Report on Medicaid Data Analyses For

Transcription

1 Report on Medicaid Data Analyses For King, Pierce, Spokane, Thurston, Skagit and Kitsap Counties NW HIDTA/DASA Drug Court Evaluation Alcohol and Drug Abuse Institute University of Washington April 25, 2001 Issue Medicaid claim data provide a wealth of information about health care utilization patterns and the use of public resources to pay health care costs. Many social programs share an implicit, if not explicit, goal of helping individuals they serve manage their health care to achieve appropriate and cost effective use of public resources. Changes in patterns of Medicaid use have become a common variable in studies of a broad range of intervention programs. While changes in health care utilization are not a stated goal of drug court programs, the examination of utilization patterns is another way to examine the potential broad impacts of participation in DC programs. Claim data may be considered as process variables that help describe programs, or as outcome variables if changes in utilization patterns are considered as program goals. The choice between prcess or outcome use of the data is somewhat arbitrary. In this drug court evaluation we might assume that increasing claims for chemical dependency treatment services is a desirable outcome indicating that more people are seeking appropriate treatment, and that Medicaid claims are being used to supplement and therefore extend state and local funding for treatment. Likewise, we might assume that a reduction in claims for emergency room and medical in-patient services is desirable since they are expensive and, in many cases, avoidable, and that there should be a concomitant increase in the regular use of less expensive medical out-patient services. Thus, decreases in ER and in-patient services and increases in out-patient services might be seen as desirable outcome of DC programs. Conclusions Methods The two categories of Medicaid claims that show the highest levels of use are Chemical Dependency Out Patient and general Medical Out Patient treatment. Medical OP has substantially higher use rates than CD OP, suggesting that Medicaid could be used more extensively to support drug court treatment. Graduates generally show greater increases in the use of these two categories from pre-referral to post-referral than other groups of subjects. Drug Court Outcome Groups. Within each court, subjects are grouped as follows: s are persons who passed an initial legal screen and were referred to the court, but on closer examination were found to be ineligible on either legal or clinical grounds. Opt Outs are persons who met all criteria, and were offered entry to the court, but who personally declined to participate. Graduates are individuals who graduated from a drug court. Did Not Finish (s) are individuals who were admitted to a drug court program and either failed or dropped out. Actives are all remaining cases still in the drug court. They are not included in these analyses. Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 1

2 Data. Data were provided by the State Medical Aid Administration (MAA), for the period of January, 1993 to November, Because different subjects entered and left the program at different times, subjects vary on how much time they have pre and post referral (subjects entering late in the study will usually have full data pre, but truncated data post referral, and vice versa for those entering early). We provided MAA with subject names, dates of birth and social security numbers, and the matches were made by MAA. If no match was identified, we assumed this meant that person had not made Medicaid claims. Subjects with no match were assigned zeros as data for the duration of their time in the study, thus all subjects were included for the full time they were in the study. The reimbursement requests were broken into categories (described below), and for each category and for the total, we derived two scores, one a yes/no for whether a subject made claims in each quarter in which they were in the study, the other a dollar amount of reimbursements made in each quarter. These are the values used in the graphs (pages 13-36). The "percent receiving" graphs show the percent of each group that received that category of reimbursement in each quarter. The "average reimbursement" graphs show the mean amount of reimbursement per group member (all group members included) for each category for each quarter. Tables showing the values used in the graphs are provided on pages for percentages, and pages for mean reimbursements. The percentage of subjects in each group that made at least one claim in any of the quarters during the pre-referral period and during the post-referral period are reported in the table on page 8. For the statistical analyses we aggregated these two variables for each subject. For the proportion making claims, the value used for each subject was the proportion of quarters in which a claim was made (the number of quarters in which a claim was made divided by the number of quarters for which the subject had data), calculated separately for the pre and post-referral periods. Similarly, for each person the mean reimbursement per quarter was determined separately for pre and post-referral periods (the mean per quarter was used rather than the total because subjects had different periods of time before and after referral). The mean values for the pre-referral and post-referral periods by Medicaid categories for subjects combined in each county are reported in the table on page 8. Medicaid reimbursement records were broken into 8 categories of service, plus total reimbursement (the sum of all eight categories). The service categories are: Chemical Dependency Emergency/Crisis Medical In Patient Medical Out Patient Detoxification Mental Health Nursing home/congregate care Psychiatric In Patient The last four categories occurred so infrequently that their statistical analyses were not meaningful, nor are graphs included for them. They are included in the statistical analyses as part of the overall total Medicaid utilization and charges. The three most recent programs, Thurston, Skagit and Kitsap counties, all had relatively small sample sizes, low Medicaid usage percentages, and/or such short post-referral follow-up periods that their data are generally not analyzable statistically. Tables are provided of the sample sizes by quarters, and the percentages and charges appear in tables and are also graphed. Data from these counties are included in those analyses that combine all subjects across the six counties. In the statistical analyses 1 pre-existing differences among the groups on the variables are controlled by using change scores, that is, the pre-referral value is subtracted from the post-referral value to determine how much change occurred between the two time periods. A positive score means that the post score was higher (larger 1 Multivariate Analyses of Variance. Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 2

