Eva Westley, Marna Miller, Rebecca Goodvin, Casey Hicks - December 2019

Initiative 502 (I-502) legalized recreational cannabis for adults in Washington State. The law directs a portion of cannabis revenues to be spent on substance abuse prevention and treatment services that have been demonstrated to be effective. Specifically, state law requires at least 85% of programs funded by cannabis revenues to be evidence-based or research-based, and up to 15% to be promising practices.

In this inventory, we rate the research evidence for programs intended for the prevention or treatment of youth substance use, and we identify those specifically effective for reducing marijuana use. The 2018 Washington State Legislature directed WSIPP to update this inventory. This is the fourth update in the series.

John Hansen, Julia Cramer, Patrick Chase - December 2019

The 2018 Washington State Legislature assigned WSIPP to examine the per-student cost of required textbooks and course materials and the use of open educational resources (OER) at public four-year universities across the state. OER is an alternative model for course materials and relies on content that is free to use, alter, and distribute for educational purposes.

In this report, we estimate the average cost of required items, the average cost of required materials per course, and the average cost of required materials for students earning a bachelor’s degree. We found that, on average, students completing a bachelor’s degree at public universities in Washington were expected to spend approximately $2,734 on required textbooks and course materials.

We could not precisely measure the prevalence of OER use in Washington’s public four-year universities, because OER use has not been tracked systematically. Using data from campus book stores, we found that 26% of undergraduate courses required $0 of course materials. Relying on interviews, a review of available research, and additional analyses, we examined several potential practices for supporting OER use in four-year universities. We found that grant programs like Washington’s current OER Grant Pilot Program were a potentially cost-effective approach to supporting wider OER adoption in four-year universities.

Rebecca Goodvin, John Hansen - December 2019

In the Early Start Act of 2015, the Washington State Legislature required child care and early learning providers who serve non-school aged children and receive state subsidies to participate in Early Achievers, the state’s quality rating and improvement system (QRIS). This legislation also directed WSIPP to examine the relationship between Early Achievers quality ratings and long-term outcomes for children who participate in state-subsidized child care and early learning programs. WSIPP is required to produce annual reports to the legislature from December 2019 through December 2022, and the final report must include a benefit-cost analysis of Early Achievers.

In this first report we present background information from a review of QRIS programs and evaluations in other states, and detail Early Achievers implementation, key program features, and summary ratings data. We also outline WSIPP’s research questions, planned research design, and data sources, and address study limitations.

Our review of the national QRIS child outcome evaluation literature indicates that other states have found limited, inconsistent relationships between quality ratings and outcomes for children. However, this body of research is in an early stage, which limits our confidence in the resulting conclusions.

WSIPP’s next report in the Early Achievers evaluation series, due in December 2020, will address the impact of Early Achievers during children’s pre-kindergarten year on outcomes in kindergarten, including kindergarten readiness assessed using the WaKIDS.

Chasya Hoagland, Danielle Fumia, Martine Reynolds - December 2019

The WSIPP Board of Directors and the 2019 Washington State Legislature directed WSIPP to update previous findings on early childhood education. In 2013, the legislature directed WSIPP to conduct an outcome evaluation and return on investment analysis of the state’s Early Childhood Education and Assistance Program (ECEAP). As part of that assignment, WSIPP produced a report summarizing the national research literature on the long-term effectiveness of early childhood education programs and conducting a benefit-cost analysis for these programs.

This report updates those previous findings and presents new findings for three types of programs: 1) state early childhood education programs targeting low-income children, 2) universal state early childhood education programs, and 3) Head Start.

We find that increases in academic achievement for participants in these programs are likely to produce long-term monetary benefits that outweigh the costs.

Marna Miller, Lauren Knoth-Peterson - November 2019

The 2018 Washington State Legislature directed WSIPP to conduct a statewide study on the needs of girls and young women involved in both the juvenile justice and child welfare systems, referred to in the legislation as “dually involved females.”

This study compared dually involved females to dually involved males and to females with only juvenile justice involvement in criminal justice system involvement, mental health and substance abuse diagnoses and treatment, medical care, employment, homelessness, teen birth, and use of Temporary Assistance to Needy Families and the Supplemental Nutritional Assistance Program.

