REQUEST FOR INFORMATION HMS 904-15-01-S

BESSD Systems Modernization Project Request for Information

BESSD RFI July 17, 2014

STATE OF HAWAII

DEPARTMENT OF HUMAN SERVICES

BENEFITS, EMPLOYMENT AND SUPPORT SERVICES DIVISION

REQUEST FOR INFORMATION

HMS 904-15-01-S

Integrated Eligibility System – Phase II (BESSD – Non-Medical Programs)

July 17, 2014



Table of Contents

1.0 Introduction ........................................................................................................... 1

1.1 Project Overview ...................................................................................................... 1

1.2 Designated Single Point-of-Contact .......................................................................... 2

1.3 RFI Schedule ........................................................................................................... 2

1.4 RFI Response Instructions ....................................................................................... 3

1.4.1 General Information ..................................................................................... 3

1.4.2 Response Format/Templates ...................................................................... 3

1.4.3 Copies of Response .................................................................................... 3

1.5 Legal Disclaimers ..................................................................................................... 3

2.0 Purpose of the Request for Information .............................................................. 4

3.0 Background ........................................................................................................... 4

3.1 Overview of Benefits, Employment and Support Services Division (BESSD) ........... 4

3.2 Vision for DHS’ Integrated Health and Human Services (HHS) Platform .................. 6

3.3 Current Technology Environment, Systems and Standards...................................... 7

3.3.1 Current BESSD Technology ........................................................................ 7

3.3.2 KOLEA Platform ........................................................................................ 11

4.0 BESSD System Modernization and Legacy Retirement Project Scope and Objectives ..................................................................................................... 12

4.1 BESSD Business Drivers and Imperatives ............................................................. 12

4.2 Project Scope and Objectives ................................................................................ 12

5.0 BESSD System Modernization and Legacy Retirement Requirements .......... 15

5.1 Description of Functional Requirements ................................................................. 15

5.1.1 Use Cases ................................................................................................ 16

5.1.2 In-Scope Eligibility Determination Use Case.............................................. 16

5.2 Description of Target Environment and Non-Functional Requirements................... 20

5.2.1 Solution Architecture Principles and Guidelines ........................................ 20

5.2.2 DHS Enterprise Platform Overview ........................................................... 22

5.2.3 KOLEA Architecture Overview .................................................................. 24

5.2.4 Technology Components Deployed as a Part of KOLEA ........................... 27

5.3 Current KOLEA Status and Scope ......................................................................... 37

5.3.1 Implementation Sequencing Preference and Considerations .................... 37

5.3.2 Maintenance and Operations and Hosting Considerations ........................ 38

5.4 Multi-Party Development and Hosting Environment Vendor Coordination .............. 40

5.4.1 Multi-Source Service Integration Requirements ......................................... 41



6.0 RFI Response Templates .................................................................................... 43

7.0 Description of RFI Library .................................................................................. 44

8.0 Glossary of Terms ............................................................................................... 45


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1.0 Introduction

The Hawaii Department of Human Services (DHS) is issuing this Request for Information to gain greater insight from the vendor community regarding DHS’ effort to further develop a technology platform that will provide support for a more integrated approach to the planning, policies, model of practice, accountability and delivery of its programs and services. It is DHS’ expectation that this future technology will consist of an integrated, DHS-wide human service enterprise platform that will provide core business functionality for a more person/family centric business model rather than the traditional program centric silo approach to technology support.

Through the Affordable Care Act (ACA), DHS has begun the process of developing an enterprise platform referred to as Kauhale On-Line Eligibility Assistance (KOLEA). KOLEA supports the initial build-out of the DHS enterprise platform focused on the installation and configuration of the key components essential to achieve integrated eligibility based on Modified Adjusted Gross Income (MAGI) eligibility criteria and the expansion of Medicaid services through the State of Hawaii’s Medicaid program known as Med-QUEST. With the enhanced federal funding, DHS has established, through KOLEA, the core components for the envisioned DHS enterprise platform.

In the near future, DHS is planning on issuing a Request for Proposal (RFP) to develop functionality for the Benefit, Employment and Support Services Division (BESSD) leveraging the KOLEA platform and retire the State of Hawaii’s legacy integrated eligibility and benefits management system known as Hawaii Automated Welfare Information (HAWI) and the over-payments management system known as Hawaii Accounts Receivable Information (HARI). This project will include the incumbent vendor enhancing the KOLEA platform to support multiple DHS divisions while, concurrently and independently, the BESSD functionality is built out. The information gained through the Request for Information (RFI) will support DHS’ analysis of alternatives for the retirement of HAWI and HARI and further the establishment of DHS’ integrated human services enterprise platform leveraging the KOLEA platform where possible.

Although there is an incumbent vendor who is implementing the Med-QUEST (Medicaid) eligibility functionality on the KOLEA platform, DHS is committed to an open competitive approach for the future BESSD RFP and is interested in understanding from the vendor community viable approaches to achieving the next critical steps for DHS’ vision. Therefore, this RFI is being issued to gain insight from the vendor community to support DHS’ analysis of alternatives and the development of the forthcoming RFP.

1.1 Project Overview

The Hawaii Department of Human Services (DHS) is comprised of four (4) divisions with about twenty-two hundred (2,200) positions and an annual operating budget of approximately $2.7 billion.

The BESSD provides a continuum of services, through nine (9) programs that serve different populations, aimed at providing clients with monthly benefits to assist them with such essentials as food, shelter, and child care, as well as employment support and work-training to prevent them from becoming welfare dependent.

The Med-QUEST Division (MQD) provides health coverage, primarily through managed care plans, to low-income families, children, and individuals.


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The Social Services Division (SSD) provides services for abused adults and children, family strengthening, child abuse and neglect prevention services, and licensing certain long-term care homes.

The Division of Vocational Rehabilitation (DVR) helps persons who are disabled or blind to become employed, start their own businesses and live independently.

Although these are separate Divisions, DHS’ vision for the future is to move to a more integrated approach for the assessment and delivery of its programs and services based on a person/family centered model of practice.

The first phase of implementing an integrated platform to support DHS’ vision is KOLEA which is nearing completion. It is focused on the MAGI requirements for Medicaid expansion under ACA. The next phase of building the DHS integrated human services enterprise platform is to implement functionality to support the BESSD business units and the retirement of the legacy HAWI and HARI systems. Future phases will include modernization of the current system supporting the State of Hawaii’s Social Services (Child Welfare Services, Adult Protective Services, Foster Care for Children in Hawaii, and Missing Children).

1.2 Designated Single Point-of-Contact

State of Hawaii DHS’ official single point-of-contact for all vendor communications related to this RFI and the delivery point for all responses and correspondence is:

Alfredo Lee

Department of Human Services

Benefits, Employment & Support Services Division

820 Mililani Street, Suite 606

Honolulu, HI 96813

Telephone: (808) 586-5729

FAX: (808) 586-5229

e-mail: [email protected]

1.3 RFI Schedule

The following is an estimated timeline for the RFI process:

Procurement Schedule

RFI Release Date Step 1. July 17, 2014

Vendor Questions Due Step 2. August 1, 2014

Responses to Vendor Questions Posted Step 3. August 8, 2014

RFI Responses Received Step 4. August 22, 2014

mailto:[email protected]


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1.4 RFI Response Instructions

This section describes the requested response format and additional instructions for interested vendors. This format will allow both vendors and DHS to focus their effort on providing and collecting the specific information required to meet the RFI objectives.

1.4.1 General Information

As noted, this RFI is being issued to gain better insight from the vendor community on how to position the Design, Development and Implementation (DDI) services required for deploying the required functionality to support the BESSD business units aimed at achieving the retirement of HAWI and HARI and to further build-out the DHS enterprise platform.

Section 6 of this RFI includes the list of the templates to ensure the responses address the specific questions and to focus the vendor’s efforts. DHS requires vendors submit response using these templates. Respondent may include additional literature, specification sheets, handouts, brochures, or other information prepared either for general distribution or specifically for this RFI that relate to the areas of interest listed in Section 3 through Section 6 of this RFI. Any of these additional materials must be tied to a specific template and not randomly submitted as these templates focus on the information which DHS is trying to capture.

Responses must be submitted to DHS’ designated point-of-contact, identified in Section 1.2.

Upon review of the RFI submission, DHS may contact respondents and request further information.

Responses must be made in accordance with the rules and guidance laid out below and elsewhere in this document. Responses to this RFI are due on August 22 at 4:00 p.m., Hawaii Standard Time.

1.4.2 Response Format/Templates

Templates have been included as attachments to this RFI for vendors’ responses. The vendors must submit their responses in these templates and include a letter signed by an individual Respondent who will be the contact person for matters relating to this RFI. Contact information for the Respondent’s contact person must be provided. (This refers to “organization” only).

(The Letter of Transmittal must identify the respondent’s single point of contact for the RFI and list the RFI documents being provided in response to the RFI. The Letter of Transmittal must include an Executive Summary of the respondent’s submission.)

1.4.3 Copies of Response

Please mail or deliver one (1) hard-copy and one (1) electronic version (on CD or USB-drive) to the designated DHS point-of-contact by the date and time specified in this RFI. Responses must be double spaced in 12-point type. Electronic submissions must be in, or compatible with, Microsoft Office applications.

1.5 Legal Disclaimers

The information received will assist DHS in preparing specifications for a potential subsequent solicitation. Specifications may not be limited to the above and may be expanded based on information gained as a result of the RFI process.


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This RFI solicits input from any and all vendors to formulate the criteria to compose a competitive solicitation for the BESSD legacy HAWI and HARI system retirement project.

DHS reserves the right to incorporate into its solicitation, if/when issued, any recommendations or comments presented in response to this RFI. Neither DHS nor the vendor responding has any obligation under this RFI.

DHS shall not provide any reimbursement for the cost of developing, presenting, submitting, or reviewing any information in response to this RFI.

This RFI does not constitute a solicitation of proposals, a commitment to conduct procurement, or an offer of a contract or prospective contract. DHS will not award a contract as a result of this RFI. DHS will not be liable for any costs incurred by respondents in the preparation and submission of information in response to this RFI.

