3-JM26-70 Quote and SOW.pdf

Georgia Pathways Demonstration Evaluation Design

Independent Evaluation of Utah 1115 Waiver: Cost Estimate

Prepared by the Public Consulting Group: January 6 2026

Revised Cost Estimate: Summary of Changes

PCG is submitting a revised cost estimate for the evaluation of the Utah Medicaid Reform 1115 Demonstration Waiver, for the contract period ending 12/31/2029. The initial estimate assumed the family planning services component would be implemented approximately 12 months prior to the end of the demonstration period and thus would be evaluated and included in the Summative Report, scheduled to be delivered during the current contract term.

DHHS communicated a change in the target implementation date for the family planning services component from August 2026 to early 2027. Due to this change, the cost estimate was revised. PCG’s approach to evaluating the family services amendment, services provided, and associated costs have not changed, but a large portion of the work will occur outside of our current contract period. This revised cost estimate lays the groundwork for the family services components and includes work that can be performed with available data.

Revised Cost Estimate

The cost estimate was prepared by PCG and requested by DHHS in response to the following amendments to the existing waiver:

● Addition of recently approved family planning services

● Transfer of extended postpartum coverage authority to Utah Medicaid Reform 1115 Demonstration

● Transition of dental services for Medicaid-eligible children and pregnant or postpartum women into the demonstration and the FFS delivery system (from managed care plans) in partnership with the University of Utah School of Dentistry (UUSOD) and their associated statewide provider network

● Conclusion of the ISS program provided through this demonstration

● Removal of the HRSS program from the demonstration as coverage for those services has fully transitioned to the HRSN program.

The cost estimate includes evaluation activities required for the Demonstration period July 1, 2022, through June 30, 2027, for the contract period ending on 12/31/2029. The cost and impact of the amendment is outlined in the following tables.

● TABLE 1: PROPOSED AMENDMENT COST ESTIMATE BY EVALUATION ACTIVITY

● TABLE 2: COST ESTIMATE FOR EVALUATION ACTIVITIES BY DEMONSTRATION YEAR

● TABLE 3: COST ESTIMATE IMPACT ON OVERALL 1115 WAIVER EVALUATION

PCG developed the cost estimate based on the following assumptions: (1) the evaluation will not include additional primary data collection in the form of a survey or key informant interviews/focus groups, (2) the evaluation will include a new quantitative data source and new quantitative outcome measures, and revised to include the updated assumptions that (3) the family planning services will be implemented approximately five months in advance of the end of the demonstration period and (4) insufficient data will be available to include the amendment in the Summative Report submitted during this contract period due to the early 2027 implementation date.

Table 1: Proposed Amendment cost estimate by evaluation activity

Contract Date Proposed Description Revised Cost

Increase

1115 Demonstration Waiver Evaluation- Expansion Amendment 4

January 2026 Evaluation Design Document Revisions/ CMS Engagement

$242,000

January 2026 Summative Evaluation Report $18,500

January2026 Updated Quantitative Analyses: addition of new measures and data sources

$17,500

January 2026 Project Management $ 41,700

Total $ 319,700

TABLE 2: COST ESTIMATE FOR EVALUATION ACTIVITIES BY DEMONSTRATION YEAR

Evaluation Activity

FY26 FY27 FY28 FY29 FY30

Demonstration Yr4 Demonstration Yr5 Post Yr1 Post Yr2 Post Yr3a

(7/1/25 - 6/30/26) (7/1/26 - 6/30/27) (7/1/27 - 6/30/28)

(7/1/28 - 6/30/29)

(7/1/29 -

12/31/29) TOTAL

Project Management $8,340 $8,340 $8,340 $8,340 $8,340 $41,700

Evaluation Design $242,000 $242,000

Quantitative Data $4,375.00 $4,375.00 $ 4,375.00 $4,375.00 $17,500

Summative Evaluation (Due Dec 2028) $1,267 $5,354 $8,553 $3,326 $18,500

Total $250,340 $13,982 $18,069 $21,268 $16,041 $319,700

TABLE 3: COST ESTIMATE IMPACT ON OVERALL 1115 WAIVER EVALUATIONS

Evaluation Activity FY23 FY24 FY25 FY26 FY27 FY28 FY29 FY30

Total (July 2022 – Dec 2029)

DY1 DY2 DY3 DY4 DY5 Post- DY 1 Post- DY2 Post- DY3a

(7/1/2022 - 6/30/2023)

(7/1/2023 - 6/30/2024)

(7/1/2024 - 6/30/2025)

(7/1/2025 - 6/30/2026)

(7/1/2026 - 6/30/2027)

(7/1/2027 - 6/30/2028)

(7/1/2028 - 6/30/2029)

(7/1/2029 - 12/31/2029)

Project Management $49,500 $49,500 $153,082 $212,450 $110,395 $91,260 $84,881 $27,475 $778,543 Evaluation Design 2022-2027 and Revisions $16,875 $255,137 $310,037 $582,049 Quantitative Data Collection, Cleaning and Analysis $289,980 $48,973 $102,055 $204,110 $208,485 $164,686 $167,663 $23,510

$1,209,462

Key Informant Interviews (Administrators, service providers) $81,644 $136,073 $68,037 $27,640 $25,514 $338,907 Participant Interviews Wave 1 $50,000 $91,849 $149,680 $291,530 Participant Interviews Wave 2 $163,288 $22,112 $15,308 $200,708 Beneficiary survey $180,000 $10,205 $244,932 $68,037 $503,174 Midpoint Assessment of SUD and SMI waivers (Due June 2025) $71,100 $204,110 $275,210 Midpoint Assessment of JIR waiver (Due early 2028) $116,087 $116,087 Interim Report (Due June 2026) $122,466 $353,790 $40,822 $517,078 Summative Evaluation Report (Due Dec 2028) $35,285 $149,081 $238,176 $92,624 $515,167 Summative Evaluation Report (Due Dec 2023; extended to Mar 2024) $143,820 $157,790 $301,610 Annual total $483,300 $574,238

$1,020,548

$1,611,072 $694,348 $570,866 $531,542 $143,610

$5,629,523

Notes:

▶ Table 3 includes costs for July 1, 2022 through December 31, 2029.

▶ A previously omitted deliverable (Summative Evaluation Report for prior demonstration period) now appears in the table; the revised total is $5,629,523.

▶ The contract start date was January 1, 2021.

▶ The contract value for the period January 1, 2021 through June 30, 2022 was $460,853

(not shown in table above).

▶ The addition of $460,853 to the $5,629,523 shown in the table above yields a total of

$6,090,376.

▶ The total contract value from January 1, 2021 through December 31, 2029 prior to this cost estimate was $5,770,675.

▶ The new total cost of $6,090,376 equals the previous contract value of $5,770,675 plus the $319,700 cost estimate provided in table 2.

▶ PCG is requesting a contract amendment to increase the total contract value by

$319,700