Research and Data Analysis

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Image of report cover 11.258Assessment of Phase 1 Co-responder Program Staffing Needs

Following the Trueblood et al. v. Washington State DSHS et al. lawsuit, the Trueblood Contempt Settlement Agreement established a multi-phase plan for providing services and treatment to persons in the criminal court system aiming to reduce their likelihood of recidivism. This report fulfills the Settlement Agreement’s requirement for Washington state to “perform an assessment of law enforcement agency co-responder mental health staffing needs to guide future funding requests” in the Phase 1 regions, which include 10 Washington counties. RDA conducted and analyzed data collected from two surveys to assess mental health field response and co-responder program staffing needs in Phase 1 regions. The primary survey represented law enforcement agencies (LEAs) identified by the Washington Association of Sheriffs and Police Chiefs (WASPC) within these regions. A secondary survey represented Behavioral Health Agencies (BHAs) participating in existing co-responder programs that were identified by referral from LEAs. This report presents a detailed analysis of co-responder program staffing and needs, a general description of other issues addressed in the survey, and interpretation of results.

Image of report cover 11.257Spokane Better Health through Housing: A Pilot Program Connecting Homeless High Emergency Department Utilizers to Housing

Funded by the 2019 Legislature (ESHB 1109), the Better Health Through Housing pilot program sought to reduce health care costs by providing housing and other services to homeless, frequent emergency department visitors with complex healthcare needs. The program was administered by the Department of Commerce and implemented by Better Health Together, an Accountable Community of Health located in northeastern Washington. This report describes program implementation and the experiences and characteristics of individuals referred to the pilot, including their: 1) progression through key program milestones; 2) health histories; and 3) medical utilization patterns before and after referral to the program.

Image of report cover 7.1232020 Caregiver Survey Report

Between November 2019 and September 2020, DSHS surveyed 1,346 caregivers (591 foster and 755 kinship) who had a child in care within six months of the sampling date (August and November, 2019; February and May, 2020). These caregivers were asked about their satisfaction with support, licensing, training, and information provided by the Department of Children, Youth, and Families (DCYF) and private agencies contracted by the Department. They were also asked to offer recommendations for change. The COVID-19 pandemic began five months into the 10-month survey fielding period, but overall perceptions of support remained stable compared to the prior survey. Among foster caregivers, there was a statistically significant decrease in positive responses since 2019 for social worker listening. Foster caregivers were more likely than kinship caregivers to say they had adequate support, could get help when they asked for it, and to find Licensing Division staff knowledgeable. Kinship caregivers, who typically know the children before placement, were more likely to say they had adequate information on the needs of the children. Responses to questions about licensing staff show high levels of satisfaction among caregivers who have interacted with the Division of Licensed Resources. Written comments show that there are still some areas where many desire improvement, including information sharing, inclusiveness, reimbursements, and efficient processes. Many caregivers requested the continuation of online training, with updated content and more opportunity for interaction. Caregivers continue to emphasize that participation of experienced caregivers adds value to training.

Image of report cover 11.256Trends in State Health and Social Service Use among United States Veterans in Washington State

The Veterans Health Administration (VHA) provides care to an especially vulnerable population of individuals, some of whom are also receiving state-funded health and social services. This report extends prior RDA work examining state social and health service use by Veterans living in Washington State. To better understand if state service utilization by Veterans changes over time, this report examines the use of state-administered social and health care services from 2008 through 2018 by a cohort of Veterans who were enrolled with the VHA in calendar year (CY) 2016. Overall, use of state social and health services by Veterans increased in the years following the 2008 recession, but has decreased in recent years.

Image of report cover 11.255Homelessness and Housing Instability Among Veterans in Washington

This report examines homelessness and housing instability among Washington Veterans in CY 2018. By drawing on data from both state- and Veterans Health Affairs (VHA)-administered programs, this report provides an in-depth picture of housing instability and homelessness among Veterans. Differences in rates of homelessness and housing instability are examined by age, sex, race/ethnicity, geography, and engagement in the VHA Primary Care Management Module (PCMM).

Image of report cover for Children Behavior Health DashboardBehavioral Health Treatment Needs and Outcomes among Medicaid Children in Washington State

This dashboard provides a snapshot of behavioral health needs and outcomes for children and youth under age 21 on Medicaid in Washington State and for the subgroup in foster care in SFY 2014-2018. Rates of behavioral health needs are also compared across demographic categories, region, county, Medicaid coverage type, cross-system involvement, and abuse and neglect history. Outcomes examined include behavioral health treatment penetration and utilization, psychotropic polypharmacy, juvenile justice involvement, emergency department utilization, injury rates and teen pregnancy.

Image of report cover 7.122Evaluation of the Health Care Authority’s First Steps Maternity Support Services Program in Washington State

This report describes Maternity Support Services (MSS) utilization from 2009 to 2018 and assesses the effects of prenatal MSS on health behaviors and birth outcomes. Washington State’s legislatively mandated program change in 2009 resulted in a decrease of overall MSS utilization from 69% in 2009 to 43% in 2018. Clients receiving prenatal MSS had improved health and birth outcomes during 2017-2018. After adjusting for demographics and clients’ risk factors during pregnancy, prenatal MSS was significantly associated with a reduction in smoking during pregnancy, a reduction in preterm birth, and an increase in initiation of breastfeeding. Clients receiving both prenatal MSS and prenatal care during pregnancy had stronger improved health and birth outcomes comparing to those receiving no MSS or prenatal care.