2.0 Purpose of the Request for Information

The Hawaii DHS is requesting qualified vendors to assist in their analysis of alternatives and development of a Request for Proposal (RFP) by supplying information for:

Securing technology enablement for DHS’ vision for a more integrated approach to the planning, policies, model of practice, accountability and delivery of its programs and services

Meeting BESSD business functionality and the retirement of the legacy HAWI and HARI systems, leveraging and the further build-out of the KOLEA platform where possible

The purpose/objectives of issuing this RFI are to:

Understand the alternatives for achieving DHS’ vision for technology enablement to support a more integrated approach to DHS programs and services

Gain clarity on approaches for leveraging the investments to date and further build-out the KOLEA platform

Identify what additional technology components and services may need to be added to the KOLEA platform to address BESSD business functionality and DHS’ vision for an integrated health and human services enterprise platform

Identify the appropriate sequencing and timeline for the DDI effort and eventual retirement of the legacy solutions (HAWI / HARI). For planning purposes and for developing required Federal planning documents, obtain order of magnitude costs estimates

Gauge the level of interest and availability of the vendor community in responding to a future RFP

3.0 Background

3.1 Overview of Benefits, Employment and Support Services Division (BESSD)

BESSD is the largest division in the Department of Human Services and has approximately 678 employees and 43 offices. Staff and administrators provide a continuum of services, through


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nine (9) programs that serve different populations, aimed at providing clients with monthly benefits to assist them with such essentials as food, shelter, and child care, as well as employment support and work-training and dependency diversion and prevention. The programs administered by BESSD include:

Temporary Assistance for Needy Families (TANF) and Temporary Assistance for Other Needy Families (TAONF)

General Assistance (GA)

Aid to the Aged, Blind, and Disabled (AABD)

Supplemental Nutrition Assistance Program (SNAP) – formerly known as the Food Stamp Program

Low Income Home Energy Assistance program (LIHEAP)

Homeless Programs (HP)

First-To-Work (FTW)

Employment and Training (E&T)

Child Care Subsidy and Licensing

Often, individuals receive assistance from multiple programs. As a result, with the exception of the Homeless Programs, Childcare and LIHEAP, all of the programs have been integrated into one process for applying and eligibility determination and all benefits are paid onto one Electronic Benefit Transfer (EBT) card for each Client. Below is a list of the number of Clients by program in 2013:

Table 1. Number of Clients by Program

Program # of Clients

SNAP 94,649 families

Childcare 19,863 families

TANF/TAONF 9,829 families

GA 5,722 individuals

FTW 6,591 individuals

E&T 6,038 individuals

AABD 898 individuals

LIHEAP 9,529 families


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3.2 Vision for DHS’ Integrated Health and Human Services (HHS) Platform

DHS’ stated Mission is:

“Our committed staff strive to provide timely, efficient and effective programs, services and benefits, for the purpose of achieving the outcome of empowering those who are the most vulnerable in our State to expand their capacity for self-sufficiency, self-determination, independence, healthy choices, quality of life and personal dignity.”

Historically, each DHS program has provided benefits to the clients they serve independent of each other and unaware of any other services the clients are receiving from other programs. DHS’ vision is to migrate from this “agency-centric” approach to a “person/family centric” approach in providing services as illustrated in Figure 1.

Figure 1. Moving from Agency-Centric to Person/Family Centric Approach to providing Services

The transformation to a person/family centric approach drives significant changes in how the Department views and what they expect from technology enablement. To deliver on DHS’ vision, the technology environment must be integrated as one platform and become integral to the business’ ability to effectively manage their relationship with the clients, and improve the effectiveness of the programs.

Figure 2 profiles the transformation DHS sees for the future of information technology and its expectations for support of business transformation.

Figure 2. Impact on IT of Health and Human Services (HHS) Business Transformation


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3.3 Current Technology Environment, Systems and Standards

3.3.1 Current BESSD Technology

Until recently, both the MQD and BESSD used the HAWI System to manage their programs. As of October 2013, all of the Med-QUEST functionality related to healthcare benefit eligibility determination and benefits management has been migrated to the KOLEA platform based on the Oracle SOA software stack and Oracle Siebel CRM Public Sector. BESSD, along with certain department level support organizations (e.g., overpayment collections, appeals, etc.) continue to use HAWI as their primary system. Additional applications around HAWI have been added to better support the business users and meet the changing needs. As depicted in Figure 3 and described below, the primary systems include:

HAWI (Hawaii Automated Welfare Information) system is a 25 year old system on an IBM mainframe platform that was transferred from Arizona, and relies on several software development languages (Natural, COBOL, and Assembler software development languages) and Software AG ADABAS database management system to deliver the current integrated eligibility functionality for DHS related benefits and services. There are over 900 users across the State of Hawaii who access and use the system to process applications and requests for public benefits.

HANA (Hawaii Automated Network for Assistance) is an online, interactive and integrated system that provides computerized services for the selection of candidates from the client pool, and perform intake, orientation, assessment and planning of services for families who require work-related supportive assistance. HANA is designed to provide online client tracking, case management, payment and process automation. In addition, HANA supports the licensing and certification of childcare providers and administering childcare benefits to recipients. The application provides computerized


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report capabilities for line staff and administration as well as integrated, real-time inquiry into HAWI information crucial to performing HANA related work tasks. HANA is a 3-tier, J2EE application which shares its data tier on ADABAS on the Mainframe with HAWI. There are over 40 shared tables with HAWI, and all data manipulation logic is implemented in Natural. HANA uses Software AG’s EntireX product to access the data on the mainframe, and maintains key reference data (e.g., code tables) on a DB2 database running in Linux. The developers use Apache Subversion for source code management and version control. There are also two portals that allow browser based access for internal and external users using IBM Notes and Domino technologies. There are more than 300 users who access HANA functionality to support the related business processes.

HARI is an Accounts Receivable System which supports BESSD through managing overpayment collections. This functionality crosses all programs administered by BESSD. The system maintains claim balances by accepting payments, reimbursements and adjustments. The claim balances in HARI provides HAWI case workers with current overpayment balances and activities relating to their client's accounts. HARI is a mainframe-based application transferred from Arizona’s Accounts Receivable Integrated Collections System (ARICS) and built on Software AG’s Natural and ADABAS.

ePathos is a stand-alone, cloud-based application which was developed recently to provide process monitoring and controls for the different branch offices. It supports logging applications as they are received, monitoring them through the process and, as a result, this provides BESSD with the visibility to workload and align their resources with the workload.

Electronic Case Folder (ECF) is a content management system that was recently implemented to migrate from paper to electronic case files. The system includes scanners, workflow for processing paper documents and the IBM FileNet back-end.

Integrated Voice Response (IVR) system is integrated with HAWI and HANA and pulls information to provide users with automated responses to specific questions. BESSD is in the process of migrating to a cloud based IVR solution which should be implemented prior to the start of the HAWI Modernization project.

HRMS is an application that tracks system usage so costs can be allocated between programs based on usage.

INVO database tracks all cases under investigation state-wide. The database is in the process of being converted from Access to SQL Server.

Multiple loosely integrated small databases and applications have been developed to support the smaller programs (e.g., LIHEAP) and specific tasks (e.g., Appeals).


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Figure 3. High Level BESSD Application Architecture

HAWI interfaces with a number of other state and federal systems including:

Bank Match – Obtains account balances from selected banking institutions on all active HAWI clients over 17 years of age

Child Support — Provides the Child Support Enforcement Agency (CSEA) with information on any new TANF and Medicaid cases which become eligible during the month, as well as any changes that were made to these existing cases. Additionally, DHS will receive from CSEA, information on child support monies collected, pass through information and Third Party Liabilities (TPL) updates.

Department of Labor Wage Match (State Wage Information Collection Agency -SWICA) and Unemployment Insurance — Matches HAWI clients against the Department of Labor's computer system to determine if HAWI clients are receiving Unemployment Insurance Benefits which have not been reported or have earnings which were not reported.

Internal Revenue Service – Generates a 'Request Tape' of all active HAWI clients and sends it to the Internal Revenue Service; who will generate a 'Reply Tape' to DHS reporting any applicable unearned income for clients in HAWI.

Social Security Administration (SSA) SDX Disability Income Verification – Determines if welfare applicants/recipients reported receipt of SSI (Supplement Security Income-Disability) Income. Procedurally, the State of Hawaii receives a monthly SDX interface tape file from the Social Security Administration which contains data other than SSI income.


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SSA Enumeration – Updates the HAWI client record with a new social security number (SSN) assigned by the Social Security Administration.

SSA BENDEX – Obtains from the Social Security Administration benefit entitlement information on new clients, and informs SSA of any clients or cases which become ineligible and/or the case is closed during the month.

SSA SMI Buy-In – Identifies (by use of buy-in transaction codes) ongoing buy-in eligible clients, as well as potential buy-in eligible clients between the federal Health Care Financing Agency (HCFA) and the State of Hawaii, DHS.

SSA BEER (Beneficiary Earnings Exchange Records) Reports — Requests earnings information from the Social Security Administration regarding active HAWI clients.

SSA SSN Verification Extract File – Verifies all active HAWI client's reported Social Security Number through the Social Security Administration.

SSA Part-A – Identifies ongoing Part-A eligible clients, as well as potential buy-in eligible clients who have the TPL code of 'PM' on the EPST screen.

KEIKI Information Interface – Updates HAWI, on a monthly basis, with information from the State of Hawaii’s Child Support system (KEIKI) for the prior month. The Child Support system will generate five monthly KEIKI interface files containing child support information to be loaded into HAWI. The five interface files are: KEIKI Disbursement file, KEIKI Person file, KEIKI Receipt file, KEIKI Obligation file, and the KEIKI Case file.

Department of Labor and Industrial Relations – Ensures that Food Stamp recipients are in compliance with the State of Hawaii's work registration requirements.

Hawaii Accounts Receivable Information (HARI) – Loads overpayment information from the Automated Recovery System (ARS) into the HAWI database for online inquiry. The data is updated on a weekly basis. A monthly match run against HAWI's active recipients identifies recipients who are delinquent in their repayments and generates an alert for the Eligibility Worker.

JP Morgan – JP Morgan currently manages the EBT and Direct Deposit transactions on behalf of BESSD. HAWI provides EBT card and direct deposit information to JP Morgan who credits the appropriate accounts and manages any subsequent transactions against the EBT cards.

Hawaii Department of Accounting and General Services (DAGS) – DAGS manages the State of Hawaii’s accounting system, Financial Accounting Management and Information System (FAMIS). HAWI provides accounting transactions as a subsidiary accounting system.

Hawaii Automated Network for Assistance (HANA) – HANA is integrated with HAWI using a shared database tables.

