W DEPARTMENT OF HEALTH “WINGS” M INFORMATION SYSTEM

P a g e | 1

20SR001 • RESEARCH AND EVALUATION DIVISION • 200 W. 24th Street • Cheyenne, Wyoming 82002 TELEPHONE 307-777-7881 • EMAIL [email protected] • WEBSITE www.wyoleg.gov

SHORT REPORT

WYOMING LEGISLATIVE SERVICE OFFICE

WYOMING DEPARTMENT OF HEALTH

“WINGS”

MEDICAID MANAGEMENT INFORMATION SYSTEM

January 2020 Wyoming Legislative Service Office

Research and Evaluation Division

TABLE OF CONTENTS:

INTRODUCTION 2

DEPARTMENT OF HEALTH “WINGS” PROJECT 2

CAPABILITY OF WINGS TO PROVIDE INTERAGENCY CONNECTIVITY 4

1. Modularity

2. System Integrator with Enterprise Service Bus

3. Data Warehouse with Business Intelligence Tools

4. Identity and Access Management System

OPPORTUNITY FOR DFS CONNECTIVITY TO WINGS 7

1. WYCAPS/CCWIS

2. EPICS Replacement

3. Previous Attempts at Interagency Connectivity: WES II

POTENTIAL ISSUES WITH INTERAGENCY CONNECTIVITY 10

1. Governance

2. Agency it Structures

3. WINGS Procurement and Implementation Schedule

4. Project Complexity and Cost

MONITORING CHINS POPULATION ACROSS AGENCIES 12

COLLABORATION AND CONVERSATION BETWEEN RELEVANT AGENCIES 13

CONCLUSION 13

APPENDIX A: SUMMARY OF WINGS PROJECT PROCUREMENT 15

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20SR001 • RESEARCH AND EVALUATION DIVISION • 200 W. 24th Street • Cheyenne, Wyoming 82002 Telephone 307-777-7881 • Email [email protected] • Website www.wyoleg.gov

INTRODUCTION:

The Management Audit Committee, at its November 22nd, 2019, meeting, directed LSO staff to

provide information on agency data systems and the potential of inter-agency integration.

Specifically, information on the Wyoming Department of Health’s Wyoming Integrated Next

Generation System (WINGS) Project’s ability to connect with other agencies housing data

pertaining to the Children in Need of Supervision (CHINS) population. LSO had previously been

performing an evaluation of the CHINS population and reported to the Committee that CHINS

youth were not being tracked across the relevant agencies with jurisdiction. During the process of

performing this evaluation WINGS was identified as a system with qualities that could mitigate

some of the issues discovered. Therefore, this report discusses the background of the WINGS

Project, the Project’s potential capabilities for cross-agency integration, the conversations and

collaboration that have occurred between agencies, and how the Project could be utilized to

monitor the CHINS population.

DEPARTMENT OF HEALTH “WINGS” PROJECT:

The Wyoming Department of Health uses two separate data systems for Medicaid data

management. The Department’s first system is their Wyoming Eligibility System (WES) which

is an online application system used to determine whether an applicant is eligible for Medicaid.

The Department’s second data system is the Medicaid Management Information System (MMIS)

which the Department uses for Medicaid claims processing and benefit plan design. The current

MMIS was coded in the 1980s-90s and as such, is outdated. The Department of Health is in the

process of procuring and implementing a new MMIS called the Wyoming Integrated Next

Generation System (WINGS) predominantly using federal funding. Under the Affordable Care

Act, federal funding will cover 90 percent of the $75 million development cost and 75 percent of

maintenance costs.

The WINGS Project will allow the Department to tie together its existing eligibility

system (WES) with the MMIS, providing operational efficiency and collection of longitudinal

data.1 Rather than procure one large system, the WINGS Project consists of the procurement of

eight separate system and service modules that will collectively replace the current MMIS system:2

1 Longitudinal data, sometimes referred to as panel data, track the same sample at different points in time. The

sample can consist of individuals, households, establishments, and so on. In contrast, repeated cross-sectional data,

which also provides long-term data, gives the same survey to different samples over time.

https://www.nlsinfo.org/content/getting-started/what-are-longitudinal-data

2 https://health.wyo.gov/healthcarefin/wyoming-integrated-next-generation-system-wings-project/

https://www.nlsinfo.org/content/getting-started/what-are-longitudinal-data

https://health.wyo.gov/healthcarefin/wyoming-integrated-next-generation-system-wings-project/

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• Benefit Management Service. The Benefit Management Service vendor will conduct and

manage claims processing and supporting services.

