[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},"mediaId",6126498,"mediaKeyId","2668067-47253c354f3efc640cfa17f857f04da7","parentId",2668067,"title","HCA officials flag federal and state budget uncertainty that could affect Medicaid services","audioSeconds",598,"startMs",415000,"endMs",1013000,"viewUrl","/Search/View?dp=1&key=2668067-47253c354f3efc640cfa17f857f04da7&start=415&end=1013","thumbnailUrl","https://assets.pipeline.soar.com/2668067-47253c354f3efc640cfa17f857f04da7/thumbnail_415000.jpg","articleUrl","/articles/6126498/Spokane-County/Washington/HCA-officials-flag-federal-and-state-budget-uncertainty-that-could-affect-Medicaid-services","mediaUrl","https://secure.pipeline.soar.com/6126498-6ef2c3499151ee5ad63573ecce0c25c6/orig.mp4?Expires=1771131316&Signature=Hno7B19Q66kkH-8e5GLxJ~criegwq91daUjal4A-J4yLin2EpesQMvrljTuznbLqm3~cuKRl9JrKJ~KyyOCE-GQ5SbyrHNysszuLQjXOvthuvWD7AmwlIlApLRyDFd7vbtwKWsz6WCcnSTeigJWTLLSMZ0HRmtqr-u4TAl7UVaYGxkBpD9i-l6F7PYrdh1~VduwvRBXgCTcgZUL9pLDqK3ZuJFYr2teaEUJN3wPfFkJ6YSaAY19P5~j1X3IhNSpeBM19L5OlGIqX~Nj8ljyHD6JdCkGw4DTRmPwGmc0zNcJGScgiRpNh-whW6G~j35pA9IkkkVQfCmv-n9ea2sNaYA__&Key-Pair-Id=KUT5TJCACFTXG","author","Spokane County, WA","date","2025-03-17T18:30:59Z","article","Representatives of the Washington State Health Care Authority used a regional meeting to warn that federal changes and state budget work could materially affect Medicaid funding and services in Washington.

HCA speakers said communications with federal agencies were limited during January and February, but have resumed; they noted staffing reductions at federal agencies including the Centers for Medicare & Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The agency said a number of federal demonstration projects have been ended early and that new federal rule‑making or waiver guidance is uncertain.

HCA outlined two near‑term fiscal risks: a potential U.S. government shutdown (noted as a short‑term staffing risk that does not change Medicaid’s mandatory status) and the broader budget reconciliation work that could reshape federal funding levels. The briefing said the House framework under discussion includes large reductions to health and human services spending and that some reconciliation work must be completed in time for fall budget rules; participants repeatedly cited a September milestone for reconciliation outcomes.

Why it matters: changes in federal matching rates, reduced covered services or altered rules about Medicaid waivers and health‑related social needs could require states to change eligibility, benefits or program design—affecting providers and beneficiaries in Spokane and across Washington.

HCA’s posture and state coordination

HCA staff said the agency is collecting and sharing data with the governor’s office and congressional delegation—including district‑level analyses of people affected by potential Medicaid changes—and that the agency is preparing one‑page summaries for stakeholders. HCA described its current posture as “responsive”: communicating with federal partners as information arrives, but not proactively shifting statewide systems until federal priorities and rules become clearer.

Uncertain federal rulemaking

HCA officials said they had been told some new federal rules may be issued without typical public comment periods because HHS will exercise discretion on when to solicit public input. HCA also said CMS and HHS staffing reductions are ongoing and that the agency expects further changes that could affect Medicaid financing.

Next steps

HCA will continue to update counties and local partners as federal guidance and legislative budgets evolve; staff offered to share written materials and slide decks with meeting participants and to provide updated modeling and outreach materials for local audiences.

Ending

County leaders thanked HCA for ongoing monitoring and analysis and asked the agency to continue producing district‑level estimates of affected populations and fiscal exposures so counties and providers can plan for potential changes.","mediaType","Video","parentTitle","SCRILS Audio Visual Recording 03 14 2025","oneSentenceSummary","Health Care Authority staff told Spokane regional leaders that changing federal leadership, reduced agency staffing and the budget reconciliation process could put Medicaid financing and related programs at risk; the agency is preparing analyses and sharing data with the governor and congressional delegation.","taxTitle","Spokane County, Washington","taxId",2643,"location","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6126503,"Spokane County reports delays, billing and pharmacy issues with 11:15 jail reentry waiver",763,3683000,4446000,"/Search/View?dp=1&key=2668067-47253c354f3efc640cfa17f857f04da7&start=3683&end=4446","https://assets.pipeline.soar.com/2668067-47253c354f3efc640cfa17f857f04da7/thumbnail_3683000.jpg","/articles/6126503/Spokane-County/Washington/Spokane-County-reports-delays-billing-and-pharmacy-issues-with-1115-jail-reentry-waiver","https://secure.pipeline.soar.com/6126503-3c1ec8e493bbf26b9da43c723273d638/orig.mp4?Expires=1771131316&Signature=jCMGtZuAgfdFMq7rrWLOHR-aKGEimZFUxglM3KxcYGkZt-dDRB7Ko2-7ESvJNUoQoxVnM1zhQAkNmypvDYQ~-VUpwTyVyOI8NogYQJr9N1LmIFuxz5nTiolag7N4CnsMDjRI~6LZkuOa2pcNZNR6ajRttpmBidIoKITCf3TSb-qDFCR~H~L2QHAxG62ZMQwaCvg7Ugg1bkmsfxCppD4ozN8z92MYgVZgVEn9OD2ZUkKXSkwfC-gjA~r0XUNrFWVY1Nr3Qv8bymL-rlCs~Aq-KMAu6rXUyhQI3jI7Opmt6l7fwq0YI6FdYQ-yN4LuTje~l35JB6rviSM5WrHijp4Gaw__&Key-Pair-Id=KUT5TJCACFTXG","Spokane County staff told the regional meeting that implementation of the 11:15 partial reentry (jail‑to‑community) waiver has encountered multiple operational and billing hurdles and that county leaders expect a delayed rollout for the county jail.

