Policy, System Design, & Financing
Our work in this area focuses on federal, state and local policies and reform initiatives impacting the delivery of services for children, youth and young adults with behavioral health challenges and their families. It addresses the organization, system design and financing of delivery systems in Medicaid, child welfare, juvenile justice and behavioral health.
Topics of importance we address under Policy, System Design and Financing include:
- Medicaid: Customizing Medicaid re-design and health reforms for children, youth and young adults with behavioral health challenges and those in child welfare.
- Mental Health Block Grant: Leveraging the set aside for early onset mental health disorders
- Substance Use Prevention and Treatment Block Grant: Promoting policies and financing for prevention and treatment of adolescent substance use disorders
- Title IV-E Child Welfare: Coordination with Medicaid and other financing
- Grant Administration: Managing specific requirements of federal grants
- Purchasing Models: Implementing value-based purchasing arrangements and use of case rates
- System Design: Identifying key components of effective, accountable and sustainable systems of care along with planning and implementation strategies
- Financing and Utilization Analysis: Analyzing child behavioral health service use and expense across child-serving systems
- Cost Benefit Analyses: Designing and implementing cost-benefit analyses related to home and community-based services and evidence-based practices
- Return on Investment (ROI): Measuring ROI related to the provision of home and community-based services and intensive care coordination using Wraparound
- Sustainability: Designing and implementing cross-agency financing strategies to sustain children’s behavioral health reforms
- Governance: Designing and implementing decision making and oversight structures involving day-to-day operations, as well as system of care governance
- System, Community and Population Considerations: Identification of populations of focus using prevalence and utilization data, qualitative data, state and community priorities and other factors
Los Angeles County - Assisted the county in evaluating its current EPSDT claiming guidelines and practices and identified guidance changes to improve access to and utilization of EPSDT services.
Washington State - Supported efforts to respond to its EPSDT TR Settlement agreement through system design changes and assisted in the development of a Center of Excellence.
Illinois – Provided TA on the integration of home- and community-based services, mobile response, and intensive care coordination using Wraparound into the state’s evolving Medicaid managed care delivery system.
New York State – Provided TA and data analysis in examining Medicaid claims and encounter data and expense for youth in Medicaid who use behavioral health services and psychotropic medications; identified disparities and utilization and expense patterns.
Colorado – Strategized with state agencies about integrating Care Management Entities providing intensive care coordination with Wraparound into the state’s Accountable Care Organization.
Oklahoma – Provided input into the state’s Health Home State Plan Amendment for Medicaid recipients with serious mental illness to integrate best practices for children and youth.
Multi-state and county – Implemented Medicaid Managed Care Academies with cross-agency state representation to focus on effective design, implementation and MCO contractual specifications.
Expert Convenings – Sponsored convenings to identify best practice consensus for the field.