CHILD SUPPORT AUTOMATED SYSTEMS IMPROVEMENTS - LEVERAGING THE AFFORDABLE CARE ACT (ACA) OR NOT

Transcription

1 CHILD SUPPORT AUTOMATED SYSTEMS IMPROVEMENTS - LEVERAGING THE AFFORDABLE CARE ACT (ACA) OR NOT Presenters: Joe Bodmer, PMP, MPM, DIRECTOR, DIVISION OF STATE AND TRIBAL SYSTEMS, OCSE, ACF, HHS Karen Coleman, CHILD SUPPORT SYSTEM MODERNIZATION PROJECT EXECUTIVE, OREGON DEPT. OF JUSTICE Moderator - China Widener, PMP, Principal, Deloitte Consulting, LLP

2 One Destination, Two Paths Leveraging ACA Preparation, plan and Define the new System Shared Components Enhanced FFP X-Program Coordination Excludes Unique Components Statutory Time frames Holistic Approach Standard FFP Stakeholder Coordination Negotiable time frame New or Substantially New System Implementation Traditional Model

3 The ACA and Child Support: Understanding the options with Eligibility and Enrollment (E&E) systems Understanding remaining CSE opportunities Design considerations with E&E systems ACA and: Cost Allocation APD process

4 Understanding Options With E&E Systems CMS enhanced 90/10 funding for most development work related to Medicaid eligibility. DHHS/D of Ag provided a time-limited exception to cost allocation requirements defined in OMB Circular A-87. The exception only applies to funding for projects related to eligibility and enrollment systems under Medicaid. Allows State human services programs to utilize systems designed specifically for determining a person s eligibility for certain health coverage programs (Medicaid, CHIP, and/or premium tax credits) without having to share the common system development costs, so long as those costs would have been incurred anyway. Costs attributable to including, or that are only of benefit to other programs, which includes child support enforcement (CSE), must still be allocated to those benefiting programs. The A-87 exception terminates December 15, 2015.

5 Highlights Rules of the Road States strongly encouraged to consider including other human services programs in their systems investments as long as it does not delay achievement of the ACA deadlines. Phased system development is allowable, not required, and in some cases, encouraged. Costs must be incurred and funds expended by December 31, Any cost incurred not for health systems must be allocated to benefitting program. All programs must be engaged in planning and design throughout the systems development life cycle (SDLC). In addition to CMS, the expedited APD process is accepted by ACF (and OCSE) and FNS. An expedited APD checklist template has been developed and approved by OMB. Data.html

6 Shared vs. Non Shared Functionality Shared Functionality or Work Non-Shared Functionality or Work Purchase a business rules management system (BRMS) that will be used by Medicaid, but is also needed for other HHS and DoA programs. Development of a web page that collects necessary client address information for clients participating in Medicaid/CHIP, but also needed for other HHS programs. Purchase and initial configuration of a document generation software package necessary for Medicaid, and/or CHIP, but also needed for other HHS programs. Development of a common worker inbox necessary to handle Medicaid, CHIP for applications coming from a self service portal, but also needed for other HHS programs. Configuration of the CSE rules in the BRMS. Adding a specific section to a web page to capture EFT/Direct Deposit representative information that is just for CSE. Development of document templates specifically for use by the Child Support program in the new software. Development of the a CSE-only workflow to process the CSE application from the worker inbox.

7 Design Considerations With E&E Systems* Clients Portals Automated Account Creation and Case Notes Interfaces to Federal and State verification sources Data Warehousing and Business Intelligence Master Client Index Workflow Management Tools Business Rules Engine and Operating Systems Enterprise Service Bus Notices Eligibility Determination and Enrollment Customer Service Technical Support Analytic Tools including Decision Support and Program Integrity User Interfaces Telecommunications Authentication and Identity Management Document Imaging and Digitization of Case Records Information Security and Privacy Controls Infrastructure and Data Center Hosting

