RD627 - Semi-Annual Report on Eligibility Systems Modernization - January 2017


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 has 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. To date, MAGI Medicaid is fully implemented, certified by the Center for Medicare and Medicaid Services (CMS), and VaCMS has been used to process over 1.1 million applications since its inception. The experience in the Commonwealth with the new system and the volume of applications in the first year of MAGI implementation challenged the ability of local department of social services staff to process applications and process renewals in a timely manner.

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, the implementation of the final Medicaid categories and requirements were completed in September 2015.

DSS split Program Migration Project implementation into two phases, with the first phase focused on statewide implementation of the balance of the Medicaid program, central printing, and document management and imaging. This phase of the project was completed September 2015.

The federal Food and Nutrition Service (FNS) requires SNAP technology changes to be implemented through a pilot process. DSS worked closely with FNS to pilot the SNAP application process in 10 localities from April 25, 2016 through July 31, 2016. The 10 pilot agencies continued to process SNAP application in VaCMS until October 3, 2016 when all localities started to use VaCMS to process SNAP applications. DSS will convert the remaining public assistance program cases from the ADAPT legacy system into VaCMS in the first quarter of 2017.

The majority of the contract costs to date are eligible for 90/10 federal funding. Total expenditures through September 2016 include payments to Deloitte Consulting, LLP, salaries for the DSS staff, and procurement of hardware/software tools for the MAGI project. Total expenditures for the three projects are $138,174,252 ($114,161,251 NGF and $24,013,001 GF). Payments of $97,096,056 have been made to Deloitte Consulting, LLP to gather system requirements, design and develop system functionality, deployment functionality and train local departments of social services’ workers. Approximately $17.9 million has been spent on hardware and software products, with the balance of expenditures being for costs such as DSS staff, training and travel for local department of social services employees who participate on the project teams.