• Care/Case Management System. This system will provide the care/case management

function for the Medicaid Home and Community-Based waiver function of the Department

of Health.

• Electronic Visit Verification. This system will provide a verification mechanism to the

State for service types established under the Cures Act for type of service performed.

• Data Warehouse with Business Intelligence Tools. The Data Warehouse serves as the main

data storage repository for all the other WINGS Project modules.

• Fraud Waste & Abuse Case Tracking. This system replaces and enhances the previously

existing tools and applications to improve overall detection and recovery functions as well

as administrative activities and financial reporting.

• Provider Enrollment Screening & Monitoring. This module will provide a solution to

streamline the internal and external user’s experience through consolidation, enhancement,

and automation of existing provider enrollment processes.

• Pharmacy Benefit Management System. This module processes pharmacy point-of-sale

claims and handles pharmacy related prior authorizations, among other duties.

• System Integrator-Enterprise Service Bus. This component connects all of the modules

together into an enterprise system so that the WINGS vision can be realized.3 See Figure

1 for a schematic of the WINGS modules.

Planning of the project began approximately eight years ago according to a Department of Health

official. The Department released its first Request for Proposal in 2015, and the last module of

the Project is scheduled to go live in 2021. A Department of Health November 2019 Status Update

for the WINGS Project reported that four of the eight planned modules are currently live. See

Appendix A for the current status of all WINGS modules.4

3 Ibid.

4 https://health.wyo.gov/wp-content/uploads/2019/11/MMIS-Vendors-WY-Status-Update-for-WINGS-

project_11.12.2019.pdf and Per Department of Health Official.

https://health.wyo.gov/wp-content/uploads/2019/11/MMIS-Vendors-WY-Status-Update-for-WINGS-project_11.12.2019.pdf

https://health.wyo.gov/wp-content/uploads/2019/11/MMIS-Vendors-WY-Status-Update-for-WINGS-project_11.12.2019.pdf

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Figure 1: WINGS Project Schematic

Source: https://health.wyo.gov/healthcarefin/wyoming-integrated-next-generation-system-wings-project/

CAPABILITY OF WINGS TO PROVIDE INTERAGENCY CONNECTIVITY

Four key features of the WINGS Project would allow WINGS to function as an information

technology (IT) system for the Department of Health and, in theory, other agencies:5

1. MODULARITY

The WINGS Project uses a modular architecture or system design that separates different

program functionalities into independent modules.6 Each module executes a necessary

functionality, such as Medicaid case management, benefit management, pharmacy benefit

management, provider enrollment/screening, etc. Modular architecture is a way of

5 Information technology: the technology involving the development, maintenance, and use of computer systems,

software, and networks for the processing and distribution of data. https://www.merriam-

webster.com/dictionary/information%20technology

6 https://stackoverflow.com/questions/18034683/what-is-the-big-difference-between-modular-and-object-oriented-

programming


https://www.merriam-webster.com/dictionary/information%20technology

https://www.merriam-webster.com/dictionary/information%20technology

https://stackoverflow.com/questions/18034683/what-is-the-big-difference-between-modular-and-object-oriented-programming

https://stackoverflow.com/questions/18034683/what-is-the-big-difference-between-modular-and-object-oriented-programming

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managing the complexity of a system by breaking down the system into subsystems. The

WINGS modular design allows the agency to contract separately for the different modules,

rather than be reliant on a single vendor.7 Modularity also allows the Department of Health

to retrofit individual modules as needed in the future without overhauling the entire

system.8 Finally, a modular system design will allow for new modules to be added without

disrupting the functionality or compatibility of previous modules.

2. SYSTEM INTEGRATOR WITH ENTERPRISE SERVICE BUS

The System Integrator with Enterprise Service Bus connects all the modules together into

an enterprise system and is essentially the glue that holds the system together. It has three

main features: System Integration and Enterprise Service Bus, Technical Coordination, and

Data Management Services. The vendor provides system integration services to coordinate

and oversee architecture planning, development, and testing efforts across the various

modules of the WINGS Project.9 The Enterprise Service Bus allows the different WINGS

modules to form a coherent system. The Data Management feature provides data

standardization to allow for the transfer of data into and out of the Enterprise Service Bus

and Data Warehouse. The Enterprise Service Bus allows integration with non-WINGS

Project systems such as WES and the State of Wyoming’s Online Financial System

(WOLFS).

