Health and Human Services
As health care costs soar, agencies need cost-efficient strategies that work. Public Works’ comprehensive approach enables governments to improve the quality of their health and human services while controlling costs. We guide state agencies, national non-profits, and local service providers in excelling at their mission to care for children and families across the country focusing on creative solutions to poverty at both the state and local levels.
Here is some of what we've done ...
Public Works Supports Virginia Department of Health Program Evaluation
Public Works was selected to serve on the evaluation team assembled in
support the Virginia Department of Health’s program evaluation for state
and local public health actions to combat obesity, diabetes, heart disease
and stroke. Public Works’ personnel assigned to the project bring
specialized expertise in evaluating public health programs according to the
Centers for Disease Control (CDC) Six-Step Framework for Program
Evaluations, as well as specific expertise in issues surrounding obesity,
diabetes, heart disease, and stroke. Public Works brings to this engagement
deep analytical capabilities and a highly interactive process with staff who
are experts in the field of public health, chronic disease, health program evaluations, and extensive experience working with both state and local health agencies while engaging stakeholders at all levels.
Public Works Completes Performance Review of Alaska DHSS
In 2015, Public Works conducted a performance review of the state of Alaska’s
Department of Health and Social Services (DHSS) organizational and administrative
structures.DHSS serves thousands of Alaska’s most vulnerable citizens through
multiple, sometimes complex, programs that draw on state and federal funds.
Alaska sought an objective examination of not only spending, but the organization
including the structure of its budget, how funds are spent, and ideas to streamline
service delivery while maintaining – or improving – the quality of services delivered.
We provided the state with recommendations that addressed administrative and programmatic organization and oversight, budget structure, and funding for administrative costs – as we evaluated the efficacy of DHSS’s use of information technology, the appropriateness of proposed budget cuts, and the effectiveness of its advisory groups.
This successful project relied upon Public Works’ expertise in providing comprehensive, in-depth analysis of organizational issues and administrative structure; our broad experience and understanding of organizational design – particularly in health and human services; our work with government agencies in both densely populated and rural states; and our knowledge of best practices from across the country.
The final report is available here.
Public Works selected for Louisiana Early Childhood System implementation
Because of our successful work on the Louisiana GEMS project, Public
Works has been brought in to facilitate implementation of Louisiana’s
unified Early Childhood System of Local Networks. This will provide families
across Louisiana with access to high-quality early childhood programs by
bringing the multiple current early childhood programs – including pre-
kindergarten in public schools, the Nonpublic School Early Childhood
Development Program, Head Start, Early Head Start, Early Steps and the
Child Care and Assistance Program (CCAP) – together under one roof
within the Department of Education.
This project is an example of Public Works’s unique capacity to work closely with and within government agencies to implement policy and programmatic objectives and to being desired outcomes to fruition. Public Works is working with the Department of Children and Family Services (DCFS) and the Louisiana Department of Education (LDOE) to help transition the Child Care and Development Fund from DCFS to LDOE.
Public Works is accomplishing this by managing an extensive work plan to transition the CCDF fund and programs tied to CCDF, including the licensing of day care facilities, CCAP payments, and client eligibility. Bringing together both agencies, Public Works is working to seamlessly transition budget, programs, personnel, and computer systems from one to the other without interruption to the services they provide. In conjunction with agency leadership and staff, Public Works is managing the creation and drafting of Cooperative Endeavor Agreements and ensuring that operational and statutory deadlines are met.
West Virginia Department of Health and Human Services
In 2012, West Virginia Governor Earl Ray Tomblin directed Public Works to
conduct an extensive review of West Virginia’s health care challenges and
opportunities. Through our review, which focused specifically on the
Department of Health and Human Resources and the Medicaid program,
our team sought to make recommendations for reducing the state’s Medicaid
costs, and to review the efficiency and capacity of the Department of Health
and Human Resources and the programs it runs. The full report identifies
78 recommendations with potential General Fund savings or new revenue of
Read the full report here: WV DHHR Review Final
Louisiana Solutions to Poverty
In 2005, Public Works authored the Louisiana Governor’s Summit on
Solutions to Poverty Summary Report and The First Annual Solutions to
Poverty Initiative Roadmap and Action Plan. The report describes what
Louisiana was doing at the time to address poverty, makes initial
recommendations for what it could do in the future, and outlines concrete
next steps for action.
Delaware State Treasury: White Paper on Reverse Mortgages
Delaware State Treasurer Jack Markell retained Public Works to produce a
White Paper on reverse mortgages with the purpose of informing and
empowering older consumers and helping them sort through information
and resources of which they may not be taking advantage. This white paper
specifically explains what reverse mortgages are and how they can be used,
evaluates the potential for greater use of reverse mortgages by older homeowners
in Delaware, discusses the policy reasons for encouraging reverse mortgage use,
reviews and analyzes the impediments for doing so, and makes recommendations
on how to address these issues.
The complete White Paper can be read here: Delaware Reverse Mortgage White Paper.
Delaware State Treasurer’s Office Demographic Study
The Public Works team wrote a report published by the Delaware State Treasurer’s
office, which looks at Delaware’s future through the lens of shifting demographics
over the next 25 years and their effect on the state’s financial future.
