Florida Department of Children and Families

Contract

By and Between

STATE OF FLORIDA

DEPARTMENT OF CHILDREN AND FAMILIES

and

ACCENTURE

for the Design, Development and Implementation of

New System Components for the ACCESS Florida System

Month DD, 2013

1

Florida Department of Children and Families

TABLE OF CONTENTS

DEPARTMENT OF CHILDREN AND FAMILIES STANDARD CONTRACT

Attachment I: Statement Of Work (SOW)

1.Definitions

1.1Contract Terms

1.2Program or Service Specific Terms

2.Problem Statement

3.Contract Objectives

4.Solution Overview

5.Coordination with the Department and other Entities

6.Project Governance

7.Project Performance Periods

7.1DDI Performance Period

7.2Warranty Performance Period

8.Overall Management Responsibilities

8.1Project Management

8.2Phase Gate Reviews

8.3IV&V and Oversight Entity Review

8.4Knowledge Transfer

8.5Disaster Recovery

8.6Disaster Preparedness Plan

8.7Staffing Requirements

9.DDI Performance Period

9.1Plan Phase

9.2Define Phase

9.3Design Phase - Functional Design

9.4Design Phase - Technical Design

9.5Design Phase - Business Process Reengineering

9.6Design Phase - Interface Definition

9.7Develop Phase - Code and Unit Test

9.8Develop Phase - Reports Development

9.9Develop Phase - Forms and Correspondence Development

9.10Develop Phase – Master Test Plan

9.11Test Phase - System Integration Test

9.12Test Phase - User Acceptance Test

9.13Implement Phase - Data Conversion

9.14Implement Phase - Training

9.15Implement Phase - User Documentation

9.16Implement Phase - Installation and Implementation

10.Warranty Performance Period

10.1Provider Warranty Support Responsibilities

10.2Department Warranty Support Responsibilities

11.Operations Transition

12.Deliverables

12.1Submission, Approval, and Maintenance of Deliverables

12.2Deliverable Quality Assurance

12.3General Deliverable Preparation Instructions

13.PERFORMANCE MEASURES AND Liquidated Damages

13.1Deliverable Performance Measures

13.2Deliverables Liquidated Damages.

Exhibit A: Project Organization

Exhibit B: Sample Deliverables Expectations Document

Exhibit C: Payment Terms

Exhibit D: Special Provisions

5.1In performance of this contract, the contractor agrees to comply with and assume responsibility for compliance by his or her employees with the following requirements:

5.2Criminal/Civil Sanctions:

5.3Inspection:

1

Florida Department of Children and Families

DEPARTMENT OF CHILDREN AND FAMILIES STANDARD CONTRACT

Attachment I: Statement Of Work (SOW)

1.Definitions

1.1Contract Terms

Contract terms used in this document can be found in the Florida Department of Children and Families Glossary of Contract Terms, which is incorporated herein by reference, maintained in the Contract Manager’s file and located at the following website:

1.2Program or Service Specific Terms

The following program or service specific terms and definitions apply to Attachment I: Statement of Work (SOW).

