Research and Data Analysis

Preliminary Outcomes for Washington’s Housing Stability for Youth in Courts (H-SYNC) Program

Since 2019, the Housing Stability for Youth in Courts (H-SYNC) program has referred court-involved youth ages 12 to 18 who are at risk of homelessness to support services in their communities. This report describes the demographic characteristics, housing status, and criminal legal involvement of 112 program participants who enrolled in H-SYNC from July 2022 to March 2025, as well as 6-month pre-post outcomes for a smaller number (n = 45) of participants with sufficient follow-up data. Preliminary outcome analyses suggest that H-SYNC services were effective in connecting participants to housing services but provided insufficient evidence to identify impacts on other outcomes of interest. Several factors limited this study’s ability to evaluate the H-SYNC program including the small number of participants, the limited period for follow-up data, the absence of a statistically matched comparison group, and the lack of access to health-related outcome measures.

Children and Youth in Crisis Served by the Multiagency Rapid Care Team from January 2024 to June 2025

Washington State House Bill 1580 (2023-2024) created a multi-agency Rapid Care Team managed by the Office of the Governor to identify supportive services and living arrangements for children and youth in crisis. This report describes characteristics of children and youth referred to the Governor-led Rapid Care Team from January 2024 through June 2025 as part of a 2025 report to the legislature required by RCW 43.06.535. Measures examined include referral counts and case status, referral sources, setting at time of referral, demographic characteristics, state system engagement, health conditions, case duration, parent peer support, flexible funding, and living arrangements.

2025 DSHS Employee Engagement Survey

DSHS employees are committed to serving the people of Washington: 81% find their work meaningful, 69% are satisfied with their jobs, and 55% would recommend the agency as a great place to work. They also value their supervisors and co-workers, and they appreciate telework and the work-life balance it supports. Employees are least positive about change management, opportunities for advancement, being involved in decision-making, and being encouraged to identify barriers to access for clients. They would also like to see improvements in communication. The 2025 Employee Engagement Survey was completed by 10,243 DSHS employees, a 57% response rate. It is administered as part of the statewide employee survey, administered by the Office of Financial Management (OFM). Results are used by DSHS to inform strategic planning and to improve employee engagement at every level of the organization. The photos in this report were all submissions to the DSHS Photography Contest, which is held in conjunction with the Employee Engagement Survey every two years.

Washington State Peer Pathfinder Program: Descriptive Findings from 2017 to 2023

Washington State started the Peer Pathfinder program in 2017 using State Opioid Response funding to support outreach for adults experiencing homelessness who report opioid or stimulant use and are at risk of overdose. The program hires peer support professionals, people with lived and living behavioral health experience, who help individuals navigate care and recovery. From 2017 to 2023, 14 programs served 4,476 people across the state, many of whom had diagnosed opioid or stimulant use disorders. Most participants entered the program with prior involvement in the criminal legal system, frequent emergency department visits or hospitalizations, or recent admissions to medically managed withdrawal services. Additional evaluations could help demonstrate the program’s effectiveness and identify opportunities to strengthen it, including improving access to treatment medications and supporting ongoing engagement in care.

Evaluation of the Advanced Medication Management Program: Baseline Characteristics and Pre-Engagement Trends

This report presents a comprehensive baseline profile of participants enrolled in the Advanced Medication Management Program (AMMP), an innovative intervention designed to enhance medication adherence and safety, care coordination, and health outcomes for Medicaid clients with complex needs. The AMMP pilot served individuals who often take multiple medications prescribed by different providers, face barriers to access and adherence, and experience elevated risks of adverse drug events. This report describes the demographic, behavioral health, and clinical characteristics of program participants prior to engagement in the AMMP program, along with their patterns of service use, as a foundation for a future evaluation of the program. Findings provide context for understanding both the population served and the potential mechanisms through which AMMP may improve outcomes and reduce avoidable health care utilization.

