Issue 2

June 2012

Table of Contents

HBX Executive Board Nominated

Plans for New Health and Human Services IT System

Spotlight: ME&E Subcommittee

Market Insurance Recommendations Update

Health Reform Job Openings

June Calendar

www.healthreform.dc.gov

EXCHANGE EXECUTIVE BOARD MEMBERS NOMINATED

Mayor Vincent C. Gray announced the nominations of prominent health care professionals to the newly created Executive Board of the Health Benefit Exchange Authority (HBX).  The following nominees will be submitted to the DC Council for confirmation:

• Dr. Mohammed Akhter, current Director of the DC Department of Health
• Henry J. Aaron, PhD, Senior Fellow at the Brookings Institution
• Leighton Ku, PhD, Professor and Director of the Center for Health Policy Research, George Washington University
• Khalid Pitts, Director of Strategic Campaigns, SEIU
• Kate Sullivan Hare, Director, Policy Outreach and Public Affairs, Robert Wood Johnson Foundation
• Diane C. Lewis, Health Care Policy Consultant
• Kevin Lucia, Research Professor and Project Director, Health Policy Institute, Georgetown University

The DC Health Care Exchange Emergency Authorizing Act of 2011 called for the establishment of a seven-member Executive Board to govern the Health Benefits Exchange Authority.  Once the board members are confirmed, regular public meetings will be scheduled.

DISTRICT PLANS FOR NEW HEALTH AND HUMAN SERVICES IT SYSTEM

Planning is currently underway for the implementation of a new integrated health and human services system in the District of Columbia, called the DC Access System (DCAS). DCAS will provide all of the health benefit exchange functions required by the Affordable Care Act (ACA) as well as automated state-of-the-art health and  human services eligibility, enrollment and case management functions.  The new system will be web-based and will serve individual consumers, qualified employers and their employees, navigators and other assistors, health plan providers, brokers and agents, and designated DC government workers.

The objectives of DCAS implementation are to:

• Offer District residents a one-stop portal to access health and human services benefits
• Create an insurance marketplace for individuals and employees
• Replace the District’s aging eligibility determination and enrollment platform with a modernized, rules-based engine
• Integrate with federal and state data hubs to support real-time verification for eligibility applications
• Support new plan management and financial management processes for the health benefit exchange
• Redesign, expand and integrate Medicaid and human services case management functionality
• Design and implement a robust consumer friendly, web-portal presentation
• Integrate both current and new, consumer contact center operational and technical infrastructures
• Design oversight and governance rules, guidelines, and policies

DCAS will replace ACEDS, the District’s eligibility determination and enrollment platform that has been in use since 1992. DCAS will provide horizontal program integration so that consumers can apply for subsidized commercial health insurance and/or public benefits including Medicaid, the Children’s Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance to Needy Families (TANF), and other housing, employment, training, energy, nutrition and health care assistance programs

The new system will be developed in three releases.  Release 1, the core technical solution, will be implemented by October 1, 2013.  It will meet all required ACA functionality for the health benefit exchange, including the web portal, financial management, customer call center support, integrated eligibility and enrollment with Medicaid, and integration with various verification systems at the local and federal levels. Releases 2 and 3, which will focus on transitioning enrollment and eligibility processing for TANF, SNAP and District-provided social services programs, are projected to be implemented in the fall of 2014 and 2015, respectively.

Funding for the new system is provided through grants from the US Department of Health & Human Services, US Department of Agriculture and the Government of the District of Columbia.

The District has completed the requirements gathering phase of the project and will seek a qualified systems integration vendor who will provide and implement DCAS.  The Request for Proposals for this competitive procurement is expected to be released by June 22.  Click here to review the draft Statement of Work.  The new vendor is expected to be selected by October 2012.

SPOTLIGHT:  MEDICAID EXPANSION AND ELIGIBILITY SUBCOMMITTEE

The Health Reform Implementation Committee (HRIC) is responsible for keeping the Mayor advised on the implementation of the Affordable Care Act (ACA) and making sure that health reform implementation activities in the District are carried out successfully.  The HRIC operates through six standing subcommittees, one of which is the Medicaid Expansion and Eligibility (ME&E) Subcommittee.

This subcommittee is responsible for Medicaid expansion activities as well as activities related to eligibility and enrollment changes for all existing and new insurance affordability programs in the District.  Chaired by the Department of Human Services, the subcommittee also includes representatives with varied expertise from the DC Departments of Human Services, Health, Mental Health, Health Care Finance, Disability Services, and from educational, legal, and other advocacy organizations.

