term Services Administration Releases Information Regarding Budget Decision Package

The Aging and Long-Term Services Administration (ALTSA) has released their State Fiscal Year (SFY) 2022 Biennium Decision Package that was sent to the Governor’s office.  Please note that this is a preliminary package and nothing has been finalized as of yet.  

Currently ALTSA is proposing budget savings in two ways, increasing client eligibility to reduce the client caseload, and rate reductions for all ALTSA providers.

ALTSA is proposing increasing the minimum eligibility for Medicaid clients.  This would end services for approximately 12,000 ALTSA Medicaid clients.  Assisted Living caseload is reduced by 38% or approximately 1,415 clients for a savings of $20 million, Skilled Nursing is reduced by over 20% or approximately 2,800 clients for a savings of $222 million, ARC/EARC/Dementia is reduced by 22% or approximately 647 clients for a savings of $16 million.  The biggest change to eligibility would be requiring clients to need assistance with 4 ADLs an increase from 3 ADLs.  These reductions in caseload equate to nearly $260 million total funds in savings for SFY 2022.  You can see these cuts modeled in the following table. 

Care Setting % Reduction Client Reduction Cost Savings
Assisted Living 38%  1,415   $20,000,000 
SNF 20%  2,800   $222,000,000 
ARC/EARC/Dementia 22%  647   $16,000,000 

On top of the massive reduction in caseload, ALTSA is proposing a 2.4% rate cut for all providers.  SNFs would see a total reduction of $19 million total funds annually, AL/ARC/EARC/SDC would see a reduction of $4 million total funds annually, and Adult Day would see a reduction of $200,000 total funds annually.  You can see the rate reduction modeled in the following table.

Care Setting Rate Reduction
SNF  $19,000,000 
AL/ARC/EARC/Dementia  $4,000,000 
Adult Day  $200,000 

Total budget reduction for ALTSA over the next biennium, including client eligibility and rate reductions combined, would equal nearly $1 billion dollars.  All funds listed are total funds, the state responsibility is one-half the listed amount.

Also included in the ALTSA decision package is continuing SNF annual rebase for direct care and indirect care rates.  This would be an increase of $23 million total funds.  Along with annual rebasing, they are proposing to continue the inflation factor adjustment of 2.53%.

ALTSA no longer proposes to eliminate the Adult Day Services program.

Clearly these cuts are massive and would materially affect access to care and the financial viability of assisted living, skilled nursing, adult day and in-home services in the State of Washington.  We continue to work with a broad coalition of aging services organizations to inform the Governor and the legislature of the harm these cuts and reductions would have.  As we move forward toward the next full legislative session, we will be asking for your help to advocate for aging services.  

Please remember that these are preliminary proposals and with your help we can make the State understand that the work you do for our aging population is life changing, and should be fully funded.




David Carter | Director, Health Care Finance & Policy

C 360.888.5702

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September 16, 2020