3. DATA WAREHOUSE WITH BUSINESS INTELLIGENCE TOOLS

A data warehouse is a copy of transaction data specifically structured for analysis.10 The

WINGS Data Warehouse will serve as the main data storage repository for all the WINGS

Project modules. Business Intelligence Tools included in the Data Warehouse will be

utilized to access the stored data to compile reports and analyze Medicaid program

information to help inform Department of Health decision making. This module will

replace and enhance the current Data Warehouse solution, including new and/or expanded

data analytics, business intelligence tools, and reporting capabilities. The Department of

Health intends to bring in data from other internal areas over time.11 The Data Warehouse

also has the ability to be utilized by other systems and agencies.

7 https://health.wyo.gov/healthcarefin/wyoming-integrated-next-generation-system-wings-project/

8 Per Department of Health Official.

9 MITA 3.0 SS-A, Alternatives Analysis and Procurement Strategy, Executive Summary Report, June 9, 2015,

Wyoming Department of Health, Division of Healthcare Financing.

10 https://www.1keydata.com/datawarehousing/data-warehouse-definition.html

11 https://health.wyo.gov/healthcarefin/wyoming-integrated-next-generation-system-wings-project/.


https://www.1keydata.com/datawarehousing/data-warehouse-definition.html


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4. IDENTITY AND ACCESS MANAGEMENT SYSTEM

Identity and access management systems allow for the defining and managing of roles of

individual users in a network system.12 An identity and access management system defines

what privileges each network user has and under what circumstances those privileges can

be used. For example, a Medicaid claims processor could have access to different

information than a public health nurse. This type of identity and access management is

important when sensitive or private information is involved. An identity and access

management system will be included in the WINGS Project in order to comply with

HIPAA requirements.13 Other State agencies could leverage the identity and access

management system, only one system is necessary for the State.14

WINGS is designed to allow for theoretical leveraging by other State agencies.15 Using

WINGS’ modularity, Enterprise Service Bus, and Data Warehouse, there are four ways that data

sharing and connectivity could occur between agencies:

• An agency could create a module that functions within the WINGS Project and connects

with the Enterprise Service Bus.

• An agency could utilize the Data Warehouse. This could occur through the direct sharing

of data to the Department of Health portion of the warehouse, or an agency could create

their own partition within the warehouse. The latter would mean the Department of Health

would not have access to the data unless it was granted by the agency creating the partition.

• An agency could use, or build upon, a module already created for the WINGS Project (the

Care/Case Management System for example).

• An agency could create a wholly separate IT system that only interacts with the Enterprise

Service Bus, similar to how the Department of Health’s WES will connect with the

Enterprise Service Bus.

The Department of Health reports that additional modules and functionalities could be added to

WINGS by the Department or other agencies. The new modules would only need to be compatible

with the current Enterprise Service Bus.16 The implementation of an identity and access

12 https://www.csoonline.com/article/2120384/what-is-iam-identity-and-access-management-explained.html


14 Per ETS Official.



https://www.csoonline.com/article/2120384/what-is-iam-identity-and-access-management-explained.html

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management system could address the confidentiality concerns of a State shared Data

Warehouse.17 These concerns currently hamper cross-agency monitoring of sensitive populations

such as CHINS. The exact form in which connectivity would take place is unknown at this time,

but connectivity is possible from a purely IT perspective.

OPPORTUNITY FOR DFS CONNECTIVITY WITH WINGS:

Like the Department of Health, the Department of Family Services (DFS) is currently

pursuing the upgrade or replacement of its legacy data systems: the Wyoming Children’s

Assistance and Protection System (WYCAPS) and the Eligibility Payment Information Computer

System/Jobs Automated System (EPICS). Both of these projects represent potential opportunities

for data system integration or data sharing with the Department of Health’s WINGS Project. See

Figure 2 for a schematic showing potential opportunities for DFS connectivity to WINGS.

WYCAPS/CCWIS

Since 1998, DFS has used the WYCAPS system for case management of abuse and neglect

cases and court-ordered placements. DFS reports the system currently resides on proprietary

hardware and requires a specialized skillset for administration and maintenance. DFS anticipates

that the current supporting workforce will be retiring in the next five to seven years which will

result in increased maintenance costs.

