• Conducting financing analyses, fund maps, and expenditure reviews, including reviews of Medicaid State Plans, Amendments, and Waivers; child welfare financing, including Title IV-E and Family First Prevention Services Act (FFPSA) funding; federal and state discretionary and formula funds; and local and philanthropic funds.
• Developing comprehensive financing strategies to maximize revenue, blend and braid funds, redirect funds, and/or generate new revenue.
• Establishing draft rates for home- and community-based and residential behavioral health, child welfare, and juvenile justice services for children and youth and their families, including mobile response and stabilization services, intensive in-home services, intensive care coordination using Wraparound, qualified residential treatment programs, residential interventions, peer support, and more.

• Conducting document and desk reviews to assess system design, service array, access, or other implementation opportunities, with recommendations to improve system design, access, financing, and outcomes.
• Developing white papers, briefs, presentations, and technical reports on strategic financing and policy approaches and opportunities related to improving the well-being of children and families, particularly when involved with public child- and family-serving systems.
• Drafting Medicaid State Plan Amendments and Waivers, including related medical necessity criteria, service descriptions, provider qualifications, and the associated policies, forms, and materials to support their implementation.

We are providing the Office of the Attorney General for the District of Columbia (OAG) with expert consulting services, in connection with the lawsuit M.J. v. District of Columbia, Civil Action No. 18-01901 (D.D.C.). We conducted a desk review for the District, which included numerous recommendations, and are currently interviewing system stakeholders, providing technical assistance, and conducting a Medicaid financing review to support OAG to better understand how the District’s mental and behavioral health services and outcomes compare to other jurisdictions; how these services and outcomes could be improved; and how ongoing shifts in the District’s Medicaid system can be leveraged to improve outcomes.

In 2024, the Medicaid and CHIP Payment and Access Commission (MACPAC) awarded a contract to Mathematica, who partnered with us, to help the Commission better understand the roles and responsibilities of state Medicaid and child welfare agencies in meeting the health care needs of children and youth served by the child welfare system. As part of this 10-month contract, we led the development of a literature review, contributed to a federal policy review, informed state selection, and facilitated interviews with child welfare, Medicaid, behavioral health, and other key partners in multiple states. These activities contributed to Mathematica’s final report to MACPAC, which will inform their deliberations on policies and strategies for ensuring that Medicaid and CHIP-eligible children in the child welfare system have timely access to quality care.

In 2023, the Oregon Health Authority (OHA), Health Systems Division, Child and Family Behavioral Health contracted with us to conduct a holistic system assessment of their current Medicaid State Plan and waiver structure in Oregon for children, youth, and young adults through age 25. The request was to review the existing financing structures and approaches and make immediate, medium- and long-term recommendations to inform the development of a more efficient and effective System of Care for Oregon’s children, youth, and young adults.  This report was completed in Spring 2024. OHA then contracted with Innovations Institute to develop a preliminary and final report in response to SB 1557, related to ensuring appropriate services and supports for children and youth under 21. These reports included incorporating data and feedback from individuals with lived expertise. The preliminary report was submitted in October 2024 and the final report will be submitted in March 2025. OHA also asked us to develop clinical and behavioral health criteria for Oregon’s Psych under 21 level of care.

In partnership with the Center for Health Care Strategies (CHCS), we are working with New Hampshire’s Department of Health and Human Services to assess the current children’s system of care. With CHCS, we are reviewing a series of key documents across Medicaid, behavioral health, child welfare, and juvenile justice systems and are participating in a series of key informant interviews. We will be developing a report that summarizes the findings from the data and document review and key informant interviews and makes recommendations to New Hampshire based on national and state best practices, systems of care values and principles, and research studies.

We have been contracted by the Tow Youth Justice Institute at the University of New Haven to provide subject matter expertise to the Connecticut Transforming Children’s Behavioral Health Policy and Planning Committee. We are providing subject matter expertise and developing reports and making recommendations on interagency structures, governance, and oversight mechanisms; data-sharing, data infrastructure, and continuous quality improvement processes and structures; service array; and financing.