The report, “Facing Forward, a Look at Delaware’s Demographic Future,” sets forth
the projected demographic and related trends likely to affect Delaware over the
next quarter-century, discusses the implications of those trends for the state and its
people, and concludes with recommendations for the future.
Read the full report here:
Towards a Healthy West Virginia: Strategic Vision and Action Plan
In 2007, Public Works prepared a report for then-Governor of West Virginia Joe Manchin.
The report outlined both the Manchin Administration’s progress to that date and a strategic
vision for future work to continue to address West Virginia’s health care challenges. The
report lays out the seven guiding principles and four strategic goals that would guide the
Manchin Administration as it moved forward in making health care more affordable for
West Virginia’s individuals, families and businesses.
Arkansas Department of Health Organizational Review
In the summer of 2004, the Arkansas General Assembly expressed concern about the
existing organizational structure of the Arkansas Department of Health (ADH) and whether
this structure was resulting in operational problems at ADH’s local health units. To address
these concerns the legislature launched a two-part process to determine the degree to
which ADH’s organizational structure impeded or assisted the department in accomplishing
its statutory responsibilities. The legislature retained Public Works to examine ADH’s
organizational structure in more detail and offer recommendations for improvement.
Read the full report here: Arkansas Department of Health Organizational Review.
Georgia Department of Behavioral Health and Developmental Disabilities, Olmstead Mental Health Planning
In September 2001, the Georgia Division of Mental Health, Mental Retardation
and Substance Abuse Services (currently known as the Department of Behavioral
Health and Developmental Disabilities), asked Public Works to determine future
directions for the state’s planning processing response to the US Supreme Court’s
Olmstead decision, with particular emphasis on community Mental Health services.
Our research, analysis and recommendations focused on two aspects of Olmstead
planning: the planning process itself and the actual content of state
Read the full report, as presented to the State, here: Georgia Olmstead Planning
Georgia Department of Behavioral Health and Developmental Disabilities
Public Works spent several months studying the issues and challenges facing
the provision of behavioral health services in two regions of southwestern Georgia.
Based on visits, conversations, review of material, and ongoing analysis of the
fundamental challenges facing these regions, Public Works presented recommendations
to the Georgia Department of Behavioral Health and Developmental Disabilities
(formerly known as the Division of Mental Health, Mental Retardation, and Substance
Abuse) for improving services in this part of the state.
Read the full report here: Georgia MH MR SA Services.
Iowa Healthy Families Project
Planned Parenthood of Greater Iowa contracted Public Works to research the structure of
family planning programs nationally, in Iowa, and in other states. The resulting report
examines family planning funding sources nationally and in Iowa; details programs in
Minnesota and other states; and makes recommendations for structuring a state family
planning program in Iowa.
Read the full report here: Iowa Healthy Families
Public Works conducts comprehensive health and human services needs assessment in Broward County, Florida
As the first step in developing a county-wide strategic plan, Public Works conducted a comprehensive review of current services, engaged community stakeholders in a wide range of fact-finding and gathering of insights and opinions on current services and gaps, and developed the first-ever analysis of spending throughout the county from 12 different funding sources in seven service categories. This comprehensive analysis is the foundation to position the county to deliver the most comprehensive and cost-effective services to its most vulnerable residents in the changing environment of health reform and evidenced-based practice.
The final report on Broward County County Community Needs Assessment is available here.
The report was overwhelming accepted and positively praised by the County Commission and the community, and Public Works was subsequently engaged to assist the department with its continuing strategic planning process.
Delaware Nursing Home Residents Quality Assurance Commission
Public Works’ team member Linda Rhodes co-authored this report, which was presented to
the Commission to the Governor and General Assembly. The purpose of this Briefing Paper
was to assist Commission members in making an informed decision as to their
recommendation to the Governor and General Assembly regarding the appropriateness
and necessity of the mandated minimum requirement that Registered Nurses spend
twenty-five percent of their work time on supervision activities.
Read the full paper here: Delaware RN Supervision in Nursing Homes.
Highlights of Other Health & Human Service Projects
In Delaware, we provided policy advice and program design assistance for the development of a low-cost insurance product. In addition, Public Works assisted in writing legislation to implement the new program.
When the Pennsylvania Senate Democratic Appropriations Committee asked Public Works to find savings without the need for major cuts to education, health care, Medicaid and other programs, we produced recommendations that could save over $1 billion ($330 million in Medicaid and health care spending).
Public Works provided the Arizona Department of Environmental Quality with policy development, long- and short-term planning and management, and research and analysis support for the department’s newly created Office of Children’s Environmental Health.
In New Mexico, West Virginia and Colorado, Public Works identified ways to improve Medicaid fraud initiatives that would yield savings of $47.5 million in Colorado, $23.8 million in West Virginia, and $10.5 million in New Mexico.
By expanding the number of sites eligible for 340B prescription
drug purchasing, Public Works found that Colorado would be able
to draw down $5.6 million in Medicaid federal funds.
Public Works found in Colorado that by increasing eligibility to 150 percent of the federal poverty level for family planning services, the state would draw an additional $36 million in federal Medicaid funding over five years.