MULTIPLE - California

STATE OF CALIFORNIA B u d g e t C h a n g e P r o p o s a l - C o v e r S h e e t D F - 4 6 ( R E V 08/17)

Fiscal Year 2019-20

Business Unit 0530 4260 5180

•• • ..-1-1,, •

Department Office of Systems Integration Department of Health Care Services California Depar tment of Social Services

Priority No.

Budget Request Name 0530-405-BCP-2019-MR 4260-405-BCP-2019-MR 5180-405-BCP-2019-MR

Program M U L T I P L E

Subprogram

Budget Request Description State Verif ication Hub Planning Activit ies

Budget Request Summary

This proposal requests $1.2 mil l ion total funds ($489,000 General Fund) on a two-year, l imited-term basis for consult ing resources and staff resources equivalent to 4.0 posit ions (2.0 California Department of Social Services, 1.0 Department of Health Care Services and 1.0 Office of Systems Integration) to begin planning and implementat ion of the State Veri f icat ion Hub.

Requires Legislation

• Yes Kl No

Code Sect ion(s) to be Added/Amended/Repea led

Does this BCP contain information technology (IT) components? ^ Yes • No

If yes, departmental Chief Information Officer must sign.

Department CIO Matt Schuel ler

Date

For IT requests, specify the project number, the most recent project approval document (FSR, SPR, S1BA, S2AA, S3SD, S4PRA) , and the approval date.

Project No. 5180-219 State Verif ication Hub (State Hub) Project Approval Document: S1BA Approval Date: 04/04/2019

If proposal affects another department, does other depar tment concur with proposal? ^ Yes • No

Attach comments of affected department, signed and dated by the department director or designee.

Prepared By Date Reviewed By Date Suman Biswas Mike French

Department Director Date Agency Secretary Date Dan Kalamaras Mark Ghaly

Department of F i n a n c e U s e Only

Addit ional Review: • Capital Outlay • ITCU • FSCU • OSAE • CALSTARS • Dept. of Technology

PPBA Original Signed By

Tyler Woods

Date submit ted to the Legislature

MAY 09 —

A n a l y s i s of Probiem

A. Budget R e q u e s t S u m m a r y

This proposal requests $1.2 mill ion total funds ($489,000 General Fund) for Fiscal Year 2019-20 for a total of 4.0 two-year l imited term, ful l-t ime position resources (2.0 Cali fornia Department of Social Services [CDSS], 1.0 Department of Health Care Services [DHCS] and 1.0 Office of Sys tems Integration [OSI]) to begin the planning and implementat ion of the State Verif ication Hub.

The California Health and Human Services (CHHS) Agency is seeking to streaml ine and modernize the processes of obtaining required verif ications, and to simpli fy that process across depar tments and programs, as part of its ongoing commi tment to cont inuously improve access to benefits for Cali fornians in need of assistance.

B. Background/History

Current ly eligibility determinat ions for CalFresh, California Work Opportuni ty and Responsibi l i ty to Kids (Ca lWORKs) and Medi-Cal are made by County Wel fare Depar tments (CWD) at initial appl icat ion, periodic report, and annual recert i f icat ion/redetermination. Eligibility may also be reassessed during the certif ication period based on client report or other informat ion received by the CWD. At both initial appl icat ion and recert i f icat ion/redetermination, an eligibility determinat ion for CalFresh, Ca lWORKs and Medi-Cal requires three key steps: appl icat ion, interview, and verif ication. Under federal and state rules, all relevant eligibil ity information must be veri f ied. This includes information about household composi t ion, identity, residency, immigrat ion and cit izenship status, income, expenses, work activit ies, and disabil ity.

County wel fare departments use a variety of verif ication methods, including electronic data matching with trusted sources, review of paper documents provided by an appl icant or recipient, col lateral contacts with third part ies, and client statements. Current methods for collecting verif ication are t ime consuming and rely on data f rom multiple sources, some of which are outdated. The OSI , a long with the CDSS and the DHCS, recognize the chal lenges with both the electronic and non-electronic (paper) processes currently used to conduct the required verif ications for CalFresh, Ca lWORKs and Medi-Cal .

An analysis per formed by Social Interest Solut ions (SIS), under a contract wi th CDSS, found that the current envi ronment that supports the verif ication processes for CalFresh and Ca lWORKs is a combinat ion of data sources, systems, and access points that have significant variabil i ty throughout the state. This makes the process compl icated and results in significant chal lenges for clients and program staff. Because other health and social services programs in Cal i fornia, such as Medi-Cal , have similar verif ication requirements, these chal lenges are exacerbated for individuals and famil ies eligible for mult iple programs.

