RD629 - Semi-Annual Report on Eligibility Systems Modernization – January 2018

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 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.

DSS successfully designed, tested, and implemented automation changes in its enterprise system, Virginia Case Management System (VaCMS), to meet the Medicaid requirements for the federal Affordable Care Act (ACA). Virginia was one of only 13 states to meet the original October 1, 2013 deadline established by the Centers for Medicare and Medicaid Services (CMS). This resulted in DSS increasing the federal Medicaid operating cost recovery rate from 50% to 75%. DSS was also able to continue utilizing the 90% federal match to customize and optimize VaCMS through its completion in March 2017. For the first time, all Public Assistance Programs reside in a single automated system.

The majority of the contract costs to date were eligible for enhanced Medicaid 90% federal funding. Total expenditures for the project through acceptance of the system included payments to Deloitte Consulting, LLP, salaries for the DSS staff, and procurement of hardware/software tools. Total expenditures for the three projects were $156,148,795 ($126,948,970 NGF and $29,199,825 GF).

DSS appreciates the support of the General Assembly and the Governor's Office and the collaboration with Virginia Information Technology Agency, Department of Medical Assistance Services, Virginia Employment Commission, Department of General Services, and local departments of social services. The eligibility modernization efforts would not have been successful without the engagement of all organizations. All of this project's approved eligibility modernization efforts are complete, and local departments of social services are using VaCMS for eligibility determination and management of all Public Assistance Programs.