3 percentage of use, or higher mean reimbursements), and negative score that the post score was lower. The means by counties and by offender outcome group for the pre- and post-referral scores and for the difference scores for the four major Medicaid claim categories are reported in the tables on pages Graphical Results Chemical Dependency Services. The quarterly percents of offenders receiving Medicaid reimbursement for CD services is generally between 0% - 4% before drug court referral. Post-referral percentages for Graduates and s rise in King to 3% -6%, +4% in Pierce (only Graduates increase), and 6% - 10% in Spokane counties. Pierce and Spokane percentages drop after several quarters to previous levels. Mean quarterly reimbursements for CD service pre-referral are between $0 - $18. Post-referral the means for Graduates and s (Graduates only in Pierce) increase substantially in King (up to $15 - $30) and Spokane ($30 - $90) counties, and somewhat less in Pierce ($10-25). In Pierce and Spokane these amounts decline over time more than in King. Emergency/Crisis Services. Initial quarterly utilization percentages for Emergency services are similar for groups and counties, mostly 0% - 4% (4% -8% for s in King), with few major changes pre to post. Quarterly mean costs for Emergency services are highly erratic, ranging between $0 - $100 (highest in King, lower and similar in Pierce and Spokane) with occasional higher spikes, and not much difference pre vs. post-referral. Medical In Patient Services. Quarterly use percentages for Medical IP are low pre and post: 0% - 3% in King and 0% - 2% in Pierce and Spokane. These costs are also erratic, mostly ranging between$0 and $100, and similar pre and post-referral and across counties, although somewhat lower in Pierce. Medical Out Patient Services. These have the highest utilization percentages of the Medicaid categories. Quarterly percentages across counties are largely in the 10% to 19% range pre court referral. Post quarterly referral percentages for Graduates and s (Graduates only in Pierce) increase in all three counties, rising to the 15% to 26% range. In Pierce County these percentages taper off over time. Costs for medical OP are also the highest of any category, ranging between about $40 to $100 per person per quarter pre-referral. Post-referral there is a tendency for quarterly means for one or more groups per county to increase. In King, Graduates, s and Opt Outs all increase into the $80 - $120 range; in Pierce Graduates increase to $100 - $160, and in Spokane Graduates, s and Opt Outs are increase to approximately $75 to $175. Overall Findings. In the two areas of greatest use of Medicaid services, CD and Medical OP services, the Graduates tend to be the highest utilizers, with the group generally second. s are the highest utilizers of Emergency and Medical IP services. In the post period, the utilization percentages for Medical OP are considerably higher than for CD services, suggesting that there is a potential additional resource for supporting drug court CD treatment for a sizable group, up to as many as 20%, of court participants. Statistical Results. In the analyses below, all eight categories of Medicaid reimbursement and the totals were analyzed separately for each of the six counties and for all subjects combined. For the reasons outlined above, only results for King, Pierce and Spokane counties and all subjects combined (from all six counties), and for four categories of Medicaid and total Medicaid, are reported. For each category of Medicaid, we analyzed two Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 3

4 scores for each person for the pre-referral and post-referral periods, first, the percent of quarters in which the person received Medicaid benefits, and second, the mean amount of reimbursements made per quarter. The logic of a statistical analysis is to determine first whether there is an overall statistically significant effect. For example, in King County, among the four outcome groups and for the data from the Medicaid categories, is there a significant difference among two or more groups on some combination of the variables? If overall significance is found, it is legitimate to examine the results in more detail to identify which groups are different from each other, and the variables on which they differ. The significance levels for the statistical tests are reported in Table 1 for each of three counties and for all the subjects combined from all six counties (the groupings are identified in column 1), for total reimbursement across all 8 categories, and for the four Medicaid categories with sufficient activity to analyze (the headings in columns 4 to 8). Table 1 shows only the levels of statistical significance for the various tests run on these data. Only "statistically significant" results are reported, that is, results where probabilities were smaller than Empty cells represent "non-significant" findings. Column 2 shows that for each group, two separate sets of analyses were run, one for the percent of quarters in which the offender received Medicaid benefits, the other for the mean amount of benefit paid per quarter. Note that these analyses were performed on change scores, that is, the amount of increase or decrease between pre and post-referral. Question 1: Overall, are there some statistically significant differences among the groups on some combination of the variables? Yes, there are differences among the groups. Column 3, headed "Overall Test of Significance" shows the results of the test for whether there were any differences among any of the groups on one or more of the variables being tested. The probabilities for these tests show that there are consistent overall significant differences among the groups, so the answer to the first question is yes. Question 2: Given that there are some statistically significant differences among groups, on which variables do the groups differ? The groups are clearly different on changes in CD and Medical OP services. Not surprisingly, total expenditures are also significant in two counties and also overall. In Table 1, columns 4 through 7 show the significance levels for each of the four Medicaid categories analyzed, and column 8 the significance level for total Medicaid claims combined across all 8 Medicaid categories. These results show that there are fairly consistent significant differences in the amount of change for the Chemical Dependency and Medical OP treatment categories, but few significant results for Emergency and Medical IP treatment. On this basis, then, most of the differences in changes among groups appear to be based on differences on CD treatment and Medical OP treatment A related question is whether there are differences in results for the two types of measures, changes in percentages of quarters in which reimbursements were received, and mean amounts reimbursed. Here the answer appears to be that percentages are more likely to show group differences than are amounts of reimbursement. 2 Two values larger than.05 are listed in parentheses in the table, both for Pierce County. These "trends" toward significance are included because the overall test for Pierce is significant Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 4