The Impact of Forensic Projects for Assistance in Transition from Homelessness (FPATH) on Competency Services and Other Key Measures—An Outcome Evaluation

Forensic Projects for Assistance in Transition from Homelessness (FPATH) programs provide outreach and case management services to people involved in Washington State’s forensic mental health system who face substantial barriers to behavioral health care and community supports. This study evaluates the impact of FPATH programs in three Washington regions by comparing outcomes for Medicaid-enrolled FPATH participants with a statistically matched comparison group of people who did not participate in the program. Key outcomes examined included use of competency services, behavioral health treatment, homelessness, and criminal legal system involvement. Results demonstrated that FPATH participants used crisis services, outpatient emergency room services, inpatient substance use disorder treatment, and Foundational Community Supports more frequently and for longer periods than the comparison group. There were no meaningful differences between groups in competency orders, arrests or legal charges, inpatient or outpatient mental health services, or homelessness during the outcome period.

2025 Caregiver Survey Report

Every year, the Department of Children, Youth, and Families (DCYF) partners with the Research and Data Analysis (RDA) Division of the Department of Social and Health Services (DSHS) to gather feedback from kinship and foster caregivers in the State of Washington. Between October 2024 and June 2025, DSHS surveyed 666 kinship caregivers and 350 foster caregivers who had a child in care in the past 12 months. The response rate was 77%. Surveys were completed over the phone (63%) or online (37%). Satisfaction was high in 2025, with most caregivers giving positive responses to all structured questions. Both kinship and foster caregivers were more positive in 2025 than in 2024 on several questions. In addition, kinship caregivers were more positive than foster caregivers on most questions. In their open text comments, caregivers noted the hard work and support provided by DCYF staff and expressed appreciation for available resources. Caregivers who participated in trainings found them helpful. Caregiver comments also identify some areas that need work, including service coordination and timeliness. Many caregivers also commented that they thought DCYF needed additional staff.

Long-Term Services and Supports: 2025 Annual Report

This study is the first in a series of annual reports directed by House Bill 1694 assessing the workforce available to supply Long-Term Services and Supports (LTSS) and the projected demand for LTSS in Washington State. Data from the U.S. Census Bureau and Bureau of Labor Statistics, combined with Medicaid LTSS claims data, are used to describe current LTSS workforce and utilization patterns, and to generate forecasts to 2050 of Medicaid-paid LTSS utilization and the number of individuals providing paid direct care in LTSS settings. We found that demand for LTSS is projected to far outpace supply, based on current utilization and employment patterns. Analyses found that wages were low for the direct care workers supplying the majority of LTSS services compared to Washington’s median wage and wages of similar occupations. Potential strategies to address this gap include increasing wages and benefits for these workers from their historical lows and incentivizing new workers into the LTSS field with tax benefits, expanding training and career opportunities, enhancing public perceptions of the LTSS jobs.

Prenatal Substance Exposure in Washington State: Prevalence, Treatment, and Other Service Needs

Prenatal substance exposure, defined as the exposure of a fetus to alcohol or drugs during pregnancy, can impact a range of infant health outcomes and lead to long-term negative effects on child development. This report summarizes recent trends in prenatal substance exposure among infants in Washington’s Medicaid program (Apple Health); in maternal substance use during pregnancy; and in access to treatment during pregnancy and postpartum. Opportunities to supplement treatment with additional supports are also discussed.

Mental Health Assessments for Young Children: An Examination of Assessment Trends Following 2022 Policy Changes

This report examines trends in mental health assessments following Apple Health policy changes that went into effect January 2022, collectively referred to as Mental Health Assessment for Young Children (MHAYC). The MHAYC policy changes included reimbursement for multi-session assessments and for provider travel to home and community settings, as well as a requirement for providers to use the DC:0-5TM, the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood. This report presents an overview of trends in mental health assessment characteristics in the 3 years before and 2 years after MHAYC policy changes, covering calendar years (CY) 2019 to 2023.

TANF Caseload Changes: The Well-Being of Parents and Children Leaving WorkFirst in Washington State

The Temporary Assistance for Needy Families (TANF) program provides cash assistance to low-income families with children in Washington state. This report examines how COVID-19-related TANF program changes were associated with the well-being of parents and children leaving TANF by comparing families leaving TANF during state fiscal year (SFY) 2022 to families leaving TANF in SFY 2017.