Description: The health care authority (HCA) in conjunction with the aging and long-term support administration, department of social and health services (DSHS), intends to submit medicaid state plan amendment (SPA) 20-00XX in order to increase the medicaid rates for assisted living facilities, adult family homes, adult day health, agency providers, independent providers, nursing facilities and for nursing facility swing beds. These changes are due to an increase in appropriation from the state legislature. Additionally, this proposed Amendment will modify the nursing facility COVID-19 related add-on of $27 to $13. The proposed effective date of these changes in [is] July 1, 2020.

SPA 20-0027 is not expected to increase the annual combined total impact for state and federal dollars for assisted living facilities federal fiscal year 2020 and 2021. This planned increase was included in the fiscal impact statement submitted with SPA 19-0022.

SPA 20-0027 is expected to increase the annual combined total impact for state and federal dollars for adult family homes by $4,637,304 for federal fiscal year 2020 and $18,398,000 for federal fiscal year 2021.

SPA 20-0027 is expected to increase the annual combined total impact for state and federal dollars for adult day health by $321,118 for federal fiscal year 2020 and $1,274,000 for federal fiscal year 2021.

SPA 20-0027 is not expected to increase the annual combined total impact for state and federal dollars for agency providers or independent providers for federal fiscal year 2020 or 2021. Rates are expected to increase by one penny per quarter hour and fiscal impact is negligible.

SPA 20-0027 is expected to increase the annual combined total impact for state and federal dollars for nursing facilities by $19,049,991 for federal fiscal year 2020 and $75,578,769 for federal fiscal year 2021.

SPA 20-0027 is expected to increase the annual combined total impact for state and federal dollars for nursing facility swing beds by $52,055 for federal fiscal year 2020 and $206,521 for federal fiscal year 2021.

The annual combined total impact for state and federal dollars for the entire submission of SPA 20-00XX is $24,060,467 for federal fiscal year 2020 and $95,457,289 for federal fiscal year 2021.

SPA 21-0027 is under development. HCA and DSHS would appreciate any input or concerns regarding this SPA. To request a copy of the SPA when it becomes available, you may 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 budget dial rate for nursing facilities is $250.71. Thus, the industry as a whole will see an increase in the daily rate.	The methodology for rate calculation has not changed. This change is a result of increased state appropriation.	The state legislature increased appropriations to nursing facilities.
The proposed swing bed rate for nursing facilities is $217.23.	The methodology for the swing bed rate calculation has been adjusted to align with federal calculations. The proposed increase can be attributed to increased state appropriation.	The state legislature increased appropriations for swing beds. The average is calculated in alignment with federal calculations.

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 by July 30, 2020. 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, Department of Social and Health Services, P.O. Box 45600, Olympia, WA 98504-5600, phone 360-725-2447, 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.