1

North CarolinaDepartment ofHealth & Human Services

1

WSS & NC FASTTown Hall Briefing

February 2013

22

Agenda

Project Update Spotlight Topics:

Reporting Help Desk System Performance and Performance Monitoring Training Reception Case Routing, Work Queues, and Roles Task Utilization Universal Worker and Evidence Management

Next Steps and Best Practices

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North CarolinaDepartment ofHealth & Human Services

3

Project Update

44

P1 Update

All counties have gone to Hard Launch – Stage 1 98 counties have fully converted Two counties remain to be converted in March

Mecklenburg Forsyth

Supported 428,732 issuances for active FNS and SNAP cases in January, representing approximately $306M in FNS benefits issued since go-live

Received over 15,100 Help Desk tickets since go-live of which over 14,600 have been responded to and closed

Working to address open ticket backlog NC FAST continues to provide On-Site Support (OSS) to assist

counties through the transition

55

P1 Deployment Status

Anson

Beaufort

Bertie

Brunswick

Carteret

Columbus

Craven

Duplin

Gaston

Gates

Greene

Halifax

Harnett

Hertford

Hoke

HydeJohnston

Jones

Lee

Lenoir

Lincoln

Martin

Moore

Nash

Northampton

Onslow

Pender

Pitt

Robeson

Sampson

Scotland

Tyrrell

Union

Wayne

Wilson

Ala

man

ce

Alleghany

Ashe

Caldwell

Caswell

Catawba

ChathamDavidson

Davie

ForsythFranklinGuilford

Iredell

Person

Randolph

RockinghamStokesSurry Warren

Watauga Wilkes

Yadkin

Wake

Avery

Cherokee

Clay

Graham

BuncombeMcDowell

Macon

Polk

RutherfordSwain

Madison

Stanly

Cabarrus

Rowan

Burke

Ora

ng

e

Bladen

Dare

Jackson

Transylvania

Henderson

Haywood

Cleveland

Yancey

Mecklenburg

AlexanderEdgecombe

Pamlico

2 Counties Convert March 18th

98 Counties Fully Converted

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ePASS Update

ePASS should be able to accept applications for FNS beginning in March-April; specific date to be determined

Applications received will appear in the NC FAST online applications work queue

Supervisors will need to subscribe appropriate workers to the online applications and withdrawals work queues prior to ePASS upgrade

Specific details to come Confirming an approach to “pilot” the new ePASS application

functionality before widespread use Counties will need to make a determination about how much they

want to publicize the availability of this ePASS enhancement to the general public

77

P2&6 Overview

Detailed Design is complete System development is well underway and is targeted to be

completed in April Training material development is in process

Will be delivered in 2 waves – similar to Project 1 Will rely more extensively on distance learning than Project 1

Test script development is wrapping up and test execution is in process

Would like counties to be involved in testing activities Formal testing Sandbox access

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Wanted: Test Resources

Looking for at least 10 resources Commitment Period: March 1 through June 15, 2013 Looking for 100% dedication to NC FAST

If not 100% dedicated, then specific allotted time period’s ex. 2/3 full days a week.

Seeking program knowledgeable, independent, problem-solving individuals to execute test scripts – predominantly in the areas of Medicaid and Special Assistance, experience with FNS/SNAP welcomed.

Preferred that resources be on-site throughout testing duration, MINIMALLY required to be on-site for 2 weeks at start of testing and for periodic check-points.

