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Deltek Pulse: health care and social services – January 2012 recap

Looking back on the first month of 2012, health insurance exchanges (HIXs) continued to consume media outlets and fill legislators’ and lawmakers’ agendas nationwide. In Florida – the state leading the legal battle challenging the legality of the Affordable Care Act (ACA) – two bills were presented introducing legislation to create a statewide HIX. Thus far, Florida lawmakers have made no effort to begin planning for such an exchange. However, pending the outcome of this March’s Supreme Court hearing on the law, the state may have to succumb to creating the exchange or letting the feds do so on their behalf. It will be interesting to see how things pan out for the state and other states that hold a similar stance on the federal mandate.

Hopefully you caught one or all of last week’s blogs in our series highlighting Deltek’s newly-released report, “Evolving Health Insurance Exchanges.” Whether you have had a chance to check out the report yet or not, mark your calendars for February 26, 2012, from 2:00 – 2:45 p.m. EST. Deltek Analyst Amanda White will help you, the vendor community, answer the question: How will the Supreme Court ruling affect states’ efforts with the health insurance exchanges? To register for the free webinar, please click here. 

Other January happenings included the release of Arkansas’ long-awaited revised procurement strategy for its replacement Medicaid management information system (MMIS). Also progressing in replacing its Medicaid system, Indiana released a request for proposals (RFP) for its core MMIS. Meanwhile, the state continues to solicit proposals for the related Medicaid Data Warehouse Decision Support System/Business Intelligence (DW/DSS) Solution.

On the social services front, New York released an RFP for the Common Benefit Identification Card (CBIC), which transfers benefits for the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Families (TANF), and the Medicaid (MA) program. Florida’s Department of Children and Families (DCF), which is in the midst of overhauling many of its social services benefit programs, released an invitation to negotiate (ITN) for identification verification services.

The coming months will continue to see controversies surrounding the ACA. States already making headway on HIX implementation will likely continue to do so, even if the Supreme Court decides to overturn the law. Meanwhile, state Medicaid offices will keep chugging along at Medicaid reform efforts and will look to the vendor community to assist in reforming or replacing outdated core systems. As previously mentioned, states like Arkansas, that have struggled with Medicaid reform plans, will continue flushing out plans and drafting solicitations that strive to meet the technological requirements set by the Medicaid Information Technology Architecture (MITA) 2.0 and future 3.0 guidelines.

Once again, don’t forget to register for February’s “Evolving Health Insurance Exchanges” webinar!

As always, stay tuned to this blog for more analysis as the year progresses. You can also follow our team on Twitter @GovWin_HHS, or connect with us through LinkedIn.

Indiana Seeks Accountability and Evaluation Systems To Enhance Education

Last year, the U.S. Department of Education offered each State Educational Agency the opportunity to request flexibility requiring specific requirement of No Child Left Behind (NCLB) in order to better focus on improving student learning and increasing the quality of instruction.
After the announcement, 11 states formally submitted requests to the Department of Education for waivers from key provisions related to NCLB, with numerous other states indicating they plan to apply for waivers at a later time this year.
The 11 states which applied for waivers are Colorado, Florida, Georgia, Indiana, Kentucky, Massachusetts, Minnesota, New Jersey, New Mexico, Oklahoma and Tennessee.
In exchange for receiving waivers, these states must detail plans for meeting several goals, including developing academic standards that prepare students for college or a trade; creating statewide measures of student performance and plans for reforming schools that don’t meet requirements; and developing teacher and administrator evaluation systems tied to student performance.
Over the past weeks, Deltek has focused on a few of the state’s which have submitted initial NCLB waiver requests, and this week turns the spotlight on the state of Indiana.
As part of its waiver request, Indiana disclosed two IT-specific initiatives, including a plan to 1) Provide a State-Developed Differentiated Recognition, Accountability, and Support System, and 2) Develop and Adopt Guidelines for Local Teacher and Principal Evaluation and Support Systems.
In its request, Indiana said it plans to develop and implement a state-based System of Differentiated Recognition, Accountability and Support which is designed to improve student achievement, close achievement gaps, and increase the quality of instruction for students. This system is expected to be implemented no later than the 2012-2013 school year. In developing this assessment system, Indiana is part of a state consortium in which other states may issue RFPs for procurement. 
Elsewhere, Indiana may also seek to Develop and Adopt Guidelines for Local Teacher and Principal Evaluation and Support Systems. Currently, Indiana is using an educator evaluation tool known as RISE, which was launched in 2011-2012 as a pilot program. The pilot program is looking to:
1.     Establish that valuation systems (including the state model as well as other diverse models currently in use) can incorporate state priorities and are fair, accurate, and feasible;
2.     Gather key lessons about systems and implementation to improve resources and outcomes in the statewide rollout; and
3.     Create a community of early adopters of state priorities to share information and problem solve in real time.
Indiana said its new evaluation system provides a transparent way to validate the quality of a school’s human capital by coupling professional accountability with school accountability.