5 Table 1 Levels of Significance for Statistical Tests Counties (1) King Pierce Spokane Variable being analyzed (2) Overall Test of Significance (3) CD (4) Category of Medicaid Claims Emerg (5) Med IP (6) Med OP (7) Total (8) Percent Amount Percent.008 (.06) (.07) Amount Percent Amount Percent Counties Combined Amount Question 3: Given that there are differences among groups, which groups are different from each other in the amount of change? There are three patterns of significant differences among groups. First, as would be expected because of their involvement in treatment during drug court, Graduates show significantly larger increases in percent reimbursed for CD services in King and Pierce counties and for all subjects combined. In Spokane County the Graduates and s both show more increase than the other groups for both the percentage with reimbursements and the mean reimbursement. When all subjects are combined, the Graduates also have a larger increase than the other groups on mean reimbursement. Second, in Emergency services the only significant difference among groups is that there is a greater increase in the percent of s receiving reimbursement when all subjects are combined. Similarly in Spokane for Medical IP, the s have significantly higher increase in the percentage receiving reimbursement than the Graduates. While not expected, these findings are consistent with the idea that s experience some difficulties possibly related to their leaving the drug court programs. Third, for Medical OP services, the Graduates have a pattern of larger increases in percentages and/or amounts of reimbursement than some of the other groups. In King County and for all subjects combined, the increase in percentage is significantly larger than for any other group, and in Spokane it is higher than the Opt Out group. The increase in mean amount of reimbursement is higher for Graduates than for s and Opt Outs in Pierce County and higher than Opt Outs and s for all subjects combined. The findings by counties for total Medicaid reimbursement parallel those above: In percentages with reimbursement, but not in amounts, the Graduates increase more than the other groups in King County and for all subjects combined. In both these cases the s also have significantly larger increases than the s. In Spokane County the Graduates are significantly higher than the Opt Outs. Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 5

6 Overall, in the two areas of greatest use of Medicaid services, the Graduates tend to be the highest utilizers, with the s generally second. Conclusions Percentages with claims and reimbursement amounts are highest for Medical OP services. Percentages are next highest for CD services, but mean amounts of reimbursement are second highest for Emergency services. Use percentages for Medical OP are substantially higher than for CD, suggesting a possible underused source of drug court treatment dollars. Pre-referral to drug court the quarterly percentages of utilization of Medicaid reimbursements tend to be between 0% and 2% for most categories. Use rates for CD and Emergency services are generally higher, up to 4%, and rates for Medical OP higher yet, ranging between about 10% and 19%. Post drug court referral quarterly percentages show little change from pre rates, except Graduates and s show increased percentages of CD service reimbursements (3% - 6% in King and Pierce, and 6% - 10% in Spokane) and Medical OP reimbursement percentages (between 15% and 26%). Mean quarterly reimbursements vary widely across counties and especially across Medicaid categories. Pre-referral CD reimbursements range between $0 to $20, post-referral $15 - $30 in King and Pierce, and $30 - $90 in Spokane. Reimbursement for Emergency and Medical IP services are highly variable in all three counties, tending to range between $0 and $100, with some higher values, in all three counties, pre and post-referral. Medical OP pre-referral reimbursement group means are largely between $40 and $100, while post-referral levels are between $50 - $150. Graduates and sometimes s show the largest pre to post-referral increases in CD and Medical OP. s tend to be highest post-referral on Emergency and Medical IP. Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 6

7 List of Tables and Graphs Percents of Subjects Making Medicaid Claims And Mean Amounts of Reimbursment Groups Combined within Counties...8 Chemical Dependencey Treatment...9 Emergency/Crisis Treatment...10 Medical In Patient Treatment...11 Medical Out Patient Treatment...12 Graphs of Mean Reimbursement Amounts by Quarter And the Percentages of Subjects Making Claims by Quarter Chemical Dependency Treatment for Six Counties Emergency/Crisis Treatment for Six Counties Medical In Patient Treatment for Six Counties Medical Out Patient Treatmen for Six Countiest Tables of Quarterly Data Values Used in the Graphs Quarterly Group Percentages Making Claims for Six Counties Quarterly Group Mean Reimbursements for Six Counties Quarterly Group Total Reimbursements for Six Counties Numbers of Subjects in Each Subject Group for Each Quarter For Six Counties Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 7

8 Counties All Offenders Combined For all Offenders in Each County Percent of Subjects with One or More Medicaid Claim And Mean Amount Reimbursed Per Quarter By Categories of Medicaid Reimbursement Per Cent of All Offenders with Any Reimbursement inaverage Quarter Pre Post Difference Referral Referral Mean Dollar Amounts Reimbursed Per Person per Quarter Pre Referral Post Referral King Any Charge 13.6% 16.1% 2.5% CD OP Tx 1.6% 2.4% 0.8% Emergency 4.0% 4.7% 0.7% Medical IP 1.6% 2.0% 0.4% Medical OP 12.9% 15.3%3 2.3% Pierce Any Charge 10.9% 13.7% 2.8% CD OP Tx 1.3% 2.0% 0.7% Emergency 2.5% 3.3% 0.8% Medical IP 0.7% 1.0% 0.3% Medical OP 10.4% 13.1% 2.6% Spokane Any Charge 14.1% 12.9% -1.2% CD OP Tx 1.1% 1.3% 0.2% Emergency 2.3% 2.8% 0.5% Medical IP 0.6% 0.7% 0.1% Medical OP 13.6% 12.2% -1.5% Thurston Any Charge 14.4% 13.0% -1.3% CD OP Tx 1.5% 1.4% -0.1% Emergency 2.1% 2.7% 0.6% Medical IP 0.4% 0.8% 0.4% Medical OP 13.8% 12.4% -1.4% Skagit Any Charge 25.3% 32.6% 7.3% CD OP Tx 5.8% 13.6% 7.9% Emergency 7.1% 8.7% 1.5% Medical IP 2.1% 1.9% -0.2% Medical OP 24.1% 30.8% 6.7% Kitsap Any Charge 17.0% 19.5% 2.6% CD OP Tx 3.7% 2.5% -1.2% Emergency 0.3% 2.6% 2.3% Medical IP 0.3% 0.5% 0.2% Medical OP 17.0% 19.0% 2.0% Difference Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 8

