Research and Data Analysis

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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.

Image of report cover 8.34The Changing Patterns of Long-Term Services and Supports Use in Washington State

The policy brief examines changing patterns of Long-term services and supports (LTSS) use in Washington State, including client demographics, duration of use of Medicaid-paid LTSS services, and client transitions between LTSS service modalities. Compared to earlier cohorts, more clients are now starting their LTSS service experience receiving in-home care, rather than nursing facility services. Compared to earlier cohorts starting their LTSS service experience in home- and community-based services settings, fewer clients now transition to nursing facility care.

 

Image of report cover 7.112State and County Estimates of the ECLIPSE Eligible Population

The Early Childhood Intervention and Prevention Services (ECLIPSE) program serves children ages zero to five years old who are at risk of child abuse and neglect and may be experiencing behavioral health issues due to exposure to complex trauma. This report uses a statistical risk profile based on the characteristics of the Childhaven ECLIPSE population to estimate the potential population of eligible children statewide. We find that there are several thousand children statewide with family risk characteristics comparable to children currently served by the ECLIPSE program.

 

Image of report cover 3.45First Episode Psychosis

This report describes the demographic characteristics and social service histories of a cohort of individuals with psychotic disorders and a subgroup of individuals experiencing their first episode of psychosis. Through examination of Washington State administrative data, we found that almost 40,000 DSHS clients enrolled in Medicaid had psychotic disorder diagnoses in State Fiscal Year 2015. Among them, we identified 3,062 individuals who received a psychotic disorder diagnosis for the first time during the year. One in three of these first episode psychosis (FEP) clients received their initial psychotic disorder diagnosis in an emergency department. During the two years before being diagnosed, more than half of the FEP clients had at least one emergency room visit, one in five (21%) were involved with the child welfare system, and one in five (22%) experienced homelessness or housing instability. Seventy-five percent of the FEP clients had identified mental health treatment needs during the two years before being diagnosed with psychotic disorders, but only 44 percent received any publicly funded mental health services.

 

Image of report cover 11.2412017 Social and Health Services Client Survey

Between October 2016 and April 2017, the Washington State Department of Social and Health Services and the Washington State Health Care Authority surveyed 1,229 clients who received services between April 2015 and March 2016. These clients were asked about their satisfaction with social and health services and recommendations for change. As in previous years, the great majority of clients expressed satisfaction with services and their interactions with staff. Considering all programs together, ratings either stayed the same or improved on all questions. There were statistically significant increases in ratings of overall helpfulness, ease of getting to program offices, getting services as quickly as needed, and program staff explaining things clearly. The survey identified opportunities for improvement in certain programs, such as getting services quickly (Mental Health) and being able to talk to a live person when needed (Community Services). Suggestions for process improvement indicated interest in expanding online services, streamlining application processes, and finding easier ways to connect with staff.

Image of report cover 4.101Sustainability of Screening, Brief Intervention, and Referral to Treatment in Healthcare Settings

This report examines the post-grant experiences of clinics that implemented Screening, Brief Intervention, and Referral to Treatment (SBIRT) under the Washington SBIRT-Primary Care Integration (WASBIRT-PCI) project. SBIRT is an evidence-based, universal public health approach to identify, prevent, and reduce substance use disorders. Project sites were asked to describe the barriers and facilitators to maintaining SBIRT at their healthcare facilities. Under WASBIRT-PCI, nineteen healthcare facilities implemented the SBIRT program and currently ten continue to offer the evidence-based practice with varying degrees of fidelity. Common barriers were staff turnover, insufficient support or “buy-in” for the program from staff and leadership, lack of funding to maintain program staff, limited training opportunities, insufficient reimbursement to deliver SBIRT, and lack of performance monitoring to ensure fidelity to the program.

Image of report cover 7.111Independent Living Services for Foster Youth: Findings from the NYTD-Reported Services for Washington State 2015

This study examined Independent Living (IL) services for youth in foster care in Washington State in 2014-2015. These services are designed to assist youth in making the transition from foster care to self-sufficiency and include educational support, employment preparation, financial assistance, and life skills training. A total of 1,649 youth aged 16 to 21 years participated in at least one IL service provided by IL services contractors, social workers, and tribal partners between October 1, 2014 and September 30, 2015. This represented 30 percent of all eligible youth in the state (5,604). Youth receiving IL services were concentrated in large urban counties; these counties also served a higher proportion of their eligible youth than rural and remote counties. We found that the youth in foster care received significantly more IL services than the youth not in foster care at every age. Demographic differences among IL participants largely reflected different risk factors faced by the youth, their preferences, and changing needs as the youth grew older. However, some services that dropped off for older youth could have been beneficial to them.

Image of report cover 3.44Becoming Employed Starts Today (BEST): Baseline Characteristics and Program Services

This report provides demographic and employment information for those participants enrolled in the Becoming Employed Starts Today (BEST) program during the first year of its five-year implementation period. BEST offers evidence-based supported employment services to individuals with severe mental illnesses and co-occurring substance disorders in an effort to reduce long-term unemployment and improve participant well-being. Of the 102 participants who enrolled in the first year of the program, 57% were unemployed for the entirety of the year prior to joining the program. Participants in Grant and Clark counties receive intensive supported employment services and other types of mental health outpatient services to manage their behavioral health needs. Preliminary comparisons of pre- and post-enrollment employment rates indicate that participant employed increased by 23%, with 53% of all participants having some form of employment following enrollment in the program. Future analyses will focus on longer-term outcomes and will include a statically matched comparison group to control for other sources of changeSBIRT in select health care settings from 2011 to 2016. During this time, WASBIRT-PCI successfully screened 75,635 unique patients, 31 percent of whom were enrolled in Medicaid. This report describes the prevalence of at-risk substance use and mental health disorders among the Medicaid and non-Medicaid patients screened under the program.

 

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