Executive Steering Committee Medicaid Eligibility System Project

April 11, 2014

Minutes

Follow Up Items • Provide statistics on the volume of applications that have

been processed by no touch and how far they progressed • Report on the status of the WAS/WADOM socket error

issue

Minutes and Follow Up Items from March 28 Meeting

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Federal Partner Update

Account Transfers Federally Facilitated Marketplace (FFM)

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• As of April 7, 189,620 accounts have been received from the FFM for processing: o 29,439 accounts have been disposed by no-touch or

filtered out o 122,771 accounts have been sent to DCF workers o 31,547 accounts have been sent to FHK

• Of the accounts referred to DCF workers, 42% have been completed

• Of all accounts (case level) which have been disposed, either by no touch or by a worker: o 38,884 children have been approved o 7,124 adults have been approved

Account Transfers- Non Federal Florida Healthy Kids (FHK)

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• As of April 7, 63,036 accounts have been received from FHK for processing: o 11,891 accounts have been disposed by no-touch or

filtered out o 51,135 accounts have been sent to DCF workers

• Of the accounts referred to DCF workers, 78% have been completed

• Of all accounts (case level) which have been disposed, either by no touch or by a worker: o 30,192 children have been approved o 2,779 adults have been approved

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Solution Update

No Touch Process Flow

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Demographic Information

Technical Questions

Income & Expense

Questions

Asset Questions

Self Service Portal SSPRIDP Verification

WODM Rules

Engine

Eligible for No touch?

Client Registration

SFU/EDBC AWAA

Real Time Verifications

Real Time Eligibility

Account Transfers FFM/FHK

Electronic Applications VLP Verification

SSA Composite

Income Verification (SWICA/UC)

Assess for No Touch

Post E-Sign Process

APPLICATION ENTRY DRIVER

CR DRIVER

ELIGIBILITY DRIVER AUTHORIZATION

Application Source

Worker Processing

Disposition

Application Processing Through No Touch MES Processes MAGI Apps. Total Apps.

Total Applications 374,214 1,009,494

Real Time Verifications Passed 142,724 233,227

Real Time Verifications Failed 231,490 776,519 Real Time Eligibility Passed 14,328 262,176 Real Time Eligibility Failed 128,396 747,570

Eligible for No Touch 10,661 222,619

- Client Registration Completed 6,572 182,859

- Demographic Information Completed 6,111 164,485

- Technical Questions Completed 3,943 76,598

- Asset Questions Completed 3,586 76,589

- Income & Expense Questions Completed 1,866 14,425

- Eligibility Completed 798 2,261

- Authorization Completed 389 0 -8- Data from 12/16/2013 through 04/09/2014

Open Defects by Severity

• Open production defects by severity of incident • Includes items that remained from System Test & User

Acceptance Test (UAT) as of go-live

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Critical 0 High 0 Medium 16 Low 22 Unassigned 0 Grand Total 38

As of 1:00 PM EDT on 04/09/2014

Medium, 16, 42%

Low, 22, 58%

Critical High Medium Low Unassigned

Resolution of Defects by Deployment Date

• All remaining open defects are currently targeted for resolution in the April 16 or May 21 release

• No defects are currently in the triage process

-10- As of 1:00 PM EDT on 04/09/2014

0

10

20

30

40

50

60

70

80

1 - Critical

2 - High

3 - Medium

4 - Low

Severity:

Release 2 Status

Design Phase • Functional Design and Technical Design activities continue • Updates to design specifications are in-process Develop Phase • Construction on Child-In-Care modifications and

enhancements are in-process • Development activities for Release 2 to begin later this

month • Test Planning and Training Planning activities are underway

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Project Status Update

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Note: Fixed price contract

Project Performance Metrics

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RELEASE 2 STATUS Rules Engine for Other Medicaid Groups November 10 Account Transfer Schema Changes November 10 Child Welfare Changes July 11

RELEASE 1 REMAINING ITEMS STATUS FHK Real-Time Eligibility / Validations Being Re-Scheduled End of Warranty Period July 16 – on track

RELEASE 2 TIMELINE

MES Release 1 / Release 2

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Child In Care (CIC) Florida’s Safe Families Network (FSFN) Changes

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• Requirements completed on February 28 • Design Phase will conclude on April 14 • Development Phase is underway • Test Phase will begin on April 22

Issues Comments MEC Check Performance - A latency issue is currently being experienced in the MEC response from the AHCA system for requests received from FFM and FHK.

