For several years the Division has been advocating heavily to replace the Eligibility Information System (EIS) used to determine eligibility for thousands of people and to issue over $25 million in cash and food benefits alone each month. EIS has been a powerful tool and the backbone of our core business. Almost 30 years old, EIS’ cannot keep up with the demands created by growing workloads, changing policies and more and new federal mandates that require states to stand up systems capable of supporting real-time interfaces, online applications, client portals, and other modern functionality.
In September 2011, contractors completed a feasibility study defined the system, business, and policy requirements for a replacement system. The study’s cost and benefit analysis provided valuable information essential to develop a proposed budget that would be the basis for requesting the state funds necessary to stand-up a replacement for EIS. Between September 2011 and March of 2012, work continued on crafting a budget proposal that met our system needs yet still was as fiscally prudent as possible. A search was also initiated to find a manager with the expertise and experience needed to plan and direct an IT project of the magnitude and complexity of the EIS Replacement (EIS-R). A proposed budget of close to $100 million was approved by the Commissioned and in March of this year, Berry Kirksey was hired as the Program Manager responsible for the overall planning for what is now called the EIS Replacement Project. However, throughout the legislative session, efforts to secure state funding hung in the balance. Finally, in waning hours of the 27th Legislative Session, an appropriation of approximately $8.7 million was included in the FY13 capital budget to support efforts to replace the EIS.
While $8.7M is a far cry from the estimated $100M needed to stand up a fully functional, modern eligibility system, the Centers for Medicare and Medicaid Systems (CMS) provided states with a once in a life time opportunity. CMS agreed to enhance federal matching rates to states that demonstrate a concerted effort to modernize Medicaid eligibility systems. Under this provision CMS will cover up to 90% of the costs of a new, enhanced or modernized system. This is unprecedented and means that we can anticipate over $50M in federal contributions. The combination of state general funds in hand and the promised federal match will be enough to complete the first critical phases of the EIS replacement.
The design, development, and implementation (DDI) portion of the replacement is anticipated to take 2 years. In order to maximize federal funding, the first effort will be to stand up a fully functionally Medicaid eligibility module. Under the Affordable Care Act (ACA), by October 2013 states must have a system in place that can generate Medicaid eligibility determinations and benefit issuances in support of a Health Insurance Exchange (HIX). That system must be fully operational by January 1, 2014 to support the enrollment of people into Medicaid and also support and interface with an HIX. Functionality that supports other programs will be included as part of DDI. While the fate of the ACA will be determined in the next few days, the outcome does not affect the enhanced federal funding.
Now that funding has been secured and our initial planning documents have been approved by the governing federal agencies, we can put the pedal to the metal. Berry Kirksey is working with staff in the Division and Department to develop requests for proposals for Project Management, Quality Assurance, and the Technical Services contract that will actual develop the system replacement. Given the October 2013 milestone, it is likely that transferring an existing system from another state or a commercial off the shelf (COTS) solution are the most likely alternatives. Berry is also working closely with Division and Department leadership to organize staff into an EIS Replacement Project Team. He will also begin to post regular project updates on DPAWeb.
The EIS-R is the Division’s biggest and most important IT project in the last 30 years. It will provide better access to our programs for people who need our help and I am confident that it will also enhance the effectiveness of our re-engineered business process and create efficiencies that address the challenges presented by changing policies, federal mandates and ever growing caseloads. A new day is dawning.