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Agency 303
Department of Health
RCW 43.70

Request $503,009,307
Net change from current biennium $75,927,110 Increase
Percent change from current biennium 17.8% Increase


The Department of Health was created in 1989. It protects and enhances the health of people in Washington State by: assessing information about the health status of people and about the environments in which they live; using that information to develop policies designed to address and influence identified health issues; and assuring that actions taken as a result of policy development are effective. The Department carries out this work within the context of a complex health system that includes both environmental health and medical care designed to meet the needs of individuals, as well as population-based education, prevention, and health promotion programs designed to reach large numbers of people and have an impact on the personal choices they can make to influence their own health.

The goals of the Department are to protect and promote health and to prevent disease and injury.


Links to Program Level Detail

Epidemiology, Health Statistics, and Public Health Laboratory

Environmental Health

Health Systems Quality Assurance

Community and Family Health

Administration

State Board of Health


Agency Level Summary

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Operating Budget: Summary
1995-97 Appropriations Appropriated Funds Expenditures
Amount Estimated Balance 1993-95 Actual 1995-97 Estimated 1997-99 Proposed
90,335,720 10,720 General Fund - Basic Account - State 88,813,755 90,325,000 116,133,000
235,325,450 12,034,916 General Fund - Basic Account - Federal 175,554,399 223,290,534 262,637,450
98,110 General Fund - Basic Account - Federal Unanticipated 6,785,478 98,110
26,025,063 4,644,865 General Fund - Basic Account - Private/Local 19,055,562 21,380,198 23,989,000
General Fund - Basic Account - Private/Local Unanticipated 509,184
3,088,954 386,528 Hospital Commission Account - State 2,776,987 2,702,426 3,088,954
1,835,000 Medical Disciplinary Account - State 1,837,082 1,835,000 3,968,906
33,685,929 1,139,877 Health Professions Account - State 28,564,016 32,546,052 31,870,000
62,000 Industrial Insurance Premium Refund - State 9,813 62,000
2,824,162 291,573 Safe Drinking Water Account - State 2,520,171 2,532,589 2,495,000
23,760,338 11,772 Public Health Services Account - State 19,932,284 23,748,566 25,675,000
614,997 138,294 Waterworks Operator Certification - State 378,263 476,703 587,997
Water Resource Administration Acct - State 2,805,000
48,361 St/Loc Impr Rev Acct Water Sup Fac - State 48,361
3,180,551 Water Quality Account - State 2,979,059 3,180,551 3,066,000
2,920,407 23,106 State Toxics Control Account - State 2,873,136 2,897,301 2,855,000
469,000 Violence Reduction/Drug Enforcement - State 466,996 469,000
1,875,295 562,248 Medical Test Site Licensure Account - State 1,421,974 1,313,047 1,624,000
1,412,000 Youth Tobacco Prevention Account - State 1,604,493 1,412,000 1,812,000
19,239,243 516,520 Health Services Account - State 11,909,914 18,722,723 20,402,000

446,800,580


19,760,419

Total Appropriated Funds

367,992,566


427,040,161


503,009,307

Non-Appropriated Funds
State Agency Parking Account - Non-Appropriated 42,036
Total All Funds

367,992,566


427,082,197


503,009,307


Capital Budget: Summary*
1995-97 Appropriations Appropriated Funds Expenditures
Amount Estimated Balance 1993-95 Actual 1995-97 Estimated 1997-99 Proposed
50,000 50,000 General Fund - Basic Account - Federal
1,046,790 550,000 Char/Ed/Penal/Reform/Institutions - State 421,141 496,790 1,021,558
1,213,992 600,000 State Building Construction Account - State 564,333 613,992 2,240,374
1,709,622 1,030,552 St/Loc Impr Rev Acct Water Sup Fac - State 3,427,378 679,070 1,197,420
Local Toxics Control Account - State 1,069,231

4,020,404


2,230,552

Total Appropriated Funds

5,482,083


1,789,852


4,459,352


*For detail projects, see 1997-99 Capital Plan.