In addition HAWI currently provides data/files to a variety of other State of Hawaii agencies as scheduled (e.g. monthly, semi-annually or annually) or on demand.

These applications are hosted at the State of Hawaii’s Data Center and printing and reporting is performed by the State of Hawaii through the HAWI System. Additional information regarding these interfaces can be found in the RFI Library.


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The table below provides a mapping of the primary applications supporting the specific DHS programs.

Table 2. BESSD Program Support by Application

Program Primary Application

Temporary Assistance for Needy Families (TANF) and Temporary Assistance for Other Needy Families (TAONF)

HAWI

First-To-Work (FTW) HANA*

Child Care Program Office HANA*

Employment and Training (E&T) HANA*

General Assistance (GA) HAWI

Aid to the Aged, Blind, and Disabled (AABD) HAWI

Supplemental Nutrition Assistance Program (SNAP) – formerly known as the Food Stamp Program

HAWI

Hawaii Electronic Benefit Transfer (EBT) Program HAWI, HANA

Homeless Programs (HP) & Information HMIS

Low Income Home Energy Assistance program (LIHEAP) Access/desktop tools support

* Although the users interact with HANA, some of the back-end functionality is provided by HAWI

3.3.2 KOLEA Platform

DHS has invested significant resources into the development of a contemporary Integrated Eligibility Solution on a Service Oriented Architecture (SOA) platform using enhanced Federal Financial Participation (FFP) aligned to the Affordable Care Act (ACA) and OMB A-87 Cost Allocation Exception Waiver to support MAGI and Medicaid Expansion. The first phase of DHS’ integrated eligibility system, known as KOLEA, focused on the MAGI eligibility requirements to support Medicaid expansion.

The KOLEA System is being implemented using multiple Commercial Off-The-Shelf (COTS) technologies including Siebel CRM, Oracle OPA, Oracle Fusion Middleware (OFM), Oracle WebLogic, Siebel UCM, and Oracle OBIEE. Additional information regarding the KOLEA platform is included in the RFI library.

KOLEA’s architecture incorporates various public sector best practices and adheres to Hawaii and federal standards. The foundation for KOLEA architecture is the SOA framework that leverages proven methodologies and best of breed products in the marketplace. More information about the desired architecture and KOLEA can be found in section 5.2 of this document.

DHS’ vision is to move computer access by all the divisions onto the new KOLEA platform. This will include developing the required BESSD functionality through leveraging the KOLEA platform as much as possible and adding the capabilities for other applications to integrate with the platform. For example, in the near future, the Social Services Division (SSD) will look to leverage some of the KOLEA functionality to meet the Program’s needs and/or integrate adult and child welfare specific applications with the KOLEA platform.


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4.0 BESSD System Modernization and Legacy Retirement Project Scope and Objectives

4.1 BESSD Business Drivers and Imperatives

The key drivers for BESSD System Modernization and Legacy Retirement are aligned with DHS’ vision for a more integrated approach to planning, policies, model of practice, accountability and delivery of services and programs supported through technology enablement. The person/family centered model of practice envisioned for DHS and BESSD places emphasis on consumer empowerment and robust partnership with those served. This includes migrating DHS to a common, integrated enterprise technology platform so data and shared components and services can be leveraged across DHS divisions to improve business performance and outcomes. BESSD key drivers and imperatives for technology enhancements include:

Business Drivers –

Consumer self-service

Enhance access, outcomes, cost and quality of services

Robust decisions support at all levels to Anticipate, Support and Validate key decisions and activities

Staff will expect the new system to minimize time spent on administrative tasks

Business Imperatives –

The System must support BESSD’s To-Be Model of Practice

Allow beneficiaries to seamlessly use any channel to interact with the agency (e.g., start an application on line, complete in the office)

Standardize processes, particularly cross-program processes (e.g., eligibility, customer support, billing)

Leverage KOLEA components where ever possible (shared portal, enterprise bus, identity/access management, MDM and rules engine)

Provide one integrated decision support and data analysis platform to support department level metrics and analysis (enterprise wide business intelligence)

Establish capability to centralize/distribute workload (e.g., phone calls)

Reduce the time required to gather, process and share information

Simplify and standardize eligibility determination criteria

Improve integration to avoid and recover fraudulent payments and overpayments

4.2 Project Scope and Objectives

Until recently, both the MQD and BESSD used the HAWI system for integrated eligibility to their programs and services. HAWI was used by BESSD for the management of State of Hawaii’s benefits and life of a benefits case. Through development and deployment of KOLEA, Medicaid eligibility has been migrated from HAWI to KOLEA. DHS will be issuing a forthcoming RFP to move forward with the retirement of HAWI and HARI and the expansion of KOLEA to provide


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eligibility support for all DHS programs and services. Currently HANA and associated business processes are not in scope of this project. However, the System will need to integrate with the HANA System as it will be retained for the time being as a separate system. As a result, eligibility and payment information must be synchronized between the HAWI and HANA.

HAWI is a 25 year old system on an IBM mainframe platform which relies on software and data base languages including COBOL software development language and ADABAS database management system. Thus, HAWI is a challenge to maintain and enhance. The HAWI environment is not agile, flexible, easily extensible or supportable in meeting the significant changes the State of Hawaii has faced in the focus, mandates and management of its public assistance programs nor to support DHS’ vision for a more integrated approach to its programs and services.

Through KOLEA, DHS has invested significant resources into the development of a contemporary Integrated Eligibility Solution on a Service Oriented Architecture (SOA) platform as described in the prior section. This RFI focuses on DHS’ next set of technology enhancements that will include expansion of eligibility determination and benefits management for the following BESSD programs and services through the leveraging of the investments in KOLEA and the retirement of HAWI.

DHS envisions that this next wave of enhancements will be done through phased releases and set the foundation for even more enhancements to DHS’ technology modernization in the future.

For this RFI process, DHS is considering the following potential phased enhancements:

Identification of any additional components or services that will be needed for the KOLEA platform that will also be needed for the State of Hawaii’s Medicaid program and thus able to leverage enhanced CMS 90/10 funding before expiration of that funding stream in December 2015

Development of a robust horizontal portal to provide a single user interface for supporting BESSD business functionality while developing the new and retiring the old efforts are achieved for the HAWI system and other BESSD solutions that may be possible

Implementation of robust business intelligence and reporting capabilities for BESSD and leverageable by other DHS programs and services

Establishment of a leverageable and integrated enterprise platform for DHS that can be used by other DHS programs and services such as the Social Services Division’s Child and Adult Services

The future system functions/modules may include, but may not be limited to the following:

Integrated (all financial programs) submittal and processing of benefits applications, including –

Complete self-service anonymous pre-screening

Apply for benefits online

Assist applicant with self-service tools

Apply for benefits in person with an eligibility worker

Process a paper application


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Conduct eligibility interview and determine eligibility

Submit additional electronic documentation by client

Process documentation received in hard copy (Staff)

Managing medical referrals

Process eligibility determination or re-determination upon receiving additional information

Issue benefits, including –

Issue an EBT card to a client

Transmit approved payments to EBT vendor

Send accounting information to State Financial Systems

Ongoing benefits management and eligibility review, including —

Complete re-determination application online

Process six month re-determination application

Complete re-determination interview

Complete re-determination in person with eligibility worker

Submit a client change

Process client changes

Benefits recovery — setup collection method

Benefits recovery — process and monitor overpayment collections

LIHEAP eligibility determination and management, including –

Complete LIHEAP enrollment process

Process LIHEAP payments

Back-end administrative support including statewide caseload management, managing appointments and calendars, random moment study, ePathos and ECF’s existing and expanded functionality (Appeals, Q.C. and INVO support).

Additional details are provided in Section 5.1, Description of Functional Requirements.

In addition to supporting the functionality listed above, the vendor must support interfacing the other systems listed in this document. As mentioned above, the HANA Solution currently shares a database with HAWI. The current plan is to replace HANA with an independent application that can be integrated with the KOLEA platform. The new HAWI system must integrate with HANA so the Client experience is seamless as they migrate between the integrated eligibility process and First-to-Work, Employment and Training and other programs supported by HANA. This integration between the remediated HANA and the KOLEA platform should be included in the respondent’s cost estimate.

DHS is seeking information from qualified vendors on how they would support enhancements to the KOLEA platform to meet the BESSD’s business needs as defined through detailed functional requirements. DHS is interested in the vendor’s history of success in developing and


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supporting products in the functional areas described above as well as capacity to provide the resources for the full project life cycle.

5.0 BESSD System Modernization and Legacy Retirement Requirements

5.1 Description of Functional Requirements

DHS has identified functional and non-functional requirements for the BESSD modernization project. The requirements address the envisioned new capabilities as well as existing capabilities from the legacy HAWI and HARI systems required to achieve the objectives outlined in Section 4.0. The key business functionality for BESSD is illustrated in Figure 4.

Figure 4. BESSD Key Business Functionality

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A comprehensive Business Process Analysis (BPA) has been conducted to ensure that the next generation BESSD Modernization System is aligned with the BESSD desired model of practice and meets all federal operational requirements and the specialized needs of the DHS programs and Services in Hawaii. The To-Be processes were documented in Workflow and Use Case forms to describe the evolved functionality required for the future modernized, SOA-Based System. The Functional Requirements analysis identifies opportunities to strengthen eligibility determination, shared analytics and statewide data sharing in the future.

Sample Business Process Flows and Use Cases are provided in the RFI Library.


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5.1.1 Use Cases

The Use Cases listed below capture the business functionality that is supported by the HAWI system. This currently defines the scope of the Modernization Initiative; however the scope could be modified based on feedback received from this RFI.

5.1.2 In-Scope Eligibility Determination Use Case

As discussed above, HAWI is the primary system that supports the BESSD programs, and along with the HARI system, is being replaced by the new system. The new system will need to support:

Application pre-screening for all programs

Application processing, interviewing clients and eligibility determination for all programs

Processing of referrals

Ongoing eligibility reviews/redeterminations and processing changes

Scanning and Processing all paper documents received by BESSD

Issuing of EBT cards, tracking all financial transactions and reporting to partners (EBT Vendor and State of Hawaii Accounting Systems)

Figure 5 and 6 illustrate the universe of Use Cases that capture the functionality that must be supported by the BESSD modernization initiative.