One recent accomplishment was the completion of the Sister Agency Survey.  The purpose of the survey was to gain a better understanding of the current procedures and processes used by other District agencies and community partners for handling eligibility and enrollment into DC public assistance programs. The survey also gathered information to help determine which capabilities will be needed in the design and build of the new integrated eligibility and enrollment system (see article above).  The survey included data from 45 respondents, representing 10 District agencies and 4 community partners.  The survey provided valuable insights on how the current eligibility and enrollment system (ACEDS) is being used and challenges users face with the current system as well as recommendations for the new system.

The ME&E Subcommittee meets the second Thursday of every month. See the calendar on the Health Reform website for details.

Do You Have a Question about Health Reform? 

Check out the Frequently Asked Questions on the health reform website.  If you don't see your question, send it to [email protected].  We will try to address it in future newsletters.

MARKET INSURANCE RECOMMENDATIONS UPDATE

The Health Reform Implementation Committee (HRIC) meeting on May 17 provided another opportunity for stakeholders to comment on the Insurance Subcommittee’s Market Insurance Recommendations. The recommendations were developed by the Insurance Subcommittee and staff of the DC Department of Insurance, Securities and Banking, and were presented to the HRIC after extensive consultation and engagement with stakeholders.

Due to the high level of interest in the recommendations, the comment period was extended and time was provided at the May meeting for additional public comments. Once in place, the Executive Board of the Health Benefit Exchange Authority will be provided with the Insurance Subcommittee recommendations for consideration. 

Did You Know...?

...Health insurance plans can no longer set lifetime caps on coverage or unfair annual caps on the dollar value of benefits.

HEALTH REFORM JOB OPENINGS

Join the District’s Health Reform Team!

District of Columbia health and human services agencies are seeking candidates to work on health care reform and the District’s new health care and human services eligibility and enrollment solution. Through the DC Access Project (DCAP), the District of Columbia is breaking new ground with its implementation of the Affordable Care Act, with a goal of improving access to services for all District residents through a new health care and human services solution, which includes the District’s Health Benefit Exchange (DC HBX).

DCAP is an exciting two-to-three-year effort where team members work to develop individual and family focused benefits policies, modernize major service delivery systems, and establish an HBX as required in the Affordable Care Act.

To help make this vision a reality, several positions are now open at the DC Department of Human Services and DC Department of Health Care Finance.  Eligible candidates should have experience and knowledge related to Medicaid eligibility, health insurance, human services, consumer engagement, and/or implementation of new IT systems.

If you are interested in the following positions in the Department of Health Care Finance, please visit the DC Jobs website for more information.

• Medicaid Program Manager (Job ID: 20032)
• Medicaid Policy Project Manager (Job ID: 20033)
• Exchange Consumer Assistance Project Manager (Job ID: 20024)
• Exchange Information and Privacy Officer (Job ID: 20028)
• Ombudsman Consumer Assistance Project Manager (Job ID: 20034)

If you are interested in the following positions in the Department of Human Services, please send your cover letter and resume to [email protected]. These positions will also be posted on the Department of Human Resources website (www.DCHR.dc.gov) in the coming weeks.

• Program Analyst
• Management Analyst
• IT Project Manager
• IT Specialist (Mainframe)
• IT Specialist (Application Software)
• IT Specialist (Database Manager)

JUNE CALENDAR

Wednesday, June 6, 2:00 PM

Communications Subcommittee Meeting

John A. Wilson Building, 1350 Pennsylvania Avenue NW, Room 306

Monday, June 11, 3:00 PM

HBX Insurance Market Working Group

Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor

Tuesday, June 12, 11:00 AM

Insurance Subcommittee Meeting

Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor

Tuesday, June 12, 2:00 PM

Exchange Operations Subcommittee Meeting

Department of Health Care Finance, 899 North Capitol Street NE, Room 6130

Wednesday, June 13, 3:00 PM

Information Technology Subcommittee Meeting

Department of Human Services, 64 New York Avenue NE, 6th Floor Large Conference Room

Thursday, June 14, 2:00 PM

Medicaid Expansion & Eligibility Subcommittee Meeting

Department of Human Services, 645 H Street NE, 5th Floor Conference Room

Thursday, June 14, 2:00 PM

Health Services Delivery Subcommittee Meeting

Department of Health, 899 North Capitol Street NE, Room 535

Thursday, June 21, 2:00 PM

Health Reform Implementation Committee Executive Committee Meeting

Department of Health Care Finance, 899 North Capitol Street NE, Room 6100

Friday, June 22

DC Access System RFP Issued

Monday, June 25, 3:00 PM

HBX Insurance Market Working Group

Department of Insurance, Securities and Banking, 810 First Street NE, 7th Floor

Did You Know…

…Over 200,000 District residents receive health care services administered by the DC Department of Health Care Finance (DHCF).

Produced by The Crider Group