Furthermore, in January of 2018, the CalFresh & Nutrit ion Branch of CDSS, in partnership with Kone Consult ing and several other CDSS programs, including Ca lWORKs, launched a project that examined the over issuance (01) and overpayment (OP) of state benefi ts. Prel iminary f indings indicated that in FY 2016 California compr ised 36 percent of national OI /OP claims, result ing in $248M in OI /OP. The study found that $121M of that error was due to County Wel fare Depar tments ' errors.

The analysis recommended policy and program al ignment along with the creat ion of a State Veri f icat ion Hub to improve the cumbersome process of paper documentat ion, improve data integrity and lower the number of OI /OP cla ims.

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A n a l y s i s of Problem

C . State Level Cons idera t ions

This request proposes planning efforts for a mult i -departmental initiative and leveraging the expert ise and exper ience of the OSI for central ized management . The approach directly supports the mission of the C H H S Agency to more effectively meet the needs of all Cal i fornians. This proposal also highlights the focus on a client centered approach across mult iple programs.

The State Verif ication Hub is intended to simplify and expedite the verif ication process, minimizing the impact on the application process for beneficiaries, and minimizing the impact of errors in the process such as OI /OP claims ment ioned above.

Addit ionally, considerable stakeholder engagement will be necessary for this effort. This effort began with extensive county and stakeholder input and will cont inue throughout the life of the project. Verif ications affect the ability to simply, effectively and accurately determine program eligibility; but also affect an individual's right to privacy. It will be important to work with the State Legislature and stakeholder groups to ensure this proposal del ivers max imum value while protecting those rights. This will be achieved through existing Departmental engagement , as wel l as broad project governance.

D. Just i f icat ion

The State Verif ication Hub is intended to be a central ized system that supports fast, accurate, and efficient verif ication processes for clients and program staff across C H H S Agency depar tments and programs. Initial efforts will be focused on CalFresh, Ca lWORKs, and Medi-Cal, but with a system designed for enabl ing other programs to conduct verif ications through this service hub in the future.

This proposal provides a comprehensive approach to planning and implement ing the State Verif ication Hub through the Project Approval Lifecyle (PAL), ensuring exper ienced project management leadership is provided by OSI to all participating departments throughout the stage/gates of the PAL. Given the necessary coordinat ion between multiple depar tments, having exper ienced, dedicated resources to guide the planning effort will be critical to maintaining the schedule. The fol lowing request for posit ions reflects the needs of the mult i -departmental planning effort.

C D S S

CDSS is request ing resources for 2.0 two-year, l imited term posit ion equivalents for the planning and implementat ion of the State Verif ication Hub. These two posit ions will create the State Verif ication Hub Unit within the Automat ion, Integrity, & Client Initiative (AlCI) Branch and Information Systems Division ( ISD) at the CDSS. The Staff Services Manager I - Special ist posit ions within A lCI will engage program partners and stakeholders to develop and maintain a thorough knowledge of, business processes, and policy for CalFresh, Ca lWORKs. The staff Services Manager I - Special ist with the Information Technology Special ist I will explore alternatives and technical feasible of the State Verif ication Hub with surrounding interfacing systems such as Ca lSAWS and Income Eligibility Verif ication System ( lEVS).

D H C S

DHCS is request ing 1.0 two-year, l imited term, posit ion equivalent to serve as the primary Medi-Cal program subject matter expert in the planning and implementat ion of the State Verif ication Hub. The DHCS posit ion will be critical to verifying the planning and implementat ion of the State Verif ication Hub comports with Medi-Cal state and federal policies, and the outputs of the planning efforts are in a l ignment wi th the current electronic verif ication systems that impact Medi-Cal program operat ions. In addit ion, the posit ion will provide fundamental insight in other

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opportunit ies for further synergy of electronic verif ication policy and technology f rom the Medi-Cal program administrat ion perspect ive.

OSI

OSI is request ing 1.0 two-year, l imited term, posit ion equivalent. The requested posit ion resource will create the OSI State Verif ication Hub Project unit and direct, govern , and oversee the planning and implementat ion of the State Verif ication Hub.

