Research and Data Analysis

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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.


Image of report cover 7.115Identifying Infants at Risk of Adverse Outcomes Using Administrative Data: Findings from Washington State

This report summarizes a set of predictive models which used administrative data available at birth to predict adverse outcomes for children on Medicaid. The three outcomes of interest were: 1) infant mortality, 2) Child Protective Services involvement before age four, and 3) developmental disorder diagnosis before age four. The findings demonstrate the utility of combining birth certificate information and other state administrative data about maternal and child factors such as low birth weight, maternal child welfare involvement, and number of previous births to identify infants that are most at risk of adverse outcomes.


Image of report cover 3.49The Impact of Mental Health Court on Recidivism and Other Key Outcomes

This report presents results from a study examining outcomes for participants of the King County District Court Regional Mental Health court. The therapeutic court aims to reduce recidivism and improve community safety by facilitating behavioral health treatment for individuals with a mental disorder who are involved in the criminal justice system. Over a one year period, the mental health court significantly improved outcomes for participants across multiple domains. Mental health court participants had significantly lower rates of re-offending and psychiatric hospitalization, and fewer incarceration days and emergency department visits, relative to a matched comparison group.


Image of report cover 7.114Service Use, Risk Factors, and Assessments among ECLIPSE, ECEAP, and ESIT Clients

This report examines the children enrolled in three Department of Children, Youth, and Families (DCYF) Family Support and Early Learning Program Division programs: Early Childhood Intervention and Prevention Services (ECLIPSE), Early Childhood Education and Assistance Program (ECEAP), and Early Support for Infants and Toddlers (ESIT). The aims of the report were to examine overlaps between ECLIPSE and the other two programs, consider the feasibility of using assessments from ESIT and/or ECEAP to evaluate outcomes for the ECLIPSE population, and assess service use and risk factors of the population(s).


Image of report cover 11.247Use of State Health and Social Services Among United States Veterans Living in Washington State

This report describes the characteristics, service needs, and service receipt of Veterans in Washington State. We found that 17 percent of Veterans enrolled in Medicaid and/or received a social service from a state agency in 2016. Among this group of Veterans, 52 percent accessed Basic Food, 56 percent had an identified mental health treatment need, and 8 percent received a housing service during the year.


Image of report cover 6.62WorkFirst Parents in Vocational Education at State Community and Technical Colleges: The Role of Basic Food Education & Training

This study describes the experiences of parents pursuing education through WorkFirst with a special focus on parents who do and do not continue their education through the Basic Food Education & Training program (BFET). WorkFirst students who used BFET were more likely to complete a degree or credential, but this may be because these students tended to be more educationally prepared and had stronger work histories. WorkFirst students were also more likely to complete a credential if they did not require basic skills coursework, attended full-time, or enrolled in the Integrated Basic Education and Skills Training Program (I-BEST).


Image of report cover 7.113The Effect of Dispensing One-Year Supply of Oral Contraceptive Pills- Findings from Washington State

THE HEALTH CARE AUTHORITY (HCA) of Washington State changed the policy for oral contraceptive pills (OCPs) supply in 2014 by requiring the dispensing of one-year packages for Medicaid recipients (under Section 213, Chapter 4, Laws of 2013, 2nd Special Session). The program goals are to achieve savings by reducing unintended pregnancies that result in Apple Health (Medicaid) funded births. This report presents findings on dispensing patterns for OCPs to Medicaid women, estimates the averted births associated with the policy change and cost savings due to averted births as a result of dispensing one-year supply of OCPs. Dispensing at least a one-year supply was associated with a significant reduction (12%) in Medicaid funded births. The state saved $1.5 million, an average of $226 per client, on maternity and infant care services due to averted births compared with those who were dispensed an initial one-month supply during 2014.

