Washington Court and Recovery Enhancement System Outcome Evaluation
The Washington Court and Recovery Enhancement System (WA-CARES) project addresses the need for improved, cross-system coordination for drug courts and provides recovery support services (RSS) for high-risk clients who access substance use disorder treatment through the drug court system. In this second report about the WA-CARES program, we examine the added impact of RSS on key outcomes, including substance use disorder treatment, employment, arrest and incarceration. Drug courts located in five counties (Clallam, Cowlitz, Okanogan, Skagit and Snohomish) participated in this SAMHSA-funded portion of the WA-CARES project. Outcomes were compared over a 12-month follow-up period for a statistically matched group of adults in Washington state drug courts during the same time period. We found that recovery support services provided through WA-CARES enhances the success of the drug court model and increases the likelihood that a drug court participant will be engaged in treatment, employed and arrest free.
This report provides an overview of the organization, membership and work of the Washington State Institutional Review Board. It documents the legal authority for the Review Board, and describes major activities during 2013.
Answers to Open-Ended Questions from DSHS’ Aging and Long-Term Support Administration State Plan on Aging Survey
Worries, fears, plans, and program desires are revealed in a survey of Washington State residents who are aging and/or living with disabilities, and their caregivers. The survey reveals that people know they will not always be able to care for themselves and their present homes. They worry about isolation, boredom and lack of meaningful activities when they can no longer drive. They worry about not being able to find or afford trustworthy caregivers in the home. They fear being alone and needing help in an emergency – and they fear losing their homes, independence and privacy if they need assisted living. They long for closeness to their families – and they fear both burdening them and being neglected or exploited by them. Most of all, they fear the loss of control, independence and ability to make their own care decisions if their cognitive abilities and memories decline. Respondents would like help with home modifications for safety, with routine home, yard maintenance, and meals, and with transportation to both needed appointments and community activities when they can no longer drive. They would like to choose and pay for their own caregivers in their own homes, keep their pets near them, and have enough in-home care hours to assure safety. They would like respite, support and education for family caregivers. They would like advocates to assist in their care decisions, particularly assisted living decisions, and people to help them pay bills and manage medical paperwork. They would like to be part of family, friend, and community networks of care.
2014 Risk and Protection Profile for Substance Abuse Prevention for Washington State and its Communities
The Profiles, comprised of over 450 reports, provide annual trends for the last 5 to 10 years for the state and every county, school district, and locale. The indicators cover such topics as child and family health, availability of drugs and substance abuse, criminal justice involvement among teens and adults, academic performance of children and youth, and socioeconomic conditions in your community. Nearly 50 indicators are presented in graphs, maps and tables; the reports are available in PDF and Excel. For more information click: Washington state and county profiles, School districts and locales
This report describes the housing status of 17,471 King County households that received Temporary Assistance for Needy Families (TANF) in State Fiscal Year 2011 to gain a better understanding of how their housing status relates to receipt of social services and indicators of well-being. Five housing status categories were identified using administrative data: three groups received housing assistance (Public Housing Authority programs, the Low Income Housing Tax Credit program, programs recorded in the Homeless Management Information System) and two groups did not receive housing assistance (homeless, housed). One third of the TANF households got housing assistance from one or more of the three programs; over half were housed without help from any of the three housing programs; and 14 percent were homeless and not receiving housing assistance. TANF clients with housing assistance received more months of basic social services in the prior 3 years than those who were either homeless or housed without assistance. Those who were housed without housing assistance had the lowest rates of child welfare service use and the highest earnings. Households that received assistance for housing instability or risk of homelessness, recorded in HMIS, and those who were homeless without assistance were more likely to have substance abuse, arrests, and high frequency residential moves.
This report, using administrative data from multiple sources, describes the degree to which changing schools is associated with the receipt of basic social and health services, the incidence of behavioral health and social risk factors, and the academic performance of students. Students in two grade levels—1st and 7th grades—were followed over three consecutive school years, and the number of school changes during that time were counted. While slightly more than half did not change schools, about 45 percent of the students changed schools at least once, with 7 to 10 percent changing school three or more times during the three years. Increases in the number of school moves were associated with more use of social services for such basic needs as food, cash, and medical assistance as well as more use of child welfare services and foster care. Changing schools was also associated with greater risk for homelessness, mental health problems, substance abuse, arrests, and involvement with the juvenile justice system. School performance appeared to be adversely affected by school moves. As the number of moves increased, we found poorer performance on standard reading and mathematics tests, lower average grades, increased chance of dropping out or having unexcused absences, and decreased likelihood of graduating on time. The report provides a picture of the complex overlay of multiple challenges faced by particularly high-risk and vulnerable children. Movement between schools appears to serve as an important signal for much deeper underlying problems that the child and family may be facing.
