Description: The health care authority (HCA) in conjunction with the aging and long-term support administration (ALTSA) within the department of social and health services (DSHS), intends to submit Medicaid SPA 20-0016 in order to include an add-on payment to the medicaid rate for nursing facilities. This additional payment is the result of an increase in the federal match assistance percentage (FMAP) due to the declaration of a national emergency regarding the COVID-19 virus. The increased FMAP makes existing appropriations from the state legislature available for reinvestment into the nursing facility daily rate. These changes will not apply to the enhanced tribal rate, as that is funded with one hundred percent FMAP outside of these newly available funds.

A copy of proposed SPA 20-0016 is available for review. HCA and ALTSA would appreciate any input or concerns regarding this SPA. To request a copy of the SPA and submit comments, please contact the person named below (please note that all comments are subject to public review and disclosure, as are the names of those who comment).

Proposed Rate	Proposed Methodology	Justification
The proposed add-on for nursing facilities is $29. Thus, the industry as a whole will see an increase in the daily rate.	The add-on is calculated in a manner to capitalize on increased FMAP and utilizing the full state appropriation.	The state legislature has appropriated a certain amount for nursing facilities. The increased FMAP allows utilization of the full state appropriation. This is necessary as, while nursing facilities are expected to have an infection control policy, the scale of the COVID outbreak in this state, increased costs of supplies, and the impact to the labor market has put an outsized burden on nursing facilities. This add-on (utilizing existing appropriations) will help ensure that nursing facilities do not face closure due to financial strain at this important crossroads.

Interested parties may submit comments and concerns about the rates or the effects the changes may have on beneficiary access to care or continued service access. Please submit comments and concerns to Elizabeth Pashley with a courtesy copy to Ann Myers, state plan coordinator, at ann.myers@hca.wa.gov. Please note that all comments are subject to public review and disclosure, as are the names of those who comment.

Contact Elizabeth Pashley, Office of Rates Management, Aging and Long-Term Support, DSHS, P.O. Box 45600, Olympia, WA 98504-5600, TRS (TDD/TTY) 711, fax 360-725-2641, email Elizabeth.Pashley@dshs.wa.gov, website https://www.dshs.wa.gov/altsa/management-services-division/office-rates-management.