The study includes a survey of other states regarding systems to address and treat the needs of dually involved youth.

Adam Darnell, Michael Hirsch, Paige Wanner - August 2019

The 2018 Washington State Legislature directed WSIPP to conduct additional cannabis research, supplemental to the ongoing benefit-cost evaluation of cannabis legalization authorized by Initiative 502 in 2012. As part of the new assignments, WSIPP was directed to examine effective methods for suppressing unlicensed cultivation and distribution of marijuana in jurisdictions with legal markets. We found very little evidence on that topic. Instead, we identified numerous factors that could contribute to the survival of the illicit marijuana market in the context of legalization, such as continuing prohibitions in other states and regulations that reduce the competitive advantage of the legal market. We examined key regulatory features in the nine states with licensed non-medical cannabis supply systems and found that states varied widely in the level of restriction imposed on legal supply systems. We conclude by outlining a practical strategy for monitoring illicit market reductions as the state’s approach to legalization develops.

Eva Westley - June 2019

The 2018 Washington State Legislature directed the Washington State Institute for Public Policy (WSIPP) to conduct evidence reviews on step therapy and step therapy exceptions and to summarize step therapy exceptions codified in other states. One goal of the assignment is to determine whether this type of prescription drug utilization management practice has an effect on health outcomes. In this report, we describe the results of our evidence reviews on step therapy and step therapy exceptions and describe the limitations of the research evidence. We also summarize the step therapy exceptions codified in other states and describe Washington’s codified step therapy exception.

Lauren Knoth-Peterson, Paige Wanner, Lijian He - June 2019

In 2018, WSIPP’s Board of Directors approved a contract with the Washington State Juvenile Rehabilitation Administration in conjunction with the Community Juvenile Accountability Act Oversight Committee to evaluate a juvenile court evidence-based program. The contract required WSIPP to evaluate the effectiveness of the Washington State Aggression Replacement Training (WSART) program at reducing recidivism for court-involved youth. In addition to evaluating the overall effects, WSIPP was asked to evaluate for whom the program was most effective and under what conditions the program was most effective. This report evaluates the effects of WSART in Washington State juvenile courts from 2005 to 2016. To the extent possible, we evaluated the varying effects of WSART for subpopulations including males and females; White, Black, and Hispanic youth; younger youth and older youth; high-risk youth and moderate-risk youth; and youth assessed using the BOT and youth assessed using the PACT. Finally, we evaluated differences in the effects of WSART by characteristics of WSART program participation including trainer competence and program completion.

Adam Darnell - May 2019

The 2018 Washington State Legislature directed WSIPP to conduct additional cannabis research, supplemental to the ongoing benefit-cost evaluation of cannabis legalization authorized by Initiative 502 in 2012. As part of this supplemental work, WSIPP was directed to examine current data collection methods measuring the use of marijuana by youth and potential ways to improve on these methods. In this report, we focused on the Washington Healthy Youth Survey, the primary source of data on cannabis use among Washington youth. We reviewed the evidence for harmful consequences of cannabis use focusing on how cannabis use was measured, and we examined recently developed surveys that reflect the state-of-the-art in survey measurement of marijuana use. With this information, we identified a set of potential improvements to the HYS while considering the practical limitations of revisions to an existing survey.

John Bauer, Casey Hicks - May 2019

The 2018 Washington State Legislature directed WSIPP to conduct a study of single-payer and universal health coverage systems. Our interim report discussed policies to promote universal health care, outlined health care coverage and expenditures in Washington, examined potential effects of implementing single-payer health care, discussed challenges to implementing it, and summarized characteristics of national and state single-payer proposals.

Our final report examines universal coverage and single-payer systems in other high-income countries, which have achieved universal coverage and substantially lower health care spending than the US. These other countries, both single- and multi-payer, have mechanisms to control the prices of medical services and pharmaceuticals. They have lower insurer administrative costs and, in the case of single-payer countries, lower provider administrative burdens. These countries also have, to varying degrees, limited the utilization of some high-margin procedures and advanced imaging and discouraged the diffusion of medical technologies and drugs that have modest or uncertain effectiveness.

Individuals in these countries have fewer financial barriers to health care and more equitable access to care across income groups than in the US. Finally, the higher US health expenditures do not translate to better health outcomes and quality of care for the entire population.