Do Patients on Atypical Antipsychotic Medications Have Better Outcomes?

The 2000 Legislature provided for the distribution of “atypical antipsychotic” medications to underserved populations with psychiatric disorders. Pierce County Regional Support Network (Pierce RSN) and Harborview Mental Health Services (HMHS) were participants in this pilot program, serving 282 and 192 clients, respectively. Both programs fulfilled the legislative requirements, serving a severely mentally ill population with few resources. The programs provided temporary access to medications, helping to fill the funding gap between the time a low-income person needs medication until a Medicaid coupon or an alternative medication funding source becomes available. Many participants transitioned onto Medicaid: approximately 40 percent of participants in both programs were Medicaid eligible in state records six months after the program ended. Nearly two-thirds of program participants stayed in the program for no more than two months.

The only feasible research design was a comparison of participants before and after the program. This design does not allow scientific conclusions about a program’s effectiveness. Comparing the year prior to and after program entry, Pierce RSN participants showed fewer felony and misdemeanor criminal convictions and psychiatric hospital admissions and increased participation in outpatient services; no improvement in employment status was found. HMHS participants had increased participation in outpatient services, showed slightly fewer felony convictions, but no improvement in misdemeanor convictions, psychiatric hospitalizations, or employment status

Declining Use of Subsidized Child Care: The Role of Criminal Background Checks

Between 2002 and 2004, the Working Connections Child Care caseload fell by 13 percent. Until recently, the declines were attributed to cost saving measures implemented in 2002 and 2003. A recent report by the Department of Social and Health Services (DSHS) found that caseload declines occurred only in unlicensed child care and suggests that new policies regarding criminal background checks of in-home/relative providers might be the primary reason for the caseload reductions.

To determine if there is a causal link between criminal background check policies and the caseload declines, the Institute conducted a statistical analysis of data combined from multiple administrative data systems. After controlling for family characteristics, type of child care used, employment, and the welfare caseload, the analysis revealed several significant impacts attributable to criminal background check policies.

Findings: Requiring a criminal background check per se did not affect the child care caseload. However, recent changes to policies and procedures regarding the timing and scope of background checks have: discouraged the use of in-home/relative care; contributed strongly to the decline in caseload; and disproportionately affected families receiving Temporary Assistance for Needy Families (TANF).

Washington State's Experience with Research-Based Juvenile Justice Programs: Presented at the Los Angeles County Juvenile Justice Conference May 19, 2005

This presentation describes Washington State's experiences implementing research-based programs in juvenile justice. The presentation includes a history of the research-based effort in Washington State, program outcome evaluations, quality assurance principles, and cost benefit meta-analyses. Presented at the Los Angles County Juvenile Justice Conference May 19, 2005. Robert Barnoski.

Involuntary Commitment of Sexually Violent Predators: Comparing State Laws

In 1990, the Washington State Legislature passed a new form of involuntary commitment for sex offenders identified as “sexually violent predators” (SVPs). This law permits the state to retain custody of individuals found by a judge or jury to pose risks for reoffending. Since Washington’s enactment, 16 other states have adopted similar laws. Texas requires outpatient treatment rather than confinement; Pennsylvania law pertains only to 20-year-olds “aging out” of the juvenile system.

This paper summarizes key features of the SVP laws, focusing on three questions:

• How many individuals have been held under these laws?
• How many have been released under some form of less restrictive alternative?
• What are the program costs?

Washington’s Dangerous Mentally Ill Offender Law: Was Community Safety Increased?

The 1999 Washington State Legislature passed Substitute Senate Bill 5011 to improve the process of identifying and providing additional mental health treatment for mentally ill offenders who are being released from the Department of Corrections (DOC), who pose a threat to public safety, and agree to participate in the program. A “Dangerous Mentally Ill Offender” (DMIO) is identified in the legislation as a person with a mental disorder who has been determined to be dangerous to self or others. The legislation also directs the Washington State Institute for Public Policy (Institute) and the Washington Institute for Mental Illness Research and Training (WIMIRT) to evaluate the Act to determine:

• Whether criminal recidivism or inpatient hospitalization was reduced;
• Whether mental health, drug/alcohol, case management, housing assistance, and other services were improved;
• Whether the risk assessment tool assessing dangerousness was valid; and
• Whether the state saved money because of early Medicaid enrollment or reduced use of DOC beds.

These outcomes were analyzed by comparing DMIO participants released from prison (DMIO participants) with a similar group of offenders from the Community Transition Study (CTS), who were released in 1996 and 1997. This study covers all offenders admitted to the program during its first two years, and who were followed in the community for 18 months after their release from prison. The DMIO program was designed to serve participants for five years after prison release; this evaluation covers the first 18 months of a 60-month program.

High School Graduation Rates in Washington and the United States: A Long-Run View

This short report presents updated data on Washington's high school graduation rate, along with the national rate. We also highlight results from our recent report on the long-run implications of not graduating from high school.

The Institute's previous findings on graduation rates are in the 1996 publication Trends in At-Risk Behaviors of Youth in Washington.

Long-Term Outcomes of Public Mental Health Clients: Additional Baseline Characteristics

The 2002 Washington State Legislature directed the Institute to conduct a longitudinal study on the outcomes of state-funded mental health clients. A preliminary report provided baseline information on clients' age, gender, race, education enrollment status, employment, living situation, and selected mental health conditions. This report provides additional data on baseline characteristics of Washington’s public mental health clients, including criminal justice involvement, mental health functioning assessment scores, and caseloads of regional support networks. In addition, data are provided on clients’ use of mental health services and their employment status and earnings in 2002. An outcomes report showing changes between 2002 and 2004 will be completed by the end of 2005.

Correctional Industries Programs for Adult Offenders in Prison: Estimates of Benefits and Costs

In recent years, the Washington State Legislature has directed the Institute to identify evidence-based programs that can lower crime and give Washington taxpayers a good return on their money. The purpose of this short report is to update previously published findings pertaining to correctional industries programs for adult prisoners.

Washington's Drug Offender Sentencing Alternative: An Evaluation of Benefits and Costs

The Washington State legislature directed the Institute to evaluate whether the Drug Offender Sentencing Alternative (DOSA) influences recidivism rates and whether the benefits of DOSA outweigh the costs. We analyzed the effects of the legislation by comparing a group of offenders who received DOSA sentences with a similar group of offenders sentenced prior to the 1999 implementation date of DOSA. As described in the report, our overall finding is that DOSA is an effective criminal justice policy for drug offenders but neutral for drug-involved property offenders.

English Language Learners in K-12: Trends, Policies, and Research in Washington State

The 2004 Washington State Legislature directed the Institute to review the state Transitional Bilingual Instructional Program (TBIP). The Institute interviewed TBIP staff at the state and school district levels; analyzed student enrollment and assessment data; and reviewed laws, policies, and research on instruction for English language learners (ELL students) in the public K–12 school system.