Research and Data Analysis

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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 change.

Image of report cover 11.242Identifying Substance Use and Mental Health Disorders Using an SBIRT Model: Washington State’s Experience

Screening, Brief Intervention and Referral to Treatment (SBIRT) is an evidence-based, universal public health approach used in a many healthcare settings to identify, prevent, and reduce substance use disorders (SUDs). The Washington State Department of Social and Health Services (DSHS) received a five-year federal grant to implement SBIRT 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.

Image of report cover 11.2392016 Foster Parent Survey

This report describes the results of the fifth annual DSHS Foster Parent Survey. Between September 2015 and August 2016, 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. Compared to 2015, there was a statistically significant increase in positive responses about the overall quality of support, and there were non-significant increases on four other measures. Responses about the quality of training continue to be very positive. As in previous years, foster parents indicated that they would like greater inclusion in meetings and decisions, faster and more flexible processes, consistent policies, and more complete and timely information about their foster children’s cases. Some foster parents also suggested needs for updated training materials, childcare options for training, more convenient training locations and schedules and more interaction with experienced foster parents in training.

Image of report cover 4.100Bringing Recovery into Diverse Groups through Engagement and Support - Final Report

The BRIDGES program provided evidence-based permanent supportive housing and supported employment services to chronically homeless individuals with substance use or co-occurring substance use and mental health disorders in Snohomish, Pierce and Kitsap counties. This final report about the BRIDGES program describes participants, the services they received and changes in key outcomes over a one year follow-up period. Housing improved among participants and rates of homelessness and unstable housing decreased after program enrollment. Employment also improved, but the proportion of clients employed remained low at 18 to 20 percent. Other promising findings include reduced use of outpatient emergency departments and fewer criminal charges among participants. As there was no comparison group for this study, findings should be interpreted as descriptive only and not net program effects.

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 DSHS Behavioral Health Administration, and will be updated annually

Image of report cover 11.204Housing Status of Youth Exiting Foster Care, Behavioral Health and Criminal Justice Systems

Housing Status of Youth Exiting Foster Care, Behavioral Health and Criminal Justice Systems describes the housing status (homeless or unstably housed) of youth and young adults (ages 12 to 24) aging out of Washington State foster care, discharged from publicly funded residential or inpatient treatment for behavior health, released from Juvenile Rehabilitation institutions or released from an adult correctional facility.  The report—a  collaboration between the Department of Social and Health Services Research and Data Analysis Division and the Department of Commerce—describes youth characteristics and housing status over a one-year follow-up period and will be updated annually.

Image of Generic thumbnail image of report coverHome Visiting Services for TANF Families with Young Children: Baseline Characteristics and Early Experiences

This descriptive report examines the TANF Home Visiting program, a collaborative project of the DSHS Economic Services Administration Community Services Division (CSD), the Department of Early Learning (DEL), and Thrive Washington. The report describes demographics and baseline information about parents who enrolled in TANF Home Visiting and describes the early experiences of parents while enrolled in the program. TANF Home Visiting enrolled parents of young children who faced barriers to employment, including homelessness and behavioral health issues. During their first three months in the program, participating families experienced low rates of out-of-home placement for their children and high rates of engagement in WorkFirst activities. Further study will be needed to determine the long-term impacts of the program on WorkFirst progression, positive exits from TANF, and child welfare involvement.

Image of Generic thumbnail image of report coverWashington State SBIRT Primary Care Integration: Implementation - JANUARY 2012-AUGUST 2016

Implementation of the Washington State SBIRT Primary Care Integration Program: This report examines clinic experiences with respect to implementation of the Washington State Screening, Brief Intervention, and Referral to Treatment – Primary Care Integration (WASBIRT-PCI) Program. SBIRT is an evidence-based, universal public health approach used to identify, prevent, and reduce substance use disorders. With the goal of expanding SBIRT services, the WASBIRT-PCI Program was implemented in nineteen healthcare facilities in five counties, screening nearly 83,000 patients over the five year period. Among the patients screened, 11 percent were found to be at risk for a substance use disorder or to experience adverse outcomes related to their substance use. Clinics effectively implemented the screening component, however delivery of the SBIRT intervention using a behavioral health specialist (BHS) was met with varying degrees of success depending on the setting: the BHS model appeared to be more successful in emergency department or specialty mental health settings than in primary care.