Operating Budget: Summary by Object

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries And Wages 40,631,714 44,078,002 45,895,223 47,261,984 47,651,102
Employee Benefits 10,488,496 11,235,483 11,593,013 11,989,202 12,054,704
Personal Service Contracts 2,360,553 1,839,866 2,123,663 4,145,326 3,890,104
Goods And Services 24,673,378 21,164,410 25,702,966 26,901,373 25,860,523
Travel 2,544,514 2,361,842 2,580,942 2,485,354 2,476,348
Capital Outlays 3,280,682 2,841,144 20,585,759 3,113,784 2,460,123
Grants, Benefits & Client Services 126,989,232 122,439,395 119,320,782 154,598,926 163,362,980
Debt Service 1,419,357 211,149 467,705 323,192 323,192
Interagency Reimbursements (5,143,688) (3,676,157) (3,707,463) (2,944,987) (2,943,923)
Intra-Agency Reimbursements 405,009 2 24,471
Annual Total

207,649,247


202,495,136


224,587,061


247,874,154


255,135,153


Operating Budget: Program Summary

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Epidemiology, Health, Statistics, 15,902,474 14,253,850 16,614,880 15,760,823 15,336,296
Environmental Health 18,030,847 17,636,471 20,934,753 22,482,995 21,588,596
Health Systems Quality Assurance 29,581,759 28,885,804 30,602,245 31,374,020 29,310,482
Community and Family Health 134,973,088 132,267,803 146,604,567 167,797,284 178,531,501
Administration 8,620,258 9,015,865 9,327,616 9,959,677 9,868,941
State Board of Health 540,821 435,343 503,000 499,355 499,337
Annual Total

207,649,247


202,495,136


224,587,061


247,874,154


255,135,153

Fiscal Year 1993-94 160,343,319
Biennium Total

367,992,566


427,082,197


503,009,307


Operating Budget: Change from Preceding Biennium

1993-95 Actual 1995-97 Estimated 1997-99 Proposed
Amount Percent Amount Percent Amount Percent
Epidemiology, Health, Statistics, 5,037,116 21.7% 2,656,296 9.4% 228,389 0.7%
Environmental Health 7,602,013 29.8% 5,435,315 16.4% 5,500,367 14.3%
Health Systems Quality Assurance (4,295,379) (7.4)% 5,754,132 10.7% 1,196,453 2.0%
Community and Family Health 57,420,638 32.2% 43,007,761 18.2% 67,456,415 24.2%
Administration 1,984,320 14.1% 2,249,050 14.0% 1,485,137 8.1%
State Board of Health (12,953) (1.3)% (12,923) (1.4)% 60,349 6.4%
Total

67,735,755


22.6%


59,089,631


16.1%


75,927,110


17.8%


Employment Summary

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 1,083.7 1,111.7 1,138.4 1,158.5 1,162.8
Average FTE Staff Year Costs 37,494 39,649 40,316 40,796 40,980



Program Level Detail

Epidemiology, Health Statistics, and Public Health Laboratory

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This program provides the foundation for the assessment of health for people in Washington and assists in policy development based on scientific knowledge. The program assesses health data and information needs, ensures data acquisition, data management, and data linkage capacities. The laboratory provides a wide range of analytical functions for the assessment and surveillance of infectious, genetic and chronic diseases as well as environmental contaminants. The program works closely with the Community and Family Health and Environmental Health programs. The laboratory also works closely with the Health Services Quality Assurance program to improve the analytical performance of both clinical and environmental laboratories throughout the state. The program has leadership responsibilities for developing a set of health status indicators that will be tracked by both state and local jurisdictions in the future.

The objectives of the program are to: collect, analyze, and disseminate data concerning the health and illness of the population; conduct diagnostic and analytical activities to investigate and initiate control measures for reported diseases of public health concern; and monitor the quality of services provided by clinical and environmental laboratories in the state.


Program Employment

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 190.3 185.5 187.0 187.8 190.0
Average FTE Staff Year Costs 35,543 37,931 39,680 39,252 39,208


Expenditure Detail

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries and Benefits 8,544,458 8,873,290 9,294,836 9,287,279 9,367,618
Grants and Subsidies 1,208,209 1,339,989 2,873,979 1,861,917 1,543,561
Other Operating Costs 6,149,807 4,040,571 4,446,065 4,611,627 4,425,117
Annual Total