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Health Benefit Exchange Update

North Carolina has elected to use the federal portal for initial intake of applications under the Affordable Care Act (ACA)

Applications received through the federal portal will be transmitted via interface to NC FAST

Health Benefit Exchange integration web-based training will be made available to all 100 counties in September 2013 in preparation for October 1 deadline to begin accepting ACA applications

Additional information will be provided in the next few months as the team analyzes implications of ACA on the counties

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P4 Update

Received notification that DHHS did not receive US HHS Administration for Children and Families (ACF)/Centers for Medicare and Medicaid Services (CMS) federal partner approval to expedite NC FAST Project 4 –Children Services

DHHS will continue to work with ACF/CMS to clearly define the cost allocation methodology

DHHS management decided to suspend expediting the project Will slow the effort until assured of 90/10 funding Will be able to gear up quickly if DHHS gets positive results in the

future Appears that the process may take some time given the magnitude

of federal partner questions If approval is not received in time to expedite Project 4, Project 4 will

return to its original implementation timeframe Planned timeframe to implement Project 4 is now 7/1/14 to 6/30/16

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Document Management

With the deployment of Project 2 and 6, document management functionality will be available through the evidence screens

Will support all case types in NC FAST Use of NC FAST document management functionality is optional –

yet encouraged Counties will be responsible for procuring scanning hardware and

software (usually bundled with the scanner) Refer to January 7 communication on document management

Integration design document to be released within the next 60 days

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P2&6 Implementation Schedule

P2&6 Preparation PilotSoft

LaunchHard

LaunchComplete Roll Out

January - May June Fall 2013 Early 2014

• WSS Town Hall Meetings

• Foundation Workshops

• WSS Leadership Summit

• Change Discussion Guide Reviews

• Readiness Assessments

• Training Development

• Testing

• Statewide Web-based Training Delivery

• Pilot Wave 1 Classroom Training Delivery

• Pilot Go-live with Applications

• Phase by Phase Web-based Training Delivery

• Phase by phase Wave 1 Classroom Training Delivery

• Rolling Go-live with Applications

• Readiness Assessments for Hard Launch

• Pilot Wave 2 Classroom Training

• Pilot Conversion• Phase Web-

based Training Delivery

• Phase by Phase Wave 2 Classroom Training Delivery

• Begin Rolling Go-live with Conversion and Recertifications

• Conclude Phase by Phase Wave 2 Classroom Training

• Complete Conversion

• Complete Statewide Implementation

Note: The proposed P2&6 Implementation Schedule above is subject to change

Optimization and

Maintenance

• Continue system optimization

• Support system maintenance

July-Sept

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Anson

Beaufort

Bertie

Brunswick

Carteret

Columbus

Craven

Duplin

Gaston

Gates

Greene

Halifax

Harnett

Hertford

Hoke

HydeJohnston

Jones

Lee

Lenoir

Lincoln

Martin

Moore

Nash

Northampton

Onslow

Pender

Pitt

Robeson

Sampson

Scotland

Tyrrell

Union

Wayne

Wilson

Ala

man

ce

Alleghany

Ashe

Caldwell

Caswell

Catawba

ChathamDavidson

Davie

ForsythFranklinGuilford

Iredell

Person

Randolph

RockinghamStokesSurry Warren

Watauga Wilkes

Yadkin

Wake

Avery

Cherokee

Clay

Graham

BuncombeMcDowell

Macon

Polk

RutherfordSwain

Madison

Stanly

Cabarrus

Rowan

Burke

Ora

ng

e

Bladen

Dare

P2&6 Implementation Plan

The implementation of P2&6 will follow a similar plan to that of P1, including the use of Pilot Counties and subsequent Phases of a Soft Launch and Hard

Launch moving geographically across the state.

Primary Pilot- 3 Counties

Secondary Pilot- 11 Counties

Legend

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Implementation Approach Pilot

June 17 – 3 primary pilots Remaining 97 counties will see screen changes; Web-based

training will be provided to address these changes Soft Launch

July – September – Geographically focused Focuses on applications for persons not on active EIS cases Will need to convert historical person data out of EIS to support

this; no going back to EIS during implementation Health Benefit Exchange

Web-based training in September for all 100 counties Able to take ACA applications on October 1; benefits start

