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).
This report identifies individuals who aged out of foster care in State Fiscal Year 2010 or 2011. It examines the following measures over a 12-month period following exit from out-of-home placement: housing status, receipt of public assistance, prevalence of substance abuse and mental illness, rates of employment and arrest, and average earnings. We find that approximately one-third of youth who aged out of foster care experienced homelessness in the following year. Youth who experienced homelessness were more connected to social and health services but also experienced a higher prevalence of risk factors relative to their peers who did not have identified housing needs.
Postsecondary enrollment patterns among recent graduates who received social and health services during high school
This report focuses on immediate (2009-10) postsecondary enrollment for 2008-09 Washington State public high school graduates who received services from the Department of Social and Health Services. This study is the latest in a series utilizing the INVEST cross-agency data set, linking individual-level data from DSHS with education data from the Washington State Education Research and Data Center. The results show that high school graduates who received DSHS services in high school were less likely than their peers to enroll in higher education in the year following graduation, regardless of their high school achievement levels. Among graduates who enrolled in postsecondary education, those who had received DSHS services in high school were more likely to require remedial coursework before advancing to college-level courses. These and other key findings point to the unique barriers to higher education that often accompany social and health risk factors, and highlight avenues for positive change.
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 2012.
This report describes the complex relationships between behavioral health, risk factors associated with social and health service needs, and high school progress and outcomes for DSHS clients who began 9th grade in 2005-06. Among 28,922 DSHS 9th graders, 40 percent had behavioral health service needs reflected in administrative data—either mental health needs, substance abuse needs, or both (co-occurring). Youth with behavioral health needs were less likely to graduate from and more likely to drop-out of high school and had poor test outcomes compared to peers without mental health or substance abuse problems. Graduation rates varied by diagnostic category, with the lowest graduation rates found among youth with substance abuse, psychotic disorders, bipolar disorder and/or ADHD. Youth with behavioral health needs were also more likely to experience an array of challenges and risk factors associated with educational failure, including juvenile justice involvement, homelessness, early childbirth, school changes and emergency room use. DSHS service use patterns suggest that youth with behavioral health needs were often living in difficult family situations, including both abuse/neglect and deeper poverty levels. These findings highlight the importance of integrated services and information sharing across systems serving children with behavioral health needs.
This report describes chemical dependency treatment participation and crime outcomes of 1,671 adults charged with felonies who were admitted to formally established drug courts in Washington State from July 2007 through June 2009. Three-year treatment and crime outcomes are compared to a matched comparison group of 1,671 adults charged with similar felonies in the same jurisdictions and time period and who were in need of treatment but not admitted to a drug court. Arrests, incarceration rates, and treatment participation over a three-year follow-up period are examined, as are net benefits associated with the reductions in crime attributed to admission to drug court. This is part of a series of analyses for DSHS’ Division of Behavioral Health and Recovery examining the experiences of recipients of treatment funded by the Criminal Justice Treatment Account, which pays for chemical dependency treatment for offenders who are chemically dependent or have a substance abuse problem that could, if untreated, lead to addiction.
This report examines the experience of individuals over a 12-month period following their release from a Washington State Department of Corrections (DOC) facility in SFY 2010 or 2011. We find that homeless ex-offenders who received housing assistance and transitioned to permanent housing had lower rates of criminal recidivism and higher rates of employment, Medicaid coverage, and substance abuse treatment, compared to other homeless ex-offenders. In addition, ex-offenders who received housing assistance were more likely to have Medicaid coverage, and treatment penetration rates were relatively high among substance abusers with coverage. Finally, as with housing assistance, homeless ex-offenders who had Medicaid coverage were less likely to be incarcerated or have a felony conviction in the follow-up period.
This report identifies youth released from a Juvenile Rehabilitation (JR) institution or community residential facility who experienced homelessness in a 12-month follow-up period and compares them to youth released from JR facilities who did not have an identified housing need in the year following release. Individuals who were 18 years-old or older at the time of release were at greater risk of experiencing homelessness. Relative to youth who did not have identified housing needs, homeless released youth were more likely to be arrested, convicted of a felony or misdemeanor, re-admitted to a JR institution, and receiving JR parole supervision and services. Homeless released youth also had significantly greater behavioral health, medical, and mortality risk.
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