Research and Data Analysis

2024 Caregiver Survey Report

Between September 2023 and September 2024, DSHS surveyed 1,342 caregivers (884 kinship and 458 foster) who had a child in care within six months of the sampling dates (August and November, 2023; February and May, 2024). These caregivers were asked about their satisfaction with the support and training provided by the Department of Children, Youth, and Families (DCYF) and private agencies contracted by DCYF. They were also invited to offer recommendations for change.

The Impact of Forensic Housing and Recovery Through Peer Services (FHARPS) on Homelessness and Housing Support Access – An Outcome Evaluation

This study evaluates the impact of Forensic Housing and Recovery Through Peer Services (FHARPS) programs serving three regions in Washington State on homelessness, criminal legal, and behavioral health measures for Medicaid-enrolled participants relative to statistically matched comparators. The report presents FHARPS program participant characteristics and findings from the outcome evaluation for Medicaid-enrolled program participants with and without a competency order history two years prior to FHARPS enrollment. We found that participation in FHARPS programs increased utilization of housing supports and crisis services for FHARPS participants overall, reduced indicated homelessness and re-arrest rates for FHARPS participants with a competency order history, and increased access to outpatient mental health treatment for FHARPS participants without a competency order history. There were no measurable impacts on competency orders, inpatient mental health treatment, and substance use disorder treatment.

Eating Disorders Among Apple Health-Enrolled Youth and Young Adults: Prevalence, Characteristics, and Recent Trends in Washington State

This report documents trends in the prevalence and types of eating disorders among youth and young adults enrolled in Apple Health in calendar years 2017 through 2021. Focusing on young people diagnosed in 2021, the report describes co-occurring diagnoses needs, both behavioral and physical health related; demographics and other characteristics; the behavioral health services they receive; and selected outcomes associated with eating disorder diagnoses.

Broadband Internet and Computer Access in Washington State Findings from the American Community Survey

Disparities in access to the internet and computing resources have long been an issue, but such disparities became more visible during the early years of the COVID-19 pandemic. Having no or limited access to the internet and computing resources can pose a barrier to distance education, telehealth services or other virtual social or health services for vulnerable populations. This report uses data from the American Community Survey spanning 2017-2021 to analyze disparities in digital access by geographic location and demographic groups across Washington State.

Washington State Jail-based Opioid Treatment Networks: Disparities in Initiation of MOUD Treatment

Since September 2018, the Washington State Healthcare Authority (HCA) has received State Opioid Response (SOR) grants to improve access to FDA-approved medications for opioid use disorder (MOUD) and reduce overdose deaths. This evaluation focuses on SOR-funded MOUD programs in five Washington State jails, known as Opioid Treatment Networks (OTNs), which start MOUD treatment for individuals with opioid use disorder (OUD) before their release. The report examines factors such as race, prior behavioral health diagnoses and treatments, healthcare and social service use, and criminal legal factors affecting MOUD initiation among those booked into and released from jail-based OTNs between January 2019 and September 2022. In this evaluation, we observed racial disparities in MOUD initiation across the five OTNs, as well as differences in the implementation of MOUD treatment programs at each OTN site. Future efforts in correctional settings should proactively address these disparities.

Evaluation of Washington’s COVID-19 Public Health Emergency Demonstration: The Impact of Waiver Authority on Stabilizing the Long-Term Support Services System during COVID-19

To help combat the rapid spread of COVID-19 in nursing facilities and to help stabilize the long-term services and supports (LTSS) system more broadly, Washington State applied for and received a COVID-19 Disaster waiver in April 2020. This evaluation examined if the state’s strategies to mitigate the impact of the public health emergency on LTSS provider capacity and client access to services were successful. Overall, we found that after an initial decline in service utilization in the early months of the pandemic, the use of LTSS services remained consistent with pre-COVID-19 trends. This suggests that the strategies employed under the waiver were successful at stabilizing the system.