In support of the State Verif ication Hub project's success, engaging as necessary a consult ing partner that has a depth of understanding and exper ience in CHHS and federal ly funded state systems such as integrated eligibility. Medicaid, child wel fare, etc. The scope of services that may be needed would include the fol lowing:

R e a d i n e s s A s s e s s m e n t - This assessment will focus on identifying the strengths, accompl ishments , chal lenges, gaps and potential risks as well as recommendat ions for mit igat ion of risks and strengthening the approach and plan in support of implementat ion. The assessment will include a review of four critical domains:

• Governance • Procurement and RFP evaluation process • Al ternat ives Analysis of Technical Solut ion and Best Value Identif ication • Technical Archi tecture and Environment set up

S c o p e of Work - Based on the assessment and result ing recommendat ions, the vendor will develop a "go forward" implementat ion work plan and detai led Scope of Work ready to support the State's result ing procurement effort(s).

Due to the complexi ty of creating a statewide verif ication hub, the OSI resource, in coordinat ion with the CDSS, DHCS, the County Welfare Directors' Associat ion (CWDA) , and the county consort ia, will lead the planning effort and begin to develop an implementat ion plan for the state.

The resources requested in this proposal will serve as the State sponsor representat ives and will directly oversee the planning, development, and implementat ion of the determined approach.

Table 1 - B C P R e s o u r c e R e q u e s t

Departments D H C S

Medi-Cal portion to

C D S S C D S S OSV Line Item

Total Posit ions 1.0 2.0 1.0 4.0 Personal Services $ 124,000 $ 233,000 $ 144,000 $ 501,000

Consultant Contracts $0 $0 $ 568,000 $ 568,000 Project Management Services $0 $0 $ 502,000 $ 502,000

PAL Services $0 $0 $ 66,000 $ 66,000

e t h e r C E & E $ 31,000 $ 60,000 $ 35,000 $ 126,000 Total $ 155,000 $ 293,000 $ 747,000 $ 1,195,000

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Table 2 - B C P Funding R e q u e s t

Funding^ Federa l F u n d Genera l F u n d Total

DHCS $ 77,000 $ 78,000 $ 155,000

CDSS $ 629,000 $ 411,000 $ 1,040,000

Total $ 706,000 $ 489,000 $ 1,195,000 ^ The total OSI reimbursements ($747,000) will be reflected In the Department of Social Services Local Assistance Tables, excluding $95,000 that will come from CalFresh Performance Bonus funding. 2 Funding requested is for DHCS and CDSS. The OSI request is Expenditure Authority only.

E . O u t c o m e s and Accountabi l i ty

During development, these resources will act as the l iaisons for the C H H S and CS I , along with CDSS and DHCS programs and its external partners to ensure the State Verif ication Hub meets the departmental and stakeholder business needs. The requested staff will verify that planning and development meets the PAL requirements.

After implementat ion, the staff will be responsible for system user out reach, reports, workf lows, and policy implementat ion and planning. These posit ions will assist mult i -departmental programs in adapt ing the State Verif ication Hub and meet ing cont inuously changing business needs, which result f rom the state and federal legislation changes affecting program mandates.

F. A n a l y s i s of All Feas ib le Alternatives

Alternative 1: Approve proposal and r e s o u r c e s .

P R C S : • Provides the required support to sustain the State Verif ication Hub project and col laborative

process that are intended to streamline the verif ication process to reduce work load on eligibility workers and provide accurate and t imely aid.

• Provides the required planning support to eventual ly increase the eff iciency of the programs using the State Verif ication Hub solut ion in: o Tracking, managing, sharing, and analyzing the critical program information about each

county using central ized platform; o Increasing the required forecast capabil i t ies to seek federal grant for specif ic programs;

and o Shar ing and analyzing multiple county indicators needed to drive oversight, county

performance, and ultimately client outcomes.

C O N S :

• General Fund costs.

Alternative 2 Do not approve inc reased staffing and r e s o u r c e s requested .

P R O S :

• No General Fund impact.

C O N S :

• The laborious manual processes may prevent county workforce eff iciencies and ult imately impact the lives of Cali fornians receiving assistance.

• Does not provide the resources needed to support the State Verif ication Hub planning efforts.

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G . Implementation Plan

Upon approval of the BCP, the project will develop recruitment packages to recruit and hire new state staff. The project will also develop and submit the required Advance Planning Documents (APD's) to Centers for Medicare and Medicaid Services (CMS) .

H. Supplementa l Information

Exhibit A: Proposed Organizat ion Chart ' Exhibit B: Posit ion Work load Analysis

I. Recommendat ion Approve Alternative 1 and provide funding for increased l imited-term project staffing and other resources needed for the planning and implementat ion of the State Veri f icat ion Hub for FY 2019-20 and 2020 -21 .