In addition to being an outdated system, WYCAPS is no longer compliant with federal

requirements.18 In 2016, the existing federal requirements were replaced with new Comprehensive

Child Welfare Information System (CCWIS) requirements. State child welfare agencies must

comply with the new requirements to receive federal reimbursement payments for foster care

services. In his 2021-2022 biennium budget, the Governor recommended to the legislature an

exception request for $28M for the replacement of the WYCAPS system to meet federal CCWIS

requirements.19

In 2019, DFS contracted with a consulting company to conduct a feasibility study,

alternatives analysis, and cost benefit analysis for the planning and implementation of a new


18 Alternatives Analysis for CCWIS Planning and Procurement Project, Wyoming DFS, December 6, 2019.

Prepared by Public Knowledge, Federal Way, WA.

19 State of Wyoming 2021-2022 Biennium Budget Request, Agency 049, Department of Family Services, Prepared

for the February 2020 Legislature.

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CCWIS system. The consultant identified three potential alternatives and cost estimates for the

WYCAPS replacement.20

• Alternative 1: Build a New Customized System

• Alternative 2: Configuring a Commercial Off-The-Shelf System

• Alternative 3: Modular Approach

Alternative 3 proposes a modular approach whereby DFS would share available existing State

systems, such as the Department of Health’s WES system or the WINGS’ Benefit Management

Service or Care/Case Management System modules. These shared systems or modules would be

adapted or built out to meet the needs of DFS and the new federal CCWIS requirements.

Additional required modules could be purchased as Commercial Off the Shelf (COTS) products

or custom-built. In its report, the consultant ranked Alternative 3 as the least favorable option

based upon considered impacts (business and programmatic, technical, financial and risk) and a

cost benefit analysis. Even though the feasibility analysis ranked alternative 3 as the least

favorable, DFS reported to the Joint Appropriations Committee in January 2020 that the agency

continues to analyze the cost benefits of both Alternatives 2 and 3. 21

EPICS REPLACEMENT

DFS uses the EPICS system to determine eligibility for DFS administered public assistance

programs, including Title IV-E foster care eligibility, the Supplemental Nutrition Assistance

Program (SNAP), and Temporary Assistance for Needy Families (TANF). 22 The EPICS system

was developed by the State of Alaska and adopted by Wyoming DFS in 1986. The Jobs Automated

System portion of the system was added as a subsystem in 1991. The Jobs Automated System is

used to determine eligibility for child care assistance.

DFS submitted an Eligibility System Modernization Plan to the Joint Appropriations

Committee in January 2020.23 The plan proposes to use $9.3M in unspent funds from DFS’ 2019-

2020 budget appropriation to re-platform and refactor the EPICS system. The $9.3M originally

appropriated by the legislature in 2018 for a previous DFS project, WES II, sought to leverage

20 Ibid.

21 January 6, 2020 Memo from Korin Schmidt, Director, DFS to the JAC regarding responses to questions from the

December 17, 2019 JAC Budget Hearing.

22 CHINS and other children in DFS custody must meet Title IV-E eligibility requirements in order to qualify for

federal reimbursement for foster care services, which include court-ordered placements at residential treatment

facilities (RTCs).

23 January 6, 2020 Memo from Korin Schmidt, Director, DFS to the JAC re Responses to questions from the

December 17, 2019 JAC Budget Hearing.

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Department of Health’s WES eligibility system as a replacement for the aging EPICS system. For

reasons described below, DFS abandoned the project.

DFS estimates that the total EPICS modernization project will cost $16-18.6 million, 50

percent of which will be state general funds and 50 percent federal match. DFS reports the updated

language and platform will position EPICS for easier and further modernization to include rule-

based eligibility and interfaces with other systems and will lead the way for the agency’s larger IT

plan. However, DFS states there are no immediate plans to link EPICS with the Department of

Health’s WES eligibility system.24

PREVIOUS ATTEMPTS AT INTERAGENCY CONNECTIVITY: WES II

DFS made two previous attempts to leverage Department of Health’s WES Medicaid

eligibility system to replace its aging EPICS eligibility system. Each of these attempts was referred

to as WES Phase II (WES II). DFS initiated the first WES II project in 2013. The Wyoming

Legislature appropriated funds to DFS but the agency later put the funds on hold due to the 2015

budget crisis. DFS reverted the funds to the Legislature in 2016 in response to mandated agency

budget cuts.