Image of report cover 4.99Drug Court Participants: Recidivism and Key Outcome Measures

These reports present recidivism measures and other key outcomes and characteristics of offenders participating in adult drug courts across Washington State. The reports contain yearly trends for individual courts and for courts statewide. Measures include drug court enrollment, demographics, recidivism, substance use disorder treatment participation, employment and Medicaid enrollment. The reports were written in collaboration with the Criminal Justice Treatment Account Panel and the HCA Division of Behavioral Health and Recovery, and will be updated annually. To protect client confidentiality, reports for courts with a small number of participants are not included.


Image of report cover 9.113Childhood Adversity and Medical Costs for Adolescents in Washington State

This research brief highlights results from a study examining the relationship between adverse experiences and healthcare costs of adolescents enrolled in Medicaid in Washington State. The brief focuses on findings about the association between adverse childhood experiences and medical service costs. A companion research brief highlights findings about the association between child adversity and behavioral health costs. Taken together, these two reports highlight the relationship between childhood adversity and increased healthcare costs.


Image of report cover 3.46Childhood Adversity and Behavioral Health Costs for Adolescents in Washington State

This research brief highlights results from a study examining the relationship between adverse experiences and healthcare costs of adolescents enrolled in Medicaid in Washington State. The brief focuses on findings about the association between adverse experiences and behavioral health service costs. RDA published a companion research brief that highlights findings about the association between childhood adversity and medical costs. Taken together, these two briefs highlight the relationship between childhood adversity and increased healthcare costs.


Image of report cover 6.61Home Visiting Services for TANF Families with Young Children: First Year Outcomes

This report examines 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 12 months following enrollment are 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 TANF families to engage in WorkFirst activities that prepared them for work, including education and training. Parents enrolled in TANF Home Visiting were also more likely to use Working Connections Child Care subsidies. Future follow up studies will be necessary to understand long-term impacts of this program.

Image of report cover 11.2432017 Foster Parent Survey: DSHS Foster Parents Speak

This report describes the results of the sixth annual DSHS Foster Parent Survey. Between September 2016 and August 2017, DSHS surveyed 1,350 foster parents about their satisfaction with the support and training provided by Children’s Administration and private agencies. The majority of foster parents continue to express satisfaction with the support and training they receive, and with the social workers assigned to their cases. There was a statistically significant decline in the percentage of foster parents who agreed that social workers always or usually listen to their input (78%, compared to 81% in 2016). Responses about the quality of training continue to be very positive – 87% agreed that their training was somewhat adequate or more than adequate. Foster parents continue to emphasize that training is enhanced by the participation of experienced foster parents and opportunities to interact with one another.

Image of report cover 9.114Geographic Distribution of Patients in Washington State’s Medication Assisted Treatment – Prescription Drug and Opioid Addiction Project

Opioid use disorder (OUD) continues to be a public health emergency that is receiving increased attention through legislative action. One such action, the Medication Assisted Treatment – Prescription Drug and Opioid Addiction (MAT-PDOA) program, is a three year, federally funded initiative to increase access to MAT and was awarded to Washington State’s Department of Social and Health Services in August 2015. With this funding, Washington was able to expand access to MAT with buprenorphine in three office based setting. Some patients, however, travel lengthy distances to receive MAT with buprenorphine for OUD. This report describes the geographic distribution of patients treated for OUD by the Washington State MAT-PDOA clinical sites in the first two years of funding.

Image of report cover 11.2442017 DSHS Employee Survey

The 2017 survey found widespread increases in employee engagement at DSHS since the last major survey in 2015. Positive responses increased for nearly all survey questions, and again DSHS exceeded the statewide target for the Executive Branch’s “Employer of Choice” measure. Of the 20 standard questions asked in 2015 and 2017, 18 had the highest percentage of positive responses since the current version of the survey began in 2006. The response rate in 2017 was 85%, the highest level of participation since the survey began in 2002. The survey results also show opportunities for positive change, and in some cases, important challenges. Implementation of the Governor Inslee’s “Building a Modern Work Environment” initiative and survey questions about that initiative have sparked much interest and discussion. 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 Survey is an important component of Governor Inslee’s Results Washington initiative for performance management and continuous improvement. Employee 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.

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