Health and human services

Early Childhood Education: Center for National Policy

The Center for National Policy (CNP) in Washington D.C. asked Public Works to research and write a report summarizing the evidence regarding the importance of early childhood care and education, review the state of programs and funding, and suggest directions for achieving additional progress during the next few years. The resulting paper, Early Child Care and Education: The Need for a National Policy, offered a number of recommendations, including the need for a national policy on early childhood education to help ensure that American children of all backgrounds can meet the challenges and opportunities of the economy and society of the future. Such a policy must address funding needs for quality child care programs, coordination of educational and social programming for children, development of more effective child care professional training programs, and the promotion of equity. This report served as the centerpiece of a February 2005 CNP conference on Capitol Hill.

Child Care: The Philadelphia Child Care Project

Close to 50,000 children in Philadelphia attend one of 1,400 licensed child care programs each day. Tens of thousands more attend after-school programs in a variety of community-based settings. The City of Philadelphia and the Commonwealth of Pennsylvania are responsible for ensuring that these programs meet minimum standards to ensure that buildings are sound, children are safe, and staff have the skills to build children's social, emotional, and academic skills. Licensing is the foundation upon which quality child care programs are built. Yet many providers have questioned the process to become and remain a licensed provider, as the human and financial costs of becoming licensed provider can be substantial. For many providers, the process is complicated enough, and costs great enough that they decide to operate "underground" as an unlicensed source of care. As a result of these unlicensed providers, the health and safety of the children in their care is not regulated.

The Philadelphia Office of Child Care contracted with Public Works in 2003 to work with city and state agencies to analyze and make recommendations to improve the licensing process for child care providers in Philadelphia. Specifically, the project sought to:

• Reduce barriers and obstacles that prohibit city and state licensing for new and center-based and home-based child care programs.
  
• Increase provider knowledge and understanding of state and city requirements for ongoing licensure and meeting of city and state requirements.
  
• Ensure uniform standards and enforcement across jurisdictions for existing licensed and regulated providers, both between the City and the Commonwealth as well as ensure uniformity between city agencies.
  
• Create a cross-jurisdictional format for organizational responses regarding "how to" inquiries from potential child care providers.
  

Children's Investment Strategy: City of Philadelphia

Public Works oversaw a wide-ranging strategic planning process leading to the City of Philadelphia Children's Investment Strategy. This strategy increases investments in, and improves the quality of, services to children. This strategic planning effort included the development of a comprehensive Children's Budget to identify and categorize spending for children by federal, state and local agencies, and to track trends in the public sector's investment in Philadelphia's children; the Children's Budget is developed in conjunction with an annual Children's Report Card measuring key indicators of childhood wellbeing. Together, these spending and outcomes measures form the foundation for the Children's Investment Strategy. Through an array of new and expanded services, combined with a strong focus on performance, accountability and targeting of services, the strategy is targeting spending to where it is needed most, providing a roadmap for attracting $150 million in state, federal and private sector funding, and ensuring that government is maximizing the dollars it spends. The tools used to develop this strategy - which can be replicated in cities and states across the county - can be viewed if you click here.

Early Childhood Education Research: California Children & Families Commission

Public Works synthesized all national research on early childhood care and education programs and policies for the California Children and Families Commission. This research ultimately informed the Commission's efforts to allocate its funds in early childhood programs around the state to produce more effective results for California's children and parents.

Children's Environmental Health Agenda: Arizona Department of Environmental Quality

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. The main goals of the effort were to develop an efficient streamlined management structure for the Office and to provide the Department with research and information needed to implement improvements to the existing programs governing the protection of children's environmental health. Working closely with Department staff, Public Works identified specific non-legislative programs the office could undertake to address children's environmental health in Arizona, as well as possible legislative proposals.

Low Cost Health Insurance Design: Delaware Department of Insurance

Public Works was engaged by the Delaware Insurance Commissioner to provide policy advice and program design assistance for the development of a low-cost insurance product in Delaware. Public Works is assisting the Department in the development of policy options for a public advisory group consisting of public officials, representatives from the business community, insurers, hospitals, professional associations, and advocates. In addition, Public Works is assisting in writing legislation needed to implement the program, conducting extensive research on best practices, investigation of state programs from around the country, and review of legislation on governance structures.

Social Service Policy Development: Indiana Family and Social Services Agency

Public Works was asked to recommend how the Agency could restructure the state bureaucracy that delivers family and social services to the public. The effort focused on pilot programs in two counties to coordinate services offered and delivered by multiple agencies of both the state and county governments for families and their children on welfare and to establish a seamless, single-point-of-contact system for beneficiaries.

TANF Reform: California Department of Social Services

The Department retained Public Works to research welfare sanction policies and recommend whether a stricter policy was needed to encourage compliance and participation. There had been disagreement amongst the legislature, the Department, and the Governor's Office as to how to treat non-compliant TANF participants; Public Works' recommendations threaded a difficult policy and political needle between these competing positions. Public Works determined that for certain welfare recipients, tougher sanctions, coupled with adequate services, could have a positive effect on recipient behavior and program compliance. We also determined that tougher sanctions were not called for as to others - and we found that, in general, the sanctions were pointless unless the state funded efforts to help address the reasons underlying non-willful noncompliance. The proper application of sanctions could reduce state cash payments between $17 million to $40 million annually, enabling the state to shift resources spent on noncompliant recipients to increased investment in programs that some recipients needed to boost their compliance.

Low Cost Prescription Drugs Initiatives: California and Georgia

Public Works has developed low or no-cost prescription drug initiatives in California and Georgia. In Georgia, Public Works developed low- to no-cost senior prescription drug coverage options for the Department of Community Health. In California, Public Works developed recommendations to help the Department of General Services reduce prescription drug procurement costs, as well as proposals to provide better prescription drug coverage to targeted populations, including seniors.

Mental Health Planning and Service Delivery: Georgia Division of Mental Health, Mental Retardation and Substance Abuse

The Division contracted with Public Works to assist the two of the state's regions in assessing their new and longstanding challenges and to make both short- and long-term recommendations to meet these challenges. Public Works also was directed to make recommendations that addressed state level policy and structure of Georgia's behavioral health system that directly impact the functions of the regions. This project included identification of the system constraints and challenges facing the regions through initial meetings with Division officials, site visits with both regions' Community Service Boards (CSBs) and Regional Boards, follow-up with the Regional Executive Directors and CSB directors of each region and extensive review of state and regional planning and service related documents; identification of key challenges to service delivery facing the regions; and recommendations to strengthen and maximize the service delivery system offered by the CSBs and private providers. Given the challenges and constraints identified, these recommendations included actions to be taken by the regions themselves, actions that required Division leadership, and those that required a state/regional collaboration and partnership.

Public Works also studied the advocacy community's expectations and actual state capabilities in moving to meet the de-institutionalization requirements of the U.S. Supreme Court's Olmstead decisions on behalf of the Division of Mental Health.

Delaware Nursing Home Staffing Standards Study

When the Delaware state legislature established a special commission to monitor the state's new nursing home staffing standards and study whether those standards should be further increased, the state retained Public Works to provide the study. The study was undertaken by Linda Rhodes, the former Pennsylvania Secretary of Aging. Her report became the basis for the state's continuing efforts in this area. The Delaware Patients Quality Assurance Commission wound up retaining Dr. Rhodes for a follow-up report.

• If you want to know more about Public Works, please contact us today.