Technology has the power to help break down silos between state health and human services programs and improve customer service. The promise of interoperable computer systems is that families will not have to go through multiple applications, interviews and appointments to receive services, and taxpayers will save money.
The Affordable Care Act (ACA) is spurring states across the Nation to create new eligibility and enrollment computer systems for Medicaid and health insurance exchanges. The ACA presents a unique opportunity for state health and human services programs to integrate their systems both vertically and horizontally, and bring our programs one step closer to the “no wrong door” approach to service delivery. In the past, this was not possible due to the requirement to cost allocate federal dollars across multiple programs.
However, through Dec. 31, 2015, states can design, develop and implement system modules that perform common functions across all health and human services programs with enhanced 90/10 federal funding if they request a federal cost allocation waiver.
Under a waiver, programs such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP, also known as Food Stamps), and child care services can be included in the state Medicaid agency’s project to build a new eligibility determination system. Other programs, like child support and child welfare, also can join the effort to integrate service delivery to families.
In anticipation, OCSE’s parent agency, the Administration for Children and Families (ACF), launched the Interoperability Initiative to help state human services programs effectively collaborate with their health care agency counterparts: Medicare, Medicaid, CHIP, and health insurance exchanges. In late March, OCSE was asked to manage ACF’s Interoperability Initiative because we have the background and extensive experience with data exchange standards, systems design and development, and grants management.
Our interoperability project team is busy on a number of fronts:
- We are standing up the first Human Services Domain in NIEM (the National Information Exchange Model). It will eventually establish a common set of data elements and definitions in a format easily exchanged between different human services systems, and in fact with any system.
- We are designing a common architecture and platform for all human services programs, called the National Human Services Interoperability Architecture (NHSIA), to support states to build less expensive, but more integrated human services systems in the future.
- And we recently added a new project called Data Exchange Standardization. It’s based on recent legislation applicable to the child welfare and TANF programs funded under titles IV-B and IV-A of the Social Security Act. The new law requires the Office of Management and Budget and ACF, in collaboration with states, to set up a working group to define a standard way for all states to exchange the data they report to their federal programs. HR 4282, introduced by U.S. Representative Rick Berg on March 28, 2012, would extend data exchange standardization requirements to the child support program funded under title IV-D.
In the child support world, we know the benefits of interoperable systems—and we know we will not get there overnight. Systems interoperability is a long-term vision that will take a generation to achieve. But the technology is here to begin to integrate health and human services systems. Linking them will accomplish two goals: improve client outcomes and enhance operational efficiency.
Imagine a common case intake module shared by the health programs and human services programs, including child support—an intake module that could make sure families receive the services they need. Now, imagine an integrated data warehouse where client information is gathered across all of the different health and human service programs. Using data analytics, we could understand what services a client uses, when and why, and predict the action needed next to achieve the positive outcomes we want for the families who seek our services.
With interoperable systems, we may do a better job of serving the whole person and the whole family; we may more effectively share services, streamline information and business systems, and minimize duplicative costs to build, maintain and update redundant computer systems.
Look for more news on the Interoperability Initiative in the Child Support Report soon. We’re just getting started, and despite the challenge of budget pressures and doing more with less, we could not let this opportunity pass by to change the landscape of health and human services.
Through increased integration, collaboration and information-sharing across health and human services programs, ACF hopes to improve the lives of America’s children and families and provide real value to the public.