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

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

2. 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

3. 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

4. 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)

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

6. 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

7. 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

8. 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

9. DCAS Operational Model

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

11. 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

12. 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

13. 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

14. DCAS Governance

15. 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