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Human services consolidation moves to the front of the line

"There's all kinds of side issues that states have been dealing with in preparation for moving forward, but I think we're going to see an increased amount of activity in the next year or two," says Jim Dillon, Unisys Corp.

Rick Steele

We've grown fond of the way the Internet has made some of life's most tedious and time-consuming transactions less onerous. We no longer have to register our vehicles, pay parking tickets or even file taxes in person. Just fill out a form online, press "send," and get back to whatever you were doing.

Now, citizens who receive public assistance are pressing for the same kind of online access from human services agencies.

The demand for convenience and better customer service is rapping hard on the door of human services agencies, and it's time government let it in, said Doug Doerr, executive director of human services in Accenture Ltd.'s state and local practice.

"You don't have to go down to the [motor vehicles department] to get your license renewed, and people are getting used to that," he said. "In areas such as eligibility functions, people are not satisfied with having to go and have a face-to-face with somebody at a brick-and-mortar office."

Integrated eligibility, the creation of one eligibility application for multiple human services programs, has grabbed the attention of state lawmakers and agency officials alike, said Doerr and other industry officials. State-administered public assistance programs, such as Temporary Assistance to Needy Families, welfare and food stamps, often require the same information on applications and have overlapping populations.

Integrating the eligibility and application process can decrease costs, increase efficiency, improve service and boost data collection, all while making life easier for citizens in need.
State officials who want to improve services to citizens are driving the push for eligibility.

Holding down program costs is important and is a prerequisite to justifying expensive IT projects to state legislators. But it is not the main objective, industry and public officials said.

The market is heating up for these projects, and no company knows this better than New York-based Deloitte Touche Tohmastu, which recently picked up a $69 million eligibility integration contract from Michigan.

"You'll see more states move forward in the next 12 to 24 months than we've seen in a long time," said Jessica Blume, Deloitte's national managing director for public sector consulting. "Many of these states are working on very old technology that's hard and expensive for them to support."

Emphasis: Efficiency

Most state governments are running their human services programs on IT platforms that are two or three decades old and no longer can provide the services that government leaders and citizens demand.

The push for replacements and sweeping improvements in service delivery is strong and growing, said industry officials and analysts. Market research firm Input Inc. of Reston, Va., is tracking about 80 human services acquisitions across the country.

State and local spending on human services hardware, software and services will grow at an average annual rate of 8.3 percent, from $8.3 billion in fiscal 2006 to $10.7 billion in fiscal 2009, according to market research firm Gartner Inc., Stamford, Conn.

It's unlikely that office visits will ever be removed from the eligibility equation, but the desire for access to services via telephone and a Web site is driving states to create one point of entry into all of their human services, such as through a consolidated call center with integrated eligibility capabilities.

Because there are about 55 federally funded, state-administered assistance programs, states are not looking for an all-in-one fix that immediately integrates all programs. Instead, states are planning an incremental implementation: Integrate several programs, tie together their eligibility and other back-office functions, then evaluate and consider adding more programs.

"It's starting smaller, but it's starting with the big ones. You're looking at Temporary Assistance for Needy Families, Medicaid, food stamps and child welfare, those are the big four," said John Kost, Gartner's managing vice president of worldwide public sector research. "Any one of those is a big project; integrating across them is a massive undertaking."

Systems integrators also are encouraging states to take an incremental approach.

"Take on seven, get those up and working in a technical process environment with shared services and a call center, and then begin to add programs over time," Deloitte's Blume said. "That's what we're trying to persuade clients to do. Don't take it all on, it's just too large."

Child services will offer a substantial opportunity to systems integrators, said Ron Frazier, executive vice president of state and local practice for Ciber Inc., Greenwood Village, Colo. At least 10 states are seeking child care solutions, another six are looking to modernize their child support enforcement programs, and five more looking for new child welfare systems, he said.

Software tools for consolidating human services programs include customer relationship management software and new commercial human services management solutions from companies such as Atlanta-based Albion, a division of Scandent Solutions; Curam Software Inc., Santa Monica, Calif.; and Harmony Information Systems Inc., Reston, Va.

Workflow and process automation software can help streamline the consolidation process, said Kate McCurdy, public sector technology analyst for market analysis firm Datamonitor Plc, London.

State and local governments have been preparing for such projects for years, adding high-speed broadband Internet access and improved electrical wiring at their facilities, said Jim Dillon, vice president of marketing and business development for Unisys Corp. and former New York state CIO.
"There's all kinds of side issues that states have been dealing with in preparation for moving forward, but I think we're going to see an increased amount of activity in the next year or two," Dillon said.

In addition to technology and capacity improvements, states also have worked on physically upgrading facilities, which even includes asbestos remediation, Dillon said.

Companies on the move

New York City is exploring the feasibility of using its 311 call center, which handles non-emergency services, as the initial filter for human services callers, Gartner's Kost said. However, he does not see the benefit of using 311 systems as an initial filter for human services access.

"The greater advantage is simply an integrated human services call center that looks at all the various facets of what human services are doing," he said.

At the state level, New York may consolidate its public assistance programs into a single, unified welfare management system, said New York CIO Mike Mittleman. If this happens, the state would release a "monster" request for proposals later this year, he said.

Input is tracking major human services recompetes in New Jersey and Pennsylvania. The Keystone State's recompete of its Child Support Enforcement system contract, held by Deloitte, is valued at $100 million.

New Jersey has out an RFP for a study to determine the best way to consolidate multiple human services systems. The system implementation contract could be worth $46 million, Input said.

One company making its mark with smaller human services projects is Ciber. In the last year, the company has won contracts to replace the Special Supplemental Nutrition Program for Women, Infants and Children, known as WIC, in states including Colorado, North Dakota, Utah and Wyoming. Each contract is worth between $4 million and $6 million, Ciber's Frazier said.

Georgia is looking at integrated eligibility of Medicaid, food stamps, Temporary Assistance for Needy Families, child care and a few other programs, and recently released a request for information to study the feasibility of such an approach, said Accenture's Doerr.

"They're looking for something very large that integrates more programs than are usually pulled together," Doerr said.

Accenture in November 2005 won a contract worth $25 million over three years from the Georgia Human Resources Department for a statewide automated child welfare information system. The company will design, develop and implement the system and provide warranty services.

Accenture is building features into the system that will let case workers monitor children when they move across county lines, a feature not available in the current system.

Integration is not just for the eligibility process. Georgia plans to integrate the system with operations that handle other child and family human services, said state CIO Tom Wade.

"If you have a child who is abused or potentially abused, you want to check it out and make sure you have all the information available," Wade said. "A lot of decisions have to be made as to whether the child remains in the home, and you need information from