The Systems Integrator continues to work with AHCA to resolve this issue. MEC checks are “timing-out” when the system reaches a certain threshold of requests. To address this, the load to the AHCA system has been reduced during the day to alleviate the issue. While this has reduced the number of time-outs, the issue persists. On April 9 the number of time-outs again triggered CMS to stop MEC check requests. The Department continues to work with AHCA and the service remains off until the issue is improved.

WAS/WODM Socket Errors - A few socket errors are being encountered on requests through the enterprise service bus. These errors are being seen on the Electronic Application, Eligibility, and Account Transfer services hosted on WAS/WODM. The impact is not visible to workers but could affect how far applications proceed through the real-time eligibility and no-touch processes.

The Systems Integrator is working with IBM and the NSRC to resolve this issue. The NSRC installed additional Java Virtual Machines (JVM) on March 27 to alleviate the issue but that did not solve the problem. Per IBM’s recommendation, the team has now increased heap size on the JVMs from 2 GB to 3 GB which has created additional stability. Additionally, the Systems Integrator is verifying that no memory leaks are occurring that would consume additional resources as well as segmenting each service to dedicated JVMs to provide additional transparency into the problem.

Project Issues

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Project Risks

Risks Comments

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No “High” risks to report at this time.

Independent Verification and Validation Update

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Medicaid Eligibility System Project Independent Verification and Validation (IV&V) Executive Steering Committee briefing 11 April 2014

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Topics for discussion

► General IV&V overview ► Overall risk state and trending ► Key indicators ► Overall project performance ► Upcoming IV&V activities ► Supporting information

► Summary of changes ► IV&V ratings summary ► Open deficiencies ► Project milestones

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General IV&V overview

► Overall IV&V risk state for the MES project is Amber (issues and inefficiencies). ► T5 – Security, business continuity (BC) and disaster recovery (DR) changed from

Green (no issues) to Amber (issues and inefficiencies) due to the following: ► The NSRC has not provided reasonable assurance to DCF that security and/or recovery

processes are designed appropriately and are operating effectively such that the NSRC environment meets or exceeds required service levels.

► The project team has addressed all deficiencies identified by the IV&V Team.

► Schedule and cost performance are within established control limits. ► No new deficiencies identified since the last report. ► The April IV&V PEAR will be published on 9 May 2014.

► Contract amendment in process to convert to monthly IV&V reports.

Overall IV&V risk state: Amber

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Overall risk state and trending

Risk state of MES Project Risk state with trending

Indicates that the area being assessed has critical issues that will result in significant risk to the project most likely resulting in either the inability to achieve the outcomes, inability to meet the projected schedule, or a significant cost over-run. Requires immediate action.

Indicates that the area being assessed has issues that need to be resolved; inefficiencies exist. Current process/method can be used with refinement. Indicates that the area being assessed did not have significant issues to report. Continued monitoring should be performed. Indicates that the area being assessed has incomplete information available for a conclusive finding or is not applicable.

As of 20 March 2014

Scopemanagement

Timemanagement

Costmanagement

Humanresource

management

Procurementmanagement

Integrationmanagement

Riskmanagement

Communicationsmanagement

Business caseintegrity

Complexityprofile

Capabilityand

maturity

Decision framework

Organizationalchange

management

Performancemanagement

Governanceeffectiveness

Compliance andregulatory

Benefitsdesign andrealization

Requirementsengineeringand design

Methodologyand

development

Technicalinfrastructure

Datamanagement

Security,BC and DR

Controls

Testingand

validation

Cutoverand

support

Sustainabilitymodel

Qualitymanagement

G3

G2

G1

G6

G5

G4

G9

G8

G7P1

P2

P3P4

P5

P6P7

P8

P9

T1

T2

T3

T4

T5

T6

T7

T8

T9

Program governanceBenefit realization and

sustainability

Project managementProcesses, controls,

and predictability

Technical solut ionRequirements development,

quality and transition

Program governance

Risk state with trending

G1G2

G3G8

G7

G9

G4

G6G5

P1

P4

P6

P3

P5

P7P8

P2

P9

T2T1

Technicalsolution

Projectmanagement

T3

T5

T6T4

T7T8

T9

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Key indicators

Indicator Value Comment Is the project currently on schedule?