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Figure 5. Graphic Description of In-Scope Eligibility Determination Use Cases

Applying for Eligibility Determination Use Cases

■ Complete Self-Service Anonymous Pre-screening – The Applicant navigates to the new BESSD System and answers preliminary questions to evaluate whether they may be eligible for benefits

■ Apply for Benefits Online – The Applicant logs into the System and submits an eligibility application and schedules an interview

■ Apply for Benefits In Person With an Eligibility Worker – The Eligibility Worker meets with the Applicant, completes the application and interview and determines eligibility (the Applicant has not completed the application prior to the interview)

■ Process Paper Application – The Documentation Processing Staff Worker processes paper applications submitted by Applicants which are either determined complete (and ready for an interview) or incomplete

■ Conduct Eligibility Interview and Determine Eligibility – The Eligibility Worker meets with the Applicant and performs the interview in person or via the phone (the Applicant has completed the application prior to the interview)

■ Submit Additional Electronic Documentation (Client) – The Client logs onto the System and submits documentation of any sort. The System then assesses the Client’s or Applicant’s case to identify the appropriate next steps

■ Process Documentation Received in Hard Copy (Staff) — The Documentation Processing Staff Worker scans paper documents, adds the documents to the electronic case file and the cases are flagged for appropriate action


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■ Process Eligibility upon Receiving Additional Information – After additional information is submitted (and the application seems to be complete), the Eligibility Worker reviews the completed application and determines eligibility (if possible)

■ Complete LIHEAP Enrollment – Review integrated eligibility applications that are requesting LIHEAP benefits and identify those which require updated information

■ Process LIHEAP Payments – Review approved applications, approve payment amount and process payments to the appropriate utility company (to be credited to the Client’s utility account)

■ Issue an EBT card to an Applicant – The EBT Card Distributor provides the EBT card to the qualified Applicant and collects the wet signature.

■ Send Authorized Benefits Information to EBT Vendor – The System identifies all authorized payments for each Client and sends a file to the EBT Vendor. Payments can be from any of the programs including reimbursement for First-to-Work expenses

■ Send Financial information to State Accounting System – The System identifies all payments made to Clients and Vendors and transmits financial transactions to the State Accounting System (FAMIS)

On Going Eligibility Determination Use Cases

■ Complete the Re-Determination Application Online – The Client logs into the System and completes their re-determine application (Eligibility Review or 6 Month Review)

■ Process the Six Month Re-Determination Application — The Eligibility Worker reviews the completed application and determines eligibility

■ Complete Re-Determination Interview – The Eligibility Worker meets with the Client and performs the re-determination interview (the Applicant has already been completed the application prior to the interview) and determines eligibility

■ Complete Re-Determination Application and Interview with an Eligibility Worker — The Eligibility Worker meets with the Client, completes the application and interview and determines eligibility (the Client has not completed the application prior to the interview)

■ Submit a Change – The Client logs onto the System (or a paper Change Form has been processed) and submits a change to their current eligibility

■ Process Client Changes – The Eligibility Worker processes a change (Client submitted or identified by the System) and re-determines eligibility


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Figure 6. Graphic Description of In-Scope Supporting Use Cases

Related Use Cases

■ Obtain Assistance with Self-Service Tools – The Applicant contacts BESSD and requests assistance for completing an online task

■ Random Moment Time Sampling Study – Track and capture time employees spend working on activities related to the different programs

■ Schedule an Appointment (Self-Service) – Clients schedule an appointment with an eligibility worker online

Recover Overpayments – The Collections Officer decides whether the overpayments should be collected through recoupment (deduct from future benefits) or direct payment. The System sends overpayment statements to Clients and monitors performance against collection plan

Submit Online Payment – Clients log onto the System and submit payments directly through direct debit or credit card

Receive a Payment – BESSD receives a payment (online or check) from a Client and processes the payment

Conduct Quality Control Audit – Perform random audits of the eligibility determinations in compliance with the Federal Government’s regulations. This includes auditing all documentation, performing interviews and providing documents to the Federal Government


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Conduct Investigation – Support the process of investigating any potentially illegal activity within any of the BESSD programs

Appeal Eligibility Determination or Re-determination – Track all Client appeals of the eligibility determination. This includes tracking a review by the eligibility workers and scheduling and tracking Fair Hearings

These Use Cases capture the envisioned functions of the systems needed by the BESSD users to perform their day to day activities. The Use Cases focus on “What” the system must do and are not intended to propose a specific implementation or design (the “How”). The System also needs to provide the back-end functions such as managing the work queues, prioritizing work and matching work to qualified staff and tracking the funding source for each benefit payment.

The new system must support integration with all of the systems to which HAWI is currently integrated (listed in section 3.3.1), although the approach to integration may change (e.g., real-time vs. batch). In addition, the System will need to integrate with the HANA System as it will be retained for the time being as a separate system. As a result, eligibility and payment information must be synchronized between the HAWI and HANA. Additionally, BESSD would like to increase integration with external systems to improve the eligibility determination process. External systems for integration consideration include:

The provider of medical assessments (Cyrca)

Vital statistics queries (query only)

Bureau of Motor Vehicles (query only)

PARIS (query only)

Electronic Disqualified Recipient system (eDRS)

Department of Corrections (query only)

National Directory of New Hires (NDNH) (query only)

5.2 Description of Target Environment and Non-Functional Requirements

5.2.1 Solution Architecture Principles and Guidelines

To achieve the vision for the continuum of DHS programs and services, DHS has developed a conceptual model and a broad set of guiding principles to support an integrated HHS services model of practice through the enablement of technology. These principles will guide the State of Hawaii’s procurement strategy for BESSD’s new eligibility and benefits management system and other future DHS new systems development. The principles include:

Support the Enterprise Mission and Objectives: The solution architecture should be optimized to support BESSD’s business imperatives and core business processes

Focus on User Needs: The Solution Architecture must support BESSD consumers, State of Hawaii staff and trading partners (contracted providers and other State of Hawaii agencies) through content rich and user friendly interfaces via multiple channels

Technology Solutions Aligned to Agency Requirements: Design technology solutions aligned with architecture standards to accommodate agency requirements


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while minimizing the number of departmental applications (eliminating duplication and overlap wherever possible)

Enable Data Sharing: The Solution architecture must enable enterprise-wide data sharing and also provide flexible data access for users (staff, trading partners, etc.)

Ensure Privacy and Confidentiality: The Solution architecture must ensure the privacy and confidentiality of personal data, and comply with all privacy and confidentiality laws and regulations.

Manage Information as an Enterprise Asset: DHS will establish processes to manage data as an enterprise asset

Enhance Decision-support: The Solution architecture must enable the provision of timely and accurate decision support information to users

Create a “Real-Time” Integrated Enterprise: The Solution architecture must enable all users to have current and up to the second information regarding all client’s interactions with BESSD and other DHS Programs, enabling improved sharing of data and information across agencies

Robust Infrastructure Capabilities: The Technology Architecture must be designed to ensure high availability and redundancy to consistently meet users’ availability requirements

Alignment with Industry Trends: Technology infrastructure components will be selected that are in line with industry trends, and based on long term vendor viability and support capabilities

Service-Oriented: The target solution architecture should consist of a number of business and technical services that are compliant with industry standards for service-oriented architecture to facilitate reuse, adaptability and interoperability — Build it Once – Use it Many Times

Interoperability Standards: The solution must be built upon Federal standards and related implementation efforts, including Centers for Medicaid and Medicare Services (CMS), Centers for Disease Control and Prevention (CDC), National Institute of Standards and Technology (NIST) the Office of the National Coordinator Health Information Technology (ONC HIT) Standards Committee and those for the Nationwide Health Information Network (NHIN), and comply with emerging national interoperability standards for content exchange, vocabulary/notation and privacy/security

Investment Protection: Provide the ability to integrate with existing HHS system platforms and health information exchanges

Independence: Keep architecture skills separate from product and implementation vendors’ dependencies to maintain vendor and technology neutrality in the development of the architecture

Scalable and Extensible: Provide incremental expansion of functionality over time on a base that is scalable to accommodate additional users and extensible in expanding capabilities to meet future business needs and Federal and State mandates

DHS has determined that the Target Solution Architecture for its programs and services, based on an approach that leverages an integrated HHS services platform, must be based on a


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Service Oriented Architecture (SOA). Specifically this means that the proposed solution architecture for DHS systems development must adhere to the following five principles:

1. The System must be modular. Each component of the Target System must be a service consumer, service provider or both. Modules must exist at a variety of levels of granularity (e.g., at a business process level such as certification or benefits issuance to simplify alignment with key business processes and at lower levels such as data services for a single database table to enable reuse across the application and the whole architecture).

2. The modules must be distributable. Modules of the Target System must be able to run on disparate computers and communicate with each other by sending messages over a network at runtime. Software components in an SOA application are almost always hosted on disparate computers in different locations, often miles or even continents apart. SOA applications are inherently distributed applications across multiple software and hardware tiers.

3. Module interfaces must be clearly defined and documented. It is important for the Target System to include a standard mechanism for defining SOA interfaces such as the Web Services Description Language (WSDL) and a registry or repository to make these interface definitions available to application developers.

4. A module that implements a service can be swapped out for another module that offers the same service and interface. This is an aspect of loose coupling and it enables incremental maintenance and enhancements without making other changes to the entire Target solution. This principle must be fulfilled by separating the implementation (the service provider module's code and data) from the interface metadata.

5. Service Provider modules must be shareable. This means that modules are designed and deployed in a manner that enables them to be invoked successively by disparate Service Consumer modules engaged in somewhat diverse, although partially related, business activities.

It is DHS’ intention to choose solutions and design alternatives that most closely follow these principles in their approach and meet all or as many of the requirements as defined in the Functional and Technical Requirements discussions. The working hypothesis is that given the state of today’s technological capabilities and offerings, DHS can procure a cost effective and agile IT solution that will become the foundational Enterprise Platform for all DHS automation needs for the next 7-10 years.

5.2.2 DHS Enterprise Platform Overview

DHS wants to build upon the investment in KOLEA and envisions an enterprise approach for Information Technology (IT) investments for DHS Programs and Services which places emphasis on establishing a set of standards for hardware, software, interoperability, data governance, management & operations (M&O) and hosting of the technical solutions supporting the enterprise’s business operations.

This vision focuses on the technical approach for leveraging KOLEA and other new common Service Oriented Architecture (SOA) components and Shared Services that can provide business functionality across DHS business domains.


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An enterprise approach to IT investments will enable DHS to support the vision for an integrated and Person/Family Centered model of practice (the concept of “An Agency of One”) including the provision of robust consumer self-service.

