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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.

Image of report cover 7.1182019 Caregiver Survey

Between October 2018 and August 2019, DSHS surveyed 1,342 caregivers (529 licensed and 813 kinship) who had a child in care within six months of the sampling date (August and November, 2018; February and May, 2019). 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 to provide services to caregivers. They were also asked to offer recommendations for change.

Image of report cover 7.117Home Visiting Services for TANF Families with Young Children: Second Year Outcomes

This report examines second year outcomes for families who enrolled in the TANF Home Visiting program between May 2015, when the program began, and October 2016. Outcomes for participating families during the 24 months following enrollment were compared to outcomes for similar families receiving TANF who did not enroll in home visiting. Parents enrolled in TANF Home Visiting were more likely than comparison parents to engage in WorkFirst activities that prepared them for work, including education and training activities, and to use child care subsidies. Infants born to parents in TANF Home Visiting also experienced better health and safety including fewer emergency department visits and visits for injury treatment in the second year after enrolling, and reduced likelihood of being placed out-of-home in the first year after enrolling. The results from the second year of follow-up for the TANF Home Visiting program are promising and suggest that home visiting services may impact the behavior of parents and improve outcomes for kids. The DSHS Economic Services Division should consider whether to make this type of service available to more TANF families, especially those families who are expectant or have a new baby.

Image of report cover 7.116In-Home Service Use and Family Risk for Child Welfare Involved Families: Findings from Washington State

This report describes in-home service utilization and family risk factors for families involved in the Washington State child welfare system from 2013 to 2016. In-home services are available to child welfare-involved families for the purposes of strengthening parenting capacity and supporting child safety. Family risk was measured from a variety of administrative data sources and included measures of domestic violence, parent criminality, parent substance abuse, parent mental illness, economic stress, homelessness, and prior child welfare involvement. Results show that more than half of child welfare-involved families experienced five or more family risk factors, yet only one out of ten families received an in-home service. The rate of in-home service use was especially low (6 percent) for families with children who remained at home, while half of the families with a child in a long-term out-of-home placement received an in-home service.

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.



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