State Systems Interoperability and Integration Projects

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The Affordable Care Act is spurring States to create new eligibility and enrollment systems for Medicaid and Health Insurance Exchanges. At the same time, many States are seeking ways to align program-specific information to better coordinate or integrate the provision of services for families. The Department of Health and Human Services/Administration for Children and Families (HHS/ACF), through the Office of Child Support Enforcement (OCSE), invites eligible applicants to submit competitive grant applications that explore interoperability and integration in health and human services systems (e.g. eligibility and enrollment systems, case management systems, and other related systems.) Applicants are invited to explore system design and implementation options, the costs and benefits of different options, and concrete options for the State and potentially other States to consider. Applicants will also plan to achieve one or more of the following goals: 1. improve service delivery for clients, 2. reduce errors and improve program integrity, or 3. improve administrative efficiency. As States implement plans related to the Medicaid expansion that will take effect on January 1, 2014 and, if applicable, the implementation of a State Health Insurance Exchange, States have the ability to maximize time-limited exceptions to the Office of Management and Budget Circular A-87, which permits States to integrate human services eligibility processes into their Health Insurance Exchange and Medicaid/Childrens Health Insurance Program systems without allocating the common development costs across multiple benefiting programs so long as the costs were ones that would have been incurred without the human services integration. This allows States to match common development costs at a 90 percent federal reimbursement rate (called 90/10 funding) through December 31, 2015. Under the exception to OMB Circular A-87 cost allocation principles, to the extent these business services are core components of the health program eligibility system, their design and development costs would not be required to be cost allocated to the other Federally funded human services programs for certain business process and technical services. These core components, modules and services may include the following: Client Portals; User Interfaces; Master Client Index; Document Imaging and Digitization of Case Records; Enterprise Service Bus; Data Warehousing; Business Intelligence and Analytic Tools including Decision Support. This list is not exhaustive, and there are other services that are allowable under the exception. This 12-month planning grant period will allow selected State human services agencies the ability to plan internally and with their various partners while still having the opportunity to benefit by beginning and/or continuing systems implementation under the "90/10 funding" through December 31, 2015. At the end of the planning grant period, applicants would be required to produce a public document that details the outcomes the State was seeking to improve, the set of questions that were explored, the answers to those questions, options that were developed, the identified costs and benefits of the selected option, and all planning documentation produced (e.g., Planning Advance Planning Document (APD), Implementation APD, and/or procurement documents, e.g., Request for Quote (RFQ), Request for Proposal (RFP), etc.) It is the intent that the public documents and all planning documentation produced under this grant can be shared broadly and freely amongst States in order to help those States expedite their planning efforts in health and human services systems interoperability.

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