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Exhibi t A

State Verification Hub Budget Change Proposal

Exhibit A

Proposed Organization Chart

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Department of Healtti Care Services (DHCS) Department of Social Services (CDSS) Office of Systems Integration (OSI)

Department of Healtti Care Services

DHCS - Medi-Divh

Deputy I

Cal Eligibility >ion

Director

DHCS - Medi-Cal Eligibility Division Team

HPS II (1.0)

Counts: DHCS 1 C D S S 2 OSI 1

Exhibi t A

Organizational Chart

California Heaith and Human Services Agency

Department of Social Services Office of Systems Integration

CDSS - Automation. Integrity. & Client Initiative

Deputy Director

C D S S -Automation,

Integrity. & Client initiative

State Verification Hub Unit

SSM I Specialist (1.0)

C D S S -Automation,

Integrity. & Client Initiative

information Systems Division

ITS I (1.0)

OSI - Statewide Automated Welfare System

Deputy Director

OSI - Consortium Management Team

IT Specialist II (1.0)

Legend:

DHCS • C D S S • OSI •

P A G E 11-7

Exhibi t B

State Verification Hub Budget Change Proposal

Exhibit B

Workload Analysis

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Exhibit B

D H C S M e d i - C a l E l ig ib i l i ty D i v i s i o n

1.0 Hea l th P r o g r a m S p e c i a l i s t II

Act ivi t ies Hours to Complete

T a s k s Per Y e a r

Total Hours Required

Serve as the primary Medi-Cal policy subject matter on Medi-Cal eligibility verif ication policies to ensure outputs comport with State and Federal policies.

900 ongoing 900

Serve as the DHCS program lead in the development of the State Verif ication Hub governance structure.

5 20 100

Provide extensive technical program consultat ion to other DHCS departmental staff and lead any cross-departmental consultat ion as it relates to Medi-Cal policy.

3 50 150

Identify, document , assess, track, communicate key State Verif ication Hub project risks to DHCS leadership, and provide guidance for mit igat ion.

2 52 104

Provide informed and data-dr iven recommendat ions to DHCS leadership on implementat ion opt ions.

3 30 90

Provide Medi-Cal policy guidance for State Verif ication Hub business requirements gather ing sessions.

4 30 120

Participate in user-centered design sessions representing the Medi-Cal program.

4 30 120

Participate in the val idation of business requirements and user acceptance test ing.

4 30 120

Analyze new State and Federal legislation related to Medi-Cal eligibility verif ication policy that may impact the State Verif ication Hub initiative.

4 25 100

Participate in stakeholder meet ings and provide necessary guidance as it pertains to Medi-Cal policy.

5 4 20

Total Annual Hours 1824 Total Pos i t ions 1

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Exhibit B

C D S S F a m i l y E n g a g e m e n t a n d E m p o w e r m e n t D i v i s i o n

1.0 Sta f f S e r v i c e s M a n a g e r I S p e c i a l i s t




Management • Management and oversight of project deve lopment • Manage day-to-day activit ies of the Project tasks and

work load. Provide overal l program direction to the CDSS program liaisons.

300 2 600

Administrat ive • Ensure complet ion and implementat ion of all facets of the

State Verif ication Hub and provide information needed for the annual Legislative updates.

• Coordinate the preparat ion of policy recommendat ions and ensures the State Verif ication Hub is in compl iance.

200 2 400

Ongoing Overs ight • Oversight and evaluat ion of eff icacy of the State

Veri f icat ion Hub. • Identify and recommend enhancements to the service

based on feedback f rom users and data analyt ics. • Provide ongoing support and administrat ion of State

Veri f icat ion Hub system and process. •

100 3 300

Stakeholder Communica t ion • Coordinate communicat ion between state, county,

C a l W O R K S program, and critical stakeholders. • Work with stakeholders in development of project analysis.

85 6 510

Pol ic ies and P r o c e d u r e s • Review program policies to ensure compl iance with state

and federal laws/regulat ions. • Review and approve policy and state procedures related

to State Veri f icat ion Hub.

50 2 100

Total Annual Hours 1910 Total Pos i t ions 1

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Exhibit B

C D S S F a m i l y E n g a g e m e n t a n d E m p o w e r m e n t D i v i s i o n

1.0 In fo rmat ion T e c h n o l o g y S p e c i a l i s t I




IT SME / IT Technical Liaison - Understanding the existing IT systems will need full-time staff to act as an IT SME responsible for defining business requirements and recommending a technical approach to meet those needs.