8 The ACA and APD Process Advance Planning Documents Medicaid requires an approved APD for 90/10 FFP. Medicaid has an Expedited APD Process. Doesn t waive APD requirements, allows more time to flesh out the details later Medicaid has primary approval authority of Expedited APD s ACF and FNS will also review. Must address the seven conditions and standards Must include all programs up-front in planning phase

9 ACA and Cost Allocation Cost Allocation Still applies to those systems costs not required for E&E systems Cost allocation for Development cannot use operational models, e.g., caseload, # of users, etc. Developmental cost allocation requires: Break system down to lowest level of component/module Apply metrics, such as: Weighting, Complexity, LOC, FPA Cost Allocation Plan must be approved in an APD

10 The Traditional System Replacement Path IAPD Business Case PAPD BPR Stakeholder & Staff Buy-In Procurement Feasibility Study

11 Oregon s Approach Business Case PAPD Feasibility Study BPR Stakeholder & Staff Buy-in IAPD Procurement Justification to Act Obtaining FFP to Act Ascertaining the Better Path to the Future Determining a View of the Future Getting Commitment Chartering the Future Path Purchasing Services Completed WE ARE HERE Planning Stage

12 Business Case Key Considerations Recognize and accept that our aging system has become a liability instead of an asset Determine the best approach Research what other states have done Incremental modernization Big bang Use in-house resources or seek vendor support Establish modernization as a priority for the Program Part of Oregon s Strategic Plan Commit Program support Staff resources Allocate budget

13 PAPD Getting Started Ask for Federal Approval/Funding for Planning Activities Draft Planning Advance Planning Document (2-4 months) Problem Statement Project Management Plan* Planning Budget Total overall projected project budget Submit PAPD to OCSE Receive OCSE Approval ( 60 days) * Elaborated on the next slide

14 PAPD Getting Started PAPD Project Management Plan Components Key Personnel Tentative project planning schedule Task oriented planning activities Needs Assessment/Gaps Analysis Requirements Definition Evaluation Criteria Alternatives Analysis Function Point Analysis Cost Benefit Analysis Feasibility Study Report Other: Support of legislative approval, IAPD, Implementation Vendor RFP

15 Feasibility Selecting the Right Path for You Conduct Feasibility Study Activities (12-18 months) Establish Agency /Vendor Project Teams Project Management Plans Work Breakdown Structure Project Oversight Identify Key Stakeholders OCSE Program Staff State Level Partners Program Staff Time Commitment Staff Interviews Define Requirements Evaluation Team Cost Benefit Analysis Document & Deliverables Review Receive OCSE Approval ( 60 days)

16 BPR Deciding What to Build Business Process Re-engineering (BPR) (12-14 months) Do you need to conduct a BPR? When do you conduct the BPR? Use in-house resources or seek vendor support? How do you conduct a BPR? Determining just how different you want the next system to be Are there enhancements to be maintained? Level of automation Program Staff Time Commitment As-Is Staff Interviews To-Be Staff Interviews Document and Deliverables Input and Review

17 Stakeholder & Staff Buy-in Building Commitment Identify Key Stakeholders OCSE Oregon took an unprecedented approach Steering Committee State level partner agencies (program and technology) IV-A, IV-E, Title XIX; Oregon Judicial Department Department of Administrative Services (State Data Center) Other agency interfaces Program staff State Department of Justice Division of Child Support County District Attorney Family Support Divisions Program Staff Commitment Define Requirements Evaluation Team Document & Deliverables Review

18 IAPD Committing the Money Implementation Planning State level funding commitment Clarity of time-frames Clarity of Scope Clarity of Approach Clarity of Resource Needs Develop Implementation Advance Planning Document

19 Procurement Buying the Needed Services Types of Services Project Management Quality Assurance Independent Verification and Validation Implementation Vendor Hire Vendor and Kick-off the Project Agency Project Team / Vendor Project Team Project Management Plans Work Breakdown Structure Project Oversight

20 QUESTIONS NOW AND LATER Contact Information: Joseph Bodmer Phone: (202) Karen Coleman Phone: (503) China Widener Phone: (513)