9 Chemical Dependency Treatment: For Each Subgroup in Each County Mean Percent Receiving Any Reimbursement And Mean Amount of Reimbursement Per Person Per Quarter, Pre- and Post-Referral Out Patient Chemical Dependency Treatment Reimbursement Counties All Medicaid Categories Average Per Cent of Offender Group Mean Dollar Amounts Reimbursed Per Combined with Any Reimbursement in Quarter Person per Quarter Pre Post Difference Pre Post Difference Referral Referral Referral Referral King All Offenders 1.6% 2.4% 0.8% Graduates 1.9% 4.6% 2.7% Did Not Finish 3.1% 3.8% 0.7% Opt Out 1.1% 1.7% 0.6% % 1.8% 0.5% Pierce All Offenders 1.3% 2.0% 0.7% Graduates 1.2% 3.0% 1.8% Did Not Finish 1.9% 1.7% -0.2% Opt Out 1.3% 1.9% 0.5% % 2.0% 1.0% Spokane All Offenders 1.1% 1.3% 0.2% Graduates 2.5% 5.7% 3.2% Did Not Finish 1.6% 6.6% 5.0% Opt Out 1.7% 1.2% -0.5% % 0.8% 0.0% Thurston All Offenders 1.5% 1.4% -0.1% Graduates 0.8% 0.0% -0.8% Did Not Finish 1.5% 1.1% -0.4% Opt Out 1.7% 1.7% -0.1% % 1.6% 0.9% Skagit All Offenders 5.8% 13.6% 7.9% Graduates 4.4% 17.7% 13.2% Did Not Finish 7.6% 9.2% 1.6% Opt Out 0.0% 0.0% 0.0% Kitsap All Offenders 3.7% 2.5% -1.2% Graduates 0.0% 0.0% 0.0% Did Not Finish 6.3% 4.2% -2.0% Opt Out 0.0% 0.0% 0.0% % 0.0% 0.0% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 9

10 Emergency/Crisis Treatment: For Each Subgroup in Each County Mean Percent Receiving Any Reimbursement And Mean Amount of Reimbursement Per Person Per Quarter, Pre- and Post-Referral Emergency/Crisis Treatment Reimbursement Counties All Medicaid Categories Average Per Cent of Offender Group Mean Dollar Amounts Reimbursed Per Combined with Any Reimbursement in Quarter Person per Quarter Pre Post Difference Pre Post Difference Referral Referral Referral Referral King All Offenders 4.0% 4.7% 0.7% Graduates 3.2% 3.1% -0.1% Did Not Finish 5.8% 6.7% 0.9% Opt Out 3.4% 4.3% 0.9% % 4.2% 0.1% Pierce All Offenders 2.5% 3.3% 0.8% Graduates 1.8% 2.0% 0.2% Did Not Finish 1.9% 3.5% 1.6% Opt Out 2.4% 3.4% 1.0% % 3.5% 0.4% Spokane All Offenders 2.3% 2.8% 0.5% Graduates 2.5% 1.7% -0.8% Did Not Finish 2.0% 2.9% 0.8% Opt Out 2.9% 3.2% 0.3% % 2.8% 0.6% Thurston All Offenders 2.1% 2.7% 0.6% Graduates 1.3% 0.0% -1.3% Did Not Finish 3.2% 4.8% 1.6% Opt Out 1.5% 2.5% 0.9% % 1.7% -2.6% Skagit All Offenders 7.1% 8.7% 1.5% Graduates 6.9% 8.5% 1.5% Did Not Finish 7.6% 9.3% 1.6% Opt Out 0.0% 0.0% 0.0% Kitsap All Offenders 0.3% 2.6% 2.3% Graduates 0.0% 2.4% 2.4% Did Not Finish 0.5% 3.6% 3.1% Opt Out 0.0% 0.0% 0.0% % 0.0% 0.0% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 10

11 General Medical In Patient Treatment: For Each Subgroup in Each County Mean Percent Receiving Any Reimbursement And Mean Amount of Reimbursement Per Person Per Quarter, Pre- and Post-Referral General Medical In Patient Treatment Reimbursement Counties All Medicaid Categories Average Per Cent of Offender Group Mean Dollar Amounts Reimbursed Per Combined with Any Reimbursement in Quarter Person per Quarter Pre Post Difference Pre Post Difference Referral Referral Referral Referral King All Offenders 1.6% 2.0% 0.4% Graduates 1.3% 1.7% 0.4% Did Not Finish 2.2% 2.8% 0.6% Opt Out 1.4% 1.8% 0.4% % 1.7% 0.0% Pierce All Offenders 0.7% 1.0% 0.3% Graduates 0.7% 0.7% 0.0% Did Not Finish 0.7% 0.7% 0.0% Opt Out 0.6% 1.1% 0.5% % 1.2% 0.4% Spokane All Offenders 0.6% 0.7% 0.1% Graduates 1.0% 0.2% -0.8% Did Not Finish 0.6% 1.5% 0.9% Opt Out 0.8% 0.9% 0.1% % 0.6% 0.1% Thurston All Offenders 0.4% 0.8% 0.4% Graduates 0.0% 0.4% 0.4% Did Not Finish 0.4% 0.9% 0.4% Opt Out 0.4% 0.9% 0.5% % 0.5% -0.9% Skagit All Offenders 2.1% 1.9% -0.2% Graduates 2.8% 1.8% -1.0% Did Not Finish 1.4% 2.2% 0.8% Opt Out 0.0% 0.0% 0.0% Kitsap All Offenders 0.3% 0.5% 0.2% Graduates 0.0% 0.0% 0.0% Did Not Finish 0.5% 0.9% 0.4% Opt Out 0.0% 0.0% 0.0% % 0.0% 0.0% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 11