Project manager Eric Green briefed attendees on the county’s implementation timeline, provider contracting and outstanding technical issues. Spokane County was an early cohort (cohort 1) for the waiver, Green said, but he described unclear state requirements early in the process, rolling deadlines, and slow release of billing guidance and covered services. He said Spokane’s jail medical provider initially declined to include many behavioral health commitments in its proposal; contract negotiations later produced a single vendor and the county moved into implementation in February while the provider develops an amended plan.

Why it matters: the waiver is intended to expand Medicaid‑funded clinical and reentry services—such as prerelease enrollment in Medicaid, MOUD continuity, and prerelease medications in hand—for people leaving local jails. Implementation problems could delay services that county officials consider critical to reducing overdose and recidivism among people exiting custody.

Specific implementation challenges described

- Policy and operations guidance was incomplete: Green said only an initial section of the HHS/ACA policy and operations guide had been released; other sections were still pending.
- Billing mechanics and eligibility tooling were late: billing codes were not released until late February; a state third‑party administrator (TPA) clearinghouse expected to help with billing was reported to be in contract negotiation and not anticipated to be fully stood up until November.
- Pharmacy point‑of‑sale issue: the waiver’s billing rules treat medications as point‑of‑sale purchases, but jail pharmacy operations typically purchase and dispense medication in bulk under controlled distribution, complicating how prerelease medications could be billed and provided “in hand.”
- Enrollment and release timing: many people booked into local jails lack immediate documentation (income, identification) and release dates are often unknown, complicating the 90‑day prerelease enrollment window and logistics for short stays.
- Sustainability and cost concerns: preliminary county calculations, using conservative assumptions and fee‑for‑service payment methods, projected poor sustainability; the county reported a recent roughly $5,000,000 increase in the medical provider contract even before incorporating full waiver services.

Juvenile facility: different trajectory

Green said the county’s juvenile detention program met its Milestone 2 requirements and has the local provider infrastructure to proceed; the juvenile facility’s principal remaining barrier is lack of an electronic health record (EHR) until the state’s AC Max system is available.

Local and state reaction

Jason (state HCA) and other state participants encouraged Spokane’s move to cohort 2 and urged caution about a July 1 cohort start. Jason said July 1 was an aggressive timeline to begin with and that shifting to a later cohort can reduce risk to counties and to the state while the TPA, billing rules and policy guidance are finalized.

Green said the county is continuing implementation planning with its medical provider and will request an official cohort change if needed. No formal vote was taken at the meeting; county staff said they would proceed with more detailed discussions with the state and provider to finalize a new target go‑live date.

Ending

Spokane County officials said they remain committed to implementing reentry services but asked for more definitive guidance and earlier availability of billing and pharmacy solutions before a full jail‑level rollout.","Spokane County staff reported operational and billing gaps in the federal/state 11:15 partial reentry waiver implementation and recommended moving the county from cohort 1 to cohort 2 to allow more time to resolve provider contracting, billing and medication‑dispensing issues.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6126507,"State details opioid-settlement spending; Spokane region among recipients",1001,1174000,2175000,"/Search/View?dp=1&key=2668067-47253c354f3efc640cfa17f857f04da7&start=1174&end=2175","https://assets.pipeline.soar.com/2668067-47253c354f3efc640cfa17f857f04da7/thumbnail_1174000.jpg","/articles/6126507/Spokane-County/Washington/State-details-opioid-settlement-spending-Spokane-region-among-recipients","https://secure.pipeline.soar.com/6126507-8eec4ddb1a7cec3ca1e95e6c8552ac35/orig.mp4?Expires=1771131316&Signature=o1va5r15fMxcd9QJ~lHuBmrhhZbds9hs9A0gwAM9Ms26O15JQP~F9TbDp2fE3biFeiD~4eN4c7scZ9Go4ZBbdzHrdSeG5aL~xrS4DN6aPLqH6miGUEzNhJmYEjGkrkoY~DJOaijAYf-H43uT5X8hQXD9N2ULbhiCzqWN30zq39Lo~YTzKKcY5GQBGLf3W~7STmXW~RckdmFtS~sHNj-zuOrm9~60M0VL5aEIPBp2WH0c5JKa1XJUtdg1NzOQqw7ieLKKJAiUGxRXRYwhIZ-KqvZP0XFCx2uObCkZ2QJCZj9Bt8oiL6-6Ulql3M~KCwkIHHZs6MVPd0kUA7gYVnssUA__&Key-Pair-Id=KUT5TJCACFTXG","At a Spokane County regional meeting, officials from the Washington State Health Care Authority on March (date not specified) outlined how opioid‑settlement dollars are being distributed and used in Spokane County and the six‑county region.