15,902,474


14,253,850


16,614,880


15,760,823


15,336,296

Fiscal Year 1993-94 12,309,960
Biennium Total

28,212,434


30,868,730


31,097,119


Source of Funds

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
General Fund - Basic Account - State 7,244,079 6,014,596 5,348,806 6,280,215 5,952,754
General Fund - Basic Account - Federal 2,045,695 3,042,323 2,276,418 1,636,848 1,493,848
General Fund - Basic Account - Private/Local 3,126,790 2,829,452 3,117,505 3,548,754 3,550,578
General Fund - Basic Account - Private/Local Unanticipated 19,057
Hospital Commission Account - State 1,433,838 1,055,065 1,454,361 1,445,924 1,446,926
Safe Drinking Water Account - State 15,622 22,430 20,216 19,490 19,490
Public Health Services Account - State 60,335 134,833 208,262 171,190 171,190
Water Quality Account - State 36,818 55,448 45,016 46,470 46,470
State Toxics Control Account - State 50,035 17,195 72,047 42,510 42,510
Health Services Account - State 1,870,205 1,082,508 4,072,249 2,569,422 2,612,530
Annual Total

15,902,474


14,253,850


16,614,880


15,760,823


15,336,296




Environmental Health

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The Environmental Health program protects people from chemical, physical, radiation, and biological hazards in the environment. The program, in close collaboration with local health jurisdictions, has responsibility for assuring that water systems provide safe and reliable supplies of drinking water. It provides technical assistance, information, and advisories on adverse health effects of environmental exposure to toxic substances, pesticide poisonings, and illnesses caused by contaminated shellfish and foodborne organisms through investigation, data collection, and assessment. In addition, it provides community education at state and federal hazardous waste sites. In all of these activities, the program works closely with private partners whose businesses are affected by federal regulation or proposed state rules. There are several public-private advisory committees that work to develop state regulations that meet safety requirements and, at the same time, minimize disruption to affected businesses.

The objectives of the program are to: assure that public water systems provide safe and reliable supplies of drinking water; ensure the highest level possible of prevention of environmental-borne illnesses; regulate the possession and use of ionizing radiation in Washington State; prevent illness caused by ingesting contaminated shellfish through classifying growing areas, monitoring products, and providing public information and education; and prevent adverse effects of environmental exposure to toxic substances.


Program Employment

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 244.7 252.0 263.5 288.7 292.7
Average FTE Staff Year Costs 40,011 42,374 42,612 43,526 43,606


Expenditure Detail

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries and Benefits 12,285,899 13,389,624 14,063,358 15,744,961 15,999,371
Grants and Subsidies 2,542,044 1,639,702 3,109,348 1,619,625 1,080,022
Other Operating Costs 3,202,904 2,607,145 3,762,047 5,118,409 4,509,203
Annual Total

18,030,847


17,636,471


20,934,753


22,482,995


21,588,596

Fiscal Year 1993-94 15,105,062
Biennium Total

33,135,909


38,571,224


44,071,591


Source of Funds

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
General Fund - Basic Account - State 4,057,559 3,819,618 4,038,484 3,950,619 3,950,693
General Fund - Basic Account - Federal 5,601,221 5,475,653 7,980,610 8,354,773 7,442,561
General Fund - Basic Account - Federal Unanticipated 115,663
General Fund - Basic Account - Private/Local 3,500,841 3,705,892 4,007,328 4,157,517 4,149,088
General Fund - Basic Account - Private/Local Unanticipated 208,833
Safe Drinking Water Account - State 1,502,086 1,016,175 1,288,404 1,162,926 1,168,839
Waterworks Operator Certification - State 125,120 232,221 205,882 270,521 279,114
Water Resource Administration Acct - State 1,289,000 1,290,000
St/Loc Impr Rev Acct Water Sup Fac - State 43,903
Water Quality Account - State 1,152,073 1,586,780 1,486,007 1,486,530 1,486,530
State Toxics Control Account - State 1,387,950 1,345,753 1,458,781 1,376,651 1,376,495
Health Services Account - State 379,501 410,476 469,257 434,458 445,276
Annual Total

18,030,847


17,636,471


20,934,753


22,482,995


21,588,596




Health Systems Quality Assurance

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The Health Systems Quality Assurance program helps assure that health professionals, facilities, services, and systems are available, accessible, safe, effective, and affordable. The program works with 22 professional governing bodies to develop and enforce standards for health professions. It works in partnership with the health facilities and services that it licenses, relying primarily on technical assistance as the most effective tool for correcting problems and improving the level of care they provide. The program collaborates with a committee of local officials to build and maintain the statewide trauma care network and works in concert with local officials to devise strategies for increasing the quantity and quality of health care resources in underserved areas. The program assesses health care systems in communities to determine the availability and distribution of facilities and providers and is responsible for providing this information and its assessment to the Legislature. It is responsible for advising the Legislature on the need to regulate or deregulate health professions.