12 General Medical Out Patient Treatment: For Each Subgroup in Each County Mean Percent Receiving Any Reimbursement And Mean Amount of Reimbursement Per Person Per Quarter, Pre- and Post-Referral General Medical Out Patient Treatment Reimbursement Counties All Medicaid Categories Average Per Cent of Offender Group Mean Dollar Amounts Reimbursed Per Combined with Any Reimbursement in Quarter Person per Quarter Pre Post Difference Pre Post Difference Referral Referral Referral Referral King All Offenders 12.9% 15.3% 2.3% Graduates 11.6% 19.8% 8.3% Did Not Finish 15.9% 18.7% 2.8% Opt Out 12.3% 14.3% 2.0% % 11.3% -0.5% Pierce All Offenders 10.4% 13.1% 2.6% Graduates 14.2% 19.3% 5.1% Did Not Finish 11.4% 12.4% 0.9% Opt Out 10.6% 12.7% 2.1% % 11.5% 3.0% Spokane All Offenders 13.6% 12.2% -1.5% Graduates 14.3% 18.9% 4.6% Did Not Finish 14.8% 17.4% 2.6% Opt Out 17.0% 14.4% -2.6% % 11.0% -1.7% Thurston All Offenders 13.8% 12.4% -1.4% Graduates 13.4% 11.0% -2.4% Did Not Finish 15.1% 14.5% -0.6% Opt Out 13.0% 11.2% -1.8% % 16.2% 0.0% Skagit All Offenders 24.1% 30.8% 6.7% Graduates 22.8% 35.4% 12.6% Did Not Finish 26.7% 26.4% -0.3% Opt Out 0.0% 0.0% 0.0% Kitsap All Offenders 17.0% 19.0% 2.0% Graduates 0.0% 7.5% 7.5% Did Not Finish 27.1% 25.1% -2.0% Opt Out 0.0% 0.0% 0.0% % 22.2% 13.9% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 12

13 King County Medicaid Reimbursement Amounts Chemical Dependency Treatment Average Reimbursement For All Participants $50 $40 $30 $20 $10 $0 Q -9 Q -3 Q 4 0 King County Percent Receiving Medicaid Reimbursements For Chemical Dependency Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 13

14 Pierce County Medicaid Reimbursement Amounts Chemical Dependency Treatment Average Reimbursement For All Participants $50 $40 $30 $20 $10 $0 Q -9 Q -3 Q 4 0 Pierce County Percent Receiving Medicaid Reimbursements For Chemical Dependency Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 14

15 Spokane County Medicaid Reimbursement Amounts Chemical Dependency Treatment Average Reimbursement For All Participants $100 $80 $60 $40 $20 $0 Q -9 Q -3 Q 4 0 Spokane County Percent Receiving Medicaid Reimbursements For Chemical Dependency Treatment Percent of Paritcipants 12% 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 15

16 Thurston County Medicaid Reimbursement Amounts Chemical Dependency Treatment Average Reimbursement For All Participants $25 $20 $15 $10 $5 $0 Q -9 Q -3 Q 4 0 Thurston County Percent Receiving Medicaid Reimbursements For Chemical Dependency Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 16

17 Skagit County Medicaid Reimbursement Amounts Chemical Dependency Treatment Average Reimbursement For All Participants $350 $300 $250 $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Skagit County Percent Receiving Medicaid Reimbursements For Chemical Dependency Treatment Percent of Paritcipants 30% 25% 20% 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 17

18 Kitsap County Medicaid Reimbursement Amounts Chemical Dependency Treatment Average Reimbursement For All Participants $140 $120 $100 $80 $60 $40 $20 $0 Q -9 Q -3 Q 4 0 Kitsap County Percent Receiving Medicaid Reimbursements For Chemical Dependency Treatment 20% Percent of Paritcipants 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 18

19 King County Medicaid Reimbursement Amounts Emergency Room Treatment Average Reimbursement For All Participants $350 $300 $250 $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 King County Percent Receiving Medicaid Reimbursements For Emergency Room Treatment Percent of Paritcipants 12% 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 19

20 Pierce County Medicaid Reimbursement Amounts Emergency Room Treatment Average Reimbursement For All Participants $250 $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Pierce County Percent Receiving Medicaid Reimbursements For Emergency Room Treatment Percent of Paritcipants 12% 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 20

21 Spokane County Medicaid Reimbursement Amounts Emergency Room Treatment Average Reimbursement For All Participants $300 $250 $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Spokane County Percent Receiving Medicaid Reimbursements For Emergency Room Treatment Percent of Paritcipants 12% 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 21

22 Thurston County Medicaid Reimbursement Amounts Emergency Room Treatment Average Reimbursement For All Participants $250 $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Thurston County Percent Receiving Medicaid Reimbursements For Emergency Room Treatment 20% Percent of Paritcipants 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 22

23 Skagit County Medicaid Reimbursement Amounts Emergency Room Treatment Average Reimbursement For All Participants $2,500 $2,000 $1,500 $1,000 $500 $0 Q -9 Q -3 Q 4 0 Skagit County Percent Receiving Medicaid Reimbursements For Emergency Room Treatment Percent of Paritcipants 35% 30% 25% 20% 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 23

24 Kitsap County Medicaid Reimbursement Amounts Emergency Room Treatment Average Reimbursement For All Participants $50 $40 $30 $20 $10 $0 Q -9 Q -3 Q 4 0 Kitsap County Percent Receiving Medicaid Reimbursements For Emergency Room Treatment 20% Percent of Paritcipants 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 24

25 King County Medicaid Reimbursement Amounts Medical Inpatient Treatment Average Reimbursement For All Participants $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 King County Percent Receiving Medicaid Reimbursements For Medical Inpatient Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 25

26 Pierce County Medicaid Reimbursement Amounts Medical Inpatient Treatment Average Reimbursement For All Participants $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Pierce County Percent Receiving Medicaid Reimbursements For Medical Inpatient Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 26