Term / Definition
ACCESS Florida System / The Department's existing public assistance eligibility system, which includes the following applications and subsystems: FLORIDA, ACCESS Community Partner Internet Search, ACCESS Document Imaging, ACCESS Florida KidCare, ACCESS Florida Prescreening Tool, ACCESS Florida Web Application, ACCESS Integrity Online System, ACCESS Knowledge Bank, ACCESS Management System, MyACCESS Account Authentication and User Administration, Community Partners Tracking System, Data & Reports System, Exceptions Management System, Exstream Notice System, Food For Florida, Food For Florida Volunteer and DHL Tracking, Food Stamps Data Sharing System, Integrated Benefit Recovery System, MyACCESS Account, Quality Management System, Streaming Tools, Telephonic Audio Response Unit.
ACA / The Patient Protection and Affordable Care Act of 2010 and the Healthcare and Education Reconciliation Act of 2010, collectively referred to as the Affordable Care Act
ACF / Administration for Children and Families, a division of the U.S. Department of Health and Human Services which provides federal oversight for the Refugee Medical AssistanceProgram
AHCA / Florida Agency for Health Care Administration, the State Medicaid Agency which is responsible for the administration of the Medicaid Program
APD / Advanced Planning Document
BPR / Business Process Re-engineering seeks to restructure or refocus organization’s business processes from the ground up or analyze and redesign of workflow between enterprise systems.
Business Day / Days in which the Department conducts routine business. This is typically Monday through Friday from 8 a.m. to 5 p.m. local time, excluding evenings, weekends and Department observed holidays.
CCB / Change Control Board
CHIP / Children’s Health Insurance Program, which includes: MediKids for children ages 1 through 4 which is administered by AHCA; Children’s Medical Services Network for children ages 0 through 18 with special physical health care needs which is administered by DOH; Behavioral Health Network for children ages 0 through 18 with behavioral health care needs which is administered by the Department; and Florida Healthy Kids for children ages 5 through 18 which is administered by FHKC
CMS / Centers for Medicare & Medicaid Services, a division of the U.S. Department of Health and Human Services which provides federal oversight for the Medicaid Program and CHIP
Contract Manager / The person who shall be responsible for enforcing performance of the contract terms and conditions and serve as a liaison with the Provider as required by Section 287.057(15), F.S.
COTS / Commercial-Off-The-Shelf, a term for software or hardware, generally technology or computer products, that are ready-made and available for sale, lease, or license to the general public
Days / Calendar days unless specified as otherwise
DBA / Database administrator / database administration
DCF / Florida Department of Children and Families
DDI / Design, Development and Implementation
DED / Deliverable Expectation Document
Department / Florida Department of Children and Families which performs eligibility determination for the Medicaid and Refugee Medical Assistance programs and administers the Supplemental Nutrition Assistance Program, SunCAP, Disaster Food Assistance, Temporary Assistance for Needy Families, Optional State Supplementation, Home Care for Disabled Adults, and Refugee Cash Assistance programs.
DOH / Florida Department of Health, which administers the Children’s Medical Services Network
Ensure / Use of the term "ensure" shall mean that both parties will use all reasonable and commercial efforts to accomplish their legal responsibilities under the terms of the Contract.
ESS / Department of Children and Families Office of Economic Self-Sufficiency
F.A.C. / Florida Administrative Code
FHKC / Florida Healthy Kids Corporation, a not-for-profit organization which administers the Florida Healthy Kids component of the State’s CHIP
FLORIDA / Florida Online Recipient Integrated Data Access, the Department’s existing public assistance system legacy mainframe
F.S. / Florida Statutes
Federal Oversight Agency(ies) / Federal agency(ies) responsible for overseeing states’ programs and ensuring compliance with federal regulations and policy. See ACFand CMS.
Invoice / Provider’s itemized document stating prices and quantities of goods and/or services delivered and sent to the buyer for verification and payment
ITN / Invitation to Negotiate, the Department’s ITN #03F12GC1
IVR / Interactive Voice Response
IV&V / Independent Verification and Validation
JAD / Joint Application Development
MAGI / Modified Adjusted Gross Income which is a methodology used to determine financial eligibility for certain health insurance affordability programs as defined in the Affordable Care Act and in which family size and household income is based on adjusted gross income as defined in the Internal Revenue Code.
Medicaid / Medical Assistance Program under Title IX of the Social Security Act
MITA / Medicaid Information Technology Architecture
MS / Microsoft
NSRC / Northwood Shared Resource Center
OBS / Organizational Breakdown Structure
O&M / Operations and Maintenance services for the ACCESS Florida System, including the new system components, which are described in detail in the Contract between the Department of Children and Families and PROVIDER NAME for the Operations & Management of the ACCESS Florida System.
Partner(s) / Florida agencies/entities which work in cooperation with the Department to administer the medical assistance programs that are included in the Project scope. See DOH, AHCA and FHKC
Phase Gate(s) / Specific points at which the Department will assess the Project’s progress and validate that the Project is on track to satisfy its objectives and determine whether Project work should continue
PMBOK / Project Management Body of Knowledge
PMI / Project Management Institute
PMO / Project Management Office
PMP / Project Management Plan
Project / The Medicaid Eligibility System Project
Project Director / The Department’s staff member(s), provider(s), or consultant(s) with overall responsibility and authority to oversee the contractual services being performed by the Provider for the Department as described in the Contract agreement
Project Management / The management of all resources, tasks and activities for the DDI effort including the integration, coordination and management of Provider, subcontractor, Department and NSRC staff.
Provider Contract Manager / The person who shall be responsible for assuring Provider performance in accordance with the contract terms and conditions and serve as a liaison with the Department
QA / Quality Assurance
QC / Quality Control
Reply / The offer extended to the Department in response to an Invitation to Negotiate
RMA / Refugee Medical Assistance Program, federal program administered by the Department that provides medical assistance to refugees and other eligible persons for up to eight (8) months from the date of arrival in the U.S., date of final grant of asylum for asylees, and date of certification for trafficking victims. Operationalized as a component of Medicaid.
Severity Level 1 / Critical: Critical system processing has stopped, and DCF users are unable to perform. No workaround, bypass or alternative is available. Major service delivery impact condition exists.
Severity Level 2 / Major: A key component, application, Critical System or network is down, degraded or unusable. Processing is severely impacted and no acceptable workaround, alternative or bypass exists. Minimal service delivery impact condition exists. Potential critical impact on service delivery condition exists.
Severity Level 3 / Minor: A component, minor application or procedure is down, unusable or difficult to use. There is some operational impact, but no immediate impact on service delivery. An acceptable workaround, alternative or bypass exists. Problems that would be considered Severity Level 1 or 2 that have a workaround, alternative or bypass available will be assigned a level of Severity 3.
Severity Level 4 / Cosmetic or No Impact: A component, procedure or personal application (not critical to DCF) is not usable. No impact to business, single incident failure, and a workaround, alternative or bypass is available. Deferred maintenance is acceptable.
SDLC / System Development Life Cycle
SIR / System Investigation Request
SOW / Statement of Work
Stakeholders / Anyone affected in any way by the project being conducted, or the outcome of the project
Subcontractor / A person or entity contracting to perform part of the services under the Provider’s contract with the Department, upon Department approval.
TBD / To be determined
UAT / User Acceptance Test
WBS / Work Breakdown Structure

