Child Welfare Regional Training Session 2006

 

State of Nirvana -- SACWIS Title XIX Interface

Case Study Exercises

 

Case Study Scenario

One of the SACWIS system requirements is to have a bi-directional interface between the SACWIS system and the state’s Title XIX system. 

 

Per ACF AT-OSS-05:

 

             The interface between the Title XIX system and the SACWIS must

            (1) Provide for the exchange of information needed by the State Medicaid   eligibility system to calculate and track Medicaid eligibility for children in foster     care,

            (2) Allow for the automatic exchange of common and/or relevant data           between the two systems (to prevent duplicate data entry), and

            (3) Capture the data necessary to report AFCARS foster care element #63 (this     element indicates whether the child is eligible for, or receiving assistance       under Title XIX).

 

Children receiving IV-E foster care are categorically eligible for Medicaid if they are citizens of the United States (new citizenship requirement for Medicaid goes into effect July 1, 2006). 

 

NSACWIS Status

The NSACWIS system does not have a functioning interface with Title XIX, IV-A, or IV-D.  A IV-E eligibility determination function is built into the NSACWIS system. 

 

Constraints

            Business:

q     The child welfare (business) unit, the Division of Family Services, in Nirvana state is part of a larger Nirvana Department of Social Services (NDSS). 

q     The IT department doing software development and maintenance for your SACWIS system is also housed at NDSS in a division called the Division of Information Systems (DIS), which houses IT staff supporting all software applications used by the NDSS including SACWIS. 

q     Hardware and telecommunications support are provided Nirvana Information Technology Department (NITD), the state’s central technology department which is responsible for all technology acquisition and for hardware, telecommunications, security, and standards. 

q     The eligibility determination function for Medicaid (and other benefit programs) is also within NDSS, in a separate division called the Division of Benefit Programs.

q     In Nirvana, the Title XIX cognizant state agency is the Department of Medical Assistance Services (DMAS) which is responsible for providers, payments, card distribution, and the MMIS system, which it contracts out to a third-party provider, Rich and Healthy, Inc. 

q     An interagency agreement exists between NDMAS and NDSS which outlines their multifold relationship including the exchange of data, the provision of medical services for children in foster care, and the NDSS responsibility for determining eligibility for Medicaid on behalf of DMAS. 

            Technical:

q     The SACWIS system is a combination of client-server and web-based technologies as Nirvana is incrementally migrating its application to the web. 

q     The NSACWIS system uses a Sequel back-end and operates on a secure, state network which connects all 40 state-owned and operated local social services sites.

q     Microsoft Dot.Net is used for the web-based components of the NSACWIS application. 

q     The system used to determine eligibility for Medicaid and other programs operates on an old legacy system. 

q     The MMIS system uses JAVA and an Oracle back-end. 

q     An existing “bridge” between the NDSS eligibility system and the DMAS MMIS system exchanges data on those found eligible for Medicaid. 

 


Instructions

 

            Objective:

q     Develop and verify user requirements for the NSACWIS Title XIX interface.

 

            Exercise #1:

q     Please identify five potential stakeholders (or stakeholder groups) from whom we need to gather stakeholder needs.

q     Please identify five to ten needs and their associated stakeholder(s) for this interface.

q     Synthesize stakeholder needs.

q     Prioritize top five stakeholder needs.

 

            Exercise #2:

q     Write high level user requirements for the top five stakeholder needs.

q     Run the high level requirements through the evaluation criteria and modify, as necessary.

q     Write detailed requirements (specifications) for two of the high level requirements.

q     Verify the two detailed requirements using the evaluation criteria.