Washington State Department of Social and Health Services

Transition to Adulthood - An Analysis of the National Youth in Transition Database Survey Data for Washington State

This report examines results of the first National Youth in Transition Database survey of 17-year-old youth in foster care in Washington. A total of 419 youth, or 92 percent of those eligible, participated in the survey. A majority of the surveyed youth report going to school, having no barriers to completing their education, living in a stable setting, having emotional and financial support, and receiving medical treatment as needed. However, the youth also report serious risk factors such as history of involvement with the criminal justice system (35 to 48 percent of the respondents, depending on the questions asked), history of behavioral health problems (34 to 44 percent) or housing instability (19 to 37 percent).

State/County: Trends in Social Service Use, For State Fiscal Year 2008

These Chartbooks provide local human service information for government planning, monitoring and funding purposes. For each county and for the state as an aggregate, we identify service use levels, DSHS client-based risk factors, demographics, and geographic detail for:

• Infants and their birth parents
• Youth with high levels of adverse childhood experiences in their birth families
• Youth and adults with behavioral health needs (mental health and alcohol/drug treatment)
• Youth and adults with criminal justice involvement
• Working-age adults and children with disabling health conditions

This one-time project was funded by the federal Substance Abuse and Mental Health Service Administration, through the Washington State Mental Health Transformation Project. Data provided is for State Fiscal Year 2008.

Disability Caseload Trends and Mental Illness: Incentives under Health Care Reform to Invest in Mental Health Treatment for Non-Disabled Adults

Mental illness impacts health outcomes and program costs across the social and health services spectrum. This paper documents the role of mental illness in driving disability caseload growth and health care costs. With the expansion of Medicaid under federal health care reform to more non-disabled low-income adults, and with an enhanced federal share of costs for the Medicaid Expansion population, this paper shows that states have an incentive to invest in mental health treatment for non-disabled adults prior to persons becoming functionally impaired to the point of disability.

The Health Impact of Substance Abuse: Accelerating Disease Progression and Death

Substance abuse is a key driver of adverse outcomes across the spectrum of health and human services. In the areas of medical service utilization and potentially avoidable medical costs, research has shown that substance abuse increases the risk of hospitalization, increases the risk of acquiring infectious diseases, and is associated with drug-seeking behavior that results in extreme Emergency Department (ED) utilization. This study documents another pathway through which untreated substance abuse increases medical costs: by increasing the risk of onset and accelerating the progression of cardiovascular disease. This study leverages multi-year longitudinal data available in the DSHS Integrated Client Database to analyze long-term patterns of onset of hypertension, risk of progression from hypertension to more serious cardiovascular disease, medical costs, and mortality.

The Washington State Problem Solving Court Strategic Planning Survey

In Spring 2011, the Department of Social and Health Services’ Division of Behavioral Health and Recovery conducted a survey of 59 problem solving courts that address problems of substance abuse and dependency in communities across the state of Washington. This presentation highlights the results based on responses from 35 of the courts. The survey gathered information on drug court policies and procedures and the perceptions of drug court administrators, judges and their staff concerning the potential benefits of uniform policies and practices, the degree of local and state collaboration with drug courts, and desirable components of a statewide strategic plan to help promote the sustainability of problem solving courts. The survey documented that most of the drug courts work with adult felony drug offenders who are chemically dependent at the time of admission. Nearly all of the courts reported that they conduct random drug tests, followed by court sanctions for infractions. Support for drug courts was perceived to be more common at the local level than at the state as evidenced by strong collaboration and coordination between the courts and local agencies and organizations. Two themes surfaced frequently: the need for a statewide training strategy for court professionals and the need to communicate problem-solving court effectiveness to the general public.

A Profile of Housing Assistance Recipients in Washington State by Household Type

This report examines differences in rates of DSHS social and health service use, employment and arrests by household composition for 35,908 people who received assistance from four housing and homelessness prevention programs in state fiscal year 2010. The four household types are included in the analysis are households made up of one adult plus children, households with two or more adults plus children, unaccompanied adults, and “other” households (i.e., unaccompanied minors, and multiple adults without children). Findings show that differences in service use across the housing programs (Transitional Housing, Emergency Shelter, Permanent Supportive Housing, and Homelessness Prevention and Rapid Re-housing) reflect differences in the types of households that each program serves, combined with DSHS program eligibility requirements.

Impact of Housing Assistance on Short-Term Homelessness

This report examines whether receiving housing assistance from local housing providers reduced the subsequent likelihood of self-reported homelessness. Two groups of DSHS cash and food assistance clients with recent spells of recorded homelessness were used in the analysis: (1) those who received assistance in one of four housing programs recorded in Commerce’s Homeless Management Information System (HMIS), and (2) statistically matched comparison groups of clients who did not receive housing assistance recorded in HMIS. Results show that housing assistance recipients in all four housing programs were significantly less likely than their matched peers to experience homelessness at 7 to 9 months follow-up.

2011 Client Survey DSHS Clients Speak

The 2011 Department of Social and Health Services Client Survey is the seventh client survey conducted by the Department since 2001. The main purpose of this statistically valid telephone survey is to help leadership and managers understand how clients experience our programs, to see how program changes affect client satisfaction, and to incorporate customer input into strategic planning and continuous improvement. 1,180 clients were asked about their satisfaction with the Department and for their recommendations for change.

Activity Report 2010: Washington State Institutional Review Board

This report provides an overview of the Washington State Institutional Review Board. It summarizes the Board's authority and functions, outlines the human research review process, and describes major activities during January to December 2010. It also includes a log of all research projects reviewed during this period.

A Profile of Housing Assistance Recipients in Washington State: History of Arrests, Employment, and Social and Health Service Use

This report examines histories of social and health service use, employment, and arrests for individuals who received assistance from housing programs recorded in the Department of Commerce’s Homeless Management Information System and who were also served by the Department of Social and Health Services at least once in recent years. These jointly served clients experienced increases in cash assistance, food assistance, and medical coverage over a five-year period leading up to and including SFY 2010. Their employment and arrest rates rose and then declined over the same time. People who received help from the Homelessness Prevention and Rapid Re-housing (HPRR) and Transitional Housing Programs tended to have similar demographic, employment, arrest, and social and health service use profiles. In addition, recipients of Emergency Shelter and Permanent Housing and Permanent Supportive Housing tended to be more similar to one another.

Saving Costs and Transforming Lives through Integrated Case Management in Washington State Human Services

From front-line service delivery to integrated, back-end technology solutions, Washington State is taking conscious and deliberate steps to realign social service delivery for clients and families with complex needs. Integrated service delivery for these clients results in better outcomes through coordinated case management, fewer points of entry for clients, fewer barriers to care, slower disability progression, less emergency and crisis care, reduced inpatient and institutional care, and lowered costs. Research supporting these findings is ongoing and the results so far exceed expectations. Eight Integrated Case Management initiatives are identified here, as well as integrated Information Technology directions that operate in conjunction with the initiatives to support the efforts.

Assessment Findings for Persons with Developmental Disabilities Served in Residential Habilitation Centers and Community Settings

This report expands upon analyses conducted with more limited assessment data published in early 2010. The assessments of support needs are from: 1) the Supports Intensity Scale (SIS), a measure of support needs specifically designed for individuals with developmental or similar disabilities, and 2) acuity scales based on the Division of Developmental Disabilities (DDD) Support Assessment that are designed to measure level of risk or urgency of need for care. The current report updates the earlier findings using more complete assessment data that have since become available for Residential Habilitation Center (RHC) clients.