Rising Strong West Master Plan, March 8, 2023
Summary
This letter, dated March 8, 2023, from the Department of Commerce to Gov. Inslee and Washington State Legislators transmits the second phase of the master planning report authorized by the 2022 supplemental operating budget, titled Rising Strong West Master Plan Phase 2. The budget provided funds for an agreement with Catholic Community Services/Catholic Housing Services for a master planning process for a family-centered drug treatment and housing program in western Washington, modeled after Rising Strong in Spokane. The report states that more than 43% of children entering out-of-home care experienced parental substance abuse in 2021. The signature block names Oliver Crain, Policy Contracts Manager, Housing Division.
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“Rising Strong West Master Plan, March 8, 2023.”
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STATE OF WASHINGTON
DEPARTMENT OF COMMERCE
1011 Plum Street SE PO Box 42525 Olympia, Washington 98504-2525 360-725-4000
www.commerce.wa.gov
March 8, 2023
Dear Gov. Inslee and Washington State Legislators,
Please find attached the second phase of the master planning report authorized by the 2022 supplemental
operating budget (SSB 5651 Sec. 1031) subject to the following conditions and limitations:
(1) The appropriation in this section is provided solely for an agreement with Catholic
Community Services/Catholic Housing Services to fund a master planning process for the
development of a family centered drug treatment and housing program in western
Washington that supports families staying together while they recover from addiction and
rebuild their lives. Housing developers, service providers, and other stakeholders must be
included in this master planning process.
(2) The master planning process under this section must model the project to be developed after
Rising Strong in Spokane and must include units for families that are experiencing substance
use disorder and that are involved in the child welfare system. The site must include living
quarters for families, space for services, play areas for children, and space for child care. The
program services located at the site must include, but are not limited to, case management,
counseling, substance use disorder treatment, and parenting skills classes. The site must be
located in King County, or located near King County, to provide services to families in the
western area of the state.
(3) Phase two of the planning process must: Further define the community needs; work with the
department, the health care authority, and the department of children, youth, and families in
identifying a sponsoring agency or organization and service partners; make preferred site
recommendations; determine the project budget and establish the model and sources for
funding the program located in the facility, including the conditions for sustainable funding;
and include additional components identified by Catholic Community Services/Catholic
Housing Services or its consultants needed to prepare for a 2023-2025 biennium capital
budget request.
(4) The master plan developed under this section must be submitted to the appropriate
committees of the legislature by December 31, 2022.
Commerce contracted with Catholic Community Services/Catholic Housing Services of Western
Washington to satisfy the proviso requirements. The attached report is Catholic Community
Services/Catholic Housing Services' sole work product. It reflects the Rising Strong program in Spokane.
Commerce will consider the findings and recommendations herein for future programmatic and
community funding investments.
Signed,
Oliver Crain
Oliver Crain
Policy Contracts Manager, Housing Division
Washington State Department of Commerce
Rising Strong West
Master Plan Phase 2
Authorized by 2021-2022 capital budget (Chapter 296, Laws of
2022)
March 8, 2023
HOUSING DIVISION Report to the Legislature
Interim Director Kendrick Stewart
V3.1
Acknowledgments
An acknowledgment to Tasha Irvine, Milena Stott
and Elizabeth Perry of Principle Allies for their hard
work and dedication to the development of this
report.
A special acknowledgment to Catholic Charities
Eastern Washington and the committed team at
Rising Strong Spokane. Thank you also to the staff
of Catholic Community Services and Catholic
Housing Services of Western Washington for their
active engagement in the planning process.
An additional special acknowledgment to the state
agencies and members of the Stakeholder
Workgroup, whose support was crucial to the
creation of this report.
Washington State Department of Commerce
Oliver Crain, policy contracts manager
HOUSING DIVISION
1011 Plum St. SE
P.O. Box 42525
Olympia, WA 98504-2525
www.commerce.wa.gov
For people with disabilities, this report is available
on request in other formats. To submit a request,
please call 360-725-4000 (TTY 360-586-0772)
RISING STRONG WEST MASTER PLAN PHASE 2
Table of contents
Executive summary...................................................................................................................................... 2
Introduction ................................................................................................................................................. 7
Master Plan Phase 2 .................................................................................................................................... 9
Recommendations and conclusions ........................................................................................................... 29
Appendix A: Glossary of terms, abbreviations and acronyms ...................................................................... 31
Appendix B: List of key stakeholder organizations and references .............................................................. 32
Appendix C: Detailed environmental scan ................................................................................................... 34
Appendix D: Letters of support ................................................................................................................... 42
RISING STRONG WEST MASTER PLAN PHASE 2 1
Executive summary
Overview
Purpose and authorization
Starting in 2021, a series of legislative provisos were included in the capital budget that provided funding to
Catholic Community Services/Capital Housing Services for a master planning process to develop a family-
centered drug treatment and housing program in Western Washington that supports families staying together
while they recover from addiction and rebuild their lives (Chapter 332, Laws of 2021, Sec. 1082, and most
recently Chapter 296, Laws of 2022, Sec. 1031).
The legislation required the program be modeled after Rising Strong in Spokane, a Catholic Charities Eastern
Washington program, and include units for families experiencing homelessness, substance use disorder (SUD)
and that are involved in the child welfare system.
Legislative mandate
This report was authorized by Sec. 1031 of Chapter 296, Laws of 2022 (the 2022 capital budget), which states:
Substance Use Disorder Recovery Housing (91001675)
The appropriation in this section is subject to the following conditions and limitations:
(1) The appropriation in this section is provided solely for an agreement with Catholic Community Services/Catholic
Housing Services to fund a master planning process for the development of a family-centered drug treatment and
housing program in western Washington that supports families staying together while they recover from addiction
and rebuild their lives. Housing developers, service providers, and other stakeholders must be included in this master
planning process.
(2) The master planning process under this section must model the project to be developed after Rising Strong in
Spokane and must include units for families that are experiencing substance use disorder and that are involved in the
child welfare system. The site must include living quarters for families, space for services, play areas for children,
and space for child care. The program services located at the site must include, but are not limited to, case
management, counseling, substance use disorder treatment, and parenting skills classes. The site must be located in
King County, or located near King County, to provide services to families in the western area of the state.
(3) Phase two of the planning process must:
Further define the community needs; work with the department, the health care authority, and the department of
children, youth, and families in identifying a sponsoring agency or organization and service partners, make preferred
site recommendations; determine the project budget and establish the model and sources for funding the program
located in the facility, including the conditions for sustainable funding; and include additional components identified
by Catholic Community Services/Catholic Housing Services or its consultants needed to prepare for a 2023-2025
biennium capital budget request.
(4) The master plan developed under this section must be submitted to the appropriate committees of the legislature
by December 31, 2022.
What is Rising Strong?
Rising Strong is a holistic, family-centered drug treatment and housing program supporting families in staying
together while they begin to recover from addiction, heal from trauma, and rebuild their lives.
RISING STRONG WEST MASTER PLAN PHASE 2 2
Key findings
This master planning process included interviews with stakeholders from various state and county agencies,
managed care organizations (MCOs), and potential partners, as well as in-depth site visits and analysis of the
Spokane program. Strong interest in this model stems from the potential for cross-sector cost savings and
client outcomes, which are necessary for overall community health.
The need for the Rising Strong program is great. The Department of Children, Youth, and Families
(DCYF) sees neglect and parental substance abuse as top contributing factors for child removal.
Statewide, more than 43% of children entering out-of-home care (OOHC) experienced parental substance
abuse in 2021. The youngest are more impacted by SUD. In 2020, 68% of infants entering OOHC had
parental SUD as a contributing factor; of newborns placed, 47% were in King, Pierce, and Spokane
counties.
Western Washington lacks facilities to provide family-centered SUD treatment. The region does not
have programs where families can stay together while recovering from SUD. There is not enough care for
this vulnerable pregnant, postpartum, and/or parenting women (PPW) population in Western Washington,
and available options are generally located on the other side of the state, a major barrier to treatment.
The Rising Strong approach aligns with many shared goals. These goals include cross-system
collaboration, reducing barriers to services, aligning with Coordinated Entry’s focus on permanent
supportive housing, and Health Care Authority (HCA) integrated care objectives.
