RD97 - Semi-Annual Progress Report on Eligibility Systems Modernization - January 2013


Executive Summary:
The Department of Social Services (DSS) entered into a contract with Deloitte Consulting, LLP to modernize existing automated eligibility systems for the Public Assistance programs, beginning with the Medicaid program. Medicaid customers must be allowed to file applications via mail, phone, web, fax, or in person. DSS partnered with the Department of Medical Assistance Services (DMAS) to accommodate changes to the technology to support implementation of the new Medicaid requirements and eligibility determination using Modified Adjusted Gross Income (MAGI) rules.

Within this effort, there is also an opportunity to replace the aging technology used by the other public assistance programs. The current automated eligibility system for the benefit programs of SNAP (Supplemental Nutrition Assistance Program), TANF (Temporary Assistance for Needy Families) and Medicaid, is ADAPT (Application Benefit Delivery Automation Project). ADAPT is built in the aging technology MAPPER (Maintaining and Preparing/Producing Executive Reports). It contains over 10,000 automated rules. Although program changes mandated by either federal or state legislation require adjustments to ADAPT, the MAPPER technology is difficult to program. Through the contract with Deloitte, modifications to application and eligibility determination processes that support streamlined real-time eligibility will benefit all of the public assistance programs. To streamline processes, enable eligibility determination and enroll customers in as near real-time as possible, the ADAPT eligibility system will be replaced.

A Request for Proposals (RFP) was issued late May 2012, and closed July 31, 2012. Because the DSS was in the initial stages of the procurement process in July, no report was issued in July 2012. As the procurement process proceeded, a dedicated program office within DSS, the Enterprise Delivery System Program Office (EDSPO), was established late summer of 2012 to plan, manage and monitor the projects. Staffing for the office was accomplished through reassignment of existing DSS staff. Activities prior to the December signing of the contract consisted of staffing the EDSPO, participating in pre-planning sessions and completing required federal and state documentation.

On December 19, 2012, a contract with Deloitte Consulting, LLP (Deloitte) was signed. The scope of the contract includes implementation of the changes to Medicaid to meet the PPACA requirements, replacement of the current ADAPT eligibility system, automating of Medicaid categories not currently in ADAPT, a statewide document management and imaging system, and conversion of current FAMIS and Medicaid cases from ADAPT and the DMAS system, CHAMPS. Work on the projects has begun, starting with a formal kick off held on December 21, 2012. There are three distinct projects for eligibility modernization: the MAGI project; Program Migration project; and a Conversion project. The MAGI project is the first project to be delivered. It has a very compressed schedule and defined scope. The timeframe for: this project is December 2012 through October 2013. The timeframe for the Program Migration Project is February 2013 through December 2015. The timeframe for the Conversion project is March 2013 through March 2014.

The focus of this initial report is to provide background for the three projects, and to provide detail about the first project, which is the MAGI project. The MAGI project is in the initial stages of planning, making progress and is due to be completed in October 2013. Project team members participating in the MAGI project are currently working with the vendor to finalize schedules, define dependencies and document detailed business and technical requirements.

Significant funding has been committed for modernization of the current eligibility and enrollment systems. The dedicated program office within DSS will manage and monitor the projects, with additional oversight performed by the eHHR (electronic Health and Human Resources) program office, established by the Secretary of Health and Human Resources (HHR) to coordinate IT efforts among the HHR agencies, as well as the Virginia Information Technologies Agency (VITA).

Project expenditures to date include salaries for the DSS staff and the procurement of hardware/software tools for the MAGI project. These expenditures total $756,019. To date, no payments have been made to Deloitte. Future reports will include additional detail regarding contract payments and deliverables for each project.