This report examines the educational and employment experiences of special education students in Washington State who were first time 12th graders in Academic Year (AY) 2005/06 and served by DSHS at some point between State Fiscal Year (SFY) 2006 and 2008. We found that 1) the majority of students in the study population completed their high school education and one-third had at least some college, 2) about half of the students were working or in college six years after first entering the 12th grade, and 3) DDA clients who also received DVR services were more likely to be connected to work or school.
Washington State’s TANF program, WorkFirst, underwent a major redesign in 2010 that included the development of three new program performance measures related to children’s education: 1) enrollment in K-12 public education, 2) grade progression, and 3) on-time high school graduation. This report leverages the INVEST database, developed in partnership with the Education Research and Data Center (ERDC), to investigate how key risk factors may influence these education measures. We find that although rates of enrollment, grade progression, and on-time graduation among WorkFirst children either improved or remained relatively stable from AY 2009/10 to AY 2011/12, the challenges some students faced with housing and behavioral health issues are reflected in the education data.
Between September 2012 and August 2013, DSHS surveyed 1,398 foster parents who had a child in care on the 15th day of August 2012, November 2012, February 2013 or May 2013. These foster parents were asked about their satisfaction with support, training, and information provided by Children’s Administration and private agencies contracted by the Administration to provide services to foster parents. They were also asked to offer recommendations for change. The majority of foster parents expressed satisfaction with the support and training they receive, and with the social workers assigned to their cases. In regard to support, some indicated they want more complete and timely information about their foster children’s cases; more resources, such as respite and timely reimbursements; more flexible processes; and more social workers hired. In regard to training, some suggested a need for more convenient training locations and schedules; more training on specific topics; more non-traditional training formats such as online training and foster parent panels; and more choice about which trainings they take.
11,390 employees completed the 2013 Employee Survey. They addressed communication, supervisor/manager support, fairness and diversity, job satisfaction, and business practices. The 2013 survey responses mirror the slow but steady economic recovery. The overall survey trend was upward, and pointed to a gradual lessening of employees’ uncertainty and fears about layoffs, pay and benefit reductions, loss of vital resources, and inability to meet client needs. Overall job satisfaction has increased, as have measures of employee engagement, communication, recognition, and support. As in past surveys, employees consider helping clients to be the most important and fulfilling aspect of their work. There remains considerable room for additional improvement in many areas, including communication and employee engagement. Governor Inslee has made the results of the Employee Survey an important component of the Results Washington data-driven performance management and continuous improvement system. This includes a statewide initiative to address employee concerns and increase employee survey scores in future surveys.
The Family Caregiver Support Program (FCSP) serves Washingtonians who provide uncompensated care for a parent, spouse, or another adult with medical issues, mobility limitations, or decreased cognitive functioning. In this report, we examine how the expansion of FCSP in SFY 2012 affected the utilization of Medicaid long-term care services. Due to the FCSP expansion, caregivers screened in SFY 2012 were more likely to receive a full assessment and a broader range of support services than those screened in prior years. Results show that care receivers whose caregivers were screened post-expansion were slower to transition to Medicaid long-term care services, controlling for differences in baseline characteristics; the FCSP expansion is likely a contributing factor to this positive outcome.
Since 2010, Washington State’s Fostering Well-Being (FWB) Program has provided care coordination and other services to children in out-of-home placement to enhance their access to comprehensive health care and to improve health outcomes. This report examines the characteristics of the children served by the FWB program in its first two years and uses a statistically matched comparison group to assess the program’s impacts on medical utilization. Results show that many FWB recipients have complex chronic needs. After one year in the program, FWB recipients experienced dramatically reduced medical utilization, including fewer emergency room visits and other hospitalizations. These reductions were similar in magnitude to those experienced by other medically complex children in out-of-home placement who were not served by the FWB program.