The integration and reuse of key technology components and services, and their interoperability across DHS HHS programs and services will be critical to achieving the vision of an Integrated HHS Enterprise. The use of certain shared components such as the Portal, Master Data Management (MDM), Security (Identity and Access Management), Audit, Customer Relationship Management (CRM), and Content Management will be mandated for use within the vendor’s proposed solution. Examples of key reusable technology components include:

Common Portal Architecture and Standards (Common user experience model and common architecture e.g., Model-View-Controller (MVC) implementation standard, standards for use of widgets and portlets, published Application Programming Interfaces (APIs), published Service Level Agreements (SLAs), etc.)

Rules Engine

Workflow Management

Security and Privacy: Identity and Access Management, Consent Management

Master Data Management: Master Person and Provider Indexes

Customer Relationship Management (CRM) support services: Case Management, Benefits Management, etc.

Shared Analytics and BI Platform Components

Enterprise Service Bus and Interfaces to other DHS and external systems

The following diagram provides a high level architectural view of the envisioned DHS Enterprise Platform that represents Hawaii’s technology vision:


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Figure 7. Hawaii Architecture Vision for Integrated HHS Enterprise Platform (Conceptual View)

The State of Hawaii understands that there may be other technology components that are required by specific programs, e.g., Child Welfare, Adult Protective Services, Chronic Care Management, Medicaid Management Information Systems (MMIS), etc. These Programs are envisioned to leverage the DHS Integrated Health and Human Services (IHHS) Enterprise Platform and above components, where possible, and add new Commercial Off-The-Shelf (COTS) infrastructure components to the platform, as appropriate.

The sections that follow provide an overview of the solution that has been procured by DHS to meet the needs of DHS’ Med-QUEST Division with respect to State of Hawaii’s Medicaid eligibility and enrollment requirements, and is intended to serve as a foundation for eligibility determination and benefit processing related functions for other public benefits managed and provided through BESSD, as well as a foundation for the core DHS Enterprise Platform. The details regarding the design of the overall platform and key solution components can be found in the RFI Procurement library.

5.2.3 KOLEA Architecture Overview

N-Tier Architecture

The State of Hawaii, in collaboration with KPMG (the incumbent vendor), has been developing and implementing the KOLEA System for Medicaid Eligibility since 2013 for the Med-QUEST division of DHS. KOLEA is an integrated eligibility Technology Solution that collects


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individual/family information in one platform, and determine benefit qualifications through one integrated System.

KOLEA is being implemented using multiple COTS application and infrastructure technologies including Siebel CRM, Oracle OPA, Oracle Fusion Middleware (OFM), Oracle WebLogic, Siebel UCM, Oracle OBIEE, etc. KOLEA’s architecture incorporates various public sector best practices and adheres to Hawaii and Federal Standards.

Some of the salient features of KOLEA’s architecture include –

Standard mechanisms for interoperability and data exchange

Adheres to technical standards, specifically open standards, and facilitates integration of COTS solutions and the reuse of solutions within Hawaii and other states

Implements end-to-end security using various technologies like Oracle Identity and Access Management, SOA security, Oracle database advanced security

Designed consistent with CMS’ seven standards and conditions

Adheres to various guidelines including Health Insurance Portability and Accountability Act (HIPAA), NIST standards and others

KOLEA is an n-Tier architecture that separates the presentation layer of the system from its business logic and the database. The figure below illustrates high-level architecture view for KOLEA.

Figure 8. KOLEA Logical Architecture

KOLEA’s architecture is comprehensive in that it supports the full complement of KOLEA functions in a unified and tightly-integrated environment with the capacity to meet the State of Hawaii's volume, performance, and scalability requirements


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KOLEA’s n-Tier architecture design minimizes the impact on system maintenance, cost, and personnel and allows for the separation of specific application responsibilities across several logical and physical tiers

The KOLEA system makes use of high performance, flexible, scalable Exadata and Exalogic hardware platform, and mature software tools such as Siebel Public Sector CRM, Oracle Policy Automation, Web Logic application server and Oracle RDBMS

KOLEA’s architecture is flexible, which takes full advantage of an n-tier design in a distributed systems environment

KOLEA’s architecture is scalable, making use of hardware clustering and load balancing to support throughput without changing pieces of application code

The implementation and maintenance of KOLEA has been simplified by implementing products that have demonstrated track records of smooth interoperability and integration, and by deploying components of the KOLEA system on a common hardware and operating system platform

Presentation (Web) Tier

The KOLEA system uses the LifeRay portal for external users (Hawaii residents) and Siebel Presentation service portal for internal users (Case workers and DHS staff). The Web tier (also known as presentation layer), governs what the users see at their workstation. An HTTPS server hosts the display interface. The Web tier for KOLEA has been specifically developed to capture information, not process it. It allows information to pass through it to the Application Tiers, where multiple processing stacks route the data and interact with the data store.

Application Tier

The Business Tier (or application tier) is the layer where business logic is being run. The complex processing for case management, eligibility and the consequential data exchange among the components of the service and external systems is performed within the Business Tier.

This layer is the most critical to the solution and is broken apart from the Web tier to allow the State of Hawaii to grow the application component of the solution as needed without interfering with, or having to rebuild, the front end Web tier.

Siebel Public sector CRM in combination with Oracle Policy Automation provide ready-to-use application components that would otherwise have to be custom built for integration.

Middleware Tier

The Middleware Tier comprises of the Oracle SOA Suite of tools that includes the Enterprise Service Bus (ESB) along with capabilities for complex system-to-system interfaces, data integration and web services security. In addition, Hawaii has elected to deploy a state-wide MDM solution which provides capabilities to map the master data between systems, and advanced capabilities for data matching (fuzzy matching) for client search and lookup. This tier also houses Identity and Access Management which provides overall security of the various components within the KOLEA system.


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Data Tier

The first three layers of the solution act like separate components of the overall solution that enable specific activities to occur before allowing the User to access the database where sensitive data resides. The Data Tier is designed to provide the State of Hawaii added security. Roles providing access to the application are built into the KOLEA system.

The database environment, where data is read, updated and processed according to the business rules configured for operations, is accessed after a series of approvals and processing functions occur within the previous three layers of the system.

Integration Architecture

The diagram below provides a high level view of the Integration Architecture, highlighting how the different State of Hawaii and Federal systems are connected to support the KOLEA system.

The diagram presents how the KOLEA system is connected to the existing IE system (HAWI) and the Content Management system within DHS. Also, it presents how KOLEA is connected to other State of Hawaii components and systems such as the State level Master Data Management solution, State of Hawaii Hub which interfaces to other State of Hawaii agencies, Health insurance exchange and Federal Data Services Hub.

Figure 9. KOLEA Integration Architecture

5.2.4 Technology Components Deployed as a Part of KOLEA

The following table provides a list of currently deployed software and related version information:


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The RFI respondents are asked to use the above software components, wherever possible, in providing a response and proposed solution approach to this RFI as this COTS infrastructure functionality has already been secured and paid for by the KOLEA project. The only exception is the Exeter OneGate software product. The RFI respondents are requested to suggest a technology solution and approach that does not rely on OneGate accelerators, interfaces, and the user interface (UI). The respondents can leverage an enterprise horizontal portal like the LifeRay or Oracle WebCenter Portal solutions for all external users’ UI requirements.

The diagram below provides a high level overview of how the above software components are interacting with one another in the current KOLEA implementation deployed for Med-QUEST. The graphic provides a logical view of the Solution Architecture highlighting some of the shared components and business and technical services. Please refer to design documents in the RFI Library for additional detail around intended design and implementation details.

Name Current Version Short Description

OneGate 3.1.1.2 Custom liferay software

OneGate 3.1.1 Custom liferay software

WebLogic Proxy Plugins 10.3.4 Proxies requests from a Web server to WebLogic server instances in a cluster

WebLogic Standard Edition 10.3.4 Unified application server suite

Oracle Policy Automation 10.4.1 Business rules engine

Oracle Service Bus 11.1.1.5 Connects, mediates, and manages interactions between heterogeneous services,

legacy applications, packaged applications

SOA Suite 11.1.1.5 Transforms complex application integration into agile and re-usable service

Web Tier 11.1.1.6 Web server for users

Oracle Virtual Directory 11.1.1.7 Aggregate User Repository View

Oracle Internet Directory 11.1.1.7 Central User Repository

Oracle Identity Manager Remote Manager 11.1.2.1 User Self Service Remote

Oracle Identity Manager 11.1.2.1 Tools for Identity Management (Development, Management, Integration and

Deployment)

OIM Siebel Connector 11.1.1.5 Authentication for Siebel

Oracle Access Manager (Access Server) 11.1.2.1 Access Management - Server Access

Oracle Access Manager (Web Gate - Siebel) 11.1.2.1 Access Management - Web Gate - Siebel

Oracle Access Manager (Web Gate - FMW/Liferay) 11.1.2.1 Access Management - Web Gate - FMW/Liferay

Oracle Adaptive Access Manager 11.1.2.1 Self service registration, Password reset and one time password

BI Publisher 11.1.1.7 Used for notices

Siebel Public Sector 8.2.2.2 Case Management tool

Secure Enterprise Search 11.1.2.2 Secure access to data sources—Web sites, file servers, content management systems,

business intelligence systems, and databases.

Oracle Traffic Director 11.1.1.6 Provides high-performance load-balancing, reverse proxy and HTTP 1.1 caching for

the Exalogic platform

Oracle Database 11.2.0.3 Database for storing the data

Oracle Database Client 11.2.0.3 Client used to connect to the Oracle Database

Oracle Business Intelligence Enterprise Edition 11.1.1.7 Ad-hoc Queries, Dashboard, Reporting and Publishing, Online Analytical Processing

Informatica PowerCenter and PowerConnect Adapters 9.1 ETL, Data Transformations, Data Enrichment

Oracle Service Registry 11.1.1.6 Governance (Service Registry, Metadata Management, SOA Assets, Service

Repository)

Oracle Enterprise Repository 11.1.1.6 Governance (Service Registry, Metadata Management, SOA Assets, Service

Repository)

User Productivity Kit 11.1 Collaborative content development platform

Exadata Storage Software 11.2.3.2 Software used for Exadata storage

Oracle Enterprise Gateway 11.1.2.1 Integration with Oracle Service Bus and Oracle Web Services Manager

Audit Vault 12.1 Data Security (Information needed for data audit)

Enterprise Manager 12.1.0.2 Manage Exadata and Exalogic

LifeRay Portal Enterprise (In Weblogic Container) 6.1 External user self service portal

Jrockit 28.2.5 JVM used for profiling, monitoring and diagnosis for Java applications.

