Opportunities under the Affordable Care Act for Human Services Programs to Modernize Eligibility Systems and Expedite Eligibility Determination. Jointly buying or building service capacities that will serve both programs


The most straightforward way for human services programs to benefit from this time-limited opportunity is to join with Medicaid programs in the joint procurement or development of software or hardware that will serve both programs. The 2012 letter from HHS and FNS includes the following, non-exhaustive list of business services that could fit within this approach:15

✓ Client Portals

✓ User Interfaces

✓ Master Client Index

✓ Business Rules Engine and Operating Systems

✓ Interfaces to: Federal and State verification sources; Community Assisters/ Outreach Organizations; Exchange Infrastructure

✓ Enterprise Service Bus

✓ Data Warehouse

✓ Privacy and Security Controls

✓ Workflow Management Tools

✓ Business Intelligence

✓ Notices

✓ Customer Services Technical Support

✓ Automated Account Creation and Case Notes

✓ Identity Management

✓ Document Imaging and Digitization of Case Records

✓ Analytic Tools, including Decision Support and Program Integrity

✓ Telecommunications

✓ Information Security and Privacy Controls

✓ Infrastructure and Data Center Hosting

The American Public Human Services Association (APHSA) has developed a “toolkit” that provides state officials with a practical and thorough guide towards pursuing this general strategy.16 There is no need to revisit that ground here.

We do note the wide spectrum of possibilities facing states in this general area. A state can use the cost-allocation exception to develop specific, joint functionalities that achieve incremental gains; or it can take advantage of enhanced federal funding, for as long as it lasts, to pursue a broad vision of integrated eligibility determination for health and human services programs.

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