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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 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 187 SDP participants who enrolled from July through October 2018. Compared to the three months prior to enrolment, engagement in SUD treatment services 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 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..

Image of report cover 4.102Washington State’s Medication Assisted Treatment – Prescription Drug and Opioid Addiction Project – Preliminary Outcomes through Year Two

This report examines years one and two of program implementation for the Washington State Medication Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) program. MAT-PDOA was a three year, federally funded initiative to increase access to MAT with buprenorphine in Grays Harbor, King, and Thurston counties and was awarded to Washington State’s Department of Social and Health Services in August 2015. Building upon the success of year one, MAT-PDOA provided MAT with buprenorphine to 532 patients through year two and 51 percent of all enrolled patients were in the program for a year or longer. At six months after enrollment in treatment, MAT-PDOA patients reported significant reductions in alcohol and drug use rates, including any opioids, cannabis and methamphetamine. Similar to year one findings, self-reported reductions in adverse outcomes related to opioid use disorder, including improvements in employment and school enrollment, reductions in inpatient and emergency department utilization, and increases in outpatient service utilization were seen six months after enrollment.

Image of report cover 11.2462018 Foster Parent Survey: DCYF Foster Parents Speak

This report describes the results of the 2018 DCYF Foster Parent Survey, which was previously conducted annually by the DSHS Children’s Administration. From September 2017 through August 2018, DSHS surveyed 1,349 foster parents about their satisfaction with the support and training provided by DCYF (Children’s Administration through June 2018) and private agencies. Relative to 2017, more foster parents said they get adequate support, can get help when they ask for it, find that social workers listen to their input, are treated as part of the team, and get adequate information about the needs of children placed with them. Responses about the quality of training continue to be very positive – 87% agreed that their training was somewhat adequate or more than adequate. Written comments show that there are still some areas where many desire improvement, including information sharing, inclusiveness, reimbursements, and efficient processes. Foster parents continue to emphasize that participation of experienced foster parents and the ability to interact with one another add value to training.

Image of report cover 9.118Evaluation of Integrated Managed Care for Medicaid Beneficiaries in Southwest Washington: First Year Outcomes

On April 1, 2016, two counties in Southwest Washington (Clark and Skamania) became the first region in Washington to adopt an integrated managed care (IMC) model. This evaluation examines the impact of the transition to IMC on the health and social outcomes of Medicaid beneficiaries in the IMC region. Difference-in-difference approaches were used to examine changes in a broad set of health care performance metrics in the first year after implementation of the IMC model (April 1, 2016 to March 31, 2017), relative to beneficiary experience in the prior year. We report findings derived from both simple t-tests and generalized estimating equation (GEE) models that control for the potential confounding effect of regional differences in beneficiary characteristics. Of the health and social outcome metrics examined, two-thirds showed no significant relative change in Southwest Washington, compared to the balance of state. The outcome measures that had significant differences were mostly positive for the Southwest region, with few statistically significant negative results.

Image of report cover 3.50First Episode Psychosis: Predicting the Risks of Psychosis Using Administrative Data

This report describes key risk indicators associated with first episode psychosis (FEP) among youth and young adults between the ages of 12 and 25. The report also presents a model to identify individuals with the highest risks for experiencing FEP using administrative data. We found that mental health history and mental health service utilization are the strongest predictors of FEP. High-risk individuals often have encounters with mental health and substance use disorder treatment facilities, child welfare agencies, and hospital emergency rooms within six months before being first diagnosed with psychotic disorders. They are also likely to be receiving other social services such as Basic Food and to be involved with the criminal justice system.

 

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