Sun JDK 1.6_29+ 1.6_29 Support Jrockit


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Figure 10. KOLEA Solution Architecture Logical View

The following sections that follow describe the key components of KOLEA in more detail.

5.2.4.1 Enterprise Portal Component(s)

KOLEA’s short and mid-term plans for use of Enterprise Portal Standards include Life Ray Portal for External Users and Siebel Portal for Departmental Case Worker (e.g., case management, etc.).

In the medium to long term future, a Horizontal Portal will serve as the strategic, common point of entry for all internal and external users, and enable DHS’ no wrong door strategy for the potential beneficiaries. Though the existing Portal Technologies are stable and viable and currently provide the intended services, in the long term DHS is looking to migrate to a more strategically viable product like Oracle WebCenter, which has larger industry penetration, supports various complex operations and better integration with other Oracle COTS infrastructure products out of the box.

The Enterprise Portal will be able to provide the following capabilities –

Access Control

User Interface

Search Capabilities

Integrated Collaboration and Communications

Portal Server must host the Service implementations to ensure availability and reliability, especially as service reuse and dependencies proliferate


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Integration with downstream business logic and components

5.2.4.2 SOA and Enterprise Service Bus (ESB) Component(s)

KOLEA utilizes Oracle’s ESB, Oracle Service Bus (OSB), for Service Integration, providing a common infrastructure for provisioning and publishing of services both within the KOLEA architecture and with External Systems.

OSB applies common messaging and interoperability standards across all business services and provides a consistent framework for achieving security, monitoring and guaranteed delivery

Any application function that interfaces with systems outside of KOLEA (Federal Data Hub, Various State Systems) is managed through OSB ESB. The ESB isolates KOLEA and its services from the interface details related to each system or component it needs to communicate with, and from having a point-to-point interface with each external system

5.2.4.3 CRM Component(s)

Siebel CRM Public Sector is used for benefit and case management, work flow management and group policy management.

Siebel case management is integrated with various components in different tiers.

Different Siebel modules are used along with various Siebel IDE tools.

The case management product is integrated to the case management presentation service (Uses by the case worker), Siebel portal and the Siebel OLTP.

The diagram below provides a high level Overview of the CRM Component.


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Figure 11. CRM Component Overview

5.2.4.4 Business Rules Engine Component(s)

Oracle Policy Automation (OPA) is used as a business rules engine and a repository to store business rules defined in natural language.

OPA integrates to various components in different tiers

The System uses different OPA modules for performing various functions

The System uses the policy modeling tool, which is used for transforming and modeling the business rules

The OPA suite is integrated with Siebel and LifeRay applications through the SOA suite

The diagram below provides a high level Overview of the Business Rules Engine (BRE) Component.


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Figure 12. Rules Engine Component Overview

5.2.4.5 Business Intelligence (BI) Component(s)

Oracle Business Intelligence (OBIEE) is implemented to support the development of reports, notices and dashboards. DHS’ strategic direction for Enterprise Business Intelligence (BI) includes Oracle Business Intelligence Publisher (BIP) and Business Intelligence Enterprise Edition (BIEE). In addition, DHS’ preferred Data Quality tools include Oracle Data Quality (ODQ).

DHS expects the business intelligence (BI) platform to deliver a balanced set of capabilities across three areas: information delivery, analysis, and development and integration with certain fundamental capabilities that need to be provided as part of a user-driven BI strategy.

Some of the key BI capabilities and infrastructure that DHS expects to have in place are as follows:

Information Delivery

Reporting: General information delivery that improves decision making by revealing and communicating a greater insight into business performance. Most, if not all, products are assumed to support basic reporting to include graphical displays

Dashboards: Display Key Performance Indicators (KPIs) or business metrics using intuitive visualization, including dials, gauges and traffic lights that indicate the state of various KPIs against targets

Ad Hoc Query: Queries created by users to obtain information for a specific need as it arises


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Distributed Query: Access data from multiple heterogeneous data sources. These data sources can be stored on either the same or different computers

Microsoft Office Integration: Excel add-ins for BI platforms or integration with Excel as an output capability for data extracts and additional reporting

Analysis

Online Analytical Processing (OLAP): Client- and server-based analysis tools

Advanced Visualization: Displays numerous aspects of multidimensional data using interactive pictures and charts, and often includes heat maps, geographic maps, scatter plots and other special-purpose visuals

Scenario Modeling: Simulations based on “what-if” scenarios often following a set of constrained inputs to monitor the behavior of the output

Data Mining: The process of discovering meaningful correlations, patterns and trends by sifting through large amounts of data stored in repositories

Development and Integration

Visual / Programmatic Development Environment: Specific tools must be provided to assist in the creation of queries

Web Services Integration: Web services should weave analytical applications built on a BI platform and other integration points into operational applications

The respondents are asked to leverage the infrastructure and capabilities described above as a part of the RFI response.

The diagram below provides a high level overview of the BI component.


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Figure 13. BI Component Overview

5.2.4.6 Master Data Management (MDM) Component(s)

MDM is used for Address Validation, Parsing and Standardization of data and also serves as a unique client identifier for data integrity. The customer master has household, client and address information stored.

MDM integrates to various components in different tiers. The MDM stack is integrated with the SOA suite, through which other system components communicate to MDM

MDM integrates different customer Hub data sources and consumers

MDM is connected to the MDM repository where the master data is stored

The diagram below provides a high level overview of the MDM components.


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Figure 14. MDM Component Overview

5.2.4.7 Data Tier Component(s)

The following are the Data Tier Components of the KOLEA System:

OLTP DB (Siebel PS CRM’s RDBMS and Oracle 11g RDBMS) – Provides core transactional DB that supports KOLEA business functions. These are the primary KOLEA DBs which support the consumer and self-service employee portal and other interface channels to send and receive data

OLAP Data Warehouse/BIP Instance (OBIEE and Oracle 11g RDBMS) – Provides a dimensional Data Warehouse that collects, aggregates and organizes data from various KOLEA data sources to provide OLAP and BI functions

MDM/Customer Master DB (SIEBEL UCM) – MDM houses master data (i.e., certain customer demographic) information from KOLEA, HAWI System, and other External Systems. MDM synchronizes enterprise-wide data into a ‘single version of truth’ enabling a consistent enterprise view of information

Identity Management DB (Oracle OIM) – The OIM repository is a store of Identity data which includes Entity Data (users, organizations, roles, etc.), Transactional Data (Requests, Approvals, Provisioning) and Audit Data (Request History, User Profile History)

Portal DB (LifeRay and Oracle 11g RDBMS) – LifeRay stores all User Admin information for all portal users in an instance of Oracle RDBMS, while OneGate functionality built on top of LifeRay stores all the application data submitted by Portal users

HAWI Legacy DB (ADABAS) – The current DHS Legacy DB that stores all the current application and Legacy data


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Figure 15. Logical Data Flow

5.2.4.8 Security Component(s)

KOLEA is built with core service level security features, including Advanced Security Option (ASO), Database Vault, and Data Masking.

Some of the key security features of KOLEA include –

Strong Authentication including two-factor authentication

Transparent Data Encryption that provides for encrypted database files on disk, encrypted backups, and encrypted database exports

Network Encryption that verifies secures data transmissions over public networks

Separation of Duty — controls to be implemented on administrative actions, preventing actions that violate policy or go against Best Practices


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Reporting — security-related reports to support auditing Realms and Administrative Actions

Command Rules – Security policies to be attached to almost any database operation

Data Masking – Mask sensitive information when making copies of production data for use in development, testing, or other situations that may require sharing or using production data

The Solution is built on the Identity and Access Management (IAM) product suite from Oracle to store user identities, manage, and control user access based on their roles. For data privacy, its primary components are:

Authentication — Authentication is being implemented in the KOLEA System using Oracle Identity Management system. KOLEA system implements Authentication process to verify a user’s access profile

Access Management – The KOLEA system implements Access Management capability which is the authorization piece of access control. This is the process that defines the access policy otherwise known as the Policy Access Point (PAP). When a consumer tries to access a resource, the access control process checks that the consumer has been authorized to use that resource and is a defined user within the system

Governance (Audit, Compliance, Policy, SoD) – The KOLEA system implements this capability which requires a consistency between user provisioning and managed resources through a reconciliation service. It further ensures Separation of Duties (SoD) and compliance with IT Audit policies during the provisioning process. This capability addresses the complete lifecycle of an account from creation to de-provisioning when no longer needed

5.3 Current KOLEA Status and Scope

DHS is in the process or has completed the initial phases of KOLEA which includes:

Configuration and deployment of the core KOLEA technology infrastructure components

Development of the required eligibility determination, benefit management, and related functionality for all healthcare programs

Establishment of a hosting environment for the KOLEA components

Establishment of M&O contract for support of the KOLEA application and hosting (under contract with the incumbent vendor)

Provisioning of State-wide shared services around data integration (i.e., State Data Hub) and Enterprise Content Management (i.e., FileNet ECM implementation)

For additional detail, please refer to the “6 - KOLEA Design Specification Document” and “8 – KOLEA Solution Architecture Diagram” in the RFI library.

5.3.1 Implementation Sequencing Preference and Considerations

Given the interdependencies between HAWI, HANA and HARI, a big bang implementation appears to DHS as a high risk. As a consequence, DHS would like to control risks and would


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prefer an incremental approach to retirement and/or enhancement of these systems in order to achieve the business benefits as soon as possible.

The RFI respondents should consider the Program priorities presented in the previous section, and provide a recommended approach for phased development and legacy retirement (e.g., Program by Program, Function by Function, etc.) for DHS consideration. DHS is very interested in understanding the rationale, and timing for the successful migration of all Programs and eventual retirement of HAWI eligibility functionality. It will be very helpful to the State of Hawaii for this discussion to include any assumptions around the availability and timing for use of the KOLEA Enterprise Platform shared services (i.e., technology dependencies), as well as business and policy dependencies and implications.

One of the State of Hawaii’s key criteria for success in incremental migration is minimizing any negative impact (i.e., system usability, decline in productivity, processing latency, etc.) on the user from having to sign into and access both the old and the new systems to serve the beneficiary. The State of Hawaii would like to hear about innovative ideas to shield the user from any unnecessary complexity (e.g., providing an eligibility worker portal that is able to provide seamless access to both systems, automated authentication and authorization, transparent access to all required data to serve the client, etc.).