The objectives of the program are to: ensure health facilities operate safely; license and regulate health professions; ensure appropriate emergency medical treatment and care to victims of acute illness or traumatic injury; evaluate construction and development of new health facilities and services; and protect the health and safety of the public who stay in public lodging establishments, state facilities, and farmworker housing.


Program Employment

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 310.3 327.7 337.0 332.2 330.5
Average FTE Staff Year Costs 36,349 38,324 38,324 39,115 39,359


Expenditure Detail

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries and Benefits 14,170,262 15,735,602 16,182,173 16,274,816 16,280,475
Grants and Subsidies 7,931,003 5,951,946 6,095,593 5,561,351 5,561,226
Other Operating Costs 7,480,494 7,198,256 8,324,479 9,537,853 7,468,781
Annual Total

29,581,759


28,885,804


30,602,245


31,374,020


29,310,482

Fiscal Year 1993-94 24,152,158
Biennium Total

53,733,917


59,488,049


60,684,502


Source of Funds

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
General Fund - Basic Account - State 4,964,047 3,805,841 5,100,987 4,377,233 4,408,999
General Fund - Basic Account - Federal 905,045 1,617,534 1,478,542 1,451,526 1,516,094
General Fund - Basic Account - Federal Unanticipated 532,239 56,850 39,061
General Fund - Basic Account - Private/Local 1,827,551 2,707,974 2,628,949 2,760,751 2,760,579
General Fund - Basic Account - Private/Local Unanticipated 85,501
Medical Disciplinary Account - State 692,710 725,261 957,846 2,774,428 843,447
Health Professions Account - State 14,046,383 14,266,534 15,152,442 14,499,027 14,455,037
Public Health Services Account - State 2,320,957 2,100,000 1,800,000 1,950,000 1,950,000
Medical Test Site Licensure Account - State 600,627 579,401 599,749 769,274 582,968
Health Services Account - State 3,606,699 3,026,409 2,844,669 2,791,781 2,793,358
Annual Total

29,581,759


28,885,804


30,602,245


31,374,020


29,310,482




Community and Family Health

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The Community and Family Health program collaborates with a variety of partners to promote healthy lifestyles and environments, and increase access to some personal health care services. It works to reduce disease related to cancer, heart disease, and stroke and to interrupt the transmission of human immunodeficiency virus (HIV) and other sexually transmitted diseases. The program works to control complications from diabetes and to reduce morbidity and mortality related to tuberculosis, vaccine-preventable diseases, and both intentional and unintentional injury. It facilitates the delivery of high quality, low-cost, comprehensive family planning and reproductive health care and promotes the optimal nutritional status of low-income pregnant women, infants, and children. The program uses assessment information to assist in developing and re-directing program activities.

The objectives of the program are to: provide access to quality maternal and child health care services for children and families who have limited access to those services; implement contracts through local agencies, hospitals, and other providers to provide services; provide technical assistance to communities in meeting health goals; and provide leadership in developing comprehensive community-based services.


Program Employment

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 217.7 210.7 216.0 213.3 212.9
Average FTE Staff Year Costs 38,500 40,429 41,712 41,333 41,667


Expenditure Detail

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries and Benefits 10,560,369 10,695,898 11,286,091 11,052,303 11,113,727
Grants and Subsidies 115,162,218 113,451,696 107,219,320 145,497,533 155,109,671
Other Operating Costs 9,250,501 8,120,209 28,099,156 11,247,448 12,308,103
Annual Total

134,973,088


132,267,803


146,604,567


167,797,284


178,531,501

Fiscal Year 1993-94 100,891,521
Biennium Total

235,864,609


278,872,370


346,328,785


Source of Funds

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
General Fund - Basic Account - State 30,026,193 27,679,122 26,819,150 35,695,799 43,227,172
General Fund - Basic Account - Federal 85,308,699 95,547,521 101,549,707 116,606,515 119,698,359
General Fund - Basic Account - Federal Unanticipated 6,077,633
General Fund - Basic Account - Private/Local 1,296 33,105 275,814 350,500 349,500
Public Health Services Account - State 10,645,618 6,889,749 12,562,251 10,634,470 10,734,470
Violence Reduction/Drug Enforcement - State 241,566 234,719 234,089
Youth Tobacco Prevention Account - State 1,300,428 658,130 753,856 897,000 909,000
Health Services Account - State 1,371,655 1,225,457 4,409,700 3,613,000 3,613,000
Annual Total

134,973,088


132,267,803


146,604,567


167,797,284


178,531,501




Administration

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The Administration program provides overall agency direction, management, and administrative support required to facilitate program activities.

