Policy & Practice | Spring 2023

Those looking for ideas can take a page from Georgia’s playbook. The “Georgia Access” campaign increases awareness of affordable private and state health care options through a data-driven approach that helps the state better understand uninsured audiences, their pain points and behaviors, and the channels they use. Various audiences are met on the channels they use every day, with tailored content across TV, radio, newspaper, Google, social media, and online ads. The program has been credited with a 30 percent increase in enrollment on Healthcare.gov over the previous year. Supporting a Strained Human Services System Ask human services leaders, espe cially those in child welfare, what they worry about these days and the work force crisis tops the list. The staffing challenges facing their agencies aren’t new, of course. Human services is often an underpaid, emotionally taxing, and thankless job. These typical workforce challenges have been exacerbated by the pandemic. There is insufficient staff to meet the demands of the work, including seeing children in a timely fashion, maintaining reasonable caseload sizes, and meeting statutory timeframes. An exodus of supervisors has left new

caseworkers without support and men torship. Parallel workforce crises in behavioral health and criminal justice add to the problem. And a dearth of students entering social work programs is creating pipeline challenges. 10 More evictions, increased homeless ness, rising food insecurity, and other economic stresses will increase the volume of calls and further strain an already overwhelmed workforce. The PHE led states to rapidly hire new eligibility workers and case workers while changing the typical day-to-day responsibilities of staff with expanded coverage require ments. Staff hired in the past two years generally need more experience processing renewals and doing home visits. Even more tenured workers need refresher training. Many states have started to broaden the incentives they offer to attract and retain workers. Some have increased compensation through salary increases and pay for overtime, hazardous duty, and on-call service. Others have intro duced flexible work schedules, offered work-from-home and hybrid arrange ments, enhanced benefits, and adopted tuition reimbursement programs—all strategies designed to improve the value proposition they offer current and prospective employees. To improve the well-being of its staff, Nebraska’s Division of Child and Family

assistance. Those at greatest risk of homelessness receive direct outreach from the county’s Housing for Health Division, which offers financial assis tance and referrals to other services. 9 When the PHE ends, millions of Americans will move from Medicaid to the Affordable Care Act mar ketplace, an employer plan, or the Children’s Health Insurance Program (CHIP). Many others could lose their coverage or experience coverage gaps as states resume annual eligi bility reviews. This transition raises myriad issues. Renewal forms can be confusing and can’t always be completed online or over the phone; clients who moved during the pandemic won’t even receive notice of their need to renew if their contact information isn’t current. Many clients who are no longer eligible for Medicaid may not know to enroll for marketplace coverage. To minimize the disruption to families, successful states will imple ment comprehensive strategies to reduce churn and incorrect Medicaid enrollments and to ease families’ tran sition from Medicaid or CHIP to the marketplace. Given the increased risk for children with disabilities, chronic illness, or behavioral or mental health conditions, jurisdictions may priori tize families with children affected by these conditions.

C. “Parker” Parker , LAPSW, is a manager with Deloitte Consulting LLP’s Government & Public Services practice.

Martha Donnelly is a specialist leader with Deloitte Consulting LLP.

Jamia McDonald, JD, is a principal with Deloitte Consulting LLP’s

Government & Public Services practice.

Amy Grippi , LSW, is a manager with Deloitte Consulting LLP’s Government & Public Services practice.

Tiffany Dovey Fishman is a Senior Manager with Deloitte’s Center for Government Insights practice.

Beryl Washington is a specialist leader with Deloitte Consulting LLP’s

Government & Public Services practice.

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