5.3.2 Maintenance and Operations and Hosting Considerations

The KOLEA platform environments, including development, testing, staging, training, and production have been deployed at the DR Fortress tier IV data center facility in Honolulu, Oahu, through the existing contract with the incumbent vendor. The DR site is in the process of being deployed at the Systemetrics data center facility, also in Honolulu. The respondents should assume that this infrastructure can be extended to support the proposed infrastructures to meet BESSD’s needs unless a better option is proposed.

The following graphics provide an overview of KOLEA’s production and non-production environments:


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Figure 16. KOLEA Production Environment Overview


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Figure 17. KOLEA Non-Production Environment Overview

The RFI respondents should assume that DHS through its incumbent vendor will have responsibility for KOLEA’s Production environment hosting and infrastructure M&O for the next 2-3 years, and can assume that DHS will provide all required non-production technology infrastructure and environments required to enable the development of the additional non-healthcare related functionality for the KOLEA platform.

5.4 Multi-Party Development and Hosting Environment Vendor Coordination

As described in the previous section, DHS expects the Enterprise Platform deployed for KOLEA’s Medicaid Eligibility functionality, the State Hub, the Enterprise Content Management solution and other technical components and shared business and technical services to be used as the Shared Enterprise Platform for all future DHS applications. With respect to BESSD program requirements, it is anticipated that the proposed solution will fully leverage the production and DR hosting infrastructure as well as all COTS applications and shared services deployed by the KOLEA team.

Hosting and Infrastructure Management Services –DHS has awarded the contract for provision of the required technology infrastructure for the Integrated Eligibility solution and the DHS Enterprise Platform to the incumbent vendor. The incumbent vendor has deployed the required technology infrastructure and production environment within the


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DR Fortress data center facilities in Honolulu and is responsible for maintenance and operation of the infrastructure including hardware procurement and replacement life cycle, operations and maintenance for all application support, security & compliance to meet Federal Information Security Management Act (FISMA), Internal Revenue Service (IRS), HIPAA and other regulations. The DR environment has been deployed at the Systemetrics data center facilities, also in Honolulu, HI. It is anticipated that at some point in the future, DHS may decide to move the Production and DR hosting environments to a planned state-of- the-art data center facilities that will be built and operated by the State of Hawaii and its partners.

KOLEA Application M&O – Application M&O services, including patching of software applications, application performance tuning and monitoring, application configuration, code and data migrations between environments, will be the responsibility of the respective DDI vendors.

Future DHS Applications – DHS will require that system modernization efforts and solutions for all divisions such as Social Services Division (SSD) that includes Child Welfare Services, Adult Protective Services, Foster Care for Children in Hawaii, and Missing Children) and others will be deployed using the core DHS Enterprise Platform (currently known as KOLEA) components, and any proposed new components for BESSD must be integrated with the Enterprise Platform as discussed earlier. It is also anticipated that under certain circumstances, the State of Hawaii may choose to leverage third party vendors’ Cloud and SaaS based solutions to meet specific divisional needs.

5.4.1 Multi-Source Service Integration Requirements

Starting with the BESSD application (and continuing when other divisions migrate to the KOLEA platform) it is envisioned that multiple vendors may be developing concurrently – the incumbent vendor enhancing the core KOLEA platform in parallel with the development of BESSD functionality.

Starting with the development of a new BESSD application, it is envisioned that multiple vendors may be developing concurrently during the enhancement of the core KOLEA platform by the incumbent vendor. As a result, DHS intends to build the capability to manage a multi-vendor environment for delivery of end to end IT Services. For the purposes of the RFI, this is referred to as Multi-Source Service Integration (MSI) or Service Integration and Management (SIAM). The MSI role and capabilities will focus on the following activities to achieve transparent service integration:

Managing the prioritization of enhancements requested by different divisions/stakeholders

Managing the scheduling and other challenges associated with a multi-vendor development environment

End-to-End (E2E) performance monitoring, reporting and tuning to ensure alignment of tower or process service levels to the client's business key performance indicators (KPIs)

Inter-provider management of service handoffs, including those for change management or service request processing


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Operational-level relationship coordination to ensure a collaborative working approach by all vendors

Service delivery coordination to minimize operational issues

First-level help desk — this can be a supervisory or delivery role. If a supervisory role, it's about ensuring that incident and service request handoffs are operationally efficient and issues don't fall through the cracks or bounce between providers

The State of Hawaii would be interested in respondent’s capabilities related to working in a multiple Application DDI and M&O (Maintenance and Operations) Service providers environment leveraging a common Enterprise SOA platform or set of shared technology components and services (e.g., shared Enterprise Content Management services).


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6.0 RFI Response Templates

The table below lists the templates that Vendors will submit as part of their response to this RFI.

Table 3. RFI Response Templates

Response Template

Template / Attachment Elements

Template A Corporate Experience

Template B Functional Requirements Approach

Template C Technical Requirements Approach

Template D Implementation Sequencing Approach

Template E Added Value Provided

Template F Cost Workbook


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7.0 Description of RFI Library

The following table lists the documents that have been provided as supporting information. They provide additional background which you might find valuable in preparing your responses.

Table 4. RFI Library

File # Procurement Library Item File Name

1 1 - BESSD Sample Business Processes and Use Cases

2 2 - HAWI Handbook (folder)

3 3 - HANA System Overview (folder)

4 4 - Pathos User Manual

5 5 - BESSD-Electronic Case Folder-Functional Requirements

6 6 – KOLEA Design Specification Document

7 7 - KOLEA Database Design Document

8 8 - KOLEA Solution Architecture Diagram

9 9 - KOLEA Application Architecture View

10 10 - Current HAWI Batch Jobs-Interfaces

11 11 – HARIMANUAL


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8.0 Glossary of Terms

Defined Term Acronym (if used)

Description

Affordable Care Act

ACA On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reforms that will roll out over four years and beyond.

Aid to the Aged, Blind, and Disabled

AABD The Aid to the Aged, Blind, and Disabled program provides cash benefits for food, clothing, shelter, and other essentials to adults who are elderly (65 years of age or older) and/or who meet the Social Security Administration (SSA) definition of disabled. To qualify, individuals must have countable income that is below 62.5% of the 1993 Federal Poverty Level and may not have resources more than $2,000 for a single person and $3,000 for a couple. The goal is to ensure that clients receive at least a minimally adequate standard of living.

Benefit, Employment and Support Services Division

BESSD BESSD is the largest division in the Hawaii Department of Human Services. Staff and administrators provide a continuum of services, through nine programs that serve different populations, aimed at providing clients with monthly benefits to assist them with such essentials as food, shelter, and child care, as well as employment support and work-training and dependency diversion and prevention.

Exempt Child Care Provider

There are certain situations when a child care provider can be exempt from registration or licensing requirements. Parents should be aware that there are no assurances that health and safety requirements are met or enforced for these exempt programs, therefore, they should try to check a provider’s background and experience prior to choosing this type of care. Also, although a child care provider may meet the exemption requirements, there is nothing prohibiting the provider from becoming registered or licensed. These are some of the types of child care that are exempt from registration or licensing: - Care that is provided in the child’s home - Care that is provided by relatives - Care that is provided for up to two children that is unrelated to the provider - School-aged programs that are operated by community associations or multi-service organizations - School-aged programs that operate for no more than two consecutive calendar weeks in a three-month period - Programs that are operating less than six hours per week - Programs that provide specialized training or skill development


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Description

Child Care Assistance

Child Care Assistance, aka Child Care Subsidy, helps low-income families to sustain their employment, educational efforts and job training by paying a subsidy for their children who are in the care of DHS-approved child care providers. Unless child care is required for protective purposes, families must meet income and activity requirements to qualify for this subsidy program.

Child Support Enforcement Agency

KEIKI Hawaii's automated child support enforcement system.

Client The Client is a person who is applying for benefits and services for themselves and/or their family or is already receiving them.

Contingent Approval

Contingent Approval applies only to expedited cases and refers to those cases for which eligibility can be determined without one or more required verifications. Contingently Approved cases can receive benefits, but benefits will be discontinued if the required verifications are not provided by a certain deadline. The current deadline is 10 days.

Department of Human Services (Hawaii)

DHS DHS is the second-largest State of Hawaii department, manages an annual budget of $2.7 billion. DHS has four divisions: Benefit, Employment and Support Services Division, Social Services Division, Med-QUEST Division and Vocational Rehabilitation and Services for the Blind Division. DHS also has administratively attached agencies and commissions: the Hawaii Public Housing Authority, Office of Youth Services, Hawaii State Commission on the Status of Women and State Commission on Fatherhood.

Department of Homeland Security

SAVE The Systematic Alien Verification for Entitlements (SAVE) Program is a service that helps federal, state and local benefit-issuing agencies, institutions, and licensing agencies determine the immigration status of benefit applicants so only those entitled to benefits receive them. The SAVE Program has access to immigration status information from more than 100 million records contained in the Department of Homeland Security databases.

Department of Public Safety

State jails and prison.

Division of Vocational Rehabilitation

DVR Vocational Rehabilitation is a state-federal program for individuals with disabilities who require assistance to prepare for, secure, retain or regain employment. The Hawaii Division of Vocational Rehabilitation (DVR) administers three programs that have separate but related functions to provide for the rehabilitation needs of persons with disabilities to secure employment and to lead full and productive lives. The underlying philosophy and goal of the DVR is that through employment, individuals with disabilities are empowered toward economic self-sufficiency, independence, and inclusion and integration into society.


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Description

Electronic Benefit Transfer

EBT The Hawaii Electronic Benefit Transfer (HI/EBT) system processes the payments for public financial assistance (i.e., childcare), and Supplemental Nutrition Assistance Program (SNAP). The EBT system utilizes a debit card which allows the clients to access their cash and/or SNAP benefits at food retailers through their Point of Sale (POS) machines and Automated Teller Machines (ATMs). Recipients receiving cash assistance may also choose to have their cash benefits directly deposited into their personal bank accounts. Payments distributed through this system are: Temporary Assistance for Needy Families (TANF), Temporary Assistance for Other Needy Families (TAONF), General Assistance (GA), Aid to the Aged, Blind or Disabled (AABD), Repatriates, Childcare, Employment and Training (E&T), First-To-Work (FTW) and the SNAP programs.