Image of report cover 4.107Becoming Employed Starts Today (BEST)

Becoming Employed Starts Today (BEST) was a federally funded, five-year pilot program that offered evidence-based supported employment services to individuals with severe mental illness and co-occurring substance disorders at four community-based mental health sites. This report summarizes the results of an evaluation of BEST, which compared outcomes for 362 individuals who enrolled in BEST between March 2015 and September 2018 at two program sites—one rural, one urban—to a statistically matched comparison group. BEST participation was associated with significant improvements in employment rates, average hours worked, and average number of quarters employed. BEST also reduced arrest rates and increased participation in Washington State's food assistance program, Medicaid, and mental health services. BEST participants also reported reductions in psychological distress and institutionalizations/homelessness, and improvements in overall functioning in daily life, employment rates, and school attendance compared to baseline.

Image of report cover 7.121Substance Use Disorder Treatment Penetration among Child Welfare-Involved Caregivers

This report outlines the extent of substance use disorder (SUD) treatment need and assesses treatment penetration rates for child welfare-involved caregivers across Washington State using administrative data. Many caregivers involved in the child welfare system have indications of SUD but fewer than half of child welfare-involved caregivers with SUD received SUD treatment. Rates of SUD treatment among child welfare-involved caregivers also varied considerably across Washington State.

Image of report cover 7.120Washington State’s 1115 Family Planning Demonstration Evaluation: Findings from January 2012 to May 2018

The 1115 Family Planning Demonstration Waiver in Washington State provides family planning and family planning-related services to low-income individuals not otherwise eligible for Medicaid. This report describes the access and utilization of family planning and family planning-related services and how services are impacting maternal and child outcomes in Washington State. The study examines three target populations eligible for services during the most recent waiver period, January 1, 2012 through May 31, 2018. The Affordable Care Act (ACA) resulted in an 88 percent decline in Family Planning Waiver enrollment and changed the age composition of the program. Recently pregnant women who used a most/moderate effective contraceptive method had longer interpregnancy intervals, however there was no statistically significant impact on low birth weight or pre-term birth outcomes.

Image of report cover 6.67Transportation Initiative: Evaluating the Impact of Expanded Transportation Support Services on Community Service Office Outcomes

The Transportation Initiative (TI) was a legislatively funded pilot program implemented that sought to remove transportation-related barriers to financial independence for WorkFirst clients. This evaluation examines the impact of TI pilot participation on aggregate outcomes for the 16 Community Services Offices (CSOs) that entered the TI pilot in February 2019 relative to a comparison group of non-participating CSOs. Outcomes include changes in WorkFirst caseload and work participation, employment, and sanction rates. Descriptive information comparing changes in TS service expenditures and estimated penetration rates between the pre- versus post-periods is also provided. A companion report provides summary information on the $2 million spent on TI program service and voucher expenditures and TI client characteristics from January 2016 through June 2019.

Image of report cover 6.66Transportation Initiative: Expanding Transportation Support Services for WorkFirst Clients

The Transportation Initiative (TI) was a legislatively funded pilot program implemented by the Department of Social and Health Services' Economic Services Administration (DSHS-ESA) across 26 Community Service Offices (CSOs) in Washington State. The TI pilot sought to reduce WorkFirst clients' barriers to financial independence by improving access to transportation support (TS) services and expanding the range of available TS services. This report summarizes the $2 million in TI program service and voucher expenditures and the characteristics of clients served from January 2016 through June 2019. A companion report will evaluate the impact of the TI on CSO-level measures of financial independence, caseload, and WorkFirst sanction rates.

Image of report cover 7.119Use of Effective Contraceptive Methods by Women on Medicaid in Washington State

This report describes utilization of the most and moderately effective contraceptive care (MMEC) from 2014 to 2018 for Medicaid-eligible women of reproductive age in Washington State. The report also estimates unmet contraceptive need of Medicaid-eligible women and highlights the MMEC as a performance measure for Washington’s managed care organizations (MCO). We found that Medicaid-eligible women ages 21-30 and Non-Hispanic White women used more MMEC than other age and race/ethnicity groups. Among women with a recent birth, adolescents (ages 15-20) and Hispanic women used more MMEC than older women and other race/ethnicity groups. Contraceptive need was met for the majority of Medicaid women of reproductive age, leaving opportunities for improvement to promote the use of effective contraceptive methods at one in eight adolescents and one in five 21-44 year olds. The variation in estimated unmet need of effective contraceptive use by each MCO suggests that improvement on reporting is needed for some MCOs.

 

Image of report cover 9.119Washington State Behavioral Health Treatment and Recovery Support Services Utilization

In September 2019, the Centers for Medicare and Medicaid Services (CMS) awarded Washington state $3.8 million under the §1003 SUPPORT ACT to develop a policy framework. This framework will guide future activities to advance statewide whole-person, integrated substance use disorder (SUD) treatment and recovery service improvements. An understanding of the current utilization of behavioral health treatment and recovery support services is crucial to identifying both strengths and gaps in the existing behavioral health system in Washington.

 

 

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