Collaborative Primary Care: Preliminary Findings for Depression and Anxiety

The Washington State Institute for Public Policy (WSIPP) was directed by the 2013 Legislature to prepare an inventory of evidence-based, research-based, and promising practices for prevention and intervention services for adult behavioral health. This brief report presents our preliminary findings on collaborative primary care for depression and anxiety. Final results for collaborative care will be published in May 2014.

Recidivism Trends of Domestic Violence Offenders in Washington State

Washington State Legislature passed a bill directing the Washington State Institute for Public Policy to 1) review the research literature on treatment for domestic violence offenders and other interventions effective at reducing recidivism; 2) survey states’ laws regarding domestic violence treatment for offenders; and 3) analyze recidivism rates of domestic violence offenders in Washington. Findings were published earlier this year on the first two tasks. In this report, we complete the legislative assignment and describe the recidivism rates of domestic violence offenders in Washington.

Innovative Schools in Washington: What Lessons Can Be Learned?

The 2011 Washington State Legislature passed two laws concerning innovative schools. The first recognized public schools that are “bold, creative, and innovative.” A second law sought to expand the number of innovative schools by allowing flexibility in state statutes and rules. At present, there are 34 designated schools and innovation “zones.”

For this study, we statistically analyzed school performance; conducted systematic literature reviews; and visited most designated schools. We learned that the designated innovative schools are extremely varied in their missions, student populations, strategies, and outcomes.

Updated Inventory of Evidence-Based, Research-Based, and Promising Practices

Inventory of Evidence-Based, Research-Based, and Promising Practices
For Prevention and Intervention Services for Children and Juveniles
in the Child Welfare, Juvenile Justice, and Mental Health Systems

The 2012 Legislature passed E2SHB 2536 with the intention that “prevention and intervention services delivered to children and juveniles in the areas of mental health, child welfare, and juvenile justice be primarily evidence-based and research-based, and it is anticipated that such services will be provided in a manner that is culturally competent.”

The bill directs the Washington State Institute for Public Policy (WSIPP) and the University of Washington Evidence-Based Practice Institute (UW) to publish descriptive definitions and prepare an inventory of evidence-based, research-based, and promising practices and services, and to periodically update the inventory as more practices are identified. This is the second update to the September 30, 2012 publication. The accompanying report describes the inventory update process, as well as the ongoing technical assistance process by UW.

Educational Outcomes of Foster Youth--Updated Benchmarks

This report outlines four outcome measures for tracking the educational progress of students in foster care. Previous research conducted by the Institute has shown disparities in the educational outcomes of foster youth, including a higher dropout rate, lower scores on statewide standardized assessments, and lower high school graduation rates. Improvements in state educational data have resulted in the ability to track student progress since 2005. We can now look at historical trends for many of these outcomes to determine how results have changed over time. This report provides detailed definitions and results on four long-term measures related to the educational status of youth in foster care. These measures include the following:

• School retention: Nine out of ten (90%) foster youth re-enroll in the following school year (compared to 94% of non-foster youth).
• Behind grade level: 6% of foster youth and non-foster youth are behind their expected grade level.
• Adjusted cohort graduation rate: The longitudinal (four-year) graduation rate for youth in long-term foster care was between 35 and 55% (the rate for non-foster youth was between 70 and 75%).
• Annual graduation rate: Measured on an annual basis, the graduation rate for foster youth was 48% compared to 72% for non-foster students.

Special Commitment Center for Sexually Violent Predators: Potential Paths toward Less Restrictive Alternatives

Washington State law provides for indefinite civil commitment of persons found to meet criteria as sexually violent predators (SVPs). The Special Commitment Center (SCC) on McNeil Island houses persons who are detained and/or committed as SVPs. The Institute was directed to study several aspects of SCC. Major findings include:

Releases: As of CY 2012, 86 residents have been released from SCC.

Treatment: 37% of residents actively participate in sex offense treatment.

Annual Reviews: A survey of legal practitioners revealed concerns about the timeliness of reviews, with mixed reports regarding the quality.

Senior Clinical Team: SCC’s group of senior clinicians and managers plays a key role in residents’ treatment progression and decision-making regarding readiness for a less restrictive alternative. Some practitioners in the legal community expressed confusion and/or concern about the team’s role.

Less Restrictive Alternatives: Confinement at the state’s Secure Community Transition facilities costs significantly more than confinement at the main facility.

The report includes a response from the Special Commitment Center.

Revised on 1/28/2013 to modify Exhibits 1 and 17.

What Works to Reduce Recidivism by Domestic Violence Offenders?

The 2012 Legislature directed the Institute, in collaboration with the Washington State Gender and Justice Commission and experts on domestic violence, to update its analysis of the literature on domestic violence (DV) treatment. We were also directed to 1) report on other treatments and programs for DV offenders and the general offender population; 2) survey other states to study how misdemeanor and felony domestic violence cases are handled; and 3) report recidivism rates for DV offenders in Washington. This first report summarizes our findings regarding DV treatment and other programs and treatments.

Standardizing Protocols for Treatment to Restore Competency to Stand Trial: Interventions and Clinically Appropriate Time Periods

The Washington State Institute for Public Policy (Institute) was directed by the 2012 Legislature to “study and report to the legislature the benefit of standardizing treatment protocols used for restoring competency to stand trial in Washington, and during what clinically appropriate time period said treatment might be expected to be effective.”

To conduct this work, the Institute contracted with a national expert in the field, Dr. Patricia Zapf. This report provides background on the types of interventions (treatments) used throughout the United States for the restoration of competency to stand trial, and research regarding the timelines for restoration. In addition, data on length of stay at Eastern State Hospital and Western State Hospital for incompetent defendants remanded for competence restoration are summarized.

K-12 Class Size Reductions and Student Outcomes: A Review of the Evidence and Benefit-Cost Analysis

The Washington State Legislature directed the Washington State Institute for Public Policy (Institute) to develop “a repository of research and evaluations of the cost-benefits of various K–12 educational programs and services.”

In this report, we analyze a significant policy question for the legislature: do the benefits of reducing the number of students in K-12 classrooms outweigh the costs?

Bright Futures Guidelines and Washington State Medical Assistance Programs, Revised

The 2012 Legislature directed the Institute to assess the costs and benefits of implementing the American Academy of Pediatrics’ Bright Futures Guidelines for well-child visits and developmental screening in medical assistance programs. Currently, federal regulations require non-grandfathered private health plans to comply with Bright Futures, but state Medicaid programs can choose whether to implement the guidelines or not.

We analyzed Washington Medicaid eligibility, claims and encounter data to assess the likely cost of providing additional well-child visits and developmental screening. We reviewed the literature to examine potential effects on health and other outcomes. We elicited advice from clinical experts and reviewed coverage in other state Medicaid programs and private health insurers.

The Center for Evidence-based Policy (CEbP) at the Oregon Health & Sciences University assisted the Institute by searching for studies that examined (a) the effects of additional well-child visits and developmental screening on outcomes for children and (b) the effectiveness of speech and language interventions. Links to the CEbP reports are provided.

Revised on 1/28/2013 to modify the discussion of developmental screens on p. 17.