March 2009
Minnesota Department of Human Services
The Minnesota Department of Human Services (DHS), Disability Services Division contracted with The Lewin Group to conduct a study of the infrastructure of the State’s Medicaid State Plan Personal Care Assistance (PCA) program. This study analyzes the drivers of Medical Assistance expenditures in the State’s PCA program and provides recommendations to inform legislation to strengthen the PCA program.
This report is the first of several interim reports that Lewin submitted to DHS, in addition to a comprehensive final report. This first report includes findings from a national scan of PCA programs, analysis of Minnesota PCA program enrollment and expenditure data, interviews with state officials in Minnesota and other states with PCA programs, stakeholder interviews, and initial recommendations for the State.
Client Area: State and Local Governments
Expertise Area: Aging and Disability, Medicaid and CHIP
December 2008
Colorado Department of Human Services
This report summarizes the findings from the past year’s work on the Colorado Works Program Evaluation. It presents and updates analysis of longitudinal data on TANF caseload trends, work activity participation rates, and employment and earnings outcomes of welfare participants; presents findings on county policies, strategies, and activities from a survey of county TANF directors; and analyzes client interactions with other social service agencies including the Child Support Enforcement Division and Child Welfare.
Client Area: State and Local Governments
Expertise Area: Income Security
December 2008
Colorado Department of Human Services
This report summarizes statistical models The Lewin Group developed to explain the determinants of caseload trends in the Colorado Works program from July 1998 through December 2007. Using regression analysis, equations were developed to estimate the size of the Colorado Works monthly caseload based on the Colorado economy, Colorado Works program characteristics, and other factors. Separate models of caseload size were developed for one-parent families, two-parent families, and child-only cases. In addition, models were also developed of monthly entries and exits for one-parent cases, and county-level models of the one-parent caseload for the five largest counties. Models were estimated using data from July 1999 through December 2007. Among the findings: Unemployment rate is the key factor affecting the size of the one-parent and two-parent caseloads. The caseload in a month is affected by the unemployment rate up to 24 months earlier. Several Colorado Works and federal policy variables also had a statistically significant effect on the size of the caseload.
Client Area: State and Local Governments
Expertise Area: Income Security
May 2008
California Division of Workers' Compensation
The Lewin Group was commissioned by the California Division of Workers' Compensation to evaluate the impact of switching from the current physician fee schedule to a physician fee schedule based on the Resource-Based Relative Value Scale (RBRVS) system. The current physician fee schedule requires physicians and selected health care providers to use codes and descriptors of the 1997 edition of the American Medical Association's Current Procedural Terminology to bill for their services while the RBRVS-based system bases payments for medical treatment on the resources used to provide services. The Lewin Group study reports on the impact of changing to an RBRVS-based fee schedule by estimating payments under both the current physician fee schedule and an RBRVS-based system for the same set of services.
Client Area: State and Local Governments
April 2008
Colorado Department of Human Services
The enactment of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) provided states with considerable flexibility to design their own welfare programs. The result was an increase in the variation between states’ welfare programs. In an effort to understand how Colorado’s TANF program compares to other programs across the country, the Colorado Department of Human Services (CDHS) commissioned The Lewin Group and its partners—the University of Colorado’s Health Sciences Center (UCHSC), the Johns Hopkins University’s Institute for Policy Studies (JHU), and Capital Research Corporation (CRC)—to perform an in-depth study of Colorado’s TANF program (Colorado Works) on a variety of different dimensions. This report examines how Colorado compares with other states on dimensions such as caseload changes, program expenditures, eligibility requirements and benefits, work requirements, financial incentives to work, sanctions, work participation rates, employment outcomes, and diversion policies.
Client Area: State and Local Governments
Expertise Area: Employment, Training, and Workforce Development, Income Security
December 2007
Colorado Blue Ribbon Commission for Health Care Reform
Lewin contact: John Sheils
The Lewin Group was engaged by the Colorado Blue Ribbon Commission for Health Reform to assist in developing and analyzing alternative proposals to expand health insurance coverage and reform the Colorado health care system. Lewin first developed a “baseline” projection of what health care coverage and costs would be in Colorado in 2008 under current law for major stakeholder groups, including governments, providers, employers and families. Lewin then estimated the cost and coverage effects of several proposals to expand insurance coverage for major stakeholder groups in Colorado.
Client Area: State and Local Governments
Expertise Area: Health Reform
December 2007
Colorado Department of Human Services
Federal TANF funds can be used for a range of cash and non-cash services to needy low-income families with children, including cash benefits, employment services, child care, and other support services, and services intended to prevent families from requiring monthly cash benefits. In Colorado, the federal TANF block grant and the related supplemental funds are used, along with state and county funds, to operate the Colorado Works program. This report describes the general trends in Colorado Works spending between 2000 and 2006 as well as county expenditures of Colorado Works funds, including basic cash assistance, non-cash assistance, and reserve amounts.
Client Area: State and Local Governments
Expertise Area: Income Security
December 2007
San Francisco Department of Public Health
The Lewin Group recently performed strategic planning for San Francisco's Department of Public Health and Office of the Controller in preparation for implementation of the City's Healthy San Francisco initiative, a program to insure all San Francisco adult uninsured. Key areas of The Lewin Group’s work performed for the City were: projecting demand for health services under Healthy San Francisco, analyzing the Department of Public Health’s capacity to take new patients and meet the service demands, modeling the impact of changes in fees for the safety-net population, and analyzing a ‘one-stop’ web-based eligibility and enrollment system called One-e-App, which is used by other California counties for health and welfare client program management. The Lewin Group’s analyses and recommendations were also presented at the San Francisco Health Commission.
Client Area: State and Local Governments
Expertise Area: Community Health Needs Assessment
December 2007
Colorado Department of Human Services
The Deficit Reduction Act of 2005 (DRA) reauthorized the TANF program and made policy changes that increased the effective work participation rates that states must meet to avoid a financial penalty. In Colorado, counties have been reassessing strategies to meet federal requirements while still providing services and benefits to clients that best help them to meet their immediate needs and overcome barriers to longer-term self-sufficiency. This report examines three related topics affecting participation and engagement in Colorado’s TANF program. They are: (1) Work participation activities and strategies; (2) Diversion policies among Colorado’s counties; and (3) Sanctioning practices in Colorado.
Client Area: State and Local Governments
Expertise Area: Employment, Training, and Workforce Development, Income Security
December 2007
San Francisco Department of Public Health
The Office of the Controller of the City and County of San Francisco, and the San Francisco Department of Public Health commissioned The Lewin Group to conduct a local market assessment and benchmarking analysis. The market assessment analyzes the current health care environment in the city, makes projections of demand for healthcare services, and examines the role of the Department of Public Health, in providing direct healthcare to San Franciscans. The benchmarking analysis compares San Francisco General Hospital with comparable Bay Area, California and national public healthcare delivery systems across measures designed to assess efficiency and effectiveness. The benchmarking analysis also identifies best practices contributing to the success of the benchmark safety net systems.
Client Area: State and Local Governments
Expertise Area: Community Health Needs Assessment
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