20041019_m

COUNTY OF SAN MATEO

Human Services Agency

DATE:

September 30, 2004

BOARD MEETING DATE:

October 19, 2004

TO:

Honorable Board of Supervisors

FROM:

Maureen D. Borland, Director, Human Services Agency

Kathryn Ciamarro, Director of Automation

SUBJECT:

Third Amendment to the Agreement with Deloitte Consulting for the One-e-App Project

Recommendation

Adopt a Resolution authorizing:

1.

Execution of a Third Amendment to the Agreement with Deloitte Consulting increasing the amount by $241,500, for a total obligation of $690,000, to provide for enhancements to the One-e-App program, develop an interface to the Welfare Case Data System, and extend the Agreement and maintenance for one year to July 31, 2005; and

2.

The Director of Human Services Agency (HSA) to execute amendments and modifications to this Agreement not to exceed $25,000.

Background

The San Mateo County Children’s Health Initiative (CHI), the San Mateo County Community Access Program (CAP), and the San Mateo Medical Center (SMMC) provide for the cost of this program. The total amount of the Phase I was $99,000. Funding for the Phase I was provided through the CHI. The Human Services Agency was reimbursed 100% of the costs. The total amount for Phase II was $343,000. This included the cost of services at $256,000 and annual maintenance at $87,000. The contract obligation for both Phase I and Phase II was $442,000. The Second Amendment increased the Agreement by $6,500, to $448,500.

In both August and October of 2002, the Board of Supervisors took several actions to establish the San Mateo County Children’s Health Initiative (CHI) with the goal of providing health insurance to approximately 17,000 uninsured children from low-income and middle-income households who were not eligible for Medi-Cal and/or Healthy Families in San Mateo County. As part of this action, the Board of Supervisors charged the Human Services Agency (HSA) with determining and overseeing final eligibility for the new Healthy Kids Program.

In response, HSA developed One-e-App, a web-based software application that automates the processing, collection and storage of data and the following work plan to implement health programs into One-e-App: Phase I - Healthy Kids - July 2003; Phase II - Medi-Cal and Healthy Families for Children - January 2004; Phase III - Adult Medi-Cal and Food Stamps – scheduled for Winter of 2004; and Phase IV - CHDP, Breast Cancer Detection Program, Family Planning, and WIC- scheduled for Summer of 2005. Over the past year HSA has successfully completed Phase I and Phase II using One-e-App to complete children’s health insurance applications.

One-e-App provides the County with the opportunity to implement a universal web-based enrollment system that enables families to apply for the Medi-Cal, Healthy Families and Healthy Kids programs without having to fill out more than one enrollment application. The system expedites eligibility determination and enrollment; improves data tracking, and integrates with the existing Health Plan of San Mateo (HPSM) and HSA’s Information Tracking systems. The goal is for One-e-App to eventually include all health insurance programs for children and adults, making the system a one-stop health insurance enrollment process for the entire family.

On March 13, 2003, the Board of Supervisors executed a contract with Deloitte Consulting to develop and implement the One-e-App, enabling San Mateo County to become the first county to launch this revolutionary technology.

On May 13, 2003, the Board of Supervisors approved a First Amendment to add Phase II, to expand the existing system to include additional managed health programs such as San Mateo Medi-Cal’s adult WELL program.

On December 16, 2003, the Board of Supervisors approved a Second Amendment to enhance the One-e-App system by adding a paper renewal form option and to provide data entering capabilities.

Discussion

The Human Services Agency seeks to amend the Agreement with Deloitte to:

1. Implement Healthy Kids enhancements to the One-e-App, including:

• A two way interface between One-e-App and HPSM to identify previously enrolled children and link them back to the original HPSM ID number;

• Functionality to allow application assistors to reactivate and link previously disenrolled Healthy Kids members to the original record;

• Changes to Healthy Kids Eligibility Worker (HK EW) workload screens to account for the higher than projected volume of submitted applications;

• Verification safeguards to prevent the high number of incomplete applications from being submitted to the HK EW;

• Changes to the family contribution screens for new and renewal applications as a result of policy changes.