Highlights of strengths, weaknesses, opportunities, and threats (SWOT) for both the clinical and financial
model of the program are summarized below:
RISING STRONG WEST MASTER PLAN PHASE 2 3
Figure 1: SWOT Analysis
Strengths: Weaknesses:
• Keeps families together per the Family First • Challenging to find and blend funds that pay
Prevention Services Act (FFPSA) for the holistic nature of the model
• Culturally centered approach • Access is high barrier, as a pending out-of-
• Health and housing partnership addressing home placement is required for program
the service and housing needs of families entry
• Social and medical model for comprehensive • Limited capacity to serve all families in need
family services • Development and startup funding provided by
• Considers the entire treatment, housing, and local philanthropy was foundational to the
services continuum, including employment program and expensive to replicate
and transportation • Requires high medical service thresholds to
• MCOs have a strong interest in value-based finance the program due to lack of other
programs that align these components operations fund sources
• Cross-system collaboration addresses • Dependency on the availability of permanent
barriers between systems to ensure supportive housing upon program exit for
outcomes some families and access to affordable
• Aligns with Coordinated Entry goals to secure housing for the rest
permanent housing • Challenging to coordinate the five MCOs
• Aligns with HCA goals of integrated care
Opportunities: Threats:
• Foster Care Enhancement Payments • Sustainable funding: Reunification results in
• PPW provider need in King County loss of foster care payments while the
• Potential funds for new perinatal SUD family's need for services continues
initiatives • Gaps in funding for care navigation to ensure
• Blended funding continuity across settings
• Fund stack for services and operations • Competition across vulnerable populations
• MCOs are considering milieu management (housing first versus recovery housing)
benefit • "Not in my backyard" (NIMBY) concerns
• Involves HCA in coordinating MCO benefits • Limited behavioral health workforce
• Capital development grants for rehabilitation • Western Washington construction costs are
and new construction high
• The pipeline for training behavioral health
workers is slow, given the high demand
• Operator capacity, knowledge, and resources
RISING STRONG WEST MASTER PLAN PHASE 2 4
Recommendations and conclusions
The Rising Strong model is a unique solution to an ongoing challenge of creating positive outcomes for
families at risk of child removal due to parental SUD. This report builds on the 2021 Master Plan Phase 1
by validating the community need, documenting the results of cross-agency collaboration, updating the
financial model, and making a preferred site and operator recommendation.
As a result of this process, DCYF included a $13.4 million capital funding request for Rising Strong West
in the 2023-25 capital budget. Following the analysis of facility and operator criteria, this report
recommends that Evergreen Recovery Centers in Everett be named the inaugural developer and operator
of the program in Western Washington, with a capacity of serving 24 families.
In addition to filling a vital need in the state, this program also aligns with the focus on maternal and
infant health priorities of the governor’s office, HCA and DCYF.
Evergreen Recovery Centers is recommended as the inaugural operator in Western Washington. Not only
does the organization have appropriate land, but the agency is also an experienced facility developer and
respected provider of family mental and behavioral health services.
The stakeholder workgroup process identified/finalized the facility type and related funding sources for
the program. More work must be done to codify these sources so that additional Rising Strong programs
can be opened in other parts of the state.
Next steps
To successfully launch Rising Strong in Western Washington, key system partners must continue collaborating
on implementation, particularly sustainable operating funds. The following steps are recommended to ensure
the ongoing development of a coordinated and successful model:
1. Garner support for the DCYF capital request in the 2023-25 legislative session, including engaging
legislators and staff that expressed interest during the 2022 workshops.
2. Pending approval of the capital request, convene an advisory committee consisting of the named
operator, relevant state agencies, MCOs, and community members to support the program's
implementation. State agencies should include, but not be limited to, DCYF, HCA, Commerce, and the
Office of Public Defense. The work of this committee would consist of an ongoing study of the program
impact, including a review of the results of the Washington State University-Regional Partnership Grant
(WSU-RPG) study of the Spokane program and a collaborative design of outcomes and fiscal savings
metrics with HCA and DCYF.
3. Pending approval of the capital request, engage the private sector and philanthropic organizations for
startup technical assistance funding.
The following additional steps will support the ongoing operation of Rising Strong Spokane and Rising Strong
West and will pave the way for organizations to launch multiple Rising Strong programs in other regions of the
state where the need is high:
4. Pursue operational funding for services not covered by Medicaid or Foster Care Enhancement by
leveraging the Family First Preservation Services Act (FFPSA), Title IV-E funds, or other DCYF sources.
RISING STRONG WEST MASTER PLAN PHASE 2 5
5. Develop a facility definition for Rising Strong in the Washington Administrative Code (WAC) that
maintains program fidelity while clarifying available capital funding sources in the future.
6. Create a “Rising Strong Trust Fund” to encourage operators in other parts of the state to develop
regional programs.
7. Continue to examine the possibility of pursuing additional sites (such as Red Barn Ranch in King County
and Amara in Pierce County) to meet the high demand for the program.
RISING STRONG WEST MASTER PLAN PHASE 2 6
Introduction
Background
Starting in 2021, a series of legislative provisos were included in the capital budget (Chapter 332, Laws of
2021, Sec. 1082) that provided funding to Catholic Community Services/Capital Housing Services for a master
planning process to develop a family-centered drug treatment and housing program in Western Washington
that supports families staying together while they recover from addiction and rebuild their lives. The legislation
required the program to be modeled after Rising Strong in Spokane, a Catholic Charities Eastern Washington
program, and include units for families experiencing homelessness, SUD and involved in the child welfare
system.
The December 2021 Master Plan Phase 1 analyzed the feasibility of siting a Rising Strong program in the
Historic Nurses Quarters Buildings at the Pacific Tower Campus on the north end of Beacon Hill in Seattle.
This project compared this rehabilitation option with a new construction option. The 2021 Master Plan Phase 1
concluded that while the need for the program was high, the Pacific Tower location was not a cost-effective
solution because it would serve fewer families at a higher cost. However, the new construction option was
promising.
In 2022, the proviso was amended to include further analysis of the options for opening a Rising Strong
program, keeping in mind the conclusions of the 2021 report around new construction and specific operator
requirements to ensure program fidelity and sustainability (Chapter 296, Laws of 2022, Sec. 1031). In addition,
this proviso required the second phase to:
Further define the community's needs
Work with the Department of Commerce, the Health Care Authority (HCA), and the Department of Children,
Youth and Families (DCYF) in identifying a sponsoring agency or organization and service partners
Make preferred site recommendations
Determine the project budget and establish the model and sources for funding the program located in the
facility, including the conditions for sustainable funding
Include additional components identified by Catholic Community Services/Catholic Housing Services or its
consultants needed to prepare for a 2023-25 biennium capital budget request.
This Master Plan Phase 2 is the conclusion of this project's second phase and must be submitted to the
appropriate committees of the legislature by December 31, 2022. A glossary of terms and acronyms is in
Appendix A.
Project team and stakeholder workgroup
Catholic Community Services/Catholic Housing Services contracted with Principle Allies to lead the project.
Principle Allies convened a State Stakeholder Workgroup that met bimonthly starting in June 2022. This
Workgroup included representatives from state agencies, legislative members and their staff, the criminal
justice system, regional service operators, MCOs and community advocates. See Appendix B for a complete
list of the State Stakeholder Workgroup.
RISING STRONG WEST MASTER PLAN PHASE 2 7
This Workgroup worked on identifying and addressing barriers to implementation, aligning a coordinated
system of care, determining sustainable funding, sourcing capital funding, and evaluating potential facility
locations and operators.
What is Rising Strong West?
In 2017, Catholic Charities Eastern Washington developed and launched the Rising Strong program in Spokane
with the support of a Children’s Bureau Regional Partnership Grant to positively change outcomes for families
at risk of child removal due to parental SUD. As an alternative to removing children from their parent’s care,
and revolving door crisis care, Rising Strong is a holistic family-centered treatment and housing program for at-
risk families that enables children and parents to stay together while they begin to recover from addiction, heal
from trauma, and rebuild their lives.
The program goals include:
Improve the well-being, permanency, and safety of children impacted by family substance use
Decrease the number of children in out-of-home placements
Significantly reduce or eliminate family separation by serving the entire family
Reduce trauma exposure and impacts on children and enhance parent treatment success
Timely and enduring family reunification
Because of the program's positive impact in the Spokane location, the legislature is exploring how to duplicate
and bring this program to Western Washington. This program has thus been named “Rising Strong West.”
Goals
The purposes of this report are:
Validate the need for family-centered treatment in Western Washington
Document the key elements of the Rising Strong program that are required to duplicate the positive
outcomes
Determine the points of interagency collaboration to ensure successful program implementation
Recommend a preferred site and operator
Outline the project budget, source capital for site construction, and determine sustainable operational
funding.
Because of its connection to Rising Strong Spokane, the legislative proviso named Catholic Community
Services/Catholic Housing Services (CCS/CHS) to lead the development of this Phase 2 Master Plan. However,
CCS/CHS intends for this report and the 2021 Master Plan Phase 1 to serve as a blueprint for other
organizations interested in operating the Rising Strong West model in other parts of the state.
