DC Access System (DCAS) HBX Executive Board Meeting December 12, 2012

Contents DCAS Background and Vision DCAS Funding Current IT Environment DCAS Description DCAS Implementation Timeline and Milestones Status of DCAS Implementation DCAS Governance Next Steps

Background The ACA requires states to establish a web portal to support Exchange functions, including: Integrated eligibility applications for the Exchange and Medicaid (MAGI only) Comparing and selecting health plans Providing support and educating consumers Before ACA, DC initiated a multi-tier effort to integrate government service delivery for residents, including: Interagency data exchange legislation Department of Human Services funded to implement integrated services, including case management The DC Access System brings together these two initiatives to establish a single, streamlined solution for health and human services in the District. DCAS integrated services vision developed by an interagency workgroup consisting of: DHCF, DHS, DISB, OCTO and DMH

DCAS Vision DCAS will have a secure and modular technology infrastructure to provide state-of-the-art access to health and social benefits for District residents and employees. Major Health and Human Services Programs in DCAS will include: Medical Assistance: Medicaid and Health Care Alliance Cash Assistance: Temporary Assistance for Needy Families (TANF), Program on Work, Employment and Responsibility (POWER), Interim Disability Assistance, Refugee Cash Assistance and General Assistance for Children Food Stamps: Supplemental Nutrition Assistance Program (SNAP), Food Stamp Employment and Training (FSET)

DCAS Funding Because of the broad vision of DCAS, the system implementation has multiple funding sources:

Implementation Approach DCAS will be implemented in three releases that: Allows ACA required functions to launch by October 1, 2013 Reduces the risk associated with implementation of a large, complex system Release Descriptions Release 1 (10/1/2013): Exchange and MAGI Medicaid Release 2 (10/1/2014): Non-MAGI Medicaid, Alliance, and most federal human services programs Release 3: District human services programs

Current IT Environment What we have today… To be replaced by DCAS ACEDS (mainframe eligibility system) Medicaid, SNAP, TANF and 9 others 20 years in production Will retire at the end of Release 2 To be integrated with DCAS DIMS (document management system) MMIS (Medicaid payment system) SERFF (commercial insurance management system) Interface for insurers to submit rate and form filings for review and approval by state examiners

New IT Environment (DCAS) Robust web portal for eligibility determination, health plan comparison, and case management Multiple channels of communication to interact with applicants and consumers Stream-lined business rules engine turning policy into eligibility rules Integrated data management and reporting Secure data interfaces with Federal and DC agencies

DCAS Operational Model

CCIIO and CMCS Requirements DCAS Release 1 Milestones and Timeline CCIIO and CMCS Requirements December 2011 March 2012 January 2013 11/2011 APD Submitted 2/2012-5/2012 Requirements Gathering 8/2012 Level 2 Grant Submitted 1/2013 IT Design Review 1/2012 Launch Project K/O 3/2012 Planning Review 12/2012- 2/2013 Design Phase 2/2013- 8/2013 Build and Test Phases 8/2013 Implementation Review Completed Activity Future Activity District Milestones

Release Schedule Options to recovery from 2 months delay: Shifting the release of some communication channels to November and December Gap analysis between DC requirements and other state’s implementing the same solution to determine which requirements can be pushed to other releases if not absolutely necessary Concentrate vendor team physically to work with DC team

Status of DCAS Implementation Summer 2011: High-level system planning completed by Cognosante through a contract with Mercer Winter 2012: Business process flows developed and submitted to CMS for Eligibility and Enrollment, Plan Management, Financial Management, and SHOP Spring 2012: Detailed requirements gathering completed for all three releases through a contract with Accenture July 2012: A CMS approved RFP for a System Integration (SI) vendor to design, build, and implement DCAS was released December 2012: SI Vendor contract award expected Ongoing: Staff continue to work on DCAS planning efforts, such as the local data hub and system interfaces

Functional Development Underway Development of business processes and business rules that will provide the foundation for DCAS is well underway for Exchange and non-Exchange functionality Business process flows developed and submitted to CMS for Eligibility and Enrollment, Plan Management, Financial Management, and SHOP Operational and policy questions that will inform DCAS business rules are currently under consideration Preparing organizations for deployment Change management Training

DCAS Governance

Expand DCAS Project Management Office in advance of Design Phase Next Steps Expand DCAS Project Management Office in advance of Design Phase Increase technical staff to coordinate with System Integration vendor and DC program staff Launch OCTO local data hub implementation Hire additional contract staff to support project On-board system integration vendor – Begin requirements confirmation and design