On-site Case Consultation in Child Welfare

      In July, 2011 HZA assisted in reforming the practices of the agency’s child welfare office in Pahrump (Nye County). The review stemmed from agency concerns that the standard policies and operating procedures in place in other parts of the state were not being followed in Pahrump. Over the course of three months, HZA conducted a review of the office in three stages: an assessment and identification stage, training and then mentoring. Training was provided both to the managerial and supervisory staff on how to utilize management reports in the SACWIS, called UNITY. HZA also provided training to caseworkers on how to use the developed guides and tools. Mentoring and follow-up was provided for the manager and supervisors on all the topics covered.

      Productivity Study

      In 2015, HZA teamed with the Baldacci Consulting Group to conduct a study of the complicated processes used by the University of Nevada, School of Medicine (UNSOM) and Mojave Adult, Child and Family Services (Mojave Mental Health) in its federal reimbursement practices that support the Nevada Division of Health Care Financing and Policy and the Centers for Medicare and Medicaid Services. UNSOM provides oversight and management services to Mojave Mental Health which provides a number of direct services, including Case Management, Day Treatment, Outpatient Counseling, and Medication Services to needy clients in the Las Vegas and Reno areas. HZA performed a productivity study of the mental health staff to help UNSOM and Nevada maximize its federal reimbursement. Recognizing that productivity is the relationship between the quantity of output and the quantity of input used to generate that output, the study measured the efficiency of the organization to serve its clients with the resources it had available. The measure of output was quantified by the number of billable services provided, e.g., day treatment, outpatient counseling, nursing. The input measurement used a time study that was employed to measure the time it takes to complete a billable service, accounting for the time it takes to complete discrete activities which go into performing each type of billable service. The study resulted in a number of recommendations, including the opportunity to better document current billable and non-billable case management activities, especially as they intersect with the agreements in place with various Managed Care Organizations.

      Project Management and Cost Allocation Plan for Organizational Restructuring

      From 2002 to 2004, HZA assisted the Department in restructuring child welfare services based on new legislation. Child protective services in the two largest counties, Clark (encompassing Las Vegas) and Washoe (encompassing Reno), had been provided by county staff and funding with little involvement at the state level. Once the child was placed into foster care and adjudicated, however, responsibility shifted to the state. The passage of new legislation in 2001 created a unique situation in which the State’s entire child welfare system would be county administered in the two large counties but state administered elsewhere. Playing a major role in the management of this change, HZA worked closely with state executives to re-draft the State’s child welfare regulations, revise the federal cost allocation plan, and redesign processes such as eligibility determination to reflect the organizational shift.

      Title IV-E Waiver Evaluation Cost Consultant

      From 2015 to the present, HZA is serving as a sub-contractor in Clark County, Nevada (Las Vegas) to provide consultation for the Cost Analysis for its Title IV-E Waiver. HZA’s specific role is to identify and recommend mechanisms to monitor cost effectiveness, define successful cases, collect outcome data on the treatment and comparison groups, identify the rates of success and factor that into the average cost of a successful case. HZA is working as a subcontractor to Baldacci Consulting Group.


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