The Health Care Authority (HCA) presentation described a multi‑year flow of settlements and bankruptcy payments to state and local governments, explained the state’s role in recommending uses to the governor and legislature, and listed current Spokane programs funded in part by settlement money.

The overview noted that tribes receive 20% of settlement deposits into a separate tribal account created by a recent session bill (referred to in the briefing as “bill 6099”). HCA staff said local governments receive direct payments and many regions have formed opioid abatement councils to decide local spending priorities. “There’s a lot of interest in how the opioid‑settlement dollars are being used,” HCA’s state opioid administrator, Chris Sherrer, told meeting participants.

Why it matters: opioid‑settlement funds are a continuing, multi‑year revenue stream that local officials said they are using to expand treatment, harm‑reduction and reentry services. Spokane County and its regional partners described a mix of local projects and statewide programs that affect access to medications for opioid use disorder (MOUD), naloxone distribution and short‑term housing supports.

Key Spokane uses and statewide programs described

- Maddie’s Place: a perinatal substance‑use disorder treatment pilot in Spokane funded at a little more than $5,000,000, according to HCA’s slide deck.
- Short‑term housing vouchers: four local organizations in Spokane are distributing vouchers supported by HCA funds.
- Clubhouse/recovery‑support: two Spokane organizations are receiving operational support for peer‑run recovery services under a proviso funded through HCA.
- Mobile methadone: HCA noted support through Acadia Healthcare for establishment of a mobile methadone unit serving the community.
- Recovery residence grants: operational grants for recovery housing are active in Spokane.
- Naloxone distribution: HCA said it supports naloxone supply to several Spokane area organizations and a statewide mail‑order naloxone system that can deliver to Spokane addresses.
- MOUD in jails: HCA reported that roughly 23 jails statewide have signed up for a Medicaid‑funded MOUD program supported through settlement dollars; HCA asked local leaders to consider how Spokane’s jails participate.
- Long‑acting injectable buprenorphine: HCA described a program allowing qualifying small clinics to request supplies of long‑acting injectable buprenorphine if they meet storage and regulatory requirements.

HCA said some settlement funds will come as long, scheduled payments, while others depend on ongoing litigation and bankruptcy proceedings; the agency is continuing to receive and program money over multiple years. Chris Sherrer said state executive sponsors and the legislature share decision authority because the legislature controls appropriations.

Local accountability and reporting

HCA staff said the agency is working to make information publicly available and to report to the legislature and governor’s office on how settlement funds are spent. HCA noted it publishes a state opioid and overdose response plan and convenes work groups to advise on priorities and measurement. Commissioner Rosenkrantz asked for outcome metrics beyond dollars spent; HCA staff said the agency tracks contracts and overdose events and that more work is needed to incorporate patient‑reported quality‑of‑life measures and recidivism analyses tied specifically to abatement spending.

Regional abatement council

Jessica Thompson, the Spokane Regional BHASO supervisor and regional Opioid Abatement Council administrator, briefed the group on the regional council’s work. The Spokane regional council includes Adams, Ferry, Lincoln, Pend Oreille, Stevens and Spokane counties and the cities of Cheney, Liberty Lake, Spokane and Spokane Valley. Thompson said the council meets every other month and focuses on naloxone replenishment, school‑based prevention curriculum, canine interdiction initiatives, high‑utilizer programs and co‑response teams. “Things are going really well,” she said, and the council is compiling 2024 annual expenditure reports for public posting.

Next steps and resources

HCA told the group it is finalizing additional budget analyses and will share the slides and hyperlinks used in the presentation; Chris Sherrer said he would send the slide deck to the local contact after the meeting. HCA also invited attendees to a state learning community meeting on long‑acting injectable buprenorphine and other topics (meeting registration link was posted in the meeting chat).

Ending

County staff and HCA officials said they will continue to track settlement receipts, report spending publicly, and refine outcome measures. Local officials asked HCA to provide more comparative and outcome data—for example recidivism, reduced overdoses and measures of quality of life—to help counties evaluate which spending choices are changing outcomes.","Health Care Authority officials briefed Spokane County leaders on opioid‑settlement funds, the state distribution framework and programs using those dollars in Spokane, including perinatal treatment, naloxone distribution and jail-based medication access.","actionData","errors"]

Article not found

HCA officials flag federal and state budget uncertainty that could affect Medicaid services

Spokane County reports delays, billing and pharmacy issues with 11:15 jail reentry waiver

State details opioid-settlement spending; Spokane region among recipients