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Published byDwayne Manning Modified over 9 years ago
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Screening Clients can anonymously screen themselves for eligibility to help determine the best program for them. Application Ability to apply for all programs (SNAP, Medical, TANF, ERDC & TA-DVS Submit required documents Reapplication and Maintenance Update information Fill out and submit forms Communicate with caseworker Telephony System Access benefits information Update personal and eligibility information Automated information Automated workflow Automated caseload balancing Application Centralized access to client information Automated eligibility determination Automated notice generation and issuance Enhanced ability to communicate with clients Reapplying and Maintenance Improved communication avenues Receive necessary forms and documents Retires legacy systems (CMS, TRACS, FSMIS) Reduced data entry and system duplication Telephony System Manage incoming call volume Outbound dialer for appointment reminders and automated information Client Portal Caseworker Portal DHS Modernization Vision
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DHS Modernization Goals 2 Enhance Efficiency Automate eligibility determination Automate application processing workflow Reduce paper/manual processes Centralize access to consumer information Implement real-time benefit eligibility determination Support remote workflow/workload mgmt Provide data for informed policy and strategic decision making Automate/modernize eligibility systems including legacy system retirement 1 Expand Access Increase consumer access across Oregon to DHS services for benefit application and status Remove geographic barriers to benefit application Increase benefit information access: eligibility, scheduling, renewals Improve Technology Reduce data and system duplication Increase system adaptability, sustainability and maintainability Improve ability to support business needs timely and efficiently Improve Compliance Faster response to rules changes Improved determination quality leads to reduced error rates Improve data security Support Health Insurance Exchange Enable seamless integration allowing consumers seeking health insurance coverage to move in real time between various medical programs ranging from Medicaid to Exchange covering from 0-400% of the federal poverty level 1 e.g. CAF = CMS, FSMIS, TRACS; SPD = TBD DHS serves a changing society where consumers increasingly communicate differently and expect access to program benefits and services without having to come to a field office. Eligibility workers need systems which support consumer’s use of various technology applications. These technologies also offer improved efficiency, enhanced security and allow staff to focus on assisting consumers in meeting their needs. The current technology environment is laden with risk due to age, lack of interoperability and ever increasing costs to maintain. Data is duplicated in a myriad of locations, yet not readily shared between systems. Modernization addresses these issues by expanding consumer access to culturally appropriate services, enhancing eligibility worker efficiency, improving compliance, improving technology solutions and supporting the expanded goals of the Health Insurance Exchange.
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Modernization Projects 3 Eligibility Automation –Automates eligibility determination – essential for Health Reform/Exchange –Automates workflow for eligibility workers –Uses a commercial framework with rules-based configuration – more adaptable, business centric, maintainable solution –Replaces Bridge solutions –Fully implemented by 12/14 (can be expedited to delivery between 2/13 – 8/13 with DHS/OHA Leadership intervention) Bridge Solutions –Increase consumer access to DHS services through online benefits application –Application processing solution for eligibility workers – view and process applications; some limited workflow –18-30 month “shelf-life” – replaced by Eligibility Automation –All four major eligibility programs will be in place by 10/11 I/OIS Managers/DHS IS/Presentations Telephony Solutions –Increase consumer access to DHS services by leveraging modern, integrated telephone system solutions to capture and disburse information –Business case by 6/11 –Phase in of capabilities starting in 2011-13 Eligibility Systems / Data Warehouse –Replaces 30-40 year old legacy systems with architected, integrated case management, payment and data warehouse solutions –Provides a sustainable, maintainable, scalable systems environment for DHS –Replacement anticipated to start in 2013-15 biennium The Modernization timeline to deliver real-time eligibility determination did not contemplate an Insurance Exchange need and consequently does not align to the more aggressive schedule required for the Exchange. Creating effective information channels to the existing batch systems to create a real time environment is not feasible. Aligning these schedules to expedite the current Modernization Project schedule by 16 to 22 months will require DHS and OHA Leadership intervention to succeed. Some adjustment to scope for Eligibility Automation, an increase in resources to support accelerated schedules and use of special procurement processes are examples. The four major projects and completion dates currently within the Modernization Program include:
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