January 1, 2014 Hard Launch

September – February 2014; conversion of active EIS cases

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Conversion Approach

Soft Launch 10 years of history including all IE segments and all associated data for persons on

closed cases as well as providers and facilities will be converted from EIS Converted twice a month by county in accordance with training schedule

Hard Launch Pilot Hard Launch in September and begin statewide deployment in October Active cases including 10 years of historical data and IE segments as well as

pending applications will be converted If the client has an existing FNS case in NC FAST, only additional data will be

converted from EIS, no existing NC FAST evidence will be overwritten The CNDS ID of the primary client will be used to convert and map cases into NC

FAST, creating new Integrated Cases if one does not already exist No income, resources or expenses, with the exception of medical expenses and

life insurance, will be converted in the evidence dashboard The amount of post-conversion cleanup that is required is expected to be less than

during P1 but will vary depending upon the type of case Cases will be converted from the caseworker’s EIS District Number in EIS to their

NCID in NC FAST, keeping caseloads intact

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Training Approach

1 day Foundation Workshops will be delivered in March-April 2013 Hands on planning session Regional locations across the state Practical work products to assist with county readiness for P2&6

P2&6 Training will be delivered in 3 primary segments: Web-based Training – Delivered prior to classroom training

waves Also addresses system changes introduced at Pilot

Wave 1 Classroom Training – 2 ½ days prior to soft launch HBE – Web-based training delivered in September 2013 Wave 2 Classroom Training – 2 ½ days prior to hard launch

Additional Web-based training scenarios beyond what is covered in formal training will be developed and posted in FAST Help.

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North CarolinaDepartment ofHealth & Human Services

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Spotlight Topics

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Reporting

A top concern among county users Actions taken:

Coordinated a working session between NC FAST project team, DSS Reporting team, CSDW team, and select group of counties

Identified several “quick wins” to support pulling data out of CSDW

Continue to work with CSDW and DSS Reporting team to meet county needs: Publishing reusable queries “Data Dictionary” for CSDW Clarifying how NC FAST dashboards pull data

NC FAST continuing to facilitate discussions between DSS reporting, CSDW and select group of counties

18,000 cases assigned to owners with “no access” role

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Help Desk

Increasing coordination among Tier 1, Tier 2, County Readiness, and Training teams

Consolidating Tier 1 and 2 Help Desk under one roof Considering rotating Tier 1 staff through a period of on-site support

to increase understanding of county operations Exploring options for increasing staff supporting Help Desk

operations Strongly recommend establishing a single point of contact at the

county level for Help Desk contact Reduces number of redundant tickets Increases system knowledge at county level; promotes county-

level troubleshooting Provides county with a better sense of county support needs

and staff progress up the learning curve

2020

System Performance

NC FAST is aware that several counties are experiencing poor performance when using NC FAST

Performance monitoring software has been made available to all 100 counties and is in the process of being installed

Many performance issues have been tied to county bandwidth issues

The project has encountered a few instances of performance issues on the central servers which have been resolved

Project leadership monitors system performance throughout the day and will seek to proactively notify counties when performance degradation is identified

Counties should consider implications of adding additional Project 2 and 6 users on overall county network performance

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System Monitoring Status

Still need performance monitoring software installed in the following counties:

Guilford Perquimans Scotland Wilkes

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Reception

All counties must begin utilizing Reception functionality with deployment of Project 2 and 6

Must begin using Reception at county soft launch Use of Reception required to meet federal Medicaid reporting

requirements Should consider suspending further use of county Reception work

management systems, unless there is a compelling reason to continue their use

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Case Routing, Work Queues, and Roles

Once a transaction is recorded at Reception, the Reception worker must either assign the task to a work queue or a specific worker to move it along the process

Supervisors currently have the ability to subscribe users to work queues

Will need to subscribe staff who will process ePASS applications to work queues prior to ePASS upgrade

Instructions for subscribing workers or units to work queues can be found in FAST Help

A few additional security roles will be added with Project 2 and 6 No major changes in direction The intent is to continue to support and work towards a