State & Local Pension Investments Grow, Recovery Continues, & GovCon Prospects Improve

The U.S. Census rather quietly produced a report this month on public employee retirement systems. Overall, pension news is very good and improving, with balances improving in FY 2010 after two straight years of losses. For FY 2010, cash and investment holdings for state-administered pensions increased to $2.2 Trillion (or up $190 Billion) from FY 2009 (see Figure 1, below). This is the first increase in overall balances since 2007 and fantastic news for the GovCon community. Quite simply, this will further ease pressure on state financials and open the door for state and local procurement. GovCon conractors struggling with the federal market would do well to invest in state and local. Businesses not at all engaged in GovCon should consider this a growth opportunity.  
Figure 1: Overall State Pension Growth FY 2009-2010
Subscribers, have access to the full article, with detailed analysis, data, tables, and figures, here.
Follow all of the GovWin State and Local Top Opportunities, Reports, and Podcasts, here.

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Sources: Deltek, U.S. Census, NASBO, and the LA Times.



Exploring the evolution of insurance exchanges: The final installment

Today marks the final day of Deltek’s health care and social services team’s blog series centered on the recently-released report, “Evolving Health Insurance Exchanges.” The report takes a nationwide dive into implementation processes and state statuses in instituting these novel systems. It also provides high-level advice for government contractors for getting ahead in the game. This week’s blog series covered several topics including integrated eligibility, procurement, all-payer claims databases and quality assurance. Here are a few more notable highlights across the states:
District of Columbia: The D.C. Office of Contracting and Procurement, on behalf of the Department of Health Care Finance (DHCF), released a request for task order proposal (RFTOP) on Jan. 17 for the development and design of its insurance exchange. The selected vendor will assist the state in developing a request for information (RFI) to obtain information regarding technology solutions available to support the implementation of the HIX, in addition to developing a request for proposals (RFP) for system implementation. According to DHCF, the RFP statement of work will be due by May 1, 2012. Also, the state recently passed legislation to create the DC Health Benefit Exchange Authority.
Mississippi: The state has been taking a four-phase approach and is currently evaluating proposals received for phase 1 – the Web Portal and Compare Functionality for the HIX. According to the Mississippi Comprehensive Health Insurance Risk Pool Association, the contract is expected to be awarded by the end of this month.
Florida: The state recently introduced legislation (SB 1640 and HB 1423) proposing the establishment of a state-run insurance exchange. This is an interesting turnaround considering Florida is currently one of the states leading the lawsuit against the Affordable Care Act (ACA).
Colorado: The Colorado Health Benefit Exchange Board (COHBE) released its RFP this week for customer service and technology for SHOP and individual exchanges. COHBE is seeking partnership with one or more vendors to be responsible for providing the complete COHBE solution, including all required services for a successful implementation.
Nevada: This week, the Nevada Department of Health and Human Services released an RFP for independent verification and validation (IV&V) services for its health care reform eligibility engine system. The state plans to utilize the IV&V vendor to meet various objectives for implementing an exchange by fall 2013, including modifying a system based on outdated technology, and creating an eligibility rules engine for all publicly-subsidized health coverage programs to support Medicaid, CHIP and exchange-based subsidy programs.
As always, don't forget to follow Deltek's Health Care and Social Services Team on Twitter@GovWin_HHS, or connect with us through LinkedIn!