DFS initiated WES II a second time in early 2018 to take advantage of the 90/10 percent

funding split offered by the Centers for Medicare and Medicaid Systems. While the legislature

appropriated funding in early 2018, the 90 percent federal funds were only available through

December 31, 2018. With less than a year to meet the federal funds deadline, DFS requested that

their federal oversight agency, the Administration for Children and Families, allow DFS to sole

source bid with Deloitte, the current WES vendor. Administration for Children and Families

rejected the sole source request and mandated that DFS follow a complete procurement process.

DFS evaluated the current state of the project and determined that the amount of time they had left

to complete the Request for Proposal and subsequent project was unrealistic. Continuing with the

project meant that DFS would risk losing their federal matching funds if they were unable to

complete the project before the December 31, 2018, deadline.

24 Per DFS Official.

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Figure 2: Opportunity for DFS Connectivity to WINGS

Source: LSO summary of agency information

POTENTIAL ISSUES WITH INTERAGENCY CONNECTIVITY:

While the WINGS Project has the technological capacity to allow for interagency

connectivity and data sharing, there are several non-technological issues which may be

problematic, including system governance, agency IT structure, the timeline of the WINGS Project

module procurement and implementation, and potential costs.

GOVERNANCE

DFS expressed concern about governance issues related to interagency sharing of data

systems.25 One question in particular was if one agency needed to make changes to the system to


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accommodate their needs, would the other agency allow this? Both the Department of Health and

DFS have different federal regulators with different requirements for IT systems and federal

reporting. This could create conflicting goals for the agencies. Resource allocation, whether

funding or staffing, could also present a challenge to the successful governance of a cross-agency

system. Communication between agencies would be important to solving this issue. According

to DFS’ consultant the Department of Health’s modular alternative would require a lot of cross-

agency collaboration and shared governance considerations. This alternative would have to utilize

a modular approach and could be very demanding on staff for both development and

implementation. Operations costs and cost allocation would have to be carefully navigated and

negotiated between all parties.26

AGENCY IT STRUCTURES

The Department of Health and DFS have different IT structures. The Department of Health

has in-house IT, as well as a limited number of Enterprise Technology Services (ETS) staff

assigned to the agency. DFS does not have in-house IT staff and instead utilizes an ETS IT

Coordinator. These two models of IT staffing could lead to incongruencies between how the

Department of Health and DFS deal with and solve problems.

WINGS PROCUREMENT AND IMPLEMENTATION SCHEDULE

Department of Health’s Care/Case Management Module is going through procurement in

Spring 2020. CCMS provides case management services for the Medicaid home and community-

based waiver programs. It can be leveraged by DFS as a child welfare and juvenile probation case

management system, but the procurement and implementation schedule may not coincide with

DFS’ needs.

PROJECT COMPLEXITY AND COST

As discussed above, DFS’ use of the WINGS Project for their CCWIS system is likely to

be the longest and most complicated alternative available to DFS due to three issues. First, this

alternative would likely take the longest to implement due to cross-agency collaboration and

governance negotiations between agencies. Second, during the design and building phase there

could also be conflicting priorities between agencies. Finally, this alternative will be the most

complicated to manage during the maintenance and operations phase due to multiple vendors and

shared system governance. The modular approach is not widely tested in other states, so it comes

26 Alternatives Analysis for Comprehensive Child Welfare Information Systems Planning and Procurement Project.

December 6, 2019. Public Knowledge.

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with more risks of failure.27 The estimated cost of this alternative was $32,765,000, compared to

$27,965,000 and $33,965,00 for the two other proposed alternatives. The consultant found that

the alternative of using the WINGS Project was possible, but that there are serious issues that need

to be dealt with to make the integration successful.