1280 ongoing 1280

The resource will actively contribute in identifying existing business processes, systems, plans and processes. The staff will also act as an IT Technical Liaison between various programs and business unit to understand the existing integrations, analyzing and reviewing the proposed changes. The resource will guide in generating design specifications for software development, which typically involves translating business requirements into detailed algorithms for coding.

The resource will coordinate in Enterprise Architecture efforts to evaluate the existing architecture and participate in planning of technical solution and proposed architecture. The resource will participate in the technical design sessions to provide an independent and objective evaluation of the existing IT systems from various data sources and different departments. The resource will engage resources to review technical documentation, such as user guides, training manuals and system specifications.

IT P A L S M E 320 ongoing 320

The resource will coordinate with key stakeholders including state-level control agencies to provide sufficient detail to descr ibe the solicitation results, contract management strategy, organizat ional/project readiness and project basel ines.

The resource will funct ion as a PAL SME/Representat ive for the effort to CDT and agency to deliver PAL processes as well as act as facil i tate the contract manager. The resource will assist in creating and maintaining del iverable using CA-PMF processes and templates as well as act as an IT liaison for the IT procurement activit ies including writ ing SOW, Mandatory quali f ications, evaluat ion criteria and processes. IT C h a n g e Manager 320 ongoing 320

The resource will act as an IT Change Manager to manage the change control processes and represent "Change Management" within the organizat ion.

The resource will part icipate to identify and manage the processes for change management as well as escalated At Risk Tasks to Program Leadership. The resource will assist in developing, implement ing and governing action plans to manage change management . The resource will f ind creative and innovative ways to implement new technology, procedures, and processes whi le adher ing to ISD change management policies.

PAGE 11-11

Exhibi t B

Activi t ies Hours to Complete



The resource will coordinate the communicat ion efforts to keep the stakeholders informed about risks and issues. The resource will coordinate with other depar tments, programs, businesses other stakeholders to manage, coordinate, and oversee all the project related activit ies statewide.

Total Annua l Hours 1920 Total Pos i t ions 1

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Exhibi t B

O S I S A W S C o n s o r t i u m M a n a g e m e n t Uni t

1.0 In fo rmat ion T e c h n o l o g y S p e c i a l i s t II

A c t i v i t i e s

Number of Items

(Annually)

Hours per item Total

Hours Provide leadership to the State Verif ication Hub project staff in communicat ion and outreach to customers and stakeholders. Manage the communicat ion infrastructure to assure customers and stakeholders are provided with consistent and reliable information with regards to status updates and risks

12 20 240

Advise the Project Director on all developing communicat ion strategies and documentat ion. Develop and maintain the project 's Communicat ion Management Plan documentat ion that govern communicat ion for the Project.

10 20 200

Lead and direct State Verif ication Hub business assessment , alternatives analysis, requirements gather ing, project approval , and vendor procurement sessions to evaluate the impact of the proposed State Verif ication Hub changes to the projects.

12 40 480

Work col laboratively with key stakeholders to assure that mutual ly agreeable outcomes for the State Verif ication Hub are achieved. Cversee and assist with critical and complex project tasks/documents.

2 100 200

Identify and monitor risks and issues to project success. Track and escalate to minimize and control the impact of negative risks on the State Verif ication Hub project overal l . Monitor the implementat ion of resolution and escalate to DHCS, CDSS, OSI and other stakeholders as needed.

60 2 120

Lead and facil i tate meet ings on open, outstanding policy i tems, act ion i tems, and issues and help bring them to closure. Document complex business process and technical issues t imely with sufficient detail and clarity to assist the project team on key project decisions

12 40 480

Develop and present regular status reports, issue papers and detai led briefings for execut ives and stakeholders. Facil i tate decision making with individuals with diverse goals and object ives that require the achievement of a common understanding of the problem and a satisfactory solution by convincing the individuals, arriving at a compromise, or developing suitable alternatives.

80 1 80

Perform various supervisory responsibi l i t ies related to staff management and development. Evaluate necessary staff resources and training needs. Establish reasonable deadl ines and monitor staff's work load to ensure work is completed accurately and timely. Provide advice and consultat ion to staff on the most difficult and sensit ive work issues.

60 2 120

Total Annual Hours 1,920 Total Pos i t ions 1

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