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GA-U Clients: Challenges and Opportunities

KEY FINDINGS
Most GA-U clients have chronic physical conditions, mental illness, and/or substance abuse problems.

• Among FY 2003 GA-U clients, 69 percent had at least one chronic physical condition, 36 percent had a mental illness diagnosis and 32 percent had a substance abuse problem identified in available administrative records.

Many GA-U clients become eligible for Medicaid.

• Half of FY 2003 GA-U clients transitioned to Medicaid Disabled coverage by the end of FY 2004. GA-U clients with a mental illness diagnosis were most likely to make this transition, with 66 percent on Medicaid Disabled coverage by the end of FY 2004.

Mental illness and substance abuse increase frequency of ER visits.

• The average FY 2003 GA-U client had 2.5 ER visits in the two-year period spanning FY 2003 and 2004. The 16 percent of FY 2003 GA-U clients with both a mental illness diagnosis and an indication of a substance abuse problem averaged 6 ER visits over the two-year period.

Substance abuse increases risk of arrest.

• Among all FY 2003 GA-U clients, 30 percent were arrested at least once in the two-year period spanning FY 2003 and 2004. However, 55 percent of clients with an indication of a substance abuse problem were arrested at least once over the two-year period.

Medical costs account for half of DSHS spending on GA-U clients.

• In FY 2003, the average GA-U client received $1,198 per month in DSHS services in the months they received a GA-U cash grant. Economic Services Administration expenditures averaged $420 per client per month, including $295 per client per month for the GA cash grant. Medical Assistance expenditures averaged $577 per client per month - 48 percent of the total. Hospital inpatient expenditures alone accounted for $282 per client per month - about as much as was spent on GA cash grants.

Recent research points to opportunities to improve outcomes for GA-U clients by increasing access to mental health and substance abuse treatment.

• Our findings support longstanding concerns that GA-U clients lack a medical home and access to adequate preventive care, including mental health and substance abuse treatment services. Although several initiatives have been implemented recently to address these concerns, there may be further opportunities to improve outcomes for GA-U clients by expanding access to mental health services or substance abuse treatment.

Modified: Wednesday August 30 2006

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