2.Problem Statement

The Affordable Care Act (ACA) substantially affects how eligibility determinations for Medicaid and the Children’s Health Insurance Program (CHIP) are conducted. Under the ACA, financial eligibility criteria for most populations will be based on modified adjusted gross income (MAGI). In addition, states are required to develop and use a single, streamlined application for all health insurance affordability programs, including Medicaid, CHIP and advance premium tax credits and cost sharing reductions for coverage offered through the health insurance exchange. Furthermore, state eligibility systems must be interoperable with a health insurance exchange and interface with the federal data hub to verify data used for eligibility determinations.

Inorder to address the requirements of the ACA, the State of Florida has determined that it will retain the existing public assistance eligibility system, the ACCESS Florida System, and develop and integrate new system components to support eligibility determination and benefit calculation for medical assistance programs, including:

  • Family-Related Medicaid
  • Child in Care (Title IV-E and Non-Title IV-E)
  • Refugee Medical Assistance (RMA)
  • Children’s Health Insurance Program (CHIP)
  • Medicaid for the Aged Blind and Disabled, including the waiver programs specific to Florida
  • Institutional Care

This Contract encompasses the design, development and implementation effort required to address the ACA requirements and meet the objectives of the Department.

3.Contract Objectives

The new system components are expected to meet the Department’s business goals which include the following:

Department Goal #1 -Compliance with Federal Law, Regulations and Policy

In support of this objective, the new system components willallow the State to achieve compliance with the Affordable Care Act through the implementation, configuration and customization of a web portal that supports a single, streamlined application for health insurance affordability programs, business rules engine for MAGI-based eligibility determinations, and interfaces with a health insurance exchange and the federal data hub and other verification sources.

Department Goal #2 - Easier, Timelier and Less Costly Policy Management and Changes

In support of this object, the use of open service oriented architecture and a modular business rules engine will allow for easier, timelier and less costly policy management and changes in the Medicaid, CHIP and other medical assistance programs in the future.

The objectives and requirements above are high-level and informational and not intended to be exhaustive. The Department’s detailed requirements are set forth in the Requirements Definition Document which is also hereby incorporated into this SOW as if fully set forth. These requirements shall be the primary input and basis of the “Define” phase of the SDLC detailed in Section 9.2of this SOW.The Provider shall deliver, and the Department shall accept, new system components that meet all functional and non-functional requirements specified in the Requirements Definition Document and this SOW.

  1. Solution Overview

To meet the objectives set forth above in Section 3 and ensure the success of the Project as defined in this SOW, the Provider shall design, develop and implement the new system components. The basis of the solution shall be the Provider’s existing Accenture Client Self Service Portal (ACSSP) and Accenture Public Service Platform (APSP) software products, which is described in greater detail in the Provider’s ITN reply dated 8/20/2012. Further details of the anticipated new system components are found in the Bill of Materials included in Exhibit C, Payment Terms of this SOW. The Provider shall provide enhancements and modifications to the ACSSP, APSP and ACCESS Florida system that are necessary to meet the requirements in the Requirements Definition Document (as elaborated and validated during the “Define” phase detailed in Section 9.2 of this SOW). The new system components must be based on the most current version of the Medicaid Information Technology Architecture (MITA) framework, and must meet industry and federal standards and guidelines, including the CMS Enhanced Funding Requirements: Seven Conditions and Standards and Medicaid IT Supplement (MITS-11-01-v1.0).

