Research and Data Analysis

2023 Social and Health Services Client Survey

Between October 2022 and April 2023, the Research and Data Analysis Division of the Washington State Department of Social and Health Services (DSHS) conducted 1,157 telephone interviews with randomly selected clients who received services between May 2021 and April 2022. Most services covered in the survey were provided by DSHS. Medical assistance, community-based mental health services, and substance use disorder services were provided by the Washington State Health Care Authority. 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 2023 Client Survey is the second survey to gather client feedback since the COVID-19 pandemic. Results suggest overall declines in satisfaction since the last major survey in 2021, much of which can be attributed to the extensive and continuing impact of the pandemic. Areas of significant decline indicate challenges with access to staff and ease of receiving services. Despite these challenges, clients remain highly satisfied with how they are treated by staff and the quality of the services they receive. Comments show that clients appreciate remote options for service delivery, but would like shorter wait times on the phone, faster and simpler application processes, and more user-friendly online systems.

Characteristics and Service Use of Young Adults in Extended Foster Care

Extended Foster Care (EFC) in Washington State allows eligible young adults who are dependent at age 18 to receive case management support and placement services through their 21st birthday. This report uses linked administrative data to measure demographic characteristics, prior foster care experiences, support needs, and service connections from ages 17 to 21 for three groups of young adults exiting foster care with different degrees of EFC participation (EFC-Full, EFC-Early Exit, No EFC) and a group of same-age young adults enrolled in Medicaid. Young adults exiting foster care, regardless of duration in EFC, have higher rates of support need indicators compared to the Medicaid group. Results highlight a need to ensure that young adults in and exiting foster care maintain connections to supportive services, such as health care, economic and housing programs, and independent living and transition services. This analysis contributes to a multipart Extended Foster Care systems assessment for the Department of Children, Youth, and Families.

Factors Predicting APS Involvement Among Persons Receiving Long-Term Services and Supports

The Adult Protective Services (APS) program administered by the DSHS Aging and Long-Term Support Administration investigates reports of self-neglect, financial exploitation, neglect, or abuse of vulnerable adults in Washington. In 2018, APS received 60,038 reports of abuse and neglect. This report is part of a series of analyses examining factors associated with the risk of being identified as an alleged or substantiated victim in an APS investigation. This report extends earlier descriptive analyses and predictive modeling (Bauer et al. 2022a, Bauer et al. 2022b) to better understand the association between potential risk and protective factors and APS outcomes among persons receiving Medicaid-paid long-term services and supports (LTSS), including services provided through ALTSA and the DSHS Developmental Disabilities Administration (DDA). Informed by findings from the previous reports, separate risk models are estimated by age group, allegation type (self-neglect and non-self-neglect), and substantiation status.

2021 Direct Service Workers Staff Stability Survey Descriptive Analysis: Findings from the National Core Indicators® Pilot Survey of Washington State Agencies

In the fall of 2022, the National Core Indicators® Aging and Disability organization administered a pilot survey to gather information on the direct service workforce in Washington whose primary job responsibility is to provide care and support to the aging and disabled population. Despite a low response rate among eligible agencies in Washington, a few key themes emerged from a descriptive analysis of the survey responses. This report provides a descriptive profile of the responding agencies, highlights key themes from the substantive sections of the pilot survey, and summarizes challenges in implementing the survey in Washington.

DSHS Economic Services Administration Service Trends Before and During the COVID-19 Pandemic

This study describes changes in the number of participants in four public assistance programs before and during the COVID-19 pandemic: 1) Temporary Assistance for Needy Families (TANF), 2) Basic Food, 3) Aged, Blind, and Disabled (ABD) cash assistance program, and 4) Housing and Essential Needs (HEN) Referral program. The number of TANF and Basic Food recipients dramatically increased during the pandemic and, at the end of 2021, caseloads remained above pre-pandemic levels. In contrast, the number of ABD recipients increased only slightly during the pandemic, while the number of HEN Referral recipients remained the same during early months of the pandemic before declining significantly. Trends across subgroups, such as race/ethnicity, age, region, and homeless status are also examined.

The Well-Being of Washington State’s Children During the COVID-19 Pandemic: Behavioral Health Trends

This report uses Medicaid claims data to examine trends in children’s behavioral health diagnoses and services before and during the COVID-19 pandemic in Washington State. We examine trends in outpatient mental health services, claims with specific mental health diagnoses, claims with a suicide or self-harm diagnosis, and mental health and substance use-related emergency department claims. Trends across gender and race/ethnicity are also examined.

First Episode Psychosis: Estimating Annual Incidence Using Administrative Data

This report presents estimated incidence rates of first episode psychosis (FEP) among the Washington Medicaid population in state fiscal year (SFY) 2021. Using administrative data from 1997 forward, we identified 4,388 Medicaid enrollees in Washington State who received their first psychotic disorder diagnoses in SFY 2021. The overall incidence rate of FEP was estimated at 235 per 100,000 Medicaid enrollees. The demographic characteristics and geographic distribution of Medicaid enrollees experiencing FEP are presented in the report.

Synthetic Estimates of Substance Use Treatment Need in Washington State

This report provides synthetic estimates of substance use disorder (SUD) treatment need among the low-income population in Washington State. By calibrating need estimates derived from Medicaid data to SUD prevalence rates reported by the National Survey on Drug Use and Health, we produced estimates of SUD treatment need for the Medicaid population as well as the low-income population not enrolled in Medicaid. We found that 4.4 percent of low-income youth and 15.8 percent of low-income adults had SUD treatment need in 2019. Results are presented by county and age group.