Report Image of Bringing Recovery into Diverse GroupsBringing Recovery into Diverse Groups through Engagement and Support: Second Annual Report - Preliminary Findings

The BRIDGES program provides evidence-based permanent supportive housing and supported employment services to chronically homeless individuals with substance use or co-occurring substance use and mental health disorders in Snohomish, Pierce and Kitsap counties. This second report about the BRIDGES program describes baseline participant characteristics and services along with self-reported housing, employment and substance use outcomes for the 153 individuals enrolled during the first two years of the program. Six months after enrollment, participants reported improvement in both housing and employment. Just under half (45 percent) of participants reported they were housed after 6 months of program participation, up from 3 percent at program intake. Twenty-three percent of participants were employed at 6-months, up from 10 percent at intake.

Report Image of Cover PlaceholderWashington State Medication Assisted Treatment - Prescription Drug and Opioid Addiction Project: Year One Performance

An Evaluation of the Washington State Medication Assisted Treatment – Prescription Drug and Opioid Addiction - MAT-PDOA Program This report examines the first year of program implementation of the Washington State Medication Assisted Treatment – Prescription Drug and Opioid Addiction - MAT-PDOA Project. The program expands access to integrated MAT with buprenorphine for opioid use disorders in Grays Harbor, King and Thurston counties. In year one, the program successfully expanded MAT services by implementing office-based opioid treatment with buprenorphine in one large, urban safety-net primary care setting and two opioid treatment programs. MAT-PDOA treated 211 patients and 77% of those patients were still enrolled in treatment at the end of year one. At six months after enrollment in treatment, MAT-PDOA patients reported reductions in 30-day alcohol and drug use rates, including signification reductions in opioid use, methamphetamine use, and injection drug use. Patients also reported reductions in adverse outcomes related to opioid use disorder, including improvements in self-reported employment and school enrollment, reductions in inpatient and emergency department utilization, and increases in outpatient service utilization six months after enrollment.

Report image of the ECLIPSE Program The ECLIPSE Program at Childhaven: Short-Term Outcomes for Children Receiving Early Childhood Intervention and Prevention Services

This report analyzes the impact of the Early Childhood Intervention Prevention Services - ECLIPSE program administered by the Department of Early Learning. ECLIPSE serves children ages zero to 5 years old who are at risk of child abuse and neglect and may be experiencing behavioral health issues due to exposure to complex trauma. We found that ECLIPSE served a population of very high risk young children with intensive service needs. ECLIPSE participation led to increased service utilization, most notably in the use of outpatient mental health services for children. In light of the very high risk population served, increased service utilization may indicate that children were having their pre-existing needs met after beginning to receive services at Childhaven. Further study is needed to both understand the longer-term impacts of Childhaven given the short-term impacts on service utilization found in this report, and to determine the extent to which such services are needed statewide.

Report Image of Transitioning Residents from Nursing Homes to Community Living: Impact of Washington State’s Roads to Community Living (RCL) Demonstration on Medicaid Long-Term Services and Supports CostsTransitioning Residents from Nursing Homes to Community Living: Impact of Washington State’s Roads to Community Living (RCL) Demonstration on Medicaid Long-Term Services and Supports Costs

Roads to Community Living - RCL, which is part of the federally funded “Money Follows the Person - MFP” program, is a demonstration project in Washington State designed to help people with complex, long-term care needs move from institutions back into the community. Under RCL, Medicaid beneficiaries who reside in a nursing facility for at least 90 days receive services to support their transition to a community-based care setting of their choice. This study finds that relative to a matched comparison group, Medicaid savings for the 1,738 RCL treatment group clients were $21.5 million (all funds) from the month of entry into the RCL program through the 24-month follow-up period. Nursing home cost savings more than offset RCL demonstration services costs and the increased use of home- and community-based services by the RCL group.

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