Department of Social and Health Services (DSHS)

1. Department of Social and Health Services(DSHS) Our mission: • Improve the quality of life for individuals and families in need • Help people achieve safe, self-sufficient, healthy and secure lives Department of Social and Health Services

2. Medical Cost Offset Project Shift existing fundsto provide more drug and alcohol treatment to low income citizens with serious medical disabilities (and resulting high medical costs), in order to: • Save taxpayer dollars • Reduce alcohol and drug abuse • Decrease crime Department of Social and Health Services

3. The Challenges DSHS Faced • Medical costs are rising rapidly -- especially to care for people with chronic illness • 16% of the chronically ill have serious drug and alcohol problems • Not enough money allocated to treat drug and alcohol problems • Moving money from one program to another is VERY difficult Department of Social and Health Services

4. The Big Idea • DSHSdata analysisshowed that treating drug and alcohol problems sooner would lower the amount spent on health care. • So using money from the medical care budget to pay for drug and alcohol treatment should result inNet Savings. Department of Social and Health Services

5. TREATMENT WORKS Lower hospital admissions Fewer hospital inpatient days Decreased emergency room use Fewer psychiatric hospitalizations Reduced use of alcohol/drugs Reduced use of alcohol/drugs Lower medical costs Lower medical costs Fewer drug offenses Increased earnings Enhanced productivity Higher levels of employment Fewer violent crimes Less child abuse and neglect Less child abuse and neglect Fewer property crimes Decreased use of public assistance Reduced domestic violence Fewer driving while under the influence cases Reduced incarcerations Lower criminal justice costs Lower criminal justice costs Department of Social and Health Services

6. How We Implemented the Project • Transferred funds to the Division of Alcohol and Substance Abuse so moreclients got alcohol or drug treatmentsooner. • Streamlined our intake procedures and referral processes to make it easier for clients. • Asked community providers (doctors, nurses, counselors) to identify those who needed alcohol or drug treatment. • Evaluated the project with rigorous research. Department of Social and Health Services

7. How We Evaluated the Impacts Collected data on clients identified as needing alcohol or drug treatment (15,000) Evaluatedoutcomes by • Checking DSHS medical histories/costs • Checking Washington State Patrol arrest and court conviction records Department of Social and Health Services

8. Public Benefit:Made Our State Safer Department of Social and Health Services

9. Financial Management: Saved Taxpayer Dollars! Saves $252 per month Department of Social and Health Services

10. Financial Management: $252Saved Per Client Per Month Department of Social and Health Services

11. Organizational Learning For Washington State: • Increased funding for treating substance abuse for clients with chronic illness continues • Started a similar project for welfare clients At the National level: • Recently received federal funds for a similar project in hospital emergency rooms  $16.1 million for 5 years Department of Social and Health Services

12. The Bottom Line – Treatment Works Made our state safer by lowering re-arrest and re-conviction rates. Public benefit Financial Management Customer Service Organizational Learning Saved $2.5 million annually(net) in medical costs. Streamlined intake and shortened wait for treatment. Made funding shift permanent, and expanded exploration of other cost offsets across systems. Department of Social and Health Services