27 Spokane County Medicaid Reimbursement Amounts Medical Inpatient Treatment Average Reimbursement For All Participants $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Spokane County Percent Receiving Medicaid Reimbursements For Medical Inpatient Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 27

28 Thurston County Medicaid Reimbursement Amounts Medical Inpatient Treatment Average Reimbursement For All Participants $500 $400 $300 $200 $100 $0 Q -9 Q -3 Q 4 0 Thurston County Percent Receiving Medicaid Reimbursements For Medical Inpatient Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 28

29 Skagit County Medicaid Reimbursement Amounts Medical Inpatient Treatment Average Reimbursement For All Participants $500 $400 $300 $200 $100 $0 Q -9 Q -3 Q 4 0 Skagit County Percent Receiving Medicaid Reimbursements For Medical Inpatient Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 29

30 Kitsap County Medicaid Reimbursement Amounts Medical Inpatient Treatment Average Reimbursement For All Participants $500 $400 $300 $200 $100 $0 Q -9 Q -3 Q 4 0 Kitsap County Percent Receiving Medicaid Reimbursements For Medical Inpatient Treatment Percent of Paritcipants 10% 8% 6% 4% 2% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 30

31 King County Medicaid Reimbursement Amounts Medical Outpatient Treatment Average Reimbursement For All Participants $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 King County Percent Receiving Medicaid Reimbursements For Medical Outpatient Treatment Percent of Paritcipants 30% 25% 20% 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 31

32 Pierce County Medicaid Reimbursement Amounts Medical Outpatient Treatment Average Reimbursement For All Participants $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Pierce County Percent Receiving Medicaid Reimbursements For Medical Outpatient Treatment Percent of Paritcipants 30% 25% 20% 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 32

33 Spokane County Medicaid Reimbursement Amounts Medical Outpatient Treatment $200 Average Reimbursement For All Participants $150 $100 $50 $0 Spokane County Percent Receiving Medicaid Reimbursements For Medical Outpatient Treatment Percent of Paritcipants 30% 25% 20% 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 33

34 Thurston County Medicaid Reimbursement Amounts Medical Outpatient Treatment Average Reimbursement For All Participants $200 $150 $100 $50 $0 Q -9 Q -3 Q 4 0 Thurston County Percent Receiving Medicaid Reimbursements For Medical Outpatient Treatment Percent of Paritcipants 30% 25% 20% 15% 10% 5% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 34

35 Skagit County Medicaid Reimbursement Amounts Medical Outpatient Treatment Average Reimbursement For All Participants $400 $350 $300 $250 $200 $150 $100 $50 $0 Series2 Series3 Series4 Series5 Q -10 Q -7 Q -4 Q -1 Q 3 Q 6 Q 9 2 Skagit County Percent Receiving Medicaid Reimbursements For Medical Outpatient Treatment Percent of Paritcipants 60% 50% 40% 30% 20% 10% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 35

36 Kitsap County Medicaid Reimbursement Amounts Medical Outpatient Treatment Average Reimbursement For All Participants $500 $400 $300 $200 $100 $0 Q -9 Q -3 Q 4 0 Kitsap County Percent Receiving Medicaid Reimbursements For Medical Outpatient Treatment Percent of Paritcipants 50% 40% 30% 20% 10% 0% Q -10 Q -8 Q -4 Q -2 Q 3 Q 5 Q 9 1 Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 36

37 King County Percent of Each Drug Court Group Receiving Some Medicaid Reimbursement in Each Medicaid Category For Each Quarter Pre- and Post-Drug Court Referral King County: Percent Receiving Medicaid Reimbursement By Reimbursement Category and Offender Group Chemical Dependency Outpatient Treatment 2% 3% 3% 3% 4% 1% 1% 1% 1% 2% 2% 3% 5% 5% 5% 6% 6% 5% 4% 3% 3% 4% 4% 4% 4% 4% 4% 4% 4% 4% 3% 4% 3% 4% 3% 3% 5% 5% 4% 4% 4% 3% 4% 4% 4% 3% 3% 3% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 2% 2% 1% 1% 1% 2% 2% 2% 2% 2% 2% 2% 3% 3% 1% 1% 1% 2% 1% 1% 1% 1% 2% 1% 1% 2% 1% 2% 2% 2% 2% 2% 2% 1% 2% 3% Detoxification 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Emergency Room Services 4% 3% 2% 3% 3% 3% 3% 4% 5% 3% 3% 5% 5% 4% 3% 3% 3% 3% 3% 4% 3% 3% 3% 3% 6% 6% 7% 6% 5% 4% 7% 7% 6% 7% 8% 8% 8% 7% 7% 7% 8% 6% 6% 6% 7% 6% 6% 7% 2% 3% 3% 3% 3% 3% 3% 4% 4% 4% 4% 5% 5% 4% 5% 5% 4% 4% 4% 4% 4% 4% 4% 4% 4% 5% 4% 4% 4% 4% 3% 3% 6% 5% 5% 5% 5% 5% 3% 5% 4% 3% 2% 4% 4% 2% 4% 2% Medical Inpatient Treatment 0% 2% 2% 1% 1% 2% 1% 2% 1% 2% 1% 1% 1% 2% 1% 1% 3% 2% 1% 1% 1% 2% 2% 4% 2% 2% 4% 2% 2% 1% 3% 2% 2% 2% 3% 3% 4% 3% 3% 3% 4% 3% 3% 2% 3% 2% 2% 2% 1% 2% 1% 1% 1% 2% 1% 2% 2% 1% 2% 2% 2% 2% 2% 2% 2% 2% 1% 1% 2% 1% 1% 2% 1% 2% 2% 1% 1% 2% 1% 2% 2% 3% 2% 3% 2% 2% 1% 1% 2% 1% 1% 3% 2% 1% 1% 1% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 37

