A legislative committee Thursday approved funding to hire 37 staff members to help implement a massive technological overhaul for the Agency of Health and Human Services.
The Joint Fiscal Committee voted 7-2 to allocate up to $600,000 for 37 short-term employees who will help oversee the development of the Integrated Eligibility project, one part of the long-term Health and Human Services Enterprise technology project.
The Health and Human Services Enterprise (HSE) system will replace ACCESS, the technological mainframe for the agency that is more than 30 years old. It encompasses all of the agency’s programs and departments, which are divided into four branches.
Integrated Eligibility and Enrollment (IE) includes Reach Up, 3SquaresVT, DAIL, and other general assistance programs. HSE will connect IE to services at Vermont Health Connect, the Medicaid Management Information System and the Health Information Exchange.
“The end objective of the agency is to have one single system that provides services to all of the programs in the agency, so that when someone comes in contact with the agency, they will have one caseworker instead of having to go door to door to door,” said Lawrence Miller, chief of Health Care Reform.
The request came just hours after state economists dropped their 2015 revenue forecast by $31 million, requiring agencies to submit budget cuts. After hearing the news, Miller said he considered withdrawing the request.
But in terms of guaranteeing federal monies and completing the project relatively quickly, the time was right, he said.
“We decided that the merits (of the project) are solid and we ought to keep going,” he said.
Testifying before the committee, Miller explained how the project would serve residents. He offered the example of a Vermonter calling the agency for benefits after being laid off. Ideally, when the HSE is in place, Miller said, “The amount of work the agency needs to do provide services will be reduced and the amount a Vermonter has to do to get eligible will be reduced.”
The technology project was designed six years ago, though implementation was accelerated by the Affordable Care Act, Miller told the committee. AHS estimates the project will be completed in 2019.
The federal government will cover between 90 percent and 95 percent of the cost. The $600,000 that makes up the match approved by the state includes salaries for all 37 employees if they were hired early and worked through the end of the process, Miller said. He assured the committee that all of that funding wouldn’t be necessary.
Thirteen of the employees will work in the Program Management Office under Stephanie Beck, director of the HSE. The rest will be “subject matter experts,” and will work alongside IT personnel and agency staff to ensure that the technology upgrades meet the needs of those who use it.
“It’s not the caseworkers that ought to be doing the work the way the system tells them to, the system ought to be designed to fit the needs of the caseworker,” Miller said.
The state is in the midst of completing a hiring process for an outside company that will design and implement the IT system necessary to underpin all of AHS’ services. The additional employees, Miller said, will make the process smoother and increase the chance of success for the HSE project.
The agency is currently considering several responses to its request for proposals. It plans to choose a company and hash out a contract within the next few months. Implementation will be incremental and the timeline for the new system somewhat depends on the vendor’s estimates, but Beck said the desired date for Vermont Health Connect to be linked to the system Vermont would be by 2016.
But, Miller added, “I don’t think anyone really expects that to come in at that date.”
Committee Chair Rep Martha Heath, D-Westford, wasn’t worried by the ambiguity of the timeframe.
In her experience, Heath said, successful businesses “are the ones that have the businesses processes mapped ahead of time by the people on the ground before they design the technology.”
“I’m comforted, to some degree, by what I’m hearing,” she said of the state’s approach.
Other lawmakers, however, weren’t so understanding. The AHS request comes as the the state’s online health exchange continues to struggle. On Thursday, the state said that about 22,000 Medicaid recipients had not been re-enrolled for coverage.
Legislators’ frustration over the exchange’s rollout emerged in their discussion of the proposal.
“Your goals are laudable and your explanation is excellent, but my confidence in the state pulling off a massive IT program is close to zero,” said Rep. Dave Sharpe, D-Bristol.
Sen. Tim Ashe, D-Chittenden, described his own frustration in his attempts to get a mailed invoice as he navigated Vermont Health Connect.
“In World War II, they developed a nuclear weapon in a few years,” Ashe said. “And we can’t get a program to send me a mailed piece of paper.”
But that, Miller said, was precisely why he, as chief of Health Care Reform, was the one to testify to the committee.
“My participation today was a more an extension of the work the governor asked me to do in January — to really work through lessons learned and to apply those lessons to the Health and Human Services Enterprise project, to work with the Department of Information and Innovation and others and to make sure we don’t find ourselves in this position again.”
Ashe and Sen. Diane Snelling, R-Chittenden, cast the two negative votes on allocating the $600,000.
“It’s not that we don’t need to improve these systems, because we certainly do,” Ashe said. “The short story is I’m not yet confident in the plan, in terms of staffing and costs and what we’ll get for it. More time would have been helpful.”
