RD69 - Semi-Annual Progress Report on Eligibility Systems Modernization - January 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 to 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, implementation of 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 had a highly compressed schedule: nine months from the time of contract signature in December 2012 to implementation 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. To date, over 38,000 MAGI-related Medicaid applications have been received. There are several additional portions of functionality planned for the MAGI project, which has been extended to April of 2014.

As the MAGI project unfolded, some Medicaid and statewide functional requirements were deferred to the Migration project. In addition, the intense work and tight timelines of MAGI required additional resources to be assigned to MAGI. The balance of the public assistance programs included in the Migration Project is no less complex than MAGI Medicaid. As the Migration project work continued, the team recognized a need to extend the requirements gathering and design phases of the project. The DSS worked with the vendor and the Secretary of Health and Human Resources to revise the Migration Project schedule and extend it to June 2016.

The timeframe for the Conversion project was March 2013 through March 2014. At the request of DMAS, DSS added functionality for call center staff to do telephonic renewals more efficiently, which requires the project to be extended through October 31, 2014. Currently, the Conversion project team is preparing to enter the user testing phase, working to ensure that data and case/client extracts from the legacy systems can be successfully converted into VaCMS.

The schedule changes outlined above and the need for additional functionality that was not included in the original contract have resulted in four contract modifications. The total cost of the four contract modifications is approximately $12.5M. The majority of the costs for these contract modifications are eligible for 90/10 federal funding. Total expenditures through October 2013 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 $28,000,474. Payments of $18,342,968 have been made to Deloitte Consulting, LLP. A little over $5,900,000 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.