Exploring the evolution of insurance exchanges: quality assurance services

Continuing this week’s blog series recognizing Deltek’s recently-released report, “Evolving Health Insurance Exchanges,” we’re drawing attention to an element of health insurance exchanges (HIXs) that has thus far received little attention: quality assurance (QA) services. The lack of focus on these services can be easily pinned to the early nature of HIXs and delayed implementation efforts of many states. However, as more states implement state, federal or hybrid exchanges, they will need to start considering and implementing quality measures.

States further along in HIX planning efforts such as Colorado, New York and Mississippi may have a clearer vision of needed QA practices than those that continue to delay planning and implementation. Similarly, states that have made progress in modernizing eligibility determination systems into integrated eligibility determination engines may already be planning for or have existing QA contracts in place.

As vendors continue to see more exchange-related opportunities arise as the 2014 deadline approaches, they will likely see an influx of quality-related opportunities. Though still in its draft stages, once released, federal guidance on the exchanges will hopefully contain concrete QA-related direction for states. Meanwhile, many states are anxiously awaiting the March 2012 Supreme Court verdict on the Patient Protection and Affordable Care Act (PPACA) before taking any additional steps toward HIX implementation.

If this week’s blog series has sparked your interest in learning more about HIXs and state-by-state progress of exchange implementation, be sure to check out Deltek’s “Evolving Health Insurance Exchanges” report. In addition to providing high-level recommendations for vendors trying to get ahead in the game, the report examines the following components of the national HIX market:

  • Background legislation and federally-mandated policy options
  • Which states are 'in,' which are 'out,' and which are on the fence
  • Links to project documents and opportunity profiles (where relevant) for all states
  • Emerging implementation models and active vendors involved in planning, implementation, and call center functions

Don't forget to follow Deltek's Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIn!


Exploring the evolution of insurance exchanges: We are all connected

Today’s blog marks day 3 of Deltek’s health care and social services team’s blog series centered on our recently-released report, “Evolving Health Insurance Exchanges.” The report provides an in-depth analysis of states and their steps toward implementing these one-stop shops. It also provides high-level recommendations for vendors trying to get ahead in the game.


With all of the hubbub surrounding the implementation of health insurances exchanges (HIXs), it is easy for the everyday citizen to forget that the Affordable Care Act (ACA) isn’t just about the creation of exchanges as a single, stand-alone system. Though it may seem a simple task to assemble an “Expedia-type” consumer experience that blends private insurance and Medicaid, states have an enormous undertaking ahead of them in integrating the back-end processes that will feed into the HIXs.


Think back to when you’ve tried to download a report or image that is not compatible with your current software. Frustrating, isn’t it? Now, think about the current health care and social services IT environment in the states. Eligibility for Medicaid is housed on a different IT platform than Temporary Assistance for Needy Families (TANF), which may be housed on a different platform than eligibility for child care, which is housed on a different platform than child support … you get the picture.


Most families eligible for one state service are eligible for another, therefore requiring (in many states) paper applications to be filled out several times to determine eligibility for each service. The ACA, with help from the U.S. Department of Health and Human Services (HHS), calls for the creation of a shared eligibility service that integrates the HIX, Medicaid, and Children’s Health Insurance Program (CHIP). Some states already combine Medicaid, CHIP, TANF, and Supplemental Nutrition Assistance Program (SNAP) eligibility, but many are scrambling to upgrade to an integrated eligibility system that is compliant with ACA requirements.


Some states are taking advantage of this opportunity and utilizing enhanced federal funding to create the core eligibility platform (HIX, Medicaid, CHIP), in addition to looking to integrate other service delivery programs in the future. The Illinois Department of Healthcare and Family Services is planning to release a request for proposals (RFP) in March 2012 for an integrated eligibility system covering Medicaid, CHIP, SNAP, TANF, and the HIX. Implementation costs are estimated to be between $50 million and $70 million – a hefty price tag on top of the already-estimated $57 million for the installation and management of the HIX. The new system will be implemented in two phases, the first of which will bring the state into full compliance with CMS (Centers for Medicare and Medicaid) standards by 2013, if all goes to plan. The second phase will include a complete replacement of legacy enrollment, case management, and benefits processing functions. Other states looking at integrated systems in the north-central region of the United States include Ohio, Iowa, Indiana, Missouri, and Minnesota.