38 King County (cont.) Mental Health Outpatient Treatment 1% 1% 2% 2% 1% 1% 1% 1% 2% 1% 1% 0% 1% 1% 0% 1% 1% 2% 2% 1% 2% 2% 1% 1% 1% 1% 1% 1% 1% 2% 2% 1% 1% 1% 1% 2% 2% 2% 2% 2% 1% 1% 1% 1% 2% 2% 2% 2% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 2% 1% 1% 1% 1% 2% 1% 1% 0% 1% 2% 1% 1% 0% 1% 0% 1% 1% 0% 0% 0% 0% Nursing Home and Congregate Care Services 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 1% 1% 0% 0% 0% Medical Outpatient Treatment 12% 13% 11% 12% 13% 13% 12% 13% 16% 12% 12% 14% 19% 22% 24% 21% 19% 20% 20% 18% 18% 17% 18% 21% 18% 18% 17% 16% 16% 14% 16% 18% 17% 18% 19% 21% 22% 21% 20% 19% 18% 17% 17% 17% 17% 18% 16% 16% 11% 12% 11% 12% 12% 12% 13% 14% 14% 15% 15% 15% 15% 15% 15% 14% 13% 14% 13% 14% 13% 14% 14% 14% 13% 13% 15% 13% 12% 12% 12% 11% 11% 12% 13% 13% 14% 10% 10% 12% 10% 9% 10% 10% 9% 9% 11% 11% Psychiatric Inpatient Treatment 0% 0% 0% 0% 0% 0% 1% 0% 0% 1% 0% 1% 0% 0% 1% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 0% 1% 1% 1% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 0% 0% 1% 1% 1% 1% 0% 0% 1% 1% 0% 1% 0% 1% 0% 0% 0% 0% 0% 1% 1% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 38

39 Pierce County Percent of Each Drug Court Group Receiving Some Medicaid Reimbursement in Each Medicaid Category For Each Quarter Pre- and Post-Drug Court Referral Pierce County: Percent Receiving Medicaid Reimbursement By Reimbursement Category and Offender Group Chemical Dependency Outpatient Treatment 1% 0% 1% 1% 1% 1% 2% 1% 2% 1% 1% 1% 4% 4% 4% 5% 5% 3% 3% 2% 2% 2% 0% 2% 2% 2% 2% 3% 2% 3% 3% 2% 2% 1% 1% 1% 2% 2% 2% 2% 2% 2% 2% 1% 1% 1% 2% 1% 1% 1% 1% 2% 2% 3% 2% 2% 1% 1% 0% 1% 1% 1% 1% 2% 3% 2% 3% 3% 2% 2% 2% 2% 1% 1% 1% 2% 1% 2% 2% 1% 1% 1% 1% 1% 1% 2% 2% 2% 3% 3% 2% 2% 2% 1% 2% 2% Detoxification 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Emergency Room Services 2% 2% 1% 3% 2% 2% 2% 2% 1% 2% 2% 2% 2% 4% 5% 1% 2% 2% 2% 1% 1% 1% 1% 1% 2% 2% 2% 3% 2% 3% 0% 3% 2% 1% 2% 3% 4% 6% 4% 3% 3% 2% 3% 2% 3% 3% 2% 2% 0% 2% 2% 3% 5% 2% 4% 3% 2% 3% 3% 3% 4% 4% 4% 3% 2% 3% 3% 3% 3% 2% 3% 5% 5% 6% 2% 3% 3% 3% 4% 4% 4% 4% 5% 4% 3% 4% 4% 4% 4% 3% 3% 3% 3% 3% 3% 4% Medical Inpatient Treatment 1% 1% 0% 0% 1% 0% 1% 1% 0% 1% 1% 2% 1% 1% 1% 1% 0% 1% 0% 0% 0% 0% 1% 1% 2% 0% 0% 1% 1% 1% 0% 1% 1% 0% 1% 0% 1% 2% 0% 1% 1% 0% 0% 1% 1% 1% 0% 0% 0% 0% 1% 1% 0% 1% 1% 1% 0% 0% 1% 1% 1% 1% 1% 0% 1% 1% 2% 1% 0% 1% 1% 1% 2% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 0% 1% 1% 1% 2% 1% 1% 1% 1% 1% 0% 1% 1% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 39

40 Pierce County (cont.) Mental Health Outpatient Treatment 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 1% 0% 0% 0% 1% 1% 1% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 1% 1% 1% 1% 1% 1% 0% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 0% 1% 0% 0% 0% 1% 0% Nursing Home and Congregate Care Services 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Medical Outpatient Treatment 16% 15% 14% 15% 13% 14% 15% 14% 14% 15% 16% 15% 21% 26% 25% 20% 21% 19% 18% 14% 15% 15% 14% 13% 12% 12% 13% 13% 12% 13% 11% 11% 10% 10% 12% 11% 14% 17% 17% 13% 11% 9% 10% 11% 13% 12% 11% 10% 12% 14% 15% 13% 13% 12% 10% 12% 12% 11% 13% 12% 14% 14% 13% 13% 11% 12% 12% 12% 12% 11% 12% 13% 14% 16% 12% 10% 9% 9% 10% 11% 12% 11% 10% 10% 10% 11% 11% 11% 11% 11% 11% 11% 11% 12% 11% 11% Psychiatric Inpatient Treatment 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 1% 1% 0% 0% 1% 1% 1% 1% 0% 0% 1% 1% 0% 0% 0% 0% 0% 1% 1% 1% 1% 1% 0% 1% 0% 0% 0% 0% 0% 1% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 40