Universal Worker concept Workers who fill multiple roles will need to continue to have their

security roles changed to match current duties

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Task Utilization

NC FAST does not support “case banking” Confusion may result from the term “task management”

In the WSS context, “task management” has sometimes been used synonymously with “case banking”

Confusion may arise because NC FAST does support the management of caseloads through system generated tasks

Bottom line: Workers must be assigned to cases to receive important alerts and reminders which are sent to the case owner via system-generated tasks

Refer to DCDL dated February 8, 2013

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Universal Worker

NC FAST is being designed, and security roles are being configured, with the vision that one worker manages a household

Project 2 and 6 will not have program-specific security roles Additional roles may be added, but the same eligibility worker

and eligibility supervisor roles will be leveraged across programs A single integrated application (IEG) drives the need to adopt an

integrated interview with customers In most cases, evidence is managed at the integrated case level

Changes will ripple across all product delivery cases within the household

Counties need to plan ahead for this transition Long Term Care and Adult Care Homes could continue to be

maintained by a siloed team, since there is usually only one program per household

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Evidence Management

27

North CarolinaDepartment ofHealth & Human Services

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Next Steps and Best Practices

2828

System Functionality Impacts

With the deployment of Project 2 and 6, brand new functionality as well as enhancements to the existing NC FAST will be released:

Screening for all economic service programs can be done in NC FAST Additional questions in the Intelligent Evidence Gathering (IEG) interview script New evidence types will be available in the evidence dashboard Reception function must be used to adhere to Medicaid reporting requirements Smart Panel will be activated to provide guidance to caseworkers Supervisor Dashboard reports will be enhanced to show data for multiple programs

Multiple Product Delivery Cases if clients receive more than one benefit or service

Changes to evidence may impact all Product Delivery Cases for a client and subsequently drives the need to adopt a Universal Caseworker.

Counties will have the ability to begin attaching documentation, such as the required verifications, directly into NC FAST

NC FAST will automatically generate important tasks for caseworkers to work in order to keep cases current

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Preparation Activities

Create NCIDs for all users, ensuring each has the dhhs_ncfastprd_user role enabled on their NCID

Ensure that all cases are assigned to real workers in EIS so they can be mapped to NCIDs in NC FAST at conversion

EIS District Worker Number is the source field in EIS for mapping

Displayed as “District” on screen in EIS Validate the EIS district number to NCID mapping Complete the cleanup of any cases identified in the pre-conversion

reports Ensure that all computers and networks meet the published

minimum system requirements

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Best Practices

Expose Medicaid and Work First staff to FNS; consider cycling new hires through FNS prior to staffing in another program area

Cross-train staff on policies and concepts for all programs Consider organizational changes to support a transition to a

Universal Worker Model: Establish a common intake unit Explore creation of multi-disciplinary teams to support caseloads

so staff have easy access to people with knowledge across all programs

Consider any potential job reclassifications that may be required Determine if any physical changes to your DSS office are

required Fill all vacant positions and eliminate all case processing backlogs Create a budget for overtime and/or temporary staff Actively participate in all NC FAST preparatory activities

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Best Practices (cont’d)

Establish one point of contact with the Help Desk Get involved in Project 2 and 6 testing activities Plan ahead for network and hardware upgrades, based on Project 1

experience Consider impacts of utilizing Document Management on network

performance Reconsider need to purchase document management software Reconsider use of Reception functionality in the near term to get

familiar with the functionality Align certification periods between FNS and Medicaid cases

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Next Steps

Review Change Discussion Guide – to be mailed in the next few weeks

Attend Foundation Workshops Purpose: Day long planning workshop focused on defining

action items stemming from review of Change Discussion Guide Timeframe: March/April 2013 Audience: Focused on leaders and decision makers Location: Regional sites across the state

WSS Statewide Conference April 22-23 in Raleigh

Readiness Assessments Pre-Soft Launch Pre-Hard Launch