The objectives of the program are to provide overall agency direction, guidance, and management; public relations and information; personnel services; contract administration; rules coordination; information processing; procurement services; facilities management; and budgeting, accounting, and revenue processing administration.


Program Employment

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 112.8 127.2 126.3 130.9 131.1
Average FTE Staff Year Costs 37,104 39,636 40,024 40,568 40,815


Expenditure Detail

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries and Benefits 5,269,863 6,316,166 6,335,000 6,639,359 6,687,437
Grants and Subsidies 112,443 542 500 10,500
Other Operating Costs 3,237,952 2,699,699 2,992,074 3,319,818 3,171,004
Annual Total

8,620,258


9,015,865


9,327,616


9,959,677


9,868,941

Fiscal Year 1993-94 7,474,173
Biennium Total

16,094,431


18,343,481


19,828,618


Source of Funds

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
General Fund - Basic Account - State 4,055,050 3,693,538 3,996,858 4,101,134 4,188,382
General Fund - Basic Account - Federal 1,859,409 2,140,226 2,182,000 2,235,063 2,201,863
General Fund - Basic Account - Federal Unanticipated 59,943 2,199
General Fund - Basic Account - Private/Local 803,774 1,036,179 1,038,000 1,189,478 1,172,255
General Fund - Basic Account - Private/Local Unanticipated 12,182
Hospital Commission Account - State 96,148 96,852 98,053 98,051
Medical Disciplinary Account - State 118,703 86,913 64,980 276,525 74,506
Health Professions Account - State 1,290,837 1,585,137 1,541,939 1,455,973 1,459,963
Industrial Insurance Premium Refund - State 6,606 62,000
Safe Drinking Water Account - State 130,692 106,652 78,712 60,584 63,671
Public Health Services Account - State 42,658 26,735 26,736 31,340 32,340
Waterworks Operator Certification - State 10,742 17,911 20,689 18,478 19,884
Water Resource Administration Acct - State 113,000 113,000
St/Loc Impr Rev Acct Water Sup Fac - State 4,458
Water Quality Account - State 3,650 3,650
State Toxics Control Account - State 5,871 1,325 2,200 7,839 8,995
Violence Reduction/Drug Enforcement - State 192
Medical Test Site Licensure Account - State 72,611 66,897 67,000 146,726 125,032
Youth Tobacco Prevention Account - State 6,525 14 3,000 3,000
State Agency Parking Account - Non-Appropriated 20,036 22,000
Health Services Account - State 144,655 127,655 124,000 222,484 307,999
Annual Total

8,620,258


9,015,865


9,327,616


9,959,677


9,868,941




State Board of Health

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The State Board of Health, which operates independently of, but collaboratively with, the Department of Health, provides a public forum for development of health policy. It publishes the biennial Washington State Public Health Report that outlines health priorities for the state and provides guidance to the many state agencies that have responsibilities for assuring the health of people in Washington. The Board plays an active role in rule development and holds public forums on priority health issues.


Program Employment

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
FTE Staff Years 4.9 5.0 5.0 5.6 5.6
Average FTE Staff Year Costs 35,017 35,543 40,000 36,435 37,165


Expenditure Detail

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
Salaries and Benefits 219,968 226,127 250,000 252,468 257,178
Grants and Subsidies 33,315 56,062 22,000 58,000 58,000
Other Operating Costs 287,538 153,154 231,000 188,887 184,159
Annual Total

540,821


435,343


503,000


499,355


499,337

Fiscal Year 1993-94 410,445
Biennium Total

951,266


938,343


998,692


Source of Funds

1994-95 Actual 1995-96 Estimated 1996-97 Estimated 1997-98 Proposed 1998-99 Proposed
General Fund - Basic Account - State 37,882 8,000
Health Services Account - State 502,939 435,343 495,000 499,355 499,337
Annual Total

540,821


435,343


503,000


499,355


499,337