41 Spokane County Percent of Each Drug Court Group Receiving Some Medicaid Reimbursement in Each Medicaid Category For Each Quarter Pre- and Post-Drug Court Referral Spokane County: Percent Receiving Medicaid Reimbursement By Reimbursement Category and Offender Group Chemical Dependency Outpatient Treatment 1% 0% 1% 1% 1% 4% 5% 5% 4% 4% 5% 1% 6% 8% 11% 8% 8% 6% 4% 3% 3% 0% 3% 4% 2% 2% 1% 2% 1% 0% 2% 2% 2% 2% 2% 3% 10% 9% 6% 6% 9% 6% 3% 4% 2% 2% 1% 1% 1% 1% 2% 2% 2% 2% 1% 1% 1% 2% 2% 1% 1% 1% 1% 2% 1% 2% 1% 2% 2% 1% 2% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 0% 1% 1% 1% 1% 1% 1% 1% 1% 1% Detoxification 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Emergency Room Services 4% 2% 0% 1% 5% 6% 2% 2% 1% 2% 4% 1% 2% 6% 1% 1% 0% 0% 0% 3% 0% 5% 2% 0% 1% 1% 1% 0% 2% 3% 3% 3% 3% 3% 3% 3% 3% 3% 2% 3% 4% 4% 5% 2% 3% 0% 0% 1% 2% 3% 2% 3% 3% 2% 3% 4% 2% 2% 4% 4% 4% 4% 3% 4% 3% 2% 3% 2% 4% 2% 3% 3% 2% 2% 2% 2% 2% 2% 2% 2% 3% 2% 3% 3% 3% 3% 2% 2% 2% 2% 3% 2% 3% 3% 3% 2% Medical Inpatient Treatment 0% 0% 0% 2% 1% 2% 0% 2% 1% 1% 1% 0% 1% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 1% 0% 1% 0% 2% 1% 1% 1% 1% 0% 0% 0% 2% 2% 1% 2% 1% 3% 1% 1% 0% 1% 3% 1% 0% 1% 0% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 2% 1% 1% 0% 2% 1% 0% 1% 1% 0% 0% 0% 0% 0% 1% 0% 1% 1% 1% 0% 1% 0% 0% 1% 1% 0% 1% 1% 0% 0% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 41

42 Spokane County (cont.) Mental Health Outpatient Treatment 1% 1% 1% 0% 0% 0% 1% 1% 1% 1% 0% 0% 1% 1% 1% 0% 0% 0% 1% 0% 1% 2% 0% 0% 2% 2% 2% 0% 0% 0% 0% 1% 2% 1% 1% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 1% 1% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Nursing Home and Congregate Care Services 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 0% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Medical Outpatient Treatment 13% 12% 13% 12% 12% 18% 18% 16% 15% 15% 15% 13% 16% 19% 15% 19% 18% 19% 22% 21% 19% 23% 20% 24% 16% 14% 13% 13% 14% 16% 14% 16% 14% 14% 15% 18% 18% 20% 18% 18% 19% 17% 16% 13% 16% 15% 18% 21% 14% 16% 16% 17% 17% 17% 20% 18% 18% 18% 17% 17% 15% 15% 14% 14% 13% 15% 16% 15% 17% 16% 17% 15% 12% 12% 12% 12% 13% 13% 12% 13% 13% 13% 13% 13% 12% 11% 11% 10% 10% 10% 9% 9% 8% 8% 7% 7% Psychiatric Inpatient Treatment 0% 0% 0% 0% 1% 0% 1% 1% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 1% 0% 0% 0% 0% 1% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 42

43 Thurston County Percent of Each Drug Court Group Receiving Some Medicaid Reimbursement in Each Medicaid Category For Each Quarter Pre- and Post-Drug Court Referral Thurston County: Percent Receiving Medicaid Reimbursement By Reimbursement Category and Offender Group Chemical Dependency Outpatient Treatment 0% 0% 0% 3% 0% 0% 0% 0% 0% 0% 0% 6% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 1% 1% 1% 1% 1% 2% 2% 0% 2% 4% 1% 1% 0% 2% 1% 1% 0% 4% 4% 0% 1% 1% 1% 2% 2% 2% 1% 3% 3% 2% 1% 0% 1% 3% 2% 2% 2% 1% 1% 3% 0% 0% 0% 0% 3% 3% 3% 0% 0% 0% 0% 0% 0% 0% 0% 3% 0% 3% 0% 0% 0% 0% 0% 0% Detoxification 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Emergency Room Services 0% 0% 0% 3% 0% 0% 0% 3% 6% 0% 3% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 2% 2% 2% 3% 5% 3% 2% 1% 4% 4% 2% 7% 6% 8% 2% 4% 8% 4% 5% 7% 4% 0% 0% 1% 0% 1% 1% 1% 1% 3% 1% 3% 3% 2% 2% 3% 2% 2% 1% 3% 1% 2% 0% 0% 5% 3% 5% 3% 3% 3% 8% 3% 3% 8% 5% 3% 0% 0% 3% 6% 0% 4% 0% 0% 0% 14% Medical Inpatient Treatment 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 5% 0% 0% 0% 0% 0% 0% 1% 0% 0% 0% 0% 1% 0% 3% 1% 1% 0% 1% 2% 0% 2% 2% 0% 0% 0% 0% 0% 0% 0% 0% 0% 1% 1% 0% 1% 1% 1% 1% 0% 1% 0% 0% 0% 0% 0% 0% 3% 0% 0% 3% 0% 3% 3% 0% 3% 3% 0% 0% 3% 0% 0% 0% 0% 0% 0% 0% 0% 0% Alcohol and Drug Abuse Institute, University of Washington: Washington State Drug Court Evaluation Report on Medicaid analyses. 43