Yes ► The MES project is within the prescribed schedule control limits.

Do you expect the project to complete on schedule?

Yes ► The MES project is within the prescribed schedule control limits.

Are there any scope changes?

Yes ► The ESC has approved multiple scope changes regarding items such as FFM Account Transfer Schema version changes, Presumptive Eligibility for hospitals, and IV&V test result review and attestation.

► The additional costs have been incorporated into the project budget and contract amendments have been completed.

Are there any risks or issues that the Department is not successfully managing?

No

Is the project currently within budget?

Yes ► No significant deviations from the MES project spend plan.

Do you expect the project to remain within budget?

Yes ► No significant deviations from the MES project spend plan.

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Overall project performance

This chart shows the SPI and CPI plotted as points against the tolerance ranges set up for the project.

SPI is1.00 and trending flat: The project is on schedule. It is taking the same time to

complete tasks as originally scheduled.

CPI is greater than 1.00 and trending positive: The project is under budget. It is taking less effort to complete

tasks than originally planned. Conclusions: Schedule and cost performance

are within prescribed control limits.

► Green area indicates within tolerance of +/- 5% for both SPI and CPI.

► Amber area indicates review is required and corrective actions may be necessary.

► Red area indicates out-of-tolerance and corrective actions are necessary.

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Upcoming IV&V activities

► Participate in MES project meetings. ► Review materials provided by the MES Project Team.

► Provide informal feedback as required.

► Schedule for April PEAR is as follows: ► Artifact and interview cut-off: 18 April 2014 ► Submit draft to DCF Contract Management: 25 April 2014 ► Publish final report: 9 May 2014

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Summary of changes

Item Description

Deficiencies addressed

► There are no open deficiencies.

New deficiencies

► No new deficiencies addressed since the last report.

Risk ratings ► T5 – Security, BC and DR changed from Green (no issues) to Amber (issues and inefficiencies). ► T9 – Sustainability model changed from Gray (not evaluated) to Green (no issues).

Maturity ratings

► T9 – Sustainability model changed from not evaluated to Level 3 (defined).

Interviews conducted

► No interviews conducted since the last report.

Artifacts received

► Artifacts received include budget, communications, contracts, deliverable management, Executive Steering Committee (ESC), implementation, legislative reporting, operations documentation, performance metrics, phase gate materials, project management, risks, actions, issues and decisions (RAID), requirements, schedule, staffing, status reports and training.

Supporting information

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IV&V ratings summary Supporting information

This chart shows a summary of the IV&V cube facet ratings (red, amber, green and grey), and open deficiencies for the last six reporting cycles.

The number of cube facet risk ratings has increased since the January PEAR.

The number of remained the same for the last six reporting cycles.

Conclusions: The project risks are slightly

increasing.

0

5

10

15

20

25

30

30 September 2013 31 October 2013 30 November 2013 31 December 2013 31 January 2014 Feb / Mar 2014

Number

IV&V cube facet ratings and open deficiencies per month

Critical Issues Inefficiencies No Issues Not Evaluated Open Deficiencies

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Open deficiencies

No. Areas Deficiency Implications Recommendations

Supporting information

There are no open IV&V deficiencies with the MES Project.

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Project milestones

ID Title Completion date

Baseline Planned Projected Actual

7199 Finish Requirements sub-phase 04/11/2014 04/11/2014 04/11/2014

7200 Finish Design sub-phase 06/06/2014 06/06/2014 06/06/2014

7272 Finish Development sub-phase 08/01/2014 08/01/2014 08/01/2014

7341 Finish Test sub-phase 10/30/2014 10/30/2014 10/30/2014

7488 Finish UAT sub-phase 11/21/2014 11/21/2014 11/21/2014

7568 Finish Conduct Training 10/17/2014 10/17/2014 10/17/2014

7584 Milestone: Go-Live Complete 11/10/2014 11/10/2014 11/10/2014

Supporting information

Late

Contract LF917 Deliverable Review and Approval - Release 2 Define Phase

Change Request - Ability to renew benefits using the Self Service Portal/Renew My Benefits functionality within 90 days of closure

Action Items

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