SAMHSA Uniform Reporting System (URS)
Three Year Trend Summary: DC vs US (Draft)
Each year, DBH submits key agency measures to SAMHSA. These data are then compared to the national data. As an agency, these comparisons provide some indication of how the agency is performing. This brief highlights service access and utilization, as it relates to clients receiving Medicaid funding and penetration rates; housing and homelessness, evidence-based practices, and client satisfaction with services. Further, these data examine changes over a three-year period.
Based on Figure 1, DC has a much higher rate of clients receiving Medicaid funding than the national rate. For example, in 2019, DC had a rate of 93.8% compared to the US rate of 71.9%. Over the past 3 years, DC has seen an increase and a slight decrease in rates. Similarly, DC has higher penetration rates (per 1000 population) than the national average (see Figure 2). In the last 3 years, DC has seen a decrease and a slight increase in penetration rates.
According to Figure 3, in the US, approximately 83 - 84% of clients were living in a private residence over the past three years. However, in DC, there were roughly 63 - 67% of clients living in a private residence. Although DC has seen a steady over the years, DC remains behind the national average. Additionally, DC is seeing a much higher rate of homelessness than the national rate, almost 4 times that of the US rate. Note that DC housing data are manually reported by PIPs and FIPs are encouraged to consistently maintain these data. DBH continues to refine strategies to improve data collection efforts.
Overall, DC has higher penetration rates for adult evidence-based practices (EBPs) compared to the national rate (see Figure 4). These EBPs include Assertive Community Treatment (ACT), Supported Employment, and Supported Housing (with the exception of 2019). However, in particular, DC has experienced only a slight increase in penetration rates for Assertive Community Treatment (ACT) and a decrease in Supported Employment and Supported Housing over the past 3 years. Moreover, for child consumers, DC remains significantly behind the national rate concerning Multi-Systemic Therapy (MST) and Functional Family Therapy (FFT).
In comparison to DC, the national rates for adult consumer satisfaction with services are higher for all key measures (see Figure 5), Notably, the measures with the largest differences were access to services, outcomes from services, and overall satisfaction with care. More specifically, while the US rates have remained roughly steady or unchanged over the past 3 years, DC has seen an increase in consumer satisfaction over the same time period. For child/family consumer satisfaction, the DC and US rate comparisons are mixed (see Figure 6). For example, the rates of consumers satisfied with participation in treatment planning and the cultural sensitivity of providers were mostly comparable. However, the US rates were much higher for access to services, outcomes from services, and overall satisfaction with care. Note some caution in nationwide comparisons due to differences in state-by-state data collection methods (e.g., random vs convenience sampling methods).
DBH Response. As DBH continues to learn more about access to services, housing, evidence-based practices, and consumer satisfaction, supplemental data, such as consumer feedback, could help to provide direction for improvement in these key areas. While the agency has a system in place to collect general feedback, it would be helpful to focus the feedback on these areas. Additionally, there will be a need to establish a benchmarking system and targeted goals for each fiscal year to monitor and track progress. Further, It will be imperative to identify system gaps and barriers as they relate to partnerships with other local governmental agencies, provider agencies, and community stakeholder groups. DBH can then use this information to plan for quality and process improvements.
https://dbh.dc.gov ◆ 64 New York Ave, NE Washington, DC 20002 ◆ (202) 673-2200 ◆ dbh@dc.gov