RISING STRONG WEST MASTER PLAN PHASE 2 8
Master Plan Phase 2
Community and population need
Population profile and eligibility
SUD during pregnancy and/or after birth increases the risk of adverse social and health outcomes for mothers,
their children, and other family members. The intersection of maternal health, trauma, homelessness, SUDs,
family violence, child neglect, and out-of-home placement contributes greatly to Adverse Child Experiences
(ACEs). This challenge's expensive and complex nature requires cross-sector collaboration across state
agencies to ensure programs within those agencies work together to ensure positive and desired outcomes.
The Rising Strong model and this work is a blueprint for this important collaboration.
The state of Washington’s DCYF has embraced the vision of the Families First Prevention Services Act
(FFPSA), which allows states to use federal Title IV-E funds to deliver prevention services to families with
children at risk of entering foster care. Similarly, the Health Care Authority (HCA) has a Pregnant and
Postpartum Women (PPW) benefit design that supports the family unit. Together they work to respond to the
needs of families challenged by substance use and other health challenges.
SUD among child welfare-involved caregivers
The Washington State Department of Social and Human Services (DSHS) Research and Data Analysis (RDA)
Division conducted several analyses focused on SUD. In one report, they looked at caregivers involved in child
welfare, including patterns of SUD, out-of-home placement, and access to treatment. The report found that
58% of caregivers with out-of-home placements had a SUD in the year before the child’s removal, and only 39%
had any SUD treatment in the 12 months following CPS intake or removal.
DCYF sees Neglect and Parent Substance Abuse as top contributing factors for child removal. Statewide, more
than 1,664 (43%) children entering Out-of-Home Care (OOHC) experienced parental substance abuse in 2021.
The youngest are more impacted by SUD. In 2020 68% of infants entering OOHC had Parental SUD as a
contributing factor. That year 585 newborns were placed in their first 30 days due to parental substance abuse,
47% of which were in King, Pierce, and Spokane Counties.
Behavioral health treatment needs and outcomes among Medicaid-enrolled
children
The state also looks at comparative data of all children on Medicaid and those in foster care. Current reports
indicate that of all children on Medicaid, 22% have a documented case of abuse or neglect. The data shows a
significantly higher prevalence of behavioral health (BH) conditions for youth in foster care. The full report and
detailed tables are found on the Children's BH Dashboard. Of the children enrolled in Wraparound with
Intensive Services (WISe), a specialty BH program, 71% are in Foster Care (576/807). Just under 5% of all
foster care children enroll in WISe.
The current system is designed to provide services for each individual rather than the family unit, and even
when services are available, access and coordination remain challenging and result in gaps in care and poor
outcomes. In the case of child-welfare-involved mothers, a relapse, or recurrent substance abuse, has negative
outcomes and implications for the health, education, child welfare systems, and housing settings. Rising
Strong works to combine services for the family unit across those systems. There is not enough care for this
RISING STRONG WEST MASTER PLAN PHASE 2 9
vulnerable pregnant, postpartum, and/or parenting women population in Western Washington, and available
options are generally located on the other side of the state, which is a major barrier to treatment.
Program structure and licensing
Program structure
Rising Strong is designated as a homeless emergency shelter and congregate-living program staffed by Family
Skills Coaches. The Coaches, who are often peers, provide supervision and conflict management and support
the daily structure of the milieu by ensuring and modeling activities of daily living. While the program is staffed
24/7, the clinical staff provides outpatient services during regular business hours. The “shelter” is a stand-
alone facility run and operated by the service provider. This provider is also the program entity and is licensed
as a Behavioral Health Agency (BHA) by the state of Washington. Because the program allows entry for all
family members, Medical Necessity Criteria are not required to be met for program entry, and it is therefore not
considered a Residential Treatment Facility (RTF).
Referral and access
Like all others who seek sober living environments, families entering the Rising Strong program are seeking an
environment where their choice is to participate together in an abstinence-focused and peer-supported
community. As safety is a concern in the dependency process, families opt into the program and depend on
the program structure to support their recovery goals and the safety needs of the children. The program blends
the philosophies of permanent supportive housing, harm-reduction, low-barrier, strengths-based, and trauma-
informed programming with elements of structure and facilitation around relapse to ensure the safety of all
family members.
Licensing
Program design and populations served have implications for program funding and licensing. Rising Strong
has intentionally not pursued a residential treatment facility (RTF) license. Instead, it operates as a shelter that
does not require a license. The primary reason for this is that residents need to keep their status of being
“homeless” or “at risk of homelessness” to qualify for permanent supportive housing at program exit. The
Rising Strong model is a unique hybrid of health and housing services that allows for blending fund sources
across three state agencies. Finally, on-site child care is offered on a time-limited, drop-in basis, so a child care
license is not required. This also has implications for funding as some payers (Pregnant and Postpartum
Women program (PPW), for example) require licensed providers for reimbursement.
RISING STRONG WEST MASTER PLAN PHASE 2 10
Figure 2: Rising Strong West program setting - facility versus housing
Program description
The Rising Strong West project seeks to replicate aspects of the Rising Strong Spokane program that have
been identified as effective in delivering services and promoting resident recovery. The proposed mission,
program philosophy, entry requirements, and services are modeled directly from the Rising Strong Spokane
program.
Program mission
Rising Strong is a holistic, family-centered drug treatment and housing program supporting families in staying
together while they begin to recover from addiction, heal from trauma, and rebuild their lives.
Entry criteria and eligibility
To be eligible for the program, residents must be involved in the dependency process and experiencing
homelessness or housing instability. Residents must also be willing and able to participate in treatment.
Admission to the program is determined solely by Rising Strong in collaboration with the Family Dependency
Treatment Court team and the DCYF caseworker. If all parties are in agreement, a referral is made to the
program at the initial shelter care hearing.
Core program elements and philosophy
Safe housing - The program provides safe, out-of-home placement to facilitate family reunification.
Housing is based on a shelter/transitional housing model with the long-term goal of residents
transitioning into permanent housing upon graduation from the program, on average 12 months.
Substance abuse recovery - The abstinence-focused program supports access to medication-assisted
treatment (MAT). Residents are supported in avoiding and responding to relapse to ensure child and
family safety. Substance abuse services are provided on-site for adults and teens, including non-
medically assisted withdrawal support and recovery coaching.
RISING STRONG WEST MASTER PLAN PHASE 2 11
Clinical support - Mental health assessments and services are provided on-site for adults and are
designed based on the identified need, including medication and clinician-led services (i.e., cognitive
behavioral therapy and contingency management).
Child assessment, treatment, and services - All children receive comprehensive age-appropriate
assessment, treatment, and services, including mental health services, educational support, high-quality
child care, and recreational activities. Many children enroll in WISe to support cross-system navigation,
mental, behavioral, and developmental conditions, school success, and minimizing the impact of ACEs.
More information about the WISe program is available online.
Integrated family treatment - Services are provided to parents and children together to promote family
healing and functioning. Parents are engaged and develop skills through evidence-based parenting
programs. Family coaches support supervision and skills development for daily living skills.
Education and employment - Education support for adults and children based on the identified need. The
program includes a structured employment program and often includes specific volunteer and paid
employment opportunities as part of the program.
After-care and long-term housing - Residents receive assistance transitioning to long-term, affordable
housing with ongoing support and services provided to program graduates.
For a complete description of program phases and key partnerships, please see 2021 Master Plan Phase 1
(pages 26 and 28).
Staffing model
Rising Strong utilizes a robust, person-centered staffing model focusing on recovery, healing, and skill-building.
The staffing model is built on the unique needs of the residents across the family unit and leverages the role
and inclusion of peers in promoting a healthy recovery environment.
Staff positions are broken down by program area for program fidelity and billing purposes. The multi-
disciplinary, wraparound team includes the following roles:
Rising Strong
Rising Strong program director - Provides director-level leadership of Rising Strong specific aspects of
the program, including planning, developing, and implementing programs, budget management and grant
and funding oversight.
Program manager - Oversees implementation and day-to-day management of the Rising Strong program,
including staff onboarding, training, and supervision, and acts as a conduit between clinical and
operational teams to ensure cohesive partnerships. Directly oversees the implementation of grants and
other contracted and operational funding sources.
Administrative triage specialist - Provides support and coordination to Rising Strong leadership and
staff, supervises all transportation logistics, monitors and tracks all individuals entering the building,
oversees all supplies and supports random urinalysis processes.
RISING STRONG WEST MASTER PLAN PHASE 2 12
Partnership/operations coordinator - Screens all potential families for enrollment in direct partnership
with the contracted referral coordinator and conducts all program intakes. Throughout a family’s
enrollment, monitors and supports families with ongoing compliance with operational and clinical
programming requirements; supervises the coordination of transportation, appointments, and other
resources; acts as a conduit for information sharing between DCYF/courts and other partnership
agencies supporting families.
