HB 2536 Implementation Overview

1. HB 2536 Implementation Overview

2. Bill Summary Requires DSHS and HCA to expend state funds on: • Juvenile justice programs or programs related to the prevention, treatment, or care of juvenile offenders that are evidence-based; • Children's mental health programs or programs related to the prevention, treatment, or care of recipients of children's mental health services that are evidence-based; and • Child welfare programs or programs related to the prevention, treatment, or care of recipients of child welfare services that are evidence-based.

4. Role of DSHS/HCA • By June 30, 2013 compile a baseline assessment of the utilization of evidence-based and research-based practices in child welfare, juvenile rehabilitation and children’s mental health services. • Prioritize the assessment of promising practices identified in the inventory with the goal of increasing the number of practices that meet the standards of evidence-based and research-based practices.* • By December 30, 2013; 2014 and 2015 produce reports for the Governor and the Legislature that include:

5. Role of DSHS/HCA, Cont’d. • Recommended strategies, times and cost for increasing the use of evidence-based and research-based practices • Distinguish between the reallocation of existing funding and new funding to support the recommended strategies • Expectation that there will be substantial increases above the baseline assessment of the use of evidence-based and research-based practices.

6. Inventory Process • Re-defined EBP, RBP, Promising Practice • Use existing Information to identify interventions that target outcomes of interest to: • Child Welfare • Children’s Behavioral Health • Juvenile Rehabilitation Administration …that can be purchased by DSHS and HCA • Set up promising practice app • Short timeline - Only included programs with an existing review

7. Evidence Based Practices • Current law definition of EBP requires: • At least 2 random-assignment trials • Tested across heterogeneous populations (without definition) • Proposed definition • Permits quasi-experimental studies with good statistical controls • Permits single study evidence if study is LARGE • Defines heterogeneity – program must have been studied in populations as racially/ethnically diverse as children in Washington • Requires that the program benefits exceed the cost

8. Research Based Practices • Current law definition of RBP requires: • “Some evidence” not to the standard of EBP • Proposed definition • At least one randomized or well controlled study, with demonstrated sustained outcomes • Does not meet other criteria for EBP

9. Promising Practices • Current law definition of promising: • Based upon preliminary information, program has potential for becoming a research-based or consensus-based practice. • Proposed definition • Statistical analyses or a well-established theory of change, shows potential for becoming RBP or EBP Or • Use of a program that is evidence-based for outcomes other than the alternative use. • Short time line - this list is incomplete.

10. Promising Practices Application • Need a score of 1 to qualify. Points deducted if the program uses methods known to be harmful or the approach is inappropriate for the target population as judged by reviewer consensus.

11. Promising Practice Application • Is the proposed practice/program an intervention that targets outcomes of interest to DSHS child-serving agencies? • Child abuse, neglect, need for out of home placement; crime; children’s mental health; education; or employment • OR, changes in protective/risk factors known to be associated with these outcomes.

12. Promising Practices Application • Does it have initial evidence of effectiveness? • Pre-post test indicating changes • Well designed qualitative data

13. Promising Practices Application • Does it have a “well-established theory of change?” • Logic model that rests on empirically supported correlates of change • Uses the general principles or model of an existing EBP • Is an EBP that is being used for a purpose other than its evidence-base.

14. Technical Assistance Overview

15. Evaluation TA Focus Areas • Tiered support that addresses unique needs of programs. • Tier 1 • Written and archived media that addresses foundational topics: logic models, internal research capacity, EBP definitions and development. • Tier 2 • Interactive resources for small to large group audiences: webinars, workshops, trainings. • Tier 3 • One on one support that supports a program’s development toward research/evidence-based by putting them in a better position to secure funding for sophisticated evaluation .

16. TA: Program Evaluation

17. Tier 3: One on One support • Program priority will be informed by DSHS priorities • Goal for TA will be to move eligible programs to promising practice status focusing on one of the areas below: • Assist with logic models • Assist with internal research capacity • Assist with conducting preliminary research

18. Evaluation TA: Program next steps • Can the TA establish a program as Evidence-Based? • The Evaluation TA will be primarily focused on building a foundation for moving towards more sophisticated evaluation. Current resources are not sufficient to conduct the kinds of evaluation necessary for a research/evidence-based designation. However, the goal is to put programs in a better position to secure additional funding and/or clarify agency goals in regards to EBP implementation in general.

19. EBP Implementation Assistance Form • Complete if: • Your agency would like assistance with organizational readiness, training, implementation, sustainability, or adaptation of an existing EBP • Form Includes: • Opportunity to describe Implementation/Adaptation needs • Initial organizational readiness screening • Questions about referral stream and QA • Caveat: • Completion of form does not guarantee assistance • PBHJP has limited resources and may be able to help your agency identify additional resources or partners through which your request may be filled

20. TA: Implementation • Areas of assistance available currently: • Organizational Readiness Assessment • Learning about EBPs and training opportunities • Decision making re: best EBP fit • Cultural enhancements • Maximizing implementation efforts

21. TA: Implementation • Forms of support can include: Tier 1 • Linkages to information on specific EBPS, training opportunities, cultural enhancements/adaptations Tier 2 • Interactive resources for small to large group audiences (depending on need) Tier 3 • One-on-one Implementation or Adaptation support

22. Take-aways • Intent of legislation is to increase use of evidence based and research based practices across systems in WA state • DSHS, HCA, WSIPP, and UW have distinct but complimentary roles in implementation • DSHS and HCA will complete its baseline assessment by June 30, 2013 • WSIPP will publish an updated inventory on January 31st to include promising practices • UW will offer technical assistance beginning January 31st (Access Promising Practices Application and EBP Implementation Form here.) • Our goal is to assist agencies and providers as they adjust to this legislation.

23. Question and Answer