NC FAST and Work Support Strategies Operational Readiness Workshop

1. NC FAST and Work Support StrategiesOperational Readiness Workshop July – August 2013

2. Agenda

3. NC FASTProject Update July 2013

4. Project Update ePASS Document Management Deployment Update Help Desk Schedule Update Training Update County Security Configuration Project 7 Update Project 3 Update

5. ePASS – Statewide Volumes The number of FNS Electronic Apps has gone up over 4,000 in a month

6. Document Management Update • Completed functional and detail design documents (integration with NC FAST) • Completed County Guidelines document • Completed development and testing (integration with NC FAST) • FileNet production architecture is readied for configuration • Deployed document management capability as part of Project 2&6 Pilot rollout • Working on County Sync Guide • Working on draft functional and detail design documents for county sync piece • Preparing to initiate development of county sync capability

7. Document Management Update Document management design document has been posted in FAST Help A webinar will be scheduled to discuss the design document A job aid has been posted providing guidance on what should be scanned

8. Deployment Update Upgraded NC FAST to P2&6 version of code; a significant upgrade to the base NC FAST system Working through identified defects; continuing build activities and defect fix activities Continue to identify and prioritize Cúram tickets Refining data conversion approach in preparation for Hard Launch Continue submitting test conditions, scripts, and test data sheets for Business team review Respond to Business team comments and receive sign-off for test conditions and scripts Continue to plan and execution of Cycle 3 – Day in the Life execution cycle and Frequency 1,2,3,4,5 scripts Refining internal team communication protocol to streamline getting updates to the counties

9. Help Desk Update Significant increase in call volumes last week Identified limitation with current phone system causing some calls to roll to voice mail; new phone system on order If users call the Help Desk and are unable to speak to someone or cannot leave a voicemail message, send your issue via email. Agents work to resolve tickets in the order in which they are received NC FAST Help Desk can be reached at ncfastsupport@dhhs.nc.gov or 919-855-3200, Option 3 Help Desk is available Monday – Thursday, 8:00 a.m. – 6:00 p.m. and Friday, 8:00 a.m. – 10:00 a.m., 11:00 a.m. – 6:00 p.m. Please report only one incident/issue per email.

10. Help Desk Metrics

11. P2&6 Schedule Update

12. P2&6 Training Update • Over 40 trainers have gone through Train-the-Trainer • Launched the NC FAST Learning Gateway • Posted web-based training (WBT) content into Learning Gateway • Exposed Pilot counties to preliminary version of classroom training • Delivered WBT and instructor-led content to Pilot counties and state office • Initiated training of southeast counties • Wrapping up development of final classroom training activities • Feedback from Pilot and state office delivery has been quite positive • Expectations: • Use of Captivate simulations • Training scenarios • Sandbox availability • Availability of program subject matter experts

13. County Security Configuration User Role: Inquiry Only User Role: Eligibility Worker

14. Project 7 Update • Business team continues to work closely with DMA to: • Finalize Project 7 requirements • Complete documentation for State Plan Amendments (SPA), elected state options, targeted enrollment strategies, and federal hub waiver • Design team completed joint design sessions for functionality needed to be ACA compliant; finalizing review and sign-off • Intake and assessment for Medicaid/NCHC • Integration with federal data hub for account transfers and verifications • Eligibility determination/redetermination under MAGI and non-MAGI rules • Coordination of appeals processing with FFM • Implementation of federal and state mandated reports and notifications • Interfaces team began federal data services hub Wave 4 testing with CMS

15. Project 3 Update • Team is composed of Services Business Lead Tracey Duncan, an NC FAST Business Analyst and 3 SMEs from DCDEE • Continue to reassess the business requirements • Reassessment of the Child Care Subsidy business requirements should be complete in August • Requirements for Energy Assistance (CIP and LIEAP) will then be addressed with a SME from Economic Services • Fit gap analysis is planned to begin in August, with the goal of beginning functional design in October • Deployment is targeted for late 2014

16. Project 7FFMI P7 ‘Ecosystem’ & Division of Responsibilities

17. The New P7 Ecosystem DSS MA Application FDSH PATHWAYS Electronic In-person, by phone, mail-in Database Interface FFM State Verification Systems

18. The New P7 Ecosystem New Streamlined application for MA Additional questions required for an MA eligibility determination under current rules and/or FNS Depending on programs for which the applicant is eligible, benefits may begin at different times Additional electronic verifications from federal sources may be used Ineligible applications will be transferred to the FFM/Health Insurance Marketplace for potential Advanced Payment Tax Credit (APTC) or Cost-Sharing Reduction (CSR) eligibility

19. The New P7 Ecosystem

20. MA Applications Completed via the DSS DSS Streamlined Application keyed by caseworker MAGI Notice Generated and Held by NC FAST. Traditional determination/ additional program requested? Answer additional questions for traditional MA (and FNS, if requested) YES NO Eligible Ineligible Eligible Enroll in MAGI program Enroll in Traditional MA and/or FNS Send application to FFM If eligible for FNS but not for traditional MA, enroll in FNS and MAGI. Note: benefits will begin on different dates. Benefits under MAGI programs will not begin until January 1, 2014.