Family skills coaches - Provide program milieu monitoring and management and engage with residents
in practical skill-building activities such as cooking, child care, and other activities. Provide daily life skills
and problem-solving coaching; conduct room searches/night bed checks, support urinalyses and help to
facilitate transportation to and from appointments with families.
Wraparound with Intensive Services (WISe)
Clinical director - Provides administrative leadership for clinical aspects of the program as well as
clinical oversight and supervision of the behavioral health providers.
WISe program director - Oversees implementation and day-to-day management and integration of the
WISe program and services, provides oversight and supervision for child-focused supports and monitors
the fidelity of WISe services for the Team.
Masters-level mental health therapist - Leads therapeutic groups and voluntary individual and family
mental health therapy.
Peer supports - Individuals with lived experience who lead groups and engage in individual peer support
with residents. Peers have a recovery focus and support parents with recovery-based services and
Narcotics Anonymous meetings. Due to the mission of Rising Strong, recovery peers are an integral part
of the WISe teams.
Family peers: early risers - Individuals with lived experience who work with families and children in the
Early Risers program and provide day-to-day family support, including facilitating transportation to
appointments with families.
Care coordinators - Manage program referrals and facilitate program entry, provide ongoing coordination
with partner agencies involved with families and support care and planning for child-focused services.
Provide support for families in adhering to court-ordered services. They also facilitate weekly and
monthly reporting to external partners, attend all court proceedings, and implement all state-required
WISe services.
Foundational Community Support services (FCS)
FCS employment case manager - Assists residents with finding and maintaining employment.
FCS housing case manager - Assists residents with their housing search and provides stabilization
services in preparation for discharge from the program.
RISING STRONG WEST MASTER PLAN PHASE 2 13
Behavioral health services
Clinical director - Provides administrative leadership for clinical aspects of the program as well as
clinical oversight and supervision of the behavioral health providers.
Masters-level mental health therapist - Leads therapeutic groups and voluntary individual and family
mental health therapy.
SUD providers - Lead recovery-focused groups and offer individual SUD counseling; provide independent
reporting to the courts for dependency case SUD compliance; monitor all UA’s conducted and facilitate
SUD reassessments as needed.
RISING STRONG WEST MASTER PLAN PHASE 2 14
Table 1: Staffing model and expense
Staff position Program Planned FTE Est. salary Total expense
Rising Strong program director Rising Strong 1 $95,000 $95,000
Program manager Rising Strong 0.5 $75,000 $37,500
Administrative triage specialist Rising Strong 0.5 $50,000 $25,000
Partnership/operations coordinator Rising Strong 0.5 $55,000 $27,500
Family skills coaches (day, swing and overnight) Rising Strong 14 $50,000 $700,000
Rising Strong subtotal 16.5 $885,000
FCS employment program coordinator FCS 0.5 $55,000 $27,500
FCS housing program coordinator FCS 0.5 $55,000 $27,500
FCS subtotal 1.0 $55,000
Clinical director WISe 0.25 $115,000 $28,750
Master-level mental health therapist WISe 0.75 $85,000 $63,750
WISe program director WISe 0.5 $75,000 $37,500
Peer supports WISe 2 $55,000 $110,000
Family peers: early risers WISe 2 $55,000 $110,000
Care coordinators WISe 2 $55,000 $110,000
WISe subtotal 7.5 $460,000
Clinical director BH Services 0.25 $115,000 $28,750
Master-level mental health therapist BH Services 0.25 $85,000 $21,250
SUD provider BH Services 1.5 $75,000 $112,500
BH services subtotal 2.0 $162,500
Total staff 27 $1,562,500
RISING STRONG WEST MASTER PLAN PHASE 2 15
Facility criteria
Facility and program interdependence
In Phase I of this project, extensive interviews and an in-person visit to the Rising Strong Spokane facility
demonstrated the interdependence between the facility and program design. The facility is configured as a
group living, dormitory-style environment with communal kitchens, bathrooms and living spaces, allowing the
Family Skills Coaches to work hand-in-hand with the families on their homebuilding and parenting skills, as well
as for residents to benefit from peer support in their recovery. In addition, spaces on-site for child care,
individual treatment and group meetings are essential. To support community-building and recovery, ideally,
the environment would be welcoming and cozy in contrast to typical institutional settings.
Facility characteristics
Full residential facility requirements are outlined in the 2021 Master Plan Phase 1 (pages 13-15). Highlights
include rooms large enough for at least two occupants (for example, parent and child), one communal kitchen
per six families, communal laundry, commercial laundry for program needs, meeting spaces, staff offices, staff
break and overnight shift space, residential storage (particularly for large items such as strollers and car
seats), clear lines of sight, and controlled entry and exit to ensure safety.
Facility design and construction costs
The 2021 Master Plan Phase 1 included construction cost estimates based on a conceptual new construction
design of a 12,600-square-foot facility that meets these facility specifications (pages 77-89). This facility will
serve 24 households, including 36 total children. These estimates were used to develop a capital request by
DCYF for the 2023-24 biennium. The capital budget is outlined further in the Financial pro forma and budget
section.
Operator selection criteria
Operator selection
Potential program operators must be able to offer a specific suite of services required in the Rising Strong
program, either directly or by partnering with other service providers. The following checklist outlines the
desired qualifications that can be used as components of a future RFP process if needed.
Table 2: Operator qualification checklist
Desired qualification Rationale
The program is being created with new construction and requires development oversight from the
Facility development experience
service provider.
SUD and related behavioral health services are required to participate in the Rising Strong program.
Behavioral health service provider with Furthermore, individuals with SUD need specific support in creating a living environment that
SUD expertise supports their recovery. Medically assisted treatment (MAT) and coordination with
pharmacotherapy providers are offered.
Residents typically require mental health care to support their SUD recovery, as earlier trauma might
Mental health service provider
have contributed to initial substance use.
Infant and child mental health expertise Families frequently include infants that require mental health support to stabilize their situation.
RISING STRONG WEST MASTER PLAN PHASE 2 16
Desired qualification Rationale
WISe service experience Wraparound services for children are a core component of the service package.
Shelter or residential experience Safe and secure residential facilities are key to program outcomes.
Child care experience Parents rely on on-site, drop-in child care to pursue their treatment.
Community partnerships and referral Established partnerships with community service providers and local government agencies ensure
network any specialized support (i.e., culturally specific care) can be contracted.
Track record of hiring, developing, supervising, training, and retaining staff to ensure stable service
Staff management
offerings.
Because revenue for the program comes from a variety of sources, the provider needs to be able to
Complex billing experience
manage this complexity.
Relationships with MCOs Most, if not all, residents rely on Medicaid for health care.
The use of electronic medical records, outcome measurement, strong policies and procedures, and
Organizational infrastructure
adequate licensing and regulatory qualifications underpin the provision of services.
Indicators of financial stability - a balanced budget, fiscal reserves and financial oversight ensure the
Financial stability
program's longevity.
Environmental scan
Process
As part of the process of identifying a location for the RSW facility that promotes an optimal environment for
resident healing and recovery, we conducted site visits and environmental scans of three potential locations.
Phase 1 focused solely on King County; based on feedback from the advisory group, we added sites in
Snohomish and Pierce County. The purpose of the site visits was to gain first-hand knowledge of the strengths
and limitations of each site and surrounding area. In the first phase, the Technical and Advisory Support Team
and other stakeholders identified services and environmental factors critical to creating a successful program.
A sample of the desired environmental factors and components and the strengths of each site are below. The
full Environmental Scan can be found in Appendix C.
RISING STRONG WEST MASTER PLAN PHASE 2 17
Table 3: Environmental scan
Desired environmental Amara Evergreen Recovery Red Barn Ranch
components Pierce County Snohomish County South King County
Property that can accommodate Unknown - Feasibility Study and Cultural Unknown - Planned use of
Yes
a 13,000-square-foot building Assessment are in progress the property is unknown
Facility developer No Strong interest No
No
Catholic Community Services of
Operator Strong interest No
Western Washington has shown interest
as a potential provider of WISe services
Access to public transportation Limited Yes No
Access to social services and
Yes Yes Limited
other community resources
Access to nature and greenspace
for nature-based recovery Yes Limited Yes
activities and play areas
Table 4: Site risks and potential mitigation
Site Risk Mitigation
The outcome of the Feasibility Study and Cultural Dependent on the results of the Feasibility Study and
Assessment is currently unknown Cultural Assessment
Continue searching for an operator and developer if a
Amara, Pierce County No identified operator or developer
site is selected
Siting facility outside of King County could limit
Designate priority beds for King County residents
program access for King County residents
Evergreen Recovery Center, Siting facility outside of King County could limit Develop a process for fair distribution of capacity
Snohomish County program access for King County residents among Snohomish, King and Pierce Counties
Planned use is unknown at this time - unable to
Continue trying to obtain information
obtain information
Continue searching for an operator and developer if a
Red Barn Ranch, King County No identified operator or developer
site is selected
Isolated location with no access to public Collaboration with King County transit for increased
transportation transportation options
RISING STRONG WEST MASTER PLAN PHASE 2 18
Figure 3: Map of sites under consideration
RISING STRONG WEST MASTER PLAN PHASE 2 19
Site and operator recommendation
Based on the preceding sections, which outline the facility criteria, operator selection criteria and
environmental scan, this report recommends that Evergreen Recovery Centers in Everett is the preferred
inaugural service provider in Western Washington.
