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The $1.85 billion Providing Access and Transforming Health (PATH) initiative launched in California in 2022 to help local organizations build the capacity and infrastructure needed to successfully participate in the Medi-Cal (Medicaid) delivery system under the CalAIM program.

Joy Street Consulting was recruited by Public Consulting Group (PCG), the technical partner selected to implement the PATH initiative, to provide expertise and hands-on support for the final design and launch of the PATH Technical Assistance (TA) Marketplace, one of the four pillars of the initiative. Joy Street co-led all TA Marketplace activities for the first 18 months of the endeavor, including planning, problem-solving, promoting the TA Marketplace to a statewide audience of stakeholders and potential TA recipients, managing an internal team, and ultimately successfully transitioning all tasks to permanent PCG leadership.

As of October 2025, the PATH TA Marketplace had engaged 90+ TA Vendors and made possible 450+ TA projects – enabling an unprecedented variety of community partners to contract with California managed care organizations and, by so doing, vastly expand the services that Medi-Cal offers to members.

In 2022, the Vermont Agency of Human Services (AHS) was charged with designing and implementing a $9 million Health Care Employer Nursing Pipeline and Apprenticeship Program via the state’s American Rescue Plan Act (ARPA) Coronavirus State Fiscal Recovery Funds. The program was intended to address the state’s nursing workforce shortage by enabling Vermont’s health care employers’ existing staff members, including personal care attendants, licensed nursing assistants, and licensed practical nurses, to become higher-level nursing professionals.

Joy Street Consulting was engaged by Vermont AHS to develop a grant program capable of achieving the policy goal of strengthening Vermont’s nursing workforce while getting funds out to grantees in a very short timeframe. To accomplish these goals, Joy Street collaborated closely with local subject matter experts to understand key bottle necks within the state’s system for training nurses and, along with AHS, met with numerous stakeholders to gain insight into key employer challenges, including those related to program timing, required match funds, preceptor availability, and geography. Joy Street worked with AHS to develop parameters for the grant program, then drafted and refined the Request for Proposals (RFP), organized the Round 1 RFP review process, and presented the results.

Approximately $5 million was awarded across six employers via the Round 1 RFP process, with another five employers engaged in Round 2. As of late 2025, almost 180 existing staff members had successfully engaged in the program.

In 2022, enhanced federal funding for Home and Community-Based Services in Vermont made it possible to launch a pilot program that used Medicaid funds to provide supportive housing assistance for Vermont residents with complex health and social needs – an important “first” for the state.

Joy Street Consulting was pulled in by The Technical Assistance Collaborative, Inc. (TAC), the consulting firm engaged by the Vermont Agency of Human Services (AHS) to design the program, to help get the project over the finish line. Joy Street took the lead on drafting a clear and comprehensive Provider Manual, a “must-have” for implementation that documented program parameters and requirements in a way that made them as easy as possible for first-time Medicaid provider agencies to operationalize. Joy Street also provided as-needed support for the TAC team’s work to launch a complex new program within a short timeframe and a dynamic stakeholder environment.

The Vermont Medicaid Permanent Supportive Assistance (PSHA) Program went live in April 2025, with five local nonprofit agencies successfully designated as PSHA provider agencies.

The NJ FamilyCare Housing Supports Program, which was authorized via New Jersey’s current 1115 demonstration waiver, opened in July 2025 with the goal of helping individuals with Medicaid and insecure housing find and keep housing. The initiative, like so many similar programs launched through 1115 waivers across the country, recognizes the outsized impact of housing as a critical social determinant of health.

Joy Street Consulting was brought on by numerous community-based nonprofit agencies in New Jersey to help them navigate the complex and foreign world of Medicaid to become successful Housing Supports providers. Joy Street’s role at each agency has included: creating models to inform financial planning for Medicaid as a new revenue source; drafting or updating the array of internal policies required for Medicaid compliance; and collaborating closely with the agency to outline workflows for Housing Supports service delivery and claims submissions. Importantly, we’re also creating and delivering a set of comprehensive trainings and tools to enable these clients’ frontline team members to successfully meet the unfamiliar demands of Housing Supports service authorization and documentation so that they can get services to the people who need them as soon as possible.

Joy Street is providing project management support for each agency, as well as guidance and tools aimed at “demystifying” Medicaid for these non-traditional Medicaid providers.

This engagement is still a work in progress. We look forward to sharing its impact in 2026!