Although the health insurance exchange is meant to help consumers choose health insurance, the mandate is helping drive the integration of fragmented and siloed human services delivery systems. The benefit assistance world has long grappled with how to best provide a one-stop shop to citizens in need, as stand-alone transaction processing silos can no longer effectively support the needs of states. So, while the constitutionality of the ACA continues to be battled in court, the act has required states to take a good look at how they currently provide services, and the ways in which state departments collaborate, or don’t collaborate, when creating assistance plans for families. This progress is great news for families dependent on state assistance.


Don't forget to follow Deltek's Health Care and Social Services Team on Twitter @GovWin_HHS, or connect with us through LinkedIn. We'll be tweeting and posting throughout the week with our expert analysis of health IT in the state and local market.

'Authoritative Crowdsourcing' - L.A. County LMS

PTI recently hosted a presentation by Mark Greninger, Geographic Information Officer for the County of Los Angeles, who detailed the county’s implementation of a new land management system (LMS). On the surface this might not seem noteworthy. However, Mr. Greninger struck upon the profound notion of “authoritative crowdsourcing,” which holds tremendous value for vendors and government IT decision makers looking to find value from social media—in this case, a blogging tool transformed into a distributed GIS data collection point.

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(Subscription to Deltek State & Local Industry Analysis required.)





Florida Seeks To Enhance Accountability and Evaluation Systems To Boost Education

In September 2011, President Obama announced a plan to offer greater flexibility from federal education mandates in exchange for a commitment from states to boost overall student achievement. After the announcement, 11 states formally submitted to the U.S. Department of Education requests for waivers from key provisions of No Child Left Behind (NCLB).
In this post, Deltek would like to focus on the state of Florida, and discuss its plans to:
·         Set performance targets to graduate students from high school ready for college and career;
·         Design locally-tailored interventions for schools instead of one-size-fits-all remedies prescribed at the federal level;
·         Measure school progress using multiple measures rather than just test scores; and
·         Have more flexibility in how they spend federal dollars.
As part of this, Deltek would like to discuss the various information technology (IT) initiatives associated with Florida’s waiver request.
In its request, Florida mentioned a few IT-specific initiatives, including a plan to 1) Develop and Implement a State-Based System of Differentiated Recognition, Accountability, and Support, and 2) Develop Local Teacher and Principal Evaluation and Support Systems.
Overall, Florida said its flexibility request is a “monumental step forward to significantly advance the state’s nationally-recognized and acclaimed accountability system and to further increase the quality of instruction for students and student achievement.
As part of its waiver request, Florida is seeking to create and develop a Recognition, Accountability and Support System which will improve student achievement and school performance, close achievement gaps, and increase the quality of education to students.
Florida said the new system will be designed to eliminate the duplication and confusion caused by having two separate accountability systems and to focus the state on raising achievement for all students. The Recognition, Accountability and Support System is expected to be implemented no later than the 2012-2013 school year.
In another tech-related initiative, Florida is looking to Develop and Adopt Guidelines for Local Teachers and Principal Evaluation and Support Systems. This system will increase student learning growth by improving the quality of instructional, administrative and supervisory services in the state’s public schools, while establishing procedures for evaluating the performance of teachers and principals who are employed by the state.