Facility
Not only does Evergreen Recovery Centers have available, commercially zoned, shovel-ready land, but the
available site is also located across the street from the organization’s existing PPW program, which includes a
major new capital project. The new development houses treatment spaces, licensed child care, and a neonatal
intensive care unit, which are highly compatible with the Rising Strong program. These additional facilities will
augment the services already planned for Rising Strong.
Operator criteria
Evergreen Recovery Centers has not just the service experience, it is also an experienced developer of capital
projects. The management team maintains excellent and close relationships with the community, elected
officials, county agencies and other regional service providers. Long-term relationships with the MCOs and
experience handling complex billing arrangements will also serve in the launch of a new Rising Strong
program. While Evergreen Recovery Centers does not have direct WISe service experience, it provides similar
infant and child mental health services and is familiar with the WISe model. Furthermore, Catholic Community
Services in Snohomish County is an experienced WISe service provider and has offered support to Evergreen
Recovery Centers in the program's startup.
Environmental factors
This location in urban Snohomish County is very convenient to the interstate and public transportation,
allowing clients to commute, when necessary, to appointments in King and Pierce counties.
Coordinated entry challenges
The primary challenge of siting the program at Evergreen Recovery Centers relates to access to coordinated
entry in other counties. If a homeless household originally from outside Snohomish County is residing at the
facility, it may complicate their ability to access the coordinated entry process of their county of origin if they
are not actively residing in that county. For example, if a household from Pierce or King resides at the program
in Snohomish, Pierce or King County may exclude them from coordinated entry enrollment and assessment
since they do not actively reside in Pierce or King County. This may also impact access to homeless crisis
response resources in the county of origin during and/or after their stay in the program.
Expected program outcomes and impact
Preliminary Rising Strong Spokane program data from its staff indicates positive program outcomes. For
example, two-thirds of families successfully exit the program, and more than 80% complete their treatment
requirements. For those who don’t complete the program, exit reasons include: a higher level of care needed,
dependency case successfully closed, program violations involving safety concerns, or the family no longer
feels the program meets their needs. It is anticipated that the Rising Strong model will also have a positive
impact on the following program goals:
Improve the well-being, permanency and safety of children impacted by family substance use
Decrease the number of children in out-of-home placements
Significantly reduce or eliminate family separation by serving the entire family
RISING STRONG WEST MASTER PLAN PHASE 2 20
Reduce trauma exposure and impacts on children and enhance parental treatment success
Timely and enduring family reunification
To measure the impact of the Rising Strong Program, Catholic Charities Eastern Washington in Spokane is
partnering with Washington State University (WSU) in a five-year Regional Partnership Grant (RPG). The RPG in
2017, and WSU began studying the program's impact immediately upon the launch of the Rising Strong
program. The study is structured as a quasi-experimental outcome study. The study group of 150 families will
receive the entire scope of services for twelve to eighteen months, and the comparison group of 150 families
will receive typical services. Currently, longitudinal data is being collected, and the outcome of the study, and
program impact, are unknown. Rising Strong Spokane will receive the data in the fall of 2023, delayed a year
due to the pandemic.
Measuring program success could be an ongoing challenge due to the complexity of measuring the impact
and data not consistently being available to align across agencies and intended measures. One of the
recommendations moving forward is to create discussion among the various partners to ensure alignment in
measurement across several levels and state agencies.
Fiscal savings
In addition to the direct impact on the client population, a variety of anticipated system impacts will create
fiscal savings. These include a reduction in the cost of out-of-home placements, a decrease in utilization of
public legal resources and criminal justice facilities, a reduction in the cost of medical and behavioral health
services, a reduction in higher cost emergency- and crisis-health services, and longer term social benefits of
children with lower ACEs, such as educational achievement and economic self-sufficiency.
Financial pro forma and budget
Financial projections during this phase have been fine-tuned based on an additional year of lived experience by
participants in the Spokane program and validation from funding agencies and MCOs. The expenses for this
project are divided into two categories: capital investment/startup and operational expenses. The facility under
consideration would be new construction at a commercially zoned, shovel-ready site in Everett, Washington,
with a capacity for 24 households.
Capital investment
The capital investment of $13.4 million for this project includes architectural design services, permitting,
building rehabilitation construction and project management. This estimate is based on the work of Deacon
Construction outlined in the 2021 Master Plan Phase 1 (pages 77-89). This budget formed the basis for the
DCYF capital request for the 2023-24 budget.
An allowance of $250,000 for technical assistance covers the startup and implementation for the service
provider. This model assumes the land is donated. A one-time grant will support planned startup costs. Initial
conversations with potential philanthropic funding partners confirmed their interest should the legislature fund
the capital project.
The Department of Commerce will oversee the capital project as a pass-through from DCYF. The project will
fall within the affordable housing umbrella of the Housing Trust Fund as transitional housing or shelter.
RISING STRONG WEST MASTER PLAN PHASE 2 21
Table 5: Rising Strong West capital budget
Rising Strong West Startup
INCOME
Grants
Public (federal, state, county) $13,356,000
Private (foundation, corporate, nonprofit) $250,000
TOTAL INCOME $13,606,000
EXPENSE
Facilities and occupancy
Land cost $75,000
Consultant services (predesign, design, etc.) $1,037,068
Building rehab construction $10,992,988
Artwork $66,448
Furnishings and equipment $406,983
Agency project administration $724,507
Other $53,000
Program costs
Technical assistance - implementation $250,000
TOTAL EXPENSE $13,605,994
NET INCOME $6
Factors
Lease rate- $/RSF 0.00
Square footage 12,600
Annual cost escalation 4.9%
Number of adults served 24
Number of children served 36
Cost ratios
Cost per square foot $1,080
Capital cost per household $566,916
RISING STRONG WEST MASTER PLAN PHASE 2 22
Operating budget
The ongoing operation of Rising Strong West consists of staffing, program expenses, administrative expenses,
and ongoing maintenance and totals $2.6 million in the first year. While program services revenue covers
approximately 60% of the operating budget, a gap needs to be addressed.
Expense assumptions
These projections include the following assumptions:
The facility will accommodate 24 households with 24 to 36 children.
The program will operate at 75% capacity during the first year and 100% capacity in subsequent years.
Salaries are based on U.S. Bureau of Labor Statistics data, regional comparative wages, and the HCA’s July
2022 Milliman Report on Behavioral Health Comparison Rate Development Phase 1.
Staff benefits are calculated based on 25% of the base salary.
No land or facility lease expense due to donated land and state capital investment.
Annual cost escalation factor of 4.9% cost increase and rent escalation.
Program staffing can be phased in during Year 1 as capacity ramps up, which may result in some cost
savings, although the projections include full staffing for the entire first year.
Income assumptions
Funding for Rising Strong comes from a variety of program fees for services. For these estimates, it is
assumed that all adults are eligible for behavioral health, mental health and FCS services. Our operating
revenue is based on 75% capacity during the first year, growing to 100% in year two and going forward.
Families stay in the program for 12 months on average.
Several factors impact the utilization rate of the services and, thus, impact the overall revenue for the program:
Program enrollment time: Not all services start from day one because families need time to enroll and
have insurance coverage verified.
Eligibility: Not all families are eligible for all services for the entire length of the program. For example,
the FCS is only appropriate for parents in their final months of participation.
Compliance and billing complexity: Because of the complex range of services offered, service providers
tend to be conservative to ensure fidelity. For example, while most, if not all, of the children in the
program, are eligible for WISe, only one child is enrolled per family to avoid duplication of services in the
family, which would be difficult to bill appropriately.
RISING STRONG WEST MASTER PLAN PHASE 2 23
Table 6: Program fees for services
Utilization
Fee type Estimate rate Source Type
Behavioral health treatment Health Care
$12,801.92 per adult/year 90% Health care
services Authority and MCO
Mental health treatment Health Care
$3,559.00 per adult/year 70% Health care
services Authority and MCO
Foundational Community $3,240.00 per adult/6 Health Care
75% Health care
Supports (FCS) - employment months Authority and MCO
Foundational Community $3,360.00 per adult/6 Health Care
75% Health care
Supports (FCS) – housing months Authority and MCO
Health Care
WISe program services $3,490.27 per child/month 60% Health care
Authority and MCO
Foster Care maintenance
$672.00 per child/month 60% DCYF Child Welfare
payments
While this model assumes billing for individual services, bundling service codes to establish a weekly or
monthly case rate has advantages for planning and providing long-term care. MCOs have all expressed a
willingness to engage in these conversations.
