Vulnerable populations take further reductions
The State budget passed by the Washington State Legislature (and not yet approved by the Governor) has moderate to severe reductions in health and human services funding for low income King County residents particularly those who are not eligible for Medicaid funding. These cuts in prevention and intervention services will likely result in more people using emergency rooms, becoming homeless and incarcerated.
Basic Needs and Housing:
Disability Lifeline – Eliminates Disability Lifeline Program effective October 1 and creates three new programs Aged, Blind, and Disabled Program, Pregnant Women Assistance Program and the Essential Needs and Housing Support Program. Medical coverage for participants is preserved but monthly cash grants for Disability Lifeline-Unemployable recipients are eliminated and replaced with Department of Commerce grants to counties or community-based organizations for essential needs and housing support. The $64 million funding designated for the later will not be sufficient to provide housing to all who need it. The administrative requirements for this change are still to be determined. Former DL-X recipients will continue to receive a monthly cash grant of $197, along with medical services under the new program name: Aged, Blind, and Disabled program.
Housing Trust fund – Funded at $50 million for the biennium.
Homeless services – Failure to extend and increase document recording fees supporting Home Security funds will result in cutting funding for existing community programs supporting homeless and formerly homeless persons in housing. Immediate cuts will come from the existing shortfall in State Home Security Funds where there are $42 million obligations and $31 million in revenue to support projects statewide.
Mental health services – There will be a 4% cut for non-Medicaid and 3% cut in Medicaid mental health services. Reductions in non-Medicaid reimbursement will result in less flexibility to serve non-Medicaid eligible residents in supportive housing, crisis and hospital diversion services, and outpatient services. Reduction in Medicaid reimbursement rates may require reduction in rates paid to community mental health providers.
Substance abuse services – Reduction in outpatient and residential treatment services for non-Medicaid eligible individuals will make it more difficult for people to receive needed services.
Immigrant and Refugee services – Immigrants and refugees were affected by cuts in many human service areas including support for naturalization, employment services, medical interpretation and food assistance. In terms of food assistance, $4.8 million was allocated to the State Food Assistance Program (half the current funding level) and the monthly benefit has decreased meaning fewer people will be receiving less in benefits.
Early Learning-Policymakers in the state have come to recognize the importance of early learning and its relationship to success in the K-12 system, higher education and later life. Most state funded early learning programs received approximately maintenance level funding including $1.86 million/year for home visiting, $2.256 million for Early Childhood Education Assistance Program (ECEAP), $1.276 million for information and referral through Child Care Resource and Referral Network (CCRR), $300,00 for Reach Out and Read and $400,000 for Parent and Caregiver Support including Family, Friend and Neighbor support; state funds for home visiting, however, are able to leverage federal funds and private dollars thereby increasing the total amount committed to home visiting. About $900,000 in new state money was added in order that the Kindergarten assessment, WaKIDS, be administered, on a voluntary basis, to all kids in state-funded all day kindergarten. State funds were also redirected to support a public private initiative focused on preventing and reducing the prevalence of adverse childhood experiences (ACES) and their long term effects. Sadly, the Career and Wage ladder was eliminated (including contracts with 55 child care centers statewide).
Subsidized Child Care-Eligibility for state subsidized child care remains at 175% federal poverty level; however, prioritization of teen parents and TANF recipients along with capping the number of families covered at 32,500 has created a waiting list of low income, non-TANF families who need subsidized child care to continue working
Medicaid payments to Federally Qualified Health Centers (FQHC) –Payments to community health centers and Public Health – Seattle & King County (PHSKC) are reduced by approximately 10.6% ($86.3 million cut state wide). Cash assistance used by clients to pay for care on a sliding fee scale has been eliminated or slashed. And, over the long term, budget proviso language has changed the inflation index used for FQHCs, so that reimbursement rates will increase at a lower rate from year to year. Community Health Centers provide care for approximately 200,000 low income and medically vulnerable people throughout King County. Cuts to this system will result in less service to low income residents.
Maternity Support Services (MSS) –MSS which serves low income women and children has been reduced 30% ( a $23.9 million cut state wide).
Adult Dental –Adult dental coverage for Medicaid beneficiaries is eliminated for everyone except pregnant women, disabled adults and for emergency services. This cut will shift care to emergency rooms. Over 30,000 adults affected in King County.
Apple Health for Kids – This program of health services is preserved for children under 200% of Federal Poverty Level and the costs increased for those above 200% poverty. The Children’s Health Program, serving families with illegal immigrant children, was maintained, but families with incomes above 200% of the federal poverty level will pay higher premiums. The overall reduction for CHP for the biennium was $1.6 million.
Basic Health Plan – Enrollment is frozen at the current level of enrollees. This affects over 14,000 enrollees in King County.
Other health related reductions –
Reduces support for local WIC by $800,000 and family planning grants by over 11%
Eliminates Community Health Service Grants to Community Health Centers
Reduces General Fund support for Public Health Departments by 50%
Services and programs important to older adults have all experienced cuts including: elimination of eyeglasses and hearing aids and restriction on dental coverage (except in emergency) for adults on Medicaid; changes in the adult day health program that may cause closure of some centers; a 10% cut in home health care hours needed to keep older adults in their own homes; loss of co-pay funding for low income seniors enrolled in the Medicare part D Pharmacy program (this affects 50,000 seniors in Washington); and possible reductions to Meals on Wheels, Transportation and other senior services provided through the Area Agencies on Aging.
Information and Referral:
The WIN211 information and referral system will receive $1 million, half of the amount of state funding it received in the past biennium. This will mean reductions in support for the statewide system as well as loss of grants to local call centers. At a time when needs are rising, the system will have less capability to answer calls, update the referral data base and make appropriate referrals.
K-12: Two initiatives-I-728 and I-732- that address class size reduction and COLA increases for teachers were not funded. Teacher pay was slated for a 1.9% reduction
Higher Ed: Support for state universities and technical colleges was dramatically cut at the same time that financial support for low income students was increased and well as the ability to raise tuition between 12 and 18%. State workers are taking a 3% pay cut.