California's FY 2013 Budget: More Ground to Cover

California Governor Edmund Brown presented his proposed budget on Jan. 5. In last year’s budget, even after many cuts, Brown faced a $12.5 billion deficit. The reality coming into FY 2013 is a $9.2 billion deficit that includes $4.1 billion that will be carried over from FY 2012. In his state-of-the-state address on Jan. 18, Brown acknowledged the success of the massive cuts from the previous budget, but admitted that more cuts and temporary taxes are necessary to continue pulling California out of its financial hole. The governor said he understands these measures will not be popular, but contends that continuing to amass additional debt in order to “do good” will not benefit the state in the long run. These potential cuts and temporary taxes will likely result in California continuing to be cautious on how and where its money is spent.
The FY 2013 budget increased slightly over the previous fiscal year by approximately 2.08 percent. This seems to be on target with Brown’s plan to continue paying down debts instead of adding more. Spending for several verticals also increased year over year. The top vertical gains were in health care (22.56 percent), and general government services (42.91 percent). The top vertical decreases were in natural resources/environment (20.08 percent), and economic development/regulation (41.15 percent).
The top vertical IT budgetary reductions were in health care and homeland security, both with a 100 percent decrease. These reductions are based on values given for these verticals in the state’s FY 2013 budget, and do not indicate that IT spending will be cut completely. The top vertical IT budgetary gains were in public finance, with a 75.70 percent increase; and natural resources/environment, with a 100 percent increase year over year.
The majority of the IT items identified in the FY 2013 budget relate to the operations and management costs for telecommunications, hardware, software, and other technologies used by departments. There were no new major IT projects mentioned, but funding for several ongoing large projects was once again included in the new budget. A total of $39 million was allotted for the Financial Information System for California (FI$CAL) project, as well as $96.5 million for the Enterprise Data Revenue (EDR) project, and $158 million for the California Justice Information System (CJIS).
Analyst’s Take
Governor Brown’s FY 2013 budget seems to be on par with his plans for reducing the state’s deficit over the next several years. The budget is slightly larger than the previous proposed budget, but still aims to cut spending in order to dig California out of its financial hole. The governor’s plans to make deeper cuts and implement temporary taxes will not be popular, which even he admits, but they may be just what California needs. Brown’s FY 2012 budget made drastic cuts and managed to reduce the state’s deficit from more than $26 billion to $9.2 billion for FY 2013, so continuing in that vein seems like a necessity.
The prudent 2013 budget most likely means that, as with the previous budget, there will be fewer dollars for technology contracts, and that money provided for technology will be used for IT operations and management services, and to maintain existing systems. California has come a long way in the past year, but there is still more ground to cover. Funding may increase, and the deficit may decrease, but it will still be several years before the state sees its pre-recession spending. As long as Brown continues to make wise cuts, and the state spends what money it does have cautiously, California will bounce back and continue its recovery.
Subscribers have access to expanded analysis, including detailed budget data, here.
*Note: The budgetary numbers presented by Deltek may not reflect the numbers presented in most government and media announcements. The numbers presented by Deltek are All Funds values, which include all state funds, as well as non-government cost funds and reimbursements. The values presented by most announcements include only state funds, which consist of General Funds and other funds.*



Montana public safety agencies adopt a cloud environment


Public safety agencies across the state of Montana have begun using a secure cloud environment for data sharing capabilities. Following a memorandum of understanding (MOU) between the Montana Department of Justice and Datamaxx Group, all agencies were given direct access to the Datamaxx Secure Cloud, which provides law enforcement networks and homeland security information compliant with both the FBI and the National Law Enforcement Telecommunications System (Nlets).


The cloud can be defined as a network that computers and other devices can access anytime and anywhere they have an Internet connection. A public cloud is one where the infrastructure is made available to the general public over the Internet, whereas a private cloud offers more organizational oversight and control over the security and privacy of the network. Cloud technologies can be implemented in a wide variety of architectures and deployment models and can coexist with other technologies. Many clouds may also require different permissions for accessing information.


Using a cloud not only allows for better information sharing, it also helps with curbing costs. In a cloud environment, information exchanged between state, local and federal public safety agencies is secure, fast and a cheaper investment than most in-house solutions. Clouds eliminate many costs associated with storage, staffing, and multiple application uploads.  


Many organizations have debated the risks associated with cloud computing as it presents a more portable environment without the typical manual configurations. As technology has become more advanced, there are more solutions available for automated end-to-end security including encrypted data storage, host-intrusion detection systems, firewalls and federated identity management systems. Many of these systems can be enforced through security policies that prevent any errors associated with human configuration.


Analyst’s Take:


Public safety agencies can benefit a great deal from using the cloud. The ability to share and exchange information through a cloud can lead to faster response times and help departments better plan and prepare for responding to future emergencies or terrorist attacks. For example, a city can upload building plans to the cloud, which can then be accessed by fire departments to help determine the source of the fire as well as better identify entry and exit points.


The rising availability of cloud computing resources at a lower cost may influence more agencies to take advantage of the technology, especially in the face of tightened budgets. Both the Miami and New York City Police Departments have begun using the Datamaxx Secure Cloud, which indicates this company could become one of the leaders in providing cloud solutions. As vendors like Datamaxx become more popular, there may be more opportunities for smaller companies to form partnerships. In addition, vendors offering cloud technologies should be aware of agencies’ security and privacy needs when marketing their product to ensure all requirements are met.

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