Research and Data Analysis

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Image of report cover 11.2522019 Employee Engagement Survey

The 2019 survey shows overall declines in employee engagement since the last major survey. Compared to 2017, there were statistically significant declines in positive responses to nine of the 24 items included in both surveys and only one statistically significant increase. Although down compared to the record-high positivity seen in 2017, the current survey compares favorably to years prior to 2017. The response rate in 2019 was 81%, the highest level of participation since the survey began in 2002. Survey results show opportunities for positive change, and in some cases, important challenges. Many of the opportunities and challenges are specific to administrations and major units, and are the subject of action planning at every level of the organization. The Employee Engagement Survey is an important component of Governor Inslee’s Results Washington initiative for performance management and continuous improvement. Survey results are used as the primary outcome measure for the goal to “Increase Washington as an employer of choice” under Goal 5: Effective, efficient and accountable government.

Image of report cover 3.51Mental Health Clubhouse Services in Washington State: An Evaluation

Under Washington State's 1915(b) Medicaid waiver authority, mental health clubhouse (MHC) services were offered from 2005 until 2012 to individuals with mental illness and/or co-occurring mental health and substance use disorders. Legislative interest in expanding MHC services prompted this evaluation, which compares Medicaid MHC clients—served between January 2009 and June 2012—to a matched comparison group who received some other form of mental health treatment (“treatment as usual”) during the same time period. Clubhouse services were expected to reduce outpatient emergency department utilization, inpatient hospitalizations, arrests, homelessness, and use of crisis/stabilization services while increasing employment rates and engagement in ongoing behavioral health treatment services. This study found that, relative to treatment as usual, MHC service receipt was associated with improvements in arrest rates and increased SUD treatment utilization but worsening rates of crisis mental health service utilization and homelessness. MHC services, as provided in Washington State during the study period, did not systematically outperform treatment as usual on other key behavioral health and quality of life measures for Medicaid-only clients.

Image of report cover 5.40Respite Needs Among Developmental Disabilities Administration No-Paid Caseload

The Washington State Department of Social and Health Services, Aging and Long Term Services Administration (ALTSA) Lifespan Respite grant staff collaborated with the Developmental Disabilities Council administered a survey to caregivers and clients to explore respite needs among the Developmental Disabilities Administration (DDA) no-paid client population. Nearly all survey respondents reported needing respite and currently relying on an informal network of friends and family members for assistance. Almost none of the caregivers were currently using assistive technology to take a break from caregiving.

Image of report cover 11.251The Foundational Community Supports Program: Preliminary Evaluation Findings

The Foundational Community Supports (FCS) program launched in January 2018 under Washington State's 1115 Medicaid Transformation Project. FCS provides supportive housing and supported employment services to clients with complex physical or behavioral health care needs. This brief reports preliminary outcomes for 1,736 persons enrolled during the first nine months of program operations. We found that Aging and Long-Term Support (ALTSA) and Health Care Authority (HCA) clients enrolled in supported employment services experienced statistically significant improvements in employment rates, earnings, and hours worked. Similarly, clients enrolled in supportive housing services realized increased transition out of homelessness. Supportive housing services were also associated with reductions in outpatient emergency department and inpatient utilization for Medicaid beneficiaries served through HCA. Longer-term evaluation findings will be provided by the Oregon Health Sciences University Center for Health Systems Effectiveness, in their role as the independent external evaluator for the 1115 Waiver.

Image of report cover 11.2482019 Social and Health Services Client Survey

Between September 2018 and April 2019, the Research and Data Analysis Division of the Washington State Department of Social and Health Services (DSHS) conducted 1,222 telephone interviews with randomly selected clients who received services between May 2017 and April 2018. Most services covered in the survey were provided by DSHS; medical assistance, mental health services and substance use treatment services were provided by the Washington State Health Care Authority; and children and family services were provided by the Department of Children, Youth, and Families. Clients were asked about their satisfaction with social and health services and for recommendations for change. The 2019 survey is the most positive on record. Over half (12 of 20) of the standard questions are at new highs. Compared to the 2017 survey, there were statistically significant improvements in ease of getting services, reaching a live person, timely responses to calls, knowledge of available services, ease of getting information, and client involvement in receiving services. There were no statistically significant decreases. Comments show that there are still some areas where many clients desire improvement, including more information about what services are available, easier ways to connect with staff, and streamlined application processes.

Image of report cover 11.249The Snohomish Diversion Pilot: Treatment Services for Homeless Individuals with Substance Use Disorders as an Alternative to Jail

The Snohomish Diversion Pilot (SDP) is a jail diversion program established by the 2018 Legislature (ESSB 6032) with an allocation of $800,000 for state fiscal year 2019 and additional funding provided by local sales tax dollars. Homeless individuals at risk of arrest for minor infractions who have substance use or co-occurring mental health and substance use disorders (SUD) were referred to the SDP by embedded social workers and law enforcement officers throughout Snohomish County. Eligible individuals amenable to treatment received on-site medical and behavioral health screenings by staff at the 44-bed Snohomish Diversion Center and were connected to treatment, social services, and housing resources. This report describes short-term, pre-post outcomes for 192 SDP participants who enrolled from July through October 2018. Compared to the three months prior to enrollment, engagement in SUD treatment services more than doubled, jail bookings and the average number of days jailed decreased, and almost half of participants were re-housed. Due to the short follow-up and lack of comparison group, findings should be considered preliminary. Further analyses is required to confidently assess the effectiveness of the program.