The new system components include the following:

  • Web Portal that supports integrated eligibility program screening, application data collection and submission, including functionality currently available in My Account*
  • Business rules engine containing MAGI eligibility rules for medical assistance programs*
  • Web portal that supports MAGI application eligibility determination processing*
  • Interfaces to a health insurance exchange, the federal data hub and other data verification sources*
  • Integration between the new system components and the ACCESS Florida System to accommodate new MAGI data and business processes to support the ACA*
  • Support for MAGI application processing*
  • Addition of non-MAGI eligibility rules for medical assistance programs to the business rules engine

* Item must be completed on or before January 1, 2014. After federal ACA requirements have been met, non-MAGI medical assistance program functionality will be incorporated in the business rules engine.

Solution Releases

The solution shall be implemented into the production environment in the following distinct releases:

  • Release 1 – This release Implements Accenture Citizen Self-Service Portal (ACSSP) and Accenture Public Service Platform (APSP) to enable integrated application processing as defined in the requirements as agreed for the Project including support for MAGI eligibility determination using the solution and modifications to existing systems to accommodate new MAGI data. The anticipated production implementation date for Release 1 is December 8, 2013.
  • Release 2 – This release implements incremental non-MAGI eligibility rules for medical assistance programs to the business rules engine and modifications to existing systems to utilize the medical assistance program determinations provided by the rules engine. The anticipated production implementation date for Release 2 is August 16, 2014.

Solution Components

The following section describes the establishment of new system components or modifications to existing solution components to be implemented for the solution. Provider effort will establish the APSP architecture and configuring the proposed COTS software products, configuring the Florida-specific business rules and reference data, configuring interfaces between the new components and ACCESS Florida legacy components as well as federal interfaces, and implementing the identified gaps between the proposed products and Florida’s requirements. To address gaps, Provider work is based on the expectation for the following customizations to the ACCESS Florida replacement system for the Project:

  • Rules Processing – Provider will implement the rules engine using Oracle Policy Automation (OPA).
  • Interface Processing –Provider will establish interfaces required to implement the new system components to include the following:
  • Provider will integrate the Accenture Client Self Service Portal (ACSSP) to the ACCESS Florida System. To the extent possible, existing interfaces will be altered to include new data items.
  • Provider will establish a new interface to connect the new system components with Federal data sources enabled throughthe federal hub which include IRS, Federally Facilitated Exchange (FFE) and SSA
  • Provider will modify the interface that connects the FLORIDA system with the Florida Medicaid Management Information System (FMMIS) as appropriate to meet the requirements
  • Provider will modify the interface that connects the FLORIDA system with the HealthyKids to as appropriate to meet the requirements.
  • Provider will create / modify additional interfaces not listed above, but necessary to meet system requirements defined in the requirements
  • Reporting – Provider will implement changes to pass new data and information provided by the solution to the existing ACCESS Florida reporting solution. Existing reporting mechanisms will be used to produce ACCESS Florida reports,
  • Forms / Notices – The solution for this Project will integrate with the existing ACCESS Florida correspondence architecture that utilizes HP Exstream.
  • Batch Programs – The solution primarily leverages existing batch processing of the ACCESS Florida system. New batch processing will be created or modified when required by the design.
  • Databases - The solution will create and modify databases that store ACCESS Florida data to accommodate new data.
  • Identity & Access Management – The solution implements the Oracle Identity & Access Management solution which supports replacement of MyACCESSAccount Authentication system and access controls.
  • Content Management – The solution will integrate withthe current ACCESS Florida Document Management / Enterprise Content Repository. The solution does not change document management processing capabilities.
  • Call Center – The solution will use and integrate with the Department’s existing hosted call center solution.
  • Enterprise Service Bus – Provider will implement an enterprise service bus using Oracle Service Bus (OSB) to support interface and integration processing.
  • ACCESS Florida Legacy system changes – The Provider will implement changes to the legacy systems to support the solution requirements as elaborated and validated during the DDI Performance Period.

5.Coordination with the Department and other Entities

The Provider and its subcontractor(s) shall fully cooperate and participate with the Department, Partners, and federal oversight agencies. The Department may undertake or award other contracts for services related to the Project. The Provider and its subcontractor(s) shall fully cooperate, participate and coordinate with other such service providers.