MONITORING CHINS POPULATIONS ACROSS AGENCIES:

Currently, there is no way to track the CHINS population across agencies (DFS,

Department of Health, Wyoming Department of Education), or the Judicial Branch with either one

system or one identifier. WINGS, or interconnectivity in general, could alleviate some of these

tracking issues. Interviews with the Department of Health, DFS, and ETS leadership provided two

concrete ideas regarding how the CHINS population could be tracked across agencies, depending

on the form of interconnectivity chosen:

ASSIGNMENT OF A UNIQUE CHINS IDENTIFIER

The Department of Health explained that it was possible to create unique CHINS identifiers

within the WINGS Project. Each CHINS child who interacted with a WINGS Project system

would be given a unique CHINS identifier, also called a program code, in addition to their

Medicaid identifier. 28 All the agencies who were a part of the WINGS Project could have access

granted. This would allow for searchability by those with access to the system. One of the benefits

of this option would be the ability to utilize the Data Warehouse to readily create reports and

analyze data for the CHINS population. Utilization of an identity and access management system

would be necessary to control which agencies and which personnel within each agency would be

permitted access to sensitive CHINS data.

ASSIGNMENT OF A STATE IDENTIFIER

Both DFS and ETS theorized it would be possible to create a unique Wyoming State

identifier for all individuals who interact with Wyoming state government.29 This would allow for

different populations to be better tracked across agencies, even without interagency data sharing.

A second field would be necessary to determine which identifiers correspond to individuals in the

CHINS population. A list of the identifiers could then be searched across different agencies.

Interagency data systems or sharing would enhance the ability to monitor the CHINS population

under this option but would not be required for the monitoring to work. While the creation of State

27 Alternatives Analysis for Comprehensive Child Welfare Information Systems Planning and Procurement Project.

December 6, 2019. Public Knowledge.



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identifiers would provide certain benefits and efficiencies, both agencies expressed concerns about

privacy issues. In general, ETS stated that some of the privacy concerns regarding a State identifier

could be mitigated using an identity access and management system which is a system that is

already part of the WINGS Project.30

COLLABORATION AND CONVERSATION BETWEEN RELEVANT AGENCIES:

DEPARTMENT OF HEALTH – The Department has had conversations with DFS’ consultant, who

has consulted for both the Department of Health and DFS in the past, as recently as October 2019

regarding the potential connectivity of the WINGS Project and CCWIS System.31 Department of

Health Medicaid Officials serve on the CCWIS Project Team and the Department of Health

worked with DFS’ consultants on the Alternatives Analysis. However, the Department of Health’s

current opinion is that they are not ready for the long-term conversations that would need to occur

for successful expansion. The agency is focused on simply completing the WINGS Project before

expanding its scope. The Department of Health has not had conversations with the Wyoming

Department of Education or the Judicial Branch.

DFS – DFS and the Department of Health have had conversations about interagency connectivity,

data sharing, and leveraging both agencies’ IT systems over the years.32 As explained above, the

conversations regarding WES II did not come to fruition, but DFS is leveraging a partition of

WES’ Electronic Data Management System as their own data management system. DFS used

Department of Health information to inform their consultant’s Alternatives Analysis of CCWIS

alternatives.

ETS – Since the new Chief Information Officer (CIO) started, ETS has had high level discussions

with all State agencies about existing and planned data systems. The CIO met with the Department

of Health’s State Medicaid Director and WINGS Project Manager regarding the WINGS Project.

Two ETS staff were on the WES Steering Committee. One ETS staff member was a part of the

WINGS Project Evaluation Committee to provide technical assistance.

CONCLUSION:

The WINGS Project is an IT system that is versatile due to the modular nature of its

construction. The majority of the modules of the system are live and the last module scheduled to

go live, the Care/Case Management System, is planned to launch in 2021. The versatility in the



32 Ibid.

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system allows for interagency connectivity to be an option for the future. There are four ways to

accomplish this objective for the prospective agencies and they are as follows:

• Creation of a module within the WINGS Project

• Utilization of an existing WINGS module

• Utilization of the Data Warehouse alone

• The creation of a wholly separate system that interacts with the Enterprise Service Bus

This connectivity has theoretical benefits for both the Department of Health and the prospective

agencies participating in it. Conversations between the Department of Health and other agencies

about these options have been limited up until now. The most likely candidate for future

interagency connectivity is DFS’ upcoming CCWIS system. However, there are issues that make

this option difficult for both agencies. They include governance issues, different agency IT

structures, different procurement and implementation schedules, and the project complexity and

cost. If these issues were overcome there are possible benefits regarding data sharing and the

possible future monitoring of the CHINS populations.

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Appendix A: Summary of WINGS Project Procurement The WINGS Project:

The Wyoming Department of Health (WDH) conducted competitive sealed bidding using the

Request for Proposal (RFP) process for each module in the WINGS project. A RFP is the

document used to solicit proposals from potential providers (proposers) for goods and services.

