Appendices & Annexes
About Us
Annex 1. Quantitative Landscape and Gap Analysis Report
Comprehensive analysis of quantitative data regarding Washington's behavioral health system.
Annex 2. Qualitative Perspectives on Washington's Prenatal-25 Behavioral Health System
Insights from qualitative research on the experiences within the behavioral health system.
Annex 3. Report on Funding, Oversight, and Administration
Detailed examination of financial and administrative aspects of behavioral health services.
Annex 4. The Evolution of the System of Care Approach
Historical perspective and development of the system of care methodology.
APPENDICES
Appendix A. Definition of behavioral health
Behavioral health involves the interaction between a person's body, brain, and the people and places around them. It includes the feelings and actions that can affect one's overall well-being.
Just like a person can have a short-term or long-term illness that affects their physical body and overall well-being, the same is true for behavioral health. In the case of serious mental illness, young people may not understand their condition and experience cycles of crisis. Many things can affect someone's behavioral health including stress and trauma, developmental delays or disabilities, genetics, and challenges with substances or other ways of coping that get in the way of overall well-being.
Behavioral health challenges can:
Impact how a person relates to and interacts with their families and communities and maintains long-term positive relationships that are vital for well-being.
Affect a person's physical body and overall well-being in the same way that a short-term or long-term illness might.
Stem from many things, including the stress and trauma they have experienced or are experiencing or challenges with substances or other ways of coping that get in the way of overall well-being.
Include a broad range of symptoms and diagnoses and change or be exacerbated by lack of intervention.
Coincide with other challenges and risks, including the impacts of communities being under-resourced, homelessness, disruption of schooling, challenges finding employment, and youth being at risk of incarceration.
Lead to children, youth, and young adults struggling to navigate life, maintain positive relationships, achieve their educational goals, and adapt to change.
Intersect with intellectual and developmental disabilities; as a person grows and develops, these challenges can show up in a variety of ways.
Be impacted even before birth and through exposure to maternal stress or substances and/or poor social and emotional connections during the earliest months and years of life.
Appendix B. Workstreams
This appendix will summarize the Washington Thriving process and the various workstreams that came together to inform the plan.
Appendix C. Contributors
This appendix will name and acknowledge key contributors to the planning efforts.
Appendix D: State and regional structures in Washington related to P-25
Many state and regional agencies help run Washington's behavioral health system for pregnant people, expecting parents, children, youth, and young adults.
At the state level
Health Care Authority (HCA)
Runs Medicaid and the Children's Health Insurance Program (CHIP), which are called Apple Health in Washington. HCA also manages contracts with five health insurance companies (MCOs) that pay for services under Apple Health, and has a division focused specifically on behavioral health for the P-25 population.
Department of Social and Health Services (DSHS)
Provides specialized services for youth with developmental disabilities and runs the Child Study and Treatment Center psychiatric hospital for children and youth.
Department of Children, Youth, and Families (DCYF)
Oversees early learning, juvenile rehabilitation, and child welfare programs.
Department of Health (DoH)
Licenses behavioral health professionals and facilities, runs public health campaigns, and manages the School-Based Health Center program.
Other state agencies involved include:
At the regional level
Behavioral Health Administrative Service Organizations (BH-ASOs)
Manage state funding for behavioral health crisis services and care for people without insurance.
County Programs
Counties also run and fund local behavioral health programs.
The key state and regional actors serving our community include the list below. Each of these agencies follow different regulations and each is judged on its own performance, not on how well the whole system works together:
Appendix E. Related Efforts and System Assets
This appendix will name current and recent initiatives, programs, and efforts across Washington State that align with or contribute to the goals of Washington Thriving. These existing efforts represent valuable assets and partnerships that can support the implementation of this plan's vision for transforming the P-25 behavioral health system. Rather than operating in isolation, Washington Thriving recognizes the importance of building upon, coordinating with, and learning from the work already happening across state agencies, community organizations, and other system partners. This list helps ensure strategic alignment and prevents duplication while identifying opportunities for collaboration and mutual reinforcement.
Appendix F. System of Care Definition
The excerpts below from the University of Maryland's School of Social Work's Institute for Innovation & Implementation's The Evolution of the System of Care Approach provide the academic definition of the System of Care, and provide a list of the types of services and supports that make up a comprehensive array.
"A system of care is a comprehensive spectrum of effective services and supports for children, youth, and young adults with or at risk for mental health or other challenges and their families that is organized into a coordinated network of care, builds meaningful partnerships with families and youth, and is culturally and linguistically responsive in order to help them to thrive at home, in school, in the community, and throughout life. A system of care incorporates behavioral health promotion, prevention, early identification, and early intervention in addition to treatment to address the needs of all children, youth, and young adults"
Appendix G Washington Thriving's strategic framework
The following draft frameworks were developed in collaboration with the Washington Thriving Advisory Group, ad hoc discussions groups, the CYBHWG, and other consultations. These working drafts articulate key aspects of Washington Thriving's vision of its System of Care.