Limitations in funding sources
The structural design of the program limits some of its funding sources. These gaps include:
Services provided outside of a Residential Treatment Facility license limit reimbursement rate, as
previously explained in Program structure and licensing.
Housing Vouchers cannot be applied to this program because families need to keep their status as
unhoused or at risk of homelessness to qualify for permanent supportive housing upon exit. Programs
typically used to assist this population, such as Housing and Essential Needs (HENS), Housing and
Recovery through Peer Services (HARPS), and Consolidated Homeless Grants (CHG), cannot be applied.
Although Foster Care Enhancement payments are available to families when entering the program,
eligibility goes away after reunification. However, families still need more time in the program to stabilize
before transitioning to permanent housing.
Funding gap solutions
The workgroup began to explore ways to close the funding gap of approximately $125 per household per day
in the operational model. These funds will not be required until the facility opens in 2026, so they remain under
consideration and can be included in a request during the 2025-26 operating budget. The ideas under
consideration include the following:
RISING STRONG WEST MASTER PLAN PHASE 2 24
Leveraging Family First Preservation Services Act (FFPSA) and Title IV-E federal funds to cover the cost of
the Family Skills Coaches
Funds from the DCYF program budgets
Exploring the availability of Housing Trust Fund shelter operating funds
Partnering with county human services agencies to use regional homeless crisis response funds
Table 7: Rising Strong West operation budget projections
Program budgets Year 1 Year 2 Year 3
Program service fees
Clinical services
Behavioral health treatment services $207,391 $290,071 $304,285
Mental health treatment services $44,843 $62,721 $65,794
Subtotal – Income $252,235 $352,792 $370,079
Clinical staff salaries $162,500 $170,463 $178,815
Clinical staff benefits $40,625 $42,616 $44,704
Subtotal - Staff expense $203,125 $213,078 $223,519
Net - Clinical services $49,110 $139,714 $146,560
WISe services
WISe $678,508 $949,007 $995,509
Subtotal – Income $678,508 $949,007 $995,509
WISe staff salaries $460,000 $482,540 $506,184
WISe staff benefits $115,000 $120,635 $126,546
Subtotal - Staff expense $575,000 $603,175 $632,731
Net – WISe $103,508 $345,832 $362,778
Foundational Community Supports services
RISING STRONG WEST MASTER PLAN PHASE 2 25
Program budgets Year 1 Year 2 Year 3
FCS - supported employment $43,740 61,178 $64,175
FCS - Supportive housing $45,360 $63,444 $66,552
Subtotal – Income $89,100 $124,621 $130,728
FCS staff salaries $55,000 $57,695 $60,522
FCS staff benefits $13,750 $14,424 $15,131
Subtotal - Staff expense $68,750 $72,119 $75,653
Net – FCS $20,350 $52,502 $55,075
Rising Strong Services
Foster Care maintenance payments $130,637 $182,717 $191,670
Subtotal – Income $130,637 $182,717 $191,670
RS staff salaries $885,000 $928,365 $973,855
RS staff benefits $221,250 $232,091 $243,464
Subtotal - Staff expense $1,106,250 $1,160,456 $1,217,319
Net - Rising Strong $(975,613) $(977,739) $(1,025,648)
Total services income $1,150,480 $1,609,138 $1,687,985
Total staff expense $1,953,125 $2,048,828 $2,149,221
Net service income $(802,645) $(439,690) $(461,235)
Non-staff expense
Facilities and occupancy
Lease 0 0 0
Insurance and property taxes $50,000 $52,450 $55,020
RISING STRONG WEST MASTER PLAN PHASE 2 26
Program budgets Year 1 Year 2 Year 3
Maintenance $150,000 $157,350 $165,060
Utilities $10,000 $10,490 $11,004
Program support costs
Professional services (contracted court referrals) $15,000 $15,735 $16,506
Client workshops and trainings $15,000 $15,735 $16,506
Medical supplies (UAs) $10,000 $10,490 $11,004
Program equipment, furnishings and maintenance $30,000 $31,470 $33,012
Program supplies $10,000 $10,490 $11,004
Program meetings and events $10,000 $10,490 $11,004
Client supports (i.e., baby formula, food, clothing) $15,000 $15,735 $16,506
Transportation for clients $40,000 $41,960 $44,016
Staff training and development $24,000 $25,176 $26,410
Technical assistance - implementation $75,000 0 0
Administrative costs
Admin support services (HR, payroll, tech, security) $150,000 $157,350 $165,060
Computer equipment and software $35,000 $25,000 $26,225
Insurance $10,000 $10,490 $11,004
Licenses, dues and fees $4,000 $4,196 $4,402
Office equipment and furnishings $30,000 $31,470 $33,012
Office supplies $10,000 $10,490 $11,004
Phone, internet, postage and shipping $30,000 $16,000 $16,784
RISING STRONG WEST MASTER PLAN PHASE 2 27
Program budgets Year 1 Year 2 Year 3
Total non-staff expense $723,000 $652,567 $684,543
Net income $(1,525,645) $1,092,257) $(1,145,778)
Funding gap/month/household $(5,297) $(3,793) $(3,978)
Funding gap/day/household $(174) $(125) $(131)
Note: Year 1 is 75% capacity
Table 8: Factors
Factors
Lease rate- $/RSF 0.00
Square footage 12,600
Annual rent escalation 0%
Annual cost increase 4.9%
Year 1 target capacity 75%
Staffing benefits 25%
Number of adults served (households) 24
Number of children served 36
Table 9: Cost ratios
Cost ratios
Operating cost per household/year $111,505
Cost per household/month $9,292
Cost per household/day $305
RISING STRONG WEST MASTER PLAN PHASE 2 28
Recommendations and conclusions
The Rising Strong model is a unique solution to an ongoing challenge of creating positive outcomes for
families at risk of child removal due to parental SUD. This report builds on the 2021 Master Plan Phase 1
by validating the community need, documenting the results of cross-agency collaboration, updating the
financial model, and making a preferred site and operator recommendation.
As a result of this process, DCYF has included a $13.4 million capital funding request for Rising Strong
West in the 2023-25 capital budget. Following the analysis of facility and operator criteria, this report
recommends the development of a facility in Western Washington with a capacity of serving 24 families.
In addition to filling a vital need in the state, this program also aligns with the focus on maternal and
infant health priorities of the governor’s office, HCA and DCYF.
Evergreen Recovery Centers in Everett is recommended as the inaugural developer and operator in
Western Washington. Not only does the organization have appropriate land, but the agency is also an
experienced facility developer and respected provider of family mental and behavioral health services.
The stakeholder workgroup process also finalized the facility type and related funding sources for the
program. More work must be done to codify these sources so that additional Rising Strong programs
can be opened in other parts of the state.
Next steps
To successfully launch Rising Strong in Western Washington, key system partners must continue collaborating
on implementation, particularly sustainable operating funds. We recommend the following steps to ensure the
ongoing development of a coordinated and successful model:
1. Garner support for the DCYF capital request in the 2023-25 legislative session, including engaging
legislators and staff that expressed interest during the 2022 workshops.
2. Pending approval of the capital request, convene an Advisory Committee consisting of the named
operator, relevant state agencies, MCOs and community members to support the program's
implementation. State agencies should include, but not be limited to, DCYF, HCA, Commerce, and the
Office of Public Defense. The work of this committee would include the ongoing study of the program
impact, including a review of the results of the Washington State University-Regional Partnership Grant
(WSU-RPG) study of the Spokane program and a collaborative design of outcomes and fiscal savings
metrics with HCA and DCYF.
3. Pending approval of the capital request, engage the private sector and philanthropic organizations for
startup technical assistance funding.
The following additional steps will support the ongoing operation of Rising Strong Spokane and Rising Strong
West and will pave the way for organizations to launch multiple Rising Strong programs in other regions of the
state where the need is high:
4. Pursue operational funding for services not covered by Medicaid or Foster Care Enhancement by
leveraging the Family First Preservation Services Act (FFPSA), Title IV-E funds, or other DCYF sources.
RISING STRONG WEST MASTER PLAN PHASE 2 29
5. Develop a facility definition for Rising Strong in the Washington Administrative Code (WAC) that
maintains program fidelity while clarifying available capital funding sources in the future.
6. Create a “Rising Strong Trust Fund” to encourage operators in other parts of the state to develop
regional programs.
7. Continue to examine the possibility of pursuing additional sites (e.g., Red Barn Ranch in King County
and Amara in Pierce County) to meet the large demand for the program.
