The Office of Management and Budget (OMB) Partnership Fund for Program Integrity Innovation provided the Department of Health and Human Services/Administration for Children and Families (HHS/ACF) funding for the State Systems Interoperability and Integration Projects opportunity. HHS/ACF, through the Office of Child Support Enforcement (OCSE), invites State human service agencies to submit competitive grant applications that explore and plan improved interoperability and integration in eligibility and enrollment, business process and workflows, case management, and other related functions across health and human services information technology systems.
Many States are already working to make strategic investments in information systems. For example, the Affordable Care Act (ACA) mandates new eligibility requirements and business processes for health programs and is spurring States to create new eligibility and enrollment systems for Medicaid and the 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. This has led States to consider aligning case management systems across programs and finding ways to share and exchange data, particularly data related to vulnerable children, to improve outcomes.
As States pursue such changes, there is opportunity to consider how to most effectively and efficiently leverage investments that use Federal and State funds to upgrade and integrate systems. Currently, enhanced Federal funding is available for systems upgrades related to the design, development, implementation, or enhancement of systems designed to determine Medicaid eligibility. One of the standards and conditions for States to obtain the enhanced funding makes mention of interoperability with human services programs. In 2011, policy was also issued granting time-limited exceptions to OMB Circular A-87, which permits States to integrate human services eligibility processes into their Health Insurance Exchange and Medicaid/Children’s 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.
Another recent development regarding interoperability and integration is Section 4003 of the Middle Class Tax Relief and Job Creation Act of 2012. Section 4003 tasks the Secretary of HHS with designating standards to facilitate data exchange between the Temporary Assistance for Needy Families (TANF) program and other programs and data sources. State approaches to improved data sharing across systems may provide information that can help inform the development of final rules implementing the requirements of Section 4003.
This announcement allows grantees to explore and plan improved interoperability and integration in eligibility and enrollment, case management, and other related functions across human services information technology systems, and explore integration with other programs. Grantees can explore systems design and implementation options, determine the costs and benefits of different options, the potential client outcomes and impacts of each option, and develop concrete implementation plans and options for the grantee to consider, as well as produce a road map for other States including all planning documentation. In addition, each grant will demonstrate how enhanced interoperability and integration can improve service delivery, increase program efficiency, and/or reduce errors and enhance program integrity.