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

$56.7 million.


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: 


Delaware Facing Forward Demographic Future Report.

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.

For "Healthy West Virginia Vision" Report Click Here


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

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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.

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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

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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.

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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.

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