In April 2013, the Ending Family Homelessness (EFH) pilot program began providing rapid re-housing and other services to homeless families receiving Temporary Assistance for Needy Families (TANF). This report examines baseline risk information on TANF parents and children participating in EFH compared to other TANF clients in the balance of the state. Almost all participants entered the program from emergency shelters or places not meant for housing, such as cars or the street. EFH parents were more likely than other parents on TANF to face barriers to housing and employment such as family violence, substance use, mental illness, and involvement with the criminal justice system.
In this report, we examine three basic questions about housing assistance recipients from the three public housing authorities (PHAs), Seattle, King County and Tacoma: To what extent do DSHS and PHAs serve the same individuals? What are the characteristics and service use profiles of jointly served PHA-DSHS clients? To what extent do PHA clients differ from other DSHS clients? We find that almost all (96 percent) of PHA clients in Calendar Year 2011 were DSHS clients at some point; 84 percent received a DSHS service that same year. Medical coverage and Basic Food were the most common DSHS services received by PHA recipients. Compared to DSHS clients who did not receive public housing assistance: PHA recipients were more likely to be older, female and African American; receive Temporary Assistance for Needy Families and Basic Food; and have a physical or behavioral health condition, particularly among working age adults. The report was funded by the Bill & Melinda Gates Foundation and received support from the Seattle, King County and Tacoma Housing Authorities.
Washington State is redesigning the children’s behavioral health service delivery system to better address the diverse population of children and youth with mental health and substance abuse needs. This report informs the redesign process by describing behavioral health needs and other characteristics of children and youth with Medicaid coverage served across multiple systems. Demographics, medical eligibility, diagnoses, medications, services, and abuse and neglect information are presented for children with behavioral health needs.
Effect of TANF Concurrent Benefits on the Reunification of Children following Placement in Out-of-Home Care
The TANF Concurrent Benefits Program allows TANF cash grants to continue for families from whom a child has been removed by Children’s Administration (the “removal family”) and placed with a licensed or unlicensed caregiver (the “receiving family”). The Children’s Administration must expect that absence to be temporary (180 days or less) and that the child will be reunified with the family of removal. This study examines whether receipt of concurrent TANF benefits reduces time to reunification. We compare placement outcomes for children in out-of-home care whose removal family retained the child’s portion of the family TANF benefit while the child was in care (the “concurrent benefit group”), to children whose removal family did not retain this benefit (the “comparison group”). Analyses are conducted for a set of families matched on baseline case characteristics, to control for other potential factors that could account for differences in reunification rates. Findings conclude that receipt of concurrent TANF benefits is associated with reduced time to reunification for children placed in out of home care.
The Permanent Options for Recovery-Centered Housing (PORCH) program is a partnership between the Washington State Division of Behavioral Health and Recovery, Optum Health-Pierce County and Chelan-Douglas Regional Support Networks, Washington State Department of Commerce and local mental health and housing providers in Pierce, Chelan and Douglas counties. PORCH’s goal is to increase housing stability and encourage independent living among adults with a history of mental illness and housing instability or homelessness. This is the second report in a series about the program and provides an update on those served in the second year, plus preliminary findings for those who remained enrolled in PORCH services 12 or more months. We find that since May 2011, PORCH has served 162 participants in two sites, and maintains an active caseload of about 100 participants (50 at each site). Two thirds of enrollees completed one or more years of services. For those enrolled at least 12 months, more than half had an improved recovery scale score, and housing stability and satisfaction improved substantially between the baseline and 12-month follow-up periods. A final report at the end of the five-year grant period will examine the impact of PORCH on participant housing, employment and arrest outcomes.
This brief summarizes findings from a series of reports examining the housing status of individuals following their exit from institutional or out-of-home care settings. More than one-quarter of all five study populations experienced homelessness at some point over a 12-month follow-up period. Individuals leaving residential chemical dependency treatment facilities and prisons represent particularly high opportunity populations. Compared to the other three groups, they were more likely to experience homelessness but as likely to exit to permanent housing when they received housing assistance. Across the five study populations, the proportion of individuals in need of housing who received HMIS-recorded assistance was highest for youth aging out of foster care (at 35 percent).
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