WHD indicates all modules have been competitively procured through RFP, none of the modules

have been sole sourced33, and none are planned to be sole sourced at this time.34

Appendix A Table 1: Three Methods for Procuring Goods and Services

Competitive Sealed

bidding

Competitive Negotiation Noncompetitive Negotiation

When supplies and services

exceed $7,500, and when the

final product is so similar

that cost of the project could

be the only criteria used in

evaluating a project, a

competitive sealed bidding

is required.35

When it is determined in

writing, by the administrator

of the agency letting the bid,

that competitive sealed

bidding is not feasible or

practical.

Only when competition is not

feasible as determined by the

administrator of the agency

letting the bid in writing prior

to award and the Governor or

his designee approve.

Source: LSO summary of Department of Administration and Information documents.36

33 Sole Source is a procurement method where only one supplier possesses the unique ability to or capability to meet

the particular requirement of the solicitation.

34 Per WDH Division of Healthcare Financing Official.

35 Several statutory alternative procurement process and exceptions are afforded to agencies.

36 Management Audit Committee, LSO Scoping Paper: State Procurement & Leasing of Non-Governmental

Facilities for State Agencies, December 12, 2016.

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Procurement Summary:

Appendix A Table 2 (below) provides additional information relating to the RFP process,

budget, funding sources, vendors, and current status for each of the part of the Project. This

Project is being completed in phases as indicated by the differing RFP and contract dates. In

reviewing the table columns:

• The RFP Released to Vendors indicates the date the RFP was released to the public

and start to accept vendor proposals.

• Responses known as proposals to each RFP must be submitted in accordance with the

instructions and before the scheduled proposal opening deadline this is the RFP Close

Date.

• Not all bids meet the qualifications in the RFP which requires the proposer (bidder) to

be a business entity or individual who has the financial and technical capacity to

perform the requirements and fulfill the subsequent contract. Those vendors meeting

the requirements are considered Qualified Bids.

• Once a bid is awarded contracts are negotiated, reviewed, and receive appropriate

approvals, before the agency and vendor sign the contract. The contract executed date

is the date of the final signature on the contract, which for this project is the WDH

Director.

• The next three columns provide the Total Projected Budget for each module along with

the corresponding Funding Sources and percentages. WDH indicates the current status

is on budget for all modules.

• Vendors with executed contracts are identified.

• Project Status provides the date the module system went live if completed or

information as to where the module is in the project process.

APPENDIX A TABLE 2

PROCUREMENT SUMMARY

WYOMING INTEGRATED NEXT GENERATION SYSTEM (WINGS)

WYOMING DEPARTMENT OF HEALTH

MODULE MODULE FUNCTION RFP

RELEASED

TO

VENDORS 1

RFP

CLOSE

DATE

BIDS

RECEIVED

QUALIFIED

BIDS

CONTRACT

EXECUTED

TOTAL BUDGET

(PROJECTED)

STATE

FUNDING

10%

(PROJECTED)

FEDERAL

FUNDING

90%

(PROJECTED)

VENDOR PROJECT STATUS

Pharmacy Benefit

Management System

(PBMS)

Processes pharmacy point-

of-sale claims and handles

pharmacy related prior

authorizations, among

other duties.

6/2/15 8/5/15 4 4 3/13/16 $1,300,000 $130,000 $1,170,000 Change

Healthcare

(CHC), formerly

Goold Health

Systems (GHS)

7/23/17

System live

System Integrator –

Enterprise Service Bus

(SI-ESB)

Connects all of the

modules together into an

enterprise system so that

the WINGS vision can be

realized.

9/30/16 11/30/16 5 3 10/10/17 $21,103,000

$2,110,300

$18,992,700

Deloitte

Consulting LLP

11/20/18

System live2

Data

Warehouse/Business

Intelligence Tools-

Report (DW/BI)

Serves as the main data

storage repository for all

the other WINGS Project

modules.

4/4/17 5/26/17 7 6 03/19/18 $14,950,000

$1,495,000

$13,455,000

Deloitte

Consulting LLP

3/29/19

System live3

Fraud, Waste, & Abuse

Case Tracking (FWA)

Replaces and enhances the

previously existing FWA

tool.

