RD168 - Semi-Annual Progress Report on Eligibility Systems Modernization - July 2014

Executive Summary:
In December 2012, the Department of Social Services (DSS) entered into a contract with Deloitte Consulting, LLP to modernize the existing automated eligibility systems for all public assistance programs, beginning with the Medicaid program. DSS partnered with the Department of Medical Assistance Services (DMAS) to accommodate changes in technology to support implementation of new Medicaid requirements and eligibility determination.

The scope of the contract includes implementation of the changes to Medicaid to meet federal Patient Protection and Affordable Care Act requirements, replace the current legacy eligibility system Application Benefit Delivery Automation Project (ADAPT), automate Medicaid categories not currently in ADAPT, implement a statewide document management and imaging system, and convert current Families Access to Medical Insurance Security(FAMIS) and Medicaid cases from ADAPT and the DMAS system, Child Health Administration Management Program System, into the new case management system, Virginia Case Management System (VaCMS). There are three projects for eligibility modernization: MAGI (Modified Adjusted Gross Income); Program Migration; and Conversion.

Work on the eligibility modernization projects continues. The MAGI project was implemented on October 1, 2013. Prior to implementation, state and vendor staff participated in two formal readiness reviews required by the federal Centers for Medicare and Medicaid Services. As a part of the reviews, Virginia had to test interfacing with the federal services or "hub" and be able to send applications to the federal marketplace. Other federally defined test criteria and success measures were met prior to the formal "Operational Readiness Review," and the Commonwealth received federal authority to implement the new MAGI automation on time. On October 1, 2013, MAGI Medicaid applicants were able to file applications in person, by mail, phone, fax, or online. Through March 31, 2014, over 160,000 MAGI-related Medicaid applications have been received. Since October 2013, localities statewide have experienced a 60% increase in Medicaid applications. To ensure all planned functionality is complete, and invoices paid, the MAGI project has been extended from April 2014 to June 30, 2014.

The timeframe for the Conversion project was originally March 2013 through March 2014. At the request of DMAS, DSS added functionality for call center staff to complete telephonic renewals more efficiently, which required the project to be extended. The additional functionality is planned to be rolled out the end of summer 2014, with a project closeout of October 31, 2014. Currently, the Conversion project is in the execution phase, converting data and case/client extracts from the legacy systems into VaCMS on a monthly basis.

The schedule changes outlined above and the need for additional functionality that was not included in the original contract resulted in four contract modifications. The majority of the costs for these contract modifications are eligible for 90/10 federal funding . Total expenditures through March 2014 include payments to Deloitte Consulting, LLP, salaries for the DSS staff, and procurement of hardware/software tools for the MAGI project. The total expenditures for the three projects are $37,570,609. Payments of $24,332,316 have been made to Deloitte Consulting, LLP. A little over $6,600,000 has been spent on hardware and software products, with the balance of expenditures being for costs such as DSS staff, and training and travel for local department of social services employees who participate on the project teams.