MB3 State-Level Policy Recommendations

The system: No Kentucky agency owns transition-age stabilization as a category. Young people aging out of foster care, young foster mothers and adults returning from incarceration move between Medicaid, emergency care, child welfare, behavioral health, housing, justice and workforce systems, and each cabinet has its own eligibility rules, funding and data.

The cost to MB3: A ready pilot had nowhere to land: no category to apply under, no agency with authority to approve it, and no shared measure to report against.

Wrote a state-level policy agenda for Mission Behind Bars & Beyond (MB3), built for a lobbyist to carry to agencies and legislators. The core ask: recognize Transition-Age Stabilization as a prevention category, and authorize a 90-to-180-day demonstration operated by MB3 with state observation, payer alignment, flexible barrier funding and shared outcome reporting. The agenda sets out seven changes:

1. Cross-cabinet workgroup. A Transition-Age Stabilization Workgroup, directed by the Governor's Office, the Cabinet for Health and Family Services or the legislature, giving the state one table for referral triggers, handoffs, outcomes and braided funding.
2. State demonstration pathway. A state-recognized 90-to-180-day pilot lane for community stabilization providers, with defined eligibility, service model, outcomes and reporting, and MB3 as the accountable operator.
3. TEAMKY 1115 alignment. An administrative memo or future waiver amendment treating transition-age stabilization as a health-related social needs prevention strategy inside Kentucky's existing Medicaid demonstration, rather than a new policy vehicle.
4. Foster-youth warm handoffs. Written stabilization plans before foster care exit and through age 26, covering Medicaid status, managed care contact, primary care, behavioral health, housing, documents, benefits and a mentor or sponsor.
5. Flexible barrier funds. A state-approved way to combine philanthropic dollars with state and managed-care-aligned services to cover small barriers such as IDs, transportation and urgent housing, with each expense tracked against participant outcomes.
6. Shared outcomes dashboard. A common data standard tracking coverage, care access, housing, crisis diversion, mentorship, workforce or education, referral closure, and cost per participant and per stabilized participant.
7. Prevention-first budgeting. Budget or committee language recognizing transition-age stabilization as a cost-avoidance strategy across Medicaid, child welfare, justice, housing, workforce and public health.

• State-level policy changes proposed: 7
• Demonstration window requested: 90 to 180 days
• Foster-youth stabilization plans extended through age: 26

Research & Methodology

Built on the GEN1 Transition-Age Stabilization model, which maps three entry populations (young foster mothers, youth aging out of foster care and reentry adults) to one shared mechanism of housing instability, untreated behavioral health needs and emergency-department-as-default care. Each recommendation was matched to the agency or committee that can act on it: the Cabinet for Health and Family Services, the Department for Medicaid Services, the Department for Community Based Services, the Department of Juvenile Justice, the Department of Corrections and reentry, Kentucky Housing Corporation, the Education and Labor Cabinet, the Governor's policy office, and the Medicaid and health and human services legislative committees.

Scoring & Logic

The demonstration is judged on a shared dashboard rather than service counts: coverage retained, care accessed, housing secured, crises diverted, mentorship in place, workforce or education engagement, referrals closed, and cost per participant against cost per stabilized participant.

Constraints & Assumptions

The agenda works through existing vehicles where possible, such as the TEAMKY 1115 demonstration and current cabinet authority, rather than requiring new legislation first. Cost-avoidance claims depend on cross-agency data that is fragmented today, which is why a shared dashboard is itself one of the seven asks.

Obstacles Encountered

Q: Why a cross-cabinet workgroup instead of a single-agency request?
A: No state agency owns transition-age stabilization as a category. Foster care, juvenile justice, reentry, Medicaid and housing each sit in a different cabinet, so a request to any one of them would cover only part of the population and part of the cost.