2. Develop and implement an interface to the Welfare Case Data System (CDS) ensuring that Medi-Cal applications will be transferred immediately to HSA.

3. Extend the maintenance contract to provide support services for help desk and on-going maintenance checks of the hardware/software infrastructure.

The enhancements and the interface align with the One-e-App vision by further streamlining eligibility and enrollment and will be completed at a cost of $72/hour. This one-year maintenance contract provides the County with Deloitte’s expertise to manage this cutting edge technology. During this period, HSA and the Information Services Department will determine the most cost-effective long-term solution for maintenance which could include bringing components in-house, developing a county consortium approach, or maintaining the current framework.

A Request for Proposal Waiver was granted by the County Manager when the original Agreement was submitted. It is in the best interest of the County to continue with the Waiver for this Third Amendment with Deloitte Consulting. This Third Amendment is being submitted late due to extended negotiations to develop this Amendment.

County Counsel has approved this Agreement as to form, and Risk Management has approved the evidence of insurance. The Director of the Information Services Department supports this Agreement.

Vision Alignment

The One-e-App Program keeps the commitment to: Ensure basic health and safety for all and goal number 5: Residents have access to health care and preventive care, and Responsive, effective and collaborative government and goal number 21: County employees understand, support and integrate the County vision and goals into the delivery of services. This Amendment to the Agreement with Deloitte Consulting contributes to these commitments and goals since by assisting the Human Services Agency in developing a system to ensure that all our children are afforded the best possible health care.

Fiscal Impact

This Third Amendment increases the Agreement by $241,500, for a total obligation of $690,000. The new term of the Agreement is March 14, 2003 to July 31, 2005. The amended amount of $241,500 has been included in the Approved Budget for FY 2004-05. Funding will be received from the following sources: Health Services will provide reimbursement in the amount of $182,000, of which $153,000 is from California Health Initiative (CHI) and $29,000 is a contribution from the San Mateo Medical Center. Health Plan of San Mateo will provide reimbursement in the amount of $22,500 and the remaining $37,000 will be funded 100% by state and federal Medi-Cal administration revenue. There is no Net County Cost.



COUNTY OF SAN MATEO Human Services Agency

DATE:			September 30, 2004
BOARD MEETING DATE:			October 19, 2004

TO:		Honorable Board of Supervisors

FROM:		Maureen D. Borland, Director, Human Services Agency
		Kathryn Ciamarro, Director of Automation

SUBJECT:		Third Amendment to the Agreement with Deloitte Consulting for the One-e-App Project

Recommendation
Adopt a Resolution authorizing:
1.	Execution of a Third Amendment to the Agreement with Deloitte Consulting increasing the amount by $241,500, for a total obligation of $690,000, to provide for enhancements to the One-e-App program, develop an interface to the Welfare Case Data System, and extend the Agreement and maintenance for one year to July 31, 2005; and
2.	The Director of Human Services Agency (HSA) to execute amendments and modifications to this Agreement not to exceed $25,000.

Background
The San Mateo County Children’s Health Initiative (CHI), the San Mateo County Community Access Program (CAP), and the San Mateo Medical Center (SMMC) provide for the cost of this program. The total amount of the Phase I was $99,000. Funding for the Phase I was provided through the CHI. The Human Services Agency was reimbursed 100% of the costs. The total amount for Phase II was $343,000. This included the cost of services at $256,000 and annual maintenance at $87,000. The contract obligation for both Phase I and Phase II was $442,000. The Second Amendment increased the Agreement by $6,500, to $448,500.

In both August and October of 2002, the Board of Supervisors took several actions to establish the San Mateo County Children’s Health Initiative (CHI) with the goal of providing health insurance to approximately 17,000 uninsured children from low-income and middle-income households who were not eligible for Medi-Cal and/or Healthy Families in San Mateo County. As part of this action, the Board of Supervisors charged the Human Services Agency (HSA) with determining and overseeing final eligibility for the new Healthy Kids Program.