RISING STRONG WEST MASTER PLAN PHASE 2 30
Appendix A: Glossary of terms, abbreviations and
acronyms
ACES - Adverse Child Experiences
BH - Behavioral Health
BHA - Behavioral Health Agency
BHASO - Behavioral Health Administrative Services Organization
CBT - Cognitive Behavioral Therapy
CEA - Coordinated Entry for All
DCYF - Department of Children, Youth and Families
DOH - Department of Health
DSHS - Department of Social and Human Services
FCS - Foundational Community Supports
FFPSA - Family First Preservation Services Act
HCA - Health Care Authority
HEN - Housing and Essential Needs
HMIS - Homeless Management Information System
IOP - Intensive Outpatient Program
MCO - Managed Care Organization
MH - Mental Health
MI - Motivational Interviewing
OOHC - Out-of-Home Care
OP - Outpatient Program
PCIT - Parent-Child Interaction Therapy
PPW - Pregnant and Parenting Women
RDA - Research and Data Analysis
RFP - Request for Proposal
RPG - Regional Partnership Grant
RTF - Residential Treatment Facility
SUD - Substance Use Disorder
WAC - Washington Administrative Codes
WISe - Wraparound with Intensive Services
WSU - Washington State University
RISING STRONG WEST MASTER PLAN PHASE 2 31
Appendix B: List of key stakeholder organizations and
references
Legislative stakeholders
5th Legislative District
37th Legislative District
41st Legislative District
45th Legislative District
Programmatic stakeholders
Catholic Charities Eastern Washington
Catholic Community Services of Western Washington
King County Superior Court, Family Treatment Court Program
Washington State Department of Children, Youth and Families
• Continuum of Behavioral Health Services
• Government Affairs and Community Engagement
• Office of Innovation, Alignment and Accountability
• Substance Use Prevention, Treatment, and Recovery Services
Washington State Department of Community and Health Services, Behavioral Health and Recovery Division
Washington State Department of Social and Health Services, Economic Services Administration
Facility stakeholders
Washington State Department of Health
• Opioid Treatment Program
• Pregnant and Parenting Program
• Residential Treatment Facility Program
Financial stakeholders
Amerigroup
Community Health Plan of Washington
Coordinated Care
Molina Healthcare
United Healthcare
Washington State Health Care Authority
• Children, Youth and Family Behavioral Health
• Foundational Community Supports
• Infant and Early Childhood Mental Health
• Prenatal to 25 Lifespan Mental Health and Substance Use Services
• Rates and Finance
• Recovery Supports
RISING STRONG WEST MASTER PLAN PHASE 2 32
Washington State Department of Commerce
• Apple Health and Homes/Permanent Supportive Housing
• Behavioral Health Facilities
• Housing Trust Fund
• Recovery Housing
• Supportive Housing
Partnership stakeholders
Amara
Evergreen Recovery Centers
Sound Mental Health
List of Department of Social and Health Services Research and Data
Analysis reports reviewed:
Prevalence of Substance Use Disorder Diagnoses among Medicaid Beneficiaries
Variations in Behavioral Health Treatment Penetration Rates
Variations in Utilization of Substance Use Disorder Treatment Modalities
Physical Health and Social Outcomes among Medicaid Beneficiaries with and without Behavioral Health
Diagnoses
Substance Use Disorder Treatment Penetration Rates Among Child Welfare Involved
Behavioral Health Treatment Needs and Outcomes among Medicaid Enrolled Children in WA
WISe Dashboards and Reports
WISe King County Trends and Data
RISING STRONG WEST MASTER PLAN PHASE 2 33
Appendix C: Detailed environmental scan
Table 10: County-level environmental scan
King Pierce Snohomish
Substance use 50% of cases of a child entering 41% of cases of a child entering OOHC 55% of cases of a child entering OOHC
involved child OOHC involved parental involved parental substance abuse involved parental substance abuse
welfare cases substance abuse
2021 DCYF Data
SUD treatment 25,762 people in King County 15,968 people in Pierce County needed 12,073 people in Snohomish County needed
penetration - all needed SUD treatment, and 36% SUD treatment, and 33% (5,269) received SUD treatment, and 42% (5,070) received
Medicaid (9,274) received treatment treatment treatment
Beneficiaries
2019 DSHS Data
Opioid Use 10,796 people in King County 6,128 people in Pierce County needed 5,960 people in Snohomish County needed
Disorder (OUD) needed OUD treatment, and 55% OUD treatment, and 50% (3,064) received OUD treatment, and 60% (3,576) received
treatment (5,938) received treatment treatment treatment
penetration -
general population
2019 DSHS Data
Public King County Metro provides Pierce Transit service area includes the Community Transit connects to many local
transportation service to nearly every major incorporated cities and towns of Auburn, and regional providers, such as Everett
system school, business, and place of Edgewood, Fife, Fircrest, Gig Harbor, Transit, Island Transit, King County Metro,
Source: interest in King County. The Lakewood, Milton, Pacific, Puyallup, Kitsap Transit, Sauk-Suiattle DC-Direct Shuttle
WSDOT Summary agency provides connections with Ruston, Steilacoom, Tacoma, University Public Transit, Skagit Transit, Sound Transit,
of Public Sound Transit, Community Place, and portions of unincorporated Tulalip Transit and Washington State Ferries.
Transportation Transit, Pierce Transit, Amtrak, Pierce County. The agency provides The agency also connects to national
(2020) the City of Seattle, Monorail and connections with Greyhound, King providers like Amtrak and Greyhound.
Washington State Ferries at County Metro, Sound Transit, Amtrak and Connections are provided at transit centers,
various regional transit centers Intercity Transit within its service area. park and ride facilities, ferry terminals, and
and other locations. regional employment centers in Snohomish
and King counties. The agency service in
Snohomish County includes nearly all cities,
major employment centers, many public
schools, and two college campuses.
Unemployment 2.9% 3.3% 4.3%
rate
2022 Employment
Security
Department Data
Adult education 64 colleges; 1 college for every 18 colleges; 1 college for every 46,955 22 colleges; 1 college for every 35,086
opportunities 33,096 residents residents residents
RISING STRONG WEST MASTER PLAN PHASE 2 34
Table 11a: Site environmental scan
Desired Site: Amara
environmental Address: 3501 104th Street East, Tacoma, WA 98446
components County: Pierce
Space for Amara’s current buildings use a small portion of the 29-acre property; however, a
approximately large portion has been identified as wetlands. Amara is completing a feasibility
13,000 square foot study to determine what parts of the land can be developed.
building to house Amara was requested to conduct a cultural relevance analysis and is in the
communal living process of contracting with a provider to conduct this analysis. Findings may
spaces and inform the use of some portions of the property.
program offices The site would need to be connected to the city sewer system, as the current
septic tanks would not be able to support the facility.
Access to public Walk score 7: car-dependent; almost all errands require a car
transportation Current transportation access is limited; additional public transportation options
would need to be requested from the county. Amara supports increasing access
to the existing services on the site.
The closest public bus line is 0.7 miles away along a road without sidewalks
A bus line provides access to downtown Seattle; a one-way trip is approximately 2
hours and 15 minutes.
Education and 5.5 miles to Pierce College Puyallup
employment 6.8 miles to Clover Park Technical College
services for adults 8.8 miles to the University of Washington - Tacoma Campus
Educational 1.5 miles to Midlands Kiddy Korral - Head Start Program
services for children 1.2 miles to A Step Ahead Pierce County - Head Start Program
and youth 4.0 miles to Fernhill Elementary School
4.6 miles to Baker Middle School
1.6 miles to Franklin Pierce High School
Primary care and 3.1 miles to Community Health Care - Parkland Family
other medical 4.0 miles to Lakewood Healthcare Center
services 10.8 miles to Hilltop Regional Health Center
11.1 miles to Multicare Tacoma Central Primary Care
Adult, child, and 4.7 miles to Greater Lakes Mental Healthcare (SUD and mental health services
youth behavioral serving the Medicaid population)
health and SUD 5.8 miles to Sea Mar Puyallup Behavioral Health
counseling 6.2 miles to RI International Outpatient Services (SUD and behavioral health
outpatient services serving the Medicaid population)
RISING STRONG WEST MASTER PLAN PHASE 2 35
Table 11a: Site environmental scan
Desired Site: Amara
environmental Address: 3501 104th Street East, Tacoma, WA 98446
components County: Pierce
Social services and Family Resource Center on-site operated by Amara
other community 3.5 miles to the Social and Health Services Department
resources 4.8 miles to Catholic Community Services
Ability to access The King County Courthouse is approximately two hours by public transportation
court obligations or 45 minutes driving.
Outdoor and The site offers extensive outdoor and greenspace with opportunities for gardening
greenspace and play space for children.