The Growth of Telehealth Services in Child and Youth Behavioral Health Care During the COVID-19 Pandemic

This report documents the increased use of telehealth services to deliver behavioral health services in Washington State during the COVID-19 pandemic and the extent to which providers had begun transitioning back to in-person services as of December 2021. Use of telehealth for delivery of behavioral health services to children and youth (ages 0 to 20) is examined by service type and by different population demographics.

Where are Basic Food Benefits Used in Washington State?

The Supplemental Nutrition Assistance Program (SNAP), or Basic Food in Washington State, provides low-income individuals and families a monthly benefit that can be used to buy food. This report examines the experiences of 341,122 households that were continuously enrolled in Basic Food throughout calendar year (CY) 2022. These households spent more than $1.1 billion in Basic Food benefits at participating retailers in the year, including supermarkets, convenience stores, internet retailers and others. This report describes how Basic Food benefits were used in CY 2022, breaking down expenditures by type of retailer and the characteristics of Basic Food households.

Navigating Dual Eligibility: A survey of dually enrolled Medicare and Medicaid beneficiaries

When individuals become eligible for both Medicare and Medicaid in Washington, they face a dizzying array of choices. A survey of dual-eligible beneficiaries in Washington was conducted in the spring of 2023 to learn how beneficiaries make decisions about enrollment options, identify areas for improving training for those who assist beneficiaries in making decisions, and determine whether there are differences in their experiences once enrolled. Overall, this survey found that while the state is focusing on the right areas of concern, integrated care models alone do not improve access, outcomes, or beneficiary experience. Consistent clear communication to beneficiaries, network alignment, care coordination, and training of community partners are critical for improving the beneficiary experience.

2023 DSHS Employee Engagement Survey

DSHS employees are committed to transforming lives: 69% of employees are satisfied with their jobs, 69% are proud to work for DSHS, and 81% find meaning in their work. They also appreciate their supervisors, are confident they know how to act if discrimination or harassment occurs, and value flexibility and the work-life balance it supports. In addition to these strengths, employees also identified areas of improvement for the agency. Employee satisfaction was lowest in areas related to change management. They would like better support during organizational change, clearer communication from leadership on the reasons behind important changes, and more involvement in decisions that affect their work. The 2023 Employee Engagement Survey was completed by over 12,126 DSHS employees, a 72% response rate. Under the direction of the Office of Financial Management (OFM), the 2023 questionnaire was significantly redesigned and provides a new baseline for employee engagement survey results moving forward. The Employee Engagement Survey is an important component of Governor Inslee’s Results Washington initiative for performance management and continuous improvement. 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 Healthy Transitions Project: Findings from the Impact Evaluation

The Washington State Healthy Transitions Project (HTP) provided community-based, recovery-oriented care for transition-age youth and young adults (TAY) ages 16 to 25 who experienced serious emotional disturbance or serious mental illness. Funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) from 2019 through 2023 and administered by the Washington State Health Care Authority, the program was designed to improve emotional and behavioral health functioning and to develop and refine an innovative, community-based, recovery-oriented model. This report describes the participants, services, and outcomes of the program, as implemented by four community-based provider sites in Washington State. We found that TAY who participated in HTP reported increased rates of functioning in everyday life and retention in the community, and that they were more engaged in outpatient mental health treatment services as compared to peers not enrolled in the program.

• Part 1: The frequency of SUD-related acute events among Medicaid beneficiaries and the rates of these events across various demographic characteristics.
• Part 2: The rates of subsequent SUD-related acute events, emergency department and hospital utilization, and receipt of SUD services within 3 and 12 months of an initial SUD-related acute event.
• Part 3: The rate of receipt of mental health services, support services, deaths, and arrests within 3 and 12 months of an initial SUD-related acute event.

Understanding the current utilization of behavioral health treatment and recovery support services is crucial to identifying both strengths and gaps in the existing behavioral health system in Washington state. The patterns observed in these reports highlight areas that may be underutilized as points of intervention for those receiving SUD-related acute care services.