RD156 - Semi-Annual Progress Report on Eligibility Systems Modernization - July 2015


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 Medicaid-related cases from ADAPT and the DMAS system into the new case management system, the Virginia Case Management System (VaCMS). There were three projects for eligibility modernization: MAGI (Modified Adjusted Gross Income); Program Migration; and Conversion.

The MAGI project was implemented on October 1, 2013. In the first year VaCMS was implemented, local departments of social services experienced a 43% increase in MAGI Medicaid applications. MAGI Medicaid is fully implemented and certified by the federal Centers for Medicare and Medicaid (CMS), and VaCMS has been used to process almost 500,000 applications in the past nineteen months. The experience in the Commonwealth with the new system and the increased volume of applications in the first year of MAGI implementation challenged the ability of local department of social services staff to process applications and renewals timely.

Work on the eligibility modernization projects continues. Project teams from DSS and DMAS identified a number of system changes to enhance service delivery. In addition; CMS required changes to the online portal for Medicaid to make it more Medicaid-centric and dynamic in function. As a result of implementing these changes, implementation of the final Medicaid categories and requirements is planned for August 2015.

The Program Migration Project is now being implemented in two phases, with the first phase focusing on statewide implementation of the balance of the Medicaid program, central printing, and document management and imaging. The Department of Agriculture Food and Nutrition Service (FNS) issued requirements that SNAP technology changes be implemented through a pilot process. Currently, this phase of the Program Migration project is in planning, and will require FNS approval. The goal is to perform the pilot functions in the summer of 2016, with all public assistance programs fully implemented in VaCMS by December 2016.

The majority of the contract costs are eligible for 90/10 federal funding. Total expenditures through March 2015 include payments to Deloitte Consulting, LLP, salaries for the DSS staff, and procurement of hardware/software tools for the MAGI project. Expenditures for the three projects total $86,097,932 ($73,174,002 NGF and $12,923,930 GF). Payments of $62,000,869 have been made to Deloitte Consulting, LLP. Hardware and software products spending totals $11,652,267, 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.