In response, HSA developed One-e-App, a web-based software application that automates the processing, collection and storage of data and the following work plan to implement health programs into One-e-App: Phase I - Healthy Kids - July 2003; Phase II - Medi-Cal and Healthy Families for Children - January 2004; Phase III - Adult Medi-Cal and Food Stamps – scheduled for Winter of 2004; and Phase IV - CHDP, Breast Cancer Detection Program, Family Planning, and WIC- scheduled for Summer of 2005. Over the past year HSA has successfully completed Phase I and Phase II using One-e-App to complete children’s health insurance applications.

One-e-App provides the County with the opportunity to implement a universal web-based enrollment system that enables families to apply for the Medi-Cal, Healthy Families and Healthy Kids programs without having to fill out more than one enrollment application. The system expedites eligibility determination and enrollment; improves data tracking, and integrates with the existing Health Plan of San Mateo (HPSM) and HSA’s Information Tracking systems. The goal is for One-e-App to eventually include all health insurance programs for children and adults, making the system a one-stop health insurance enrollment process for the entire family.

On March 13, 2003, the Board of Supervisors executed a contract with Deloitte Consulting to develop and implement the One-e-App, enabling San Mateo County to become the first county to launch this revolutionary technology.

On May 13, 2003, the Board of Supervisors approved a First Amendment to add Phase II, to expand the existing system to include additional managed health programs such as San Mateo Medi-Cal’s adult WELL program.

On December 16, 2003, the Board of Supervisors approved a Second Amendment to enhance the One-e-App system by adding a paper renewal form option and to provide data entering capabilities.

Discussion
The Human Services Agency seeks to amend the Agreement with Deloitte to: 1. Implement Healthy Kids enhancements to the One-e-App, including: • A two way interface between One-e-App and HPSM to identify previously enrolled children and link them back to the original HPSM ID number; • Functionality to allow application assistors to reactivate and link previously disenrolled Healthy Kids members to the original record; • Changes to Healthy Kids Eligibility Worker (HK EW) workload screens to account for the higher than projected volume of submitted applications; • Verification safeguards to prevent the high number of incomplete applications from being submitted to the HK EW; • Changes to the family contribution screens for new and renewal applications as a result of policy changes. 2. Develop and implement an interface to the Welfare Case Data System (CDS) ensuring that Medi-Cal applications will be transferred immediately to HSA. 3. Extend the maintenance contract to provide support services for help desk and on-going maintenance checks of the hardware/software infrastructure.

The enhancements and the interface align with the One-e-App vision by further streamlining eligibility and enrollment and will be completed at a cost of $72/hour. This one-year maintenance contract provides the County with Deloitte’s expertise to manage this cutting edge technology. During this period, HSA and the Information Services Department will determine the most cost-effective long-term solution for maintenance which could include bringing components in-house, developing a county consortium approach, or maintaining the current framework.

A Request for Proposal Waiver was granted by the County Manager when the original Agreement was submitted. It is in the best interest of the County to continue with the Waiver for this Third Amendment with Deloitte Consulting. This Third Amendment is being submitted late due to extended negotiations to develop this Amendment.

County Counsel has approved this Agreement as to form, and Risk Management has approved the evidence of insurance. The Director of the Information Services Department supports this Agreement.

Vision Alignment
The One-e-App Program keeps the commitment to: Ensure basic health and safety for all and goal number 5: Residents have access to health care and preventive care, and Responsive, effective and collaborative government and goal number 21: County employees understand, support and integrate the County vision and goals into the delivery of services. This Amendment to the Agreement with Deloitte Consulting contributes to these commitments and goals since by assisting the Human Services Agency in developing a system to ensure that all our children are afforded the best possible health care.

Fiscal Impact
This Third Amendment increases the Agreement by $241,500, for a total obligation of $690,000. The new term of the Agreement is March 14, 2003 to July 31, 2005. The amended amount of $241,500 has been included in the Approved Budget for FY 2004-05. Funding will be received from the following sources: Health Services will provide reimbursement in the amount of $182,000, of which $153,000 is from California Health Initiative (CHI) and $29,000 is a contribution from the San Mateo Medical Center. Health Plan of San Mateo will provide reimbursement in the amount of $22,500 and the remaining $37,000 will be funded 100% by state and federal Medi-Cal administration revenue. There is no Net County Cost.