A significant portion of the property will likely remain undeveloped as it is federally
protected wetlands.
Entertainment, Downtown Tacoma and Puyallup are accessible by bus; both areas offer opportunities
community and for shopping, entertainment, and community activities.
culture
Transitional and/or 16 miles to Fusion (Transitional housing for families)
permanent housing
Private location to The site is ideal for creating a sense of tranquility and privacy while still being located
support recovery near Puyallup and Tacoma.
and security
Isolation from The site presents as likely to be removed from criminal activity and SUD hotspots.
known criminal or
substance use
hotspots
Predicted support Amara predicts that the operating entity will need to conduct community engagement
from the local work to build local support.
community
Site control Amara owns the property and is open to entertaining offers such as a long-term
lease agreement.
Amara has not identified itself as an operator of either the facility or services.
RISING STRONG WEST MASTER PLAN PHASE 2 36
Table 11b: Site environmental scan
Desired Site: Evergreen Recovery Centers
environmental Address: 2601 Summit Avenue, Everett, 98201
components County: Snohomish
Space for The site has a one-block lot currently available for development that could
approximately potentially accommodate a 13,000-square-foot building.
13,000 square foot The lot is currently zoned for commercial use.
building to house
communal living
spaces and
program offices
Access to public Walk score: 54; somewhat walkable; some errands can be accomplished on foot
transportation Transit score: 45; some transit; a few nearby public transportation options
The closest bus stop is approximately 0.3 miles from the complex
The walk from the site to the bus stop is primarily on quiet, residential streets that
are safe for walking.
Education and 1.9 miles to Service Alternatives
employment 2.4 miles to Columbia College - NS Everett
services for adults 2.8 miles to Everett Community College
2.8 miles to Western Washington University Extended Education
Educational 2.1 miles to Head Start North County
services for children 2.8 miles to Early Learning Center (Head Start)
and youth 0.7 miles to Garfield Elementary School
0.9 miles to North Middle School
1.4 miles to Everett High School
2.1 miles to Port Gardner K-12
Primary care and 2.0 miles to Community Health Center of Snohomish County - Everett North Clinic
other medical 2.3 miles to Providence Regional Medical Center - Colby
services 2.3 miles to The Everett Clinic Primary Care
Adult, child, and Evergreen offers on-site behavioral health and other social services that could be
youth behavioral a resource for RSW residents.
health and SUD 1.4 miles to Compass Health
counseling 1.8 miles to Sunrise Services Community Behavioral Health
2.3 miles to Providence Behavioral Health Urgent Care
RISING STRONG WEST MASTER PLAN PHASE 2 37
Table 11b: Site environmental scan
Desired Site: Evergreen Recovery Centers
environmental Address: 2601 Summit Avenue, Everett, 98201
components County: Snohomish
Social services and Services within an approximate two-mile radius include the following:
other community
resources Catholic Community Services
YWCA Everett
Salvation Army
Service Alternatives
Cocoon House Central (Youth Services)
Ability to access The King County Courthouse is approximately 30 minutes by car or 1.5 hours by bus.
court obligations
Outdoor and Located in an Urban/suburban part of Everett near I-5
greenspace Once finished, the Evergreen complex will have protected outdoor space
conducive to therapeutic activities and space for children to play.
Entertainment, The site is within walking distance of downtown Everett with access to entertainment,
community, and community, and culture.
culture
Transitional and/or Evergreen has two houses they currently use for transitional housing and may
permanent housing consider adding additional housing in the future.
Private location to Evergreen is developing a campus spanning approximately 4-6 blocks which will
support recovery create a sense of privacy and community within the site.
and security
Isolation from Evergreen reports minimal criminal and SUD activity in the area – typical of what
known criminal or would be expected around a SUD treatment program.
substance use
hotspots
Predicted support Evergreen has put effort into communication and engagement with the surrounding
from the local community and reports having support from the community.
community
RISING STRONG WEST MASTER PLAN PHASE 2 38
Table 11b: Site environmental scan
Desired Site: Evergreen Recovery Centers
environmental Address: 2601 Summit Avenue, Everett, 98201
components County: Snohomish
Site control The site is owned and controlled by Evergreen
Table 11c: Site environmental scan
Desired Site: Red Barn Ranch
environmental Address: 17601 SE Lake Moneysmith Rd, Auburn, WA 98092
components County: South King County
Space for There is adequate space for a 13,000-square-foot building
approximately The intended use of the property is currently unknown. The City of Seattle is
13,000 square foot conducting a Place Assessment to determine any history or ties with local Tribes.
building to house It is assumed that the Place Assessment outcome will inform the property's future
communal living use.
spaces and The Muckleshoot Reservation is located approximately 10 miles from the Red
program offices Barn Ranch and could offer a potential opportunity for partnership and shared
resources for members of the Tribal community.
Access to public Walk score 7: Car dependent; almost all errands require a car
transportation Currently, there is essentially no access to public transportation and creating
additional public transportation options would need to be addressed with the
county.
The closest bus stop is approximately 9 miles away.
Education and 8.4 miles to Green River College
employment 9.1 miles to Pioneer Human Services (Job training)
services for adults 10.1 miles to Muckleshoot Tribal College
Educational The site appears to be on a school bus route
services for children 7.4 miles to Head Start Springwood
and youth 8.3 miles to Muckleshoot Tribal Development Center (Head Start)
3.0 miles to Lake View Elementary School
8.3 miles to Rainier Middle School
6.6 miles to Auburn High School
10.3 miles to Muckleshoot Tribal School
RISING STRONG WEST MASTER PLAN PHASE 2 39
Table 11c: Site environmental scan
Desired Site: Red Barn Ranch
environmental Address: 17601 SE Lake Moneysmith Rd, Auburn, WA 98092
components County: South King County
Primary care and 7.7 miles to South King County Healthcare Services (Focused on providing
other medical comprehensive health care for the Medicaid-eligible population)
services 7.9 miles to Multicare Auburn Family Medicine
9.1 miles to Muckleshoot Health and Wellness Center
Adult, child, and 8.0 miles to HealthPoint Valley Cities Auburn
youth behavioral 9.0 miles to Muckleshoot Behavioral Health Services
health and SUD
counseling
Social services and 8.1 miles to the Social and Health Services Department
other community 9.1 miles to Pioneer Human Services,
resources 8.3 miles to Muckleshoot Child and Family Center
Ability to access Currently, residents would not be able to access the King County Courts using public
court obligations transportation. It is approximately a 45-minute drive by car.
Outdoor and The site is in a beautiful, rural setting ideal for healing and recovery.
greenspace The property has ample outdoor space, including areas for gardening and many
outdoor activities.
Entertainment, There are limited options for culture and entertainment as it is a rural area.
community and The City of Auburn has some entertainment and community options and is located
culture approximately seven miles from the site.
Transitional and/or 8.0 miles to Valley Cities Phoenix Rising (Transitional Housing ages 18-25)
permanent housing 9.1 miles to KCHA Meadows on Lea Hill
11.8 miles to KCHA Evergreen Court
Private location to It is a peaceful and secluded location ideal for privacy and security.
support recovery
and security
RISING STRONG WEST MASTER PLAN PHASE 2 40
Table 11c: Site environmental scan
Desired Site: Red Barn Ranch
environmental Address: 17601 SE Lake Moneysmith Rd, Auburn, WA 98092
components County: South King County
Isolation from Isolated from criminal and substance use
known criminal or
substance use
hotspots
Predicted support Unknown at this time
from the local
community
Site Control Unknown at this time
The property is owned by the City of Seattle and is undergoing a Place
Assessment to determine the history and potential ties to the Tribal Community.
It is assumed that the availability and potential site usage will remain unknown
until the Place Assessment is complete.
RISING STRONG WEST MASTER PLAN PHASE 2 41
Appendix D: Letters of support
The following letters of support for Rising Strong West were received:
Amara - Nicole Mazen, LMFT, Chief Program and Policy Officer
Catholic Charities Eastern Washington - Robert McCann, Ph.D., President and Chief Executive Officer
Catholic Community Services of Western Washington - Nolita Reynolds, MA, LMHC, CMHS, Clinical
Director, Pierce, Family Behavioral Health
Community Health Plan of Washington - Erin Hafer, Vice President, Delivery and Health System Innovation
and Community Partnerships
Evergreen Recovery Centers - Linda Grant, MS, SUDP, Chief Executive Officer
King County Family Treatment Court - Jill Murphy, LICSW, Family Supervisor
Molina Healthcare - Tory Gildred, LICSW, SUDP, Associate Vice President, Behavioral Health
Snohomish County Human Services Department - Mary Jane Brell Vujovic, Director
RISING STRONG WEST MASTER PLAN PHASE 2 42
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