6/12/17 8/28/17 4 3 5/25/18 $823,297

$82,330

$740,967

Deloitte

Transactions and

Business

Analytics LLP

5/10/19

System live4

Provider Enrollment,

Screening, & Monitoring

(PRESM)

Will provide a solution to

streamline the internal and

external user’s experience

through consolidation,

enhancement, and

automation of existing

provider enrollment

processes.

12/12/18 1/10/19 1 1 8/23/19 $1,922,902

$192,290

$1,730,613

HHS

Technology

Group, LLC

(Commercial

off-the-shelf

product)

In progress for

implementation

7/23/2020

1 All modules have been competitively procured through RFP. No system modules have been sole sourced, and none are planned to be sole sourced at this time. 2 Continuously implementing new system interfaces, and technical connections through 2020 and 2021. 3 Data connections through 2019 and 2020. Major onboarding of users in February 2020. Continuously implementing new data connections and reporting capabilities through 2020 and 2021. 4 In final stages of system acceptance process to move into Federal certification phase.

Benefit Management

System – Claims

Processing with Third

Party Liability (BMS)

Will conduct and manage

claims processing and

supporting services.

1/10/19 4/5/19 45 3 Expected

February

2020

$22,864,158

$2,286,416

$20,577,742

Contract awarded

7/2019, not yet

executed 6

Electronic Visit

Verification (EVV)

A technology that tracks

where and when a client

receives services.

9//9/19 10/18/19 10 6 N/A7 Statewide

$1,357,500

Self-directed

$150,000 8

Statewide

$135,750

Self-

directed

$15,000

Statewide

$1,221,750

Self-directed

$135,000

Planned system

live for May 20219

Independent Verification

& Validation (IV&V)

Required oversight by the

Federal Government and

is not a system.10

8/31/16 10/5/16 4 4 2/10/17 $2,519,449 $251,945 $2,267,504 SLI Global

Solutions

N/A11

Care/Case Management

System 2 (CCMS-2)

Module

N/A N/A TBD

Upcoming12

N/A $1,889,430

$188,943

$1,700,487

Project planning

RFP planned

release April or

May 2020 13 Testing QA/QC $350,92714 $35,093 $315,834 Terminated CCMS $97,60015 $9,760 $87,840 Terminated External Contractor

Support $2,719,911 $271,991 $2,447,920

Internal Staffing, Facility,

Equipment, Travel, and

Related Costs

$7,297,70716

$729,771 $6,567,936

Total $79,345,881 $7,934,589 $71,411,293

Source: Wyoming Department of Health

5 Third Party Liability was initially procured by RFP but there were no bidders at bid opening. The State team interviewed potential vendors as part of an assessment of the RFP process, and reasons given were cost, technical requirements, and security

requirements. This led the State team to combine this scope with the Benefit Management Services RFP in order to not increase budget or schedule. 6 Contract currently in Centers for Medicare & Medicaid Services (CMS), Wyoming ETS and Attorney General review. Expected to go live in August or September of 2021. (18-month implementation from date of contract execution.) 7 In the process of bid award and entering contract negotiations. 8 Supplemental Budget request of approximately $2.4 M of which approximately $1,589M for the EVV in order to combine two federal requirements. 9 12-month implementation consisting of a 6-month technical system implementation, followed by a 6-month training/onboarding for providers. 10 The vendor helps the State to meet project responsibilities requirements, objectives, milestones, and deliverables for all procured WINGS project components and phases. 11 Continues through the life of the project though final certification. 12 CCMS was previously procured through RFP and contracted and was terminated using the without cause provision within the State contract. The first procurement had 7 initial bidders, and 2 that made it to qualified status. After this contract

termination, the State team did a lessons learned and thought that revising the RFP would help contribute to successful project implementation. The CCMS is currently in planning for re-procurement. 13 December 2021 for expected system live. (12-month implementation planned.) 14 The Testing QA/QC project was terminated, and the funding moved to External Contract Support. 15 The initial CCMS project was terminated and the funding moved to CCMS-2 16 $75,000,000 appropriation included 1 staff position, WDH utilized existing staff in order to take advantage of the 90/10. These positions had been funded with General Funds or with a federal split of less than 90/10. WDH has also been able to claim the

90/10 funding for all project related facility, equipment, travel, and other related cost to maximize allowable but unsustainable funding source.

W DEPARTMENT OF HEALTH “WINGS” M INFORMATION SYSTEM

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