21. MA Applications Completed via ePASS Streamlined Application keyed by applicant Applicant registers for NCID MAGI Notice Generated and Held by NC FAST. Traditional determination/ additional program requested? Answer additional questions for traditional MA (and FNS, if requested) YES NO Eligible Ineligible Eligible Enroll in MAGI program Enroll in Traditional MA and/or FNS Send application to FFM If eligible for FNS but not for traditional MA, enroll in FNS and MAGI. Note: benefits will begin on different dates. Benefits under MAGI programs will not begin until January 1, 2014.

22. MA Applications Completed via the FFM Seeking Financial Assistance? Full determination requested? Streamlined Application completed through FFM Enrolled in QHP of choice NO YES YES Potentially MA eligible? Calculate APTC/CSR NO YES FFM Application transferred to NC FAST

23. Key Points Beginning October 1, 2013 – the Streamlined Application will always be completed FIRST when applicant is seeking Medical Assistance. To receive a determination based on ‘traditional’ rules (between 10/1/2013 and 12/31/2013) and/or to apply for FNS in addition to MA, additional questions will need to be answered. Regardless of the entry point, the Medicaid/NCHC determination will ultimately be done in NC FAST. Benefits under MAGI programs will not begin until January 1, 2014 As of January 1, 2014 – MAGI rules become the standard for most Family & Children’s MA programs. Applicants who do not qualify for Medicaid/NCHC may still be eligible for APTC/CSR (federal subsidies) to help pay for insurance and should utilize the FFM/Health Insurance Marketplace.

24. P7 Division of Responsibilities: DHHS/FFM/FFMI

25. Health Insurance Marketplace

26. Health Insurance Marketplace

27. Customer Assistance DSS If a customer requires assistance completing the streamlined application for Medicaid/NCHC while at the local DSS, they are assisted by the caseworker. If a customer requires assistance completing the streamlined application for Medicaid/NCHC while using ePASS, they are advised to call the DHHS Customer Service Center. If a customer requires assistance completing the streamlined application for Medicaid/CHIP while using the FFM, they are advised to call the Federal Call Center and/or Navigator. FFM

28. Customer Assistance NAVIGATORS • Provide customers with information that assists with the following: • submitting the eligibility application • clarifying distinctions in QHPs • making informed decisions during the health plan selection process • Can assist in all different types of marketplaces • State-based Marketplace • State Partnership Marketplace • Federally-facilitated Marketplace • Funded through State and Federal grants Must complete comprehensive training to become a navigator.

29. Customer Assistance Certified Application Counselors • Serve many of the same functions as Navigators including: • Providing education to customers • Assistance completing applications • Organizations can apply online to be designated by the Marketplace to certify application counselors. Some examples of organizations include: • Social service agencies • Hospitals • Community health centers • No funding mechanism available for this program Must complete comprehensive training to be a Certified Application Counselor.

30. Customer Assistance *Source: cms.gov

31. Navigators • Role: To assist the customer in applying for an insurance affordability program • Can be a person or organization • May assist with Streamlined application completion, or complete on behalf of the applicant • Explaining APTC/CSRs or insurance options to customers • Navigators are not responsible for: • Assisting customers with ‘Traditional’ MA applications • Explaining North Carolina DMA policy • Contacting the DSS It has not been determined if Navigator’s will be assisting customers with ePASS (Streamlined) applications

32. DSS Caseworkers • Role: Take applications for Medical Assistance (and FNS/SNAP, if applicable) • Will manage integrated cases in NC FAST (Income Support and/or Insurance Affordability) • May refer ineligible applicants to the Health Insurance Marketplace as an alternative to Medicaid/NCHC • Caseworkers are not responsible for: • Helping customers navigate the FFM/Health Insurance Marketplace • Helping customers complete the application on the FFM/Health Insurance Marketplace • Explaining specific details regarding APTC/CSRs or insurance options to customers Consider having the website and/or phone number for the Health Insurance Marketplaceto give customers a place to start.

33. NC FAST • Role: Provide an eligibility determination for MAGI and non-MAGI programs and issue benefits when applicable • Will notify case worker via a task in a designated work queue when an application is received from ePASS or the FFM • Will notify applicant of eligibility result and/or when their application is transferred to the FFM • NC FAST is not responsible for: • Providing an eligibility determination for APTC/CSR • Notifying customers of insurance plan options • Enrolling customers in QHP

34. DMA Update

35. Lunch and Work Support Strategies Update

36. P7: Managing Applications & CasesStreamlined App / Multiple Dispositions & Integrated Cases / The Evidence Broker / Impacts to the Universal Worker

37. Streamlined Application Demonstration Note: The following includes preliminary screen shots which are subject to change.

38. Streamlining the Process What is the Streamlined Application? • A simplified application used to apply for all Insurance Affordability programs • Used whether applying via the FFM, ePASS, or the DSS • Will be the first application used when the customer is seeking Medical Assistance

39. Getting Started with the application.

40. Customer must agree to privacy statement before continuing.

41. The first page of the streamlined application gathers details about the primary applicant.

42. The second page gathers additional details about the primary applicant.

43. Are there any other people in the household?

44. Enter details about the additional household member.

45. Enter additional details about the household member.

46. Review the household member summary. Are there more people to add?

47. How are the household members related?

48. Identify the tax filers in the household.

49. Identify the tax dependents in the household.

50. Review the Household Summary. Make changes if necessary before continuing.