Image of report cover 11.250Prosecutorial Diversion of Individuals with Serious Mental Illness Involved in the Criminal Justice System

Program Descriptions and Participant Characteristics of DSHS-Contracted Diversion Programs Using different approaches, three DSHS-contracted prosecutorial diversion programs aim to divert individuals with behavioral health conditions from the criminal justice system and competency services, into outpatient behavioral health services. This report describes participant characteristics at program entry for the 354 individuals who entered the three prosecutorial diversion programs from January 2017 to March 2019 and the behavioral health, criminal justice, and employment history for a subset of participants. Key findings include: 1. The Lourdes (Tri Cities) and LINC (King County) programs had higher percentages of participants with court orders for competency services in the five years prior to program entry, and more extensive criminal histories, compared to the Spokane County program; 2. A larger proportion of the LINC program participants were hospitalized for inpatient mental health services and were diagnosed with a psychotic disorder compared to the other programs; 3. The Lourdes program enrolled more participants with felony charges into their program compared to the LINC and Spokane County programs.

Image of report cover 6.64The Maternal Well-Being of Washington State’s TANF Population

This descriptive report provides information on the well-being of new mothers who receive Temporary Assistance for Needy Families (TANF) and their newborns in order to identify potential service gaps and needs for this vulnerable population. Findings indicate that women who give birth and receive TANF have complex needs and face significant barriers to well-being including housing instability, behavioral health conditions, low education levels, and significant health problems. Given these needs, services to ensure well-being for new mothers on TANF are multifaceted and require coordination across service systems and agencies.

Image of report cover 6.63Washington State Youth Treatment Implementation (WSYT-I) Program: Final Evaluation Report

This report describes the outcomes of the Washington State Youth Treatment Implementation (WSYT-I) Program. Funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) from 2016 through 2019, the program provided evidence-based standardized assessment (GAIN) and substance use disorder (SUD) treatment (A-CRA), in conjunction with care coordination and recovery support services to youth (age 12-18) with SUD diagnosis, including those with co-occurring mental health needs. Self-reported results from post-enrollment interviews indicated that WSYT-I participants had increased rates of abstinence, reduced criminal justice involvement, and experienced fewer health, behavioral health, or social consequences from alcohol and drug use six months after enrollment. Youth who received WSTY-I and similar services were more likely to complete treatment than a statistically matched group of comparison youth who shared similar baseline characteristics to WSYT-I participants. Participation in WSYT-I or similar services also led to increased utilization of SUD outpatient and case management services. We did not find statistically significant differences between the WSYT-I and comparison youth in medical utilization, criminal justice involvement, and employment outcomes.

Image of report cover 6.63Basic Food Client Characteristics

This report presents a descriptive portrait of Basic Food households and the working-age clients within them. Working-age Basic Food clients face multiple barriers to economic well-being, including low education, low wages, and significant behavioral health needs. Understanding recipients’ barriers to economic well-being can help DSHS develop additional strategies to support low-income households as they work toward increased earnings and improved well-being.

Image of report cover 6.65What Follows Basic Food Exit?

This report assesses the frequency of “successful exits” from the Basic Food program and examines how the characteristics of successfully exiting households differ from other households exiting from, and remaining on, Basic Food. Success is based on consistent household earnings significantly above the poverty level in the two years following exit without a return to Basic Food. Results show that “successful exits” are more likely for households with higher educational attainment and a track record of employment and earnings.

Image of report cover 6.60TANF Supported Employment Pilot Participant Characteristics

This report describes 219 participants who enrolled in the Temporary Assistance for Needy Families Supported Employment Pilot (TANF SEP) between April 2015 and June 2017. The TANF SEP program used the Individual Placement and Support (IPS) model of supported employment services to help TANF clients with mental health and co-occurring substance abuse disorders obtain and maintain competitive employment. Individuals were eligible for participation in the pilot if they were unemployed and receiving TANF, met access to care standards for mental health treatment, expressed an interest in being employed, and lived in Skagit or Snohomish counties. TANF SEP participants faced a variety of barriers to employment, including housing instability, poor employment history, behavioral health treatment needs, other chronic health conditions, criminal justice system involvement, and childcare needs. Despite these challenges, employment rates almost doubled for program participants who enrolled in the program by June 2016 between the pre- and post-periods, and housing instability rates decreased by 22 percent. The report has two key limitations: (1) it is based on a small subset of TANF recipients in a restricted geographic area, so it may not be generalizable to Washington’s broader TANF population; and (2) the analysis did not use a comparison group necessary to assess the net effects of the program. It is unclear if the changes in observed outcomes in employment are due to participation in the program or other factors, such as participant motivation.

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