Electronic Case Folder

ECF Electronic Case Folder (ECF) is a stand-alone Content Management System that was recently implemented to migrate from paper to electronic case files. The system includes scanners, workflow for processing paper documents and Documentum back-end.

Electronic Disqualified Recipient System

eDRS The National SNAP Fraud Electronic Disqualified Recipient System (eDRS) is a system run by the Food and Nutrition Service (FNS). It tracks clients who have been disqualified from SNAP across the nation for violating SNAP program rules.

Employment and Training

E&T The Employment and Training (E&T) program is a statewide work program designed to assist able-bodied adults to become attached to the workforce. E&T serves Supplemental Nutrition Assistance Program recipients and puts emphasis on: employment, work experience, training, on-the-job training, and limited job search activities. E&T also provides supportive services in the form of a participant reimbursement to cover work-related expenses and child care.

ePathos ePathos is a stand-alone application which was developed recently to provide process monitoring and controls for the different branch offices. It supports logging applications as they are received, monitoring them through the process and, as a result, this provides BESSD with the visibility to workload and align their resources with the workload.

Financial Accounting Management and Information System

FAMIS Financial Accounting Management and Information System (FAMIS) is the State of Hawaii’s accounting system.


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Description

First-To-Work FTW The First-To-Work (FTW) program provides case management, employment and support services to work eligible individuals of TANF households. In addition, the FTW Program services other work eligible individuals that are unable to work due to temporary disability, rehabilitation from substance abuse, and with domestic violence status. Participants of the FTW Program participate in various work activities that emphasize job readiness training, skill-building, adult and vocational education, and employment placement.

General Assistance

GA The General Assistance program provides cash benefits for food, clothing, shelter, and other essentials to adults ages 18 through 64, without minor dependents, who are temporarily disabled and who do not qualify for Social Security. To be eligible, the adult must have little or no income, not qualify for a federal category of assistance, and be certified by a DHS medical board to be unable to engage in any substantial employment of at least thirty hours per week for a period of at least sixty days.

Hawaii Accounts Receivable Information

HARI Hawaii Accounts Receivable Information; HARI provides support for collecting overpayments. The system maintains claim balances by accepting payments, reimbursements and adjustments. The claim balances in HARI provides HAWI case workers with current overpayment balances and activities relating to their client's accounts. This is also a mainframe based application which was transferred from Arizona. Hawaii adopted Arizona’s Accounts Receivable Integrated Collections System (ARICS).

Hawaii Automated Network for Assistance

HANA Hawaii Automated Network for Assistance; HANA is an IBM mainframe based application which shares elements of the HAWI database. It provides support for three Client Assistance Programs – First to Work (FTW), Employment and Training (E&T), Child Care Connection Hawaii program (CCCH) and Provider Management.

Hawaii Automated Welfare Information

HAWI Hawaii Automated Welfare Information; HAWI is a 25 year old system on an IBM mainframe platform and relies on software and data base languages (COBOL software development language and ADABAS database management system).

Health Insurance Portability and Accountability Act

HIPAA The federal Health Insurance Portability and Accountability Act of 1996. The primary goal of the law is to make it easier for people to keep health insurance, protect the confidentiality and security of healthcare information ad help the healthcare industry control administrative costs.

Department of Accounting and General Services

DAGS DAGS manages the State of Hawaii’s accounting system, Financial Accounting Management and Information System (FAMIS).

Interactive Voice Response

IVR Interactive Voice Response (IVR) is a technology that allows a computer to interact with humans through the use of voice and DTMF tones input via keypad.


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Description

JP Morgan JP Morgan currently manages the EBT and Direct Deposit transactions on behalf of BESSD. HAWI provides EBT card and direct deposit information to JP Morgan who credits the appropriate accounts and manages any subsequent transactions against the EBT cards.

Kauhale On-Line Eligibility Assistance

KOLEA Kauhale On-Line Eligibility Assistance (KOLEA) has been established to support MAGI eligibility determination for the State of Hawaii’s Medicaid program known as Med-QUEST. The first phase of the KOLEA roll out is nearing completion.

Licensed Child Care Provider

A Licensed Child Care Provider has satisfactorily demonstrated compliance with the minimum standards for providing Child Care Services. The goal of the Department of Human Services’ Child Care Licensing Program is to ensure the health, safety, and well-being of children enrolled in registered Family Child Care Homes and licensed child care centers (Before & After School Child Care Facilities, Group Child Care Centers & Group Child Care Homes, and Infant & Toddler Child Care Centers) by developing and enforcing minimum standards for these types of child care. DHS’ Child Care Licensing Units monitor compliance with the child care law and the administrative rules and provides consultation and technical assistance to child care providers.

Low Income Home Energy Assistance program

LIHEAP In 1980, Congress enacted the Low-Income Home Energy Assistance Program (LIHEAP), authorizing assistance to eligible households to offset the rising costs of home energy. The U.S. Department of Health and Human Services administers the program nationally, and distributes Federal monies among state and other grantees according to an allocation formula. Each grantee uniquely structures its own program following Federal guidelines. Hawaii households may apply for help with either their shut-off or regular utility bill, from either the electric or gas company on their island

Medical Evaluation Service Provider’s System

CYRCA’s system

The State of Hawaii Department of Human Services has signed a contract with Cyrca, Inc. for medical board evaluation services for the Benefit, Employment and Support Services Division. Under this contract, Cyrca is responsible for providing medical and psychiatric evaluation services to determine if a Temporary Assistance for Needy Families (TANF), or Temporary Assistance for Other Needy Families (TAONF), and General Assistance adult recipient is disabled and the extent of the disability.

National Directory of New Hires

NDNH The National Directory of New Hires (NDNH) is the Department of Health and Human Services (HHS) Office of Child Support Enforcements' database utilized by the Department of Education (ED) through a computer matching agreement between ED and HHS to obtain address and employment information on defaulted borrowers. The NDNH database maintains some of the most comprehensive address and employment information on individuals throughout the United


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Description

States

Office of Management and Budget A-87 Circular

OMB A-87 This Circular establishes principles and standards for determining costs for Federal awards carried out through grants, cost reimbursement contracts, and other agreements with State and local governments and federally recognized Indian tribal governments (governmental units).

Public Assistance Reporting Information System

PARIS The Public Assistance Reporting Information System (PARIS) is a federal-state partnership that insures the integrity of public assistance programs through detecting and deterring improper payments.

Pended Cases Pended Cases refer to those cases for whom an Applicant has submitted their integrated eligibility application or re-determination, and additional steps are required before payment can be authorized (e.g., the Applicant has not yet provided required supporting documentation but based on the information provided will qualify for benefits to at least one benefits program).

Priority Status (LIHEAP)

Because funding for LIHEAP is limited, priority may determine which accounts will be paid first and includes elderly Applicants, disabled Applicants, or Applicants with small children.

Priority Status / Expedited (SNAP)

Expedited refers to emergency SNAP cases, which refers to applicants whose (1) households with less than $150 in monthly gross income and whose liquid resources (i.e., cash on hand, checking or savings accounts, savings certificates, etc.) do not exceed $100; (2) Seasonal farmworker households who are destitute as defined in section 17-647-49 and whose liquid resources do not exceed $100; (3) Eligible households whose combined monthly gross income and liquid resources are less than the household’s monthly rent or mortgage, and utility costs. Federal regulations require states to issue benefits within 7 days from the date of application in SNAP expedited cases.

Program Specific Program Specific refers to the concept that eligibility for each of the BESSD benefits programs will be determined independently despite the fact there is a single integrated eligibility application. Note that the application may expand to capture all of the information required to determine eligibility for the programs to which an Applicant has applied (e.g., an applicant applying to LIHEAP will be required to submit utility account information when completing the integrated eligibility application whereas a person not applying to LIHEAP may not be required to do so).


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Description

Provisional Child Care License

A Provisional Child Care License is a license awarded to Child Care Providers who applied to be licensed (as opposed to certified) and who passed all of the required checks (e.g., background checks, employment checks, etc.) but met most but not all of the site visit requirements. A Provisional Child Care License is valid for up to six months after which the Child Care Provider must re-apply or have met the requirements to be considered eligible for a non-Provisional Child Care License.

Social Services Division - Hawaii

SSD SSD provides protection from abuse and neglect for children and dependent adults. Our programs also provide safe living arrangements with the goal of reducing abuse, neglect and maltreatment.

Service Provider The Service Provider is any third party service provider, program or entity who may provide services directly to a Client.

Supplemental Nutrition Assistance Program

SNAP The Supplemental Nutrition Assistance Program (SNAP) is a federal program funded through the U.S. Department of Agriculture (USDA). It is administered at the federal level through its Food and Nutrition Service (FNS). State agencies administer the program at the State and local levels, including determination of eligibility and monthly allotments. The SNAP program provides crucial food and nutritional support to qualifying low-income and needy households, and those making the transition from welfare to self-sufficiency. In FY 2012, SNAP helped put food on the table for an estimated 90,534 Hawaii families each month. SNAP clients access their benefits with an EBT card, which they use like a debt card.

Temporary Assistance for Needy Families

TANF TANF are the time-limited federally funded welfare reform program for adults with children. TANF provide monthly cash benefits to families for food, clothing, shelter, and other essentials. To qualify for this assistance, a family must include children under the age of 19 and earn a total gross income under 185% of the 2006 Federal Poverty Level (FPL). These programs are designed to protect those who cannot work and to require those who are able to work to do so. Unlike the old welfare program, which fostered dependence and low self-esteem, the TANF program require work and promote self-reliance, responsibility, and family stability. TANF offer a package of strong incentives and penalties, child care support for working parents, and restructured welfare benefits


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Description

Temporary Assistance for Other Needy Families

TAONF TAONF are the time-limited state funded welfare reform program for adults with children. TAONF provide monthly cash benefits to families for food, clothing, shelter, and other essentials. To qualify for this assistance, a family must include children under the age of 19 and earn a total gross income under 185% of the 2006 Federal Poverty Level (FPL), and have a non-citizen residing in the household. This program is designed to protect those who cannot work and to require those who are able to work to do so. Unlike the old welfare program, which fostered dependence and low self-esteem, the TAONF program require work and promote self-reliance, responsibility, and family stability. TAONF offer a package of strong incentives and penalties, child care support for working parents, and restructured welfare benefits

REQUEST FOR INFORMATION HMS 904-15-01-S

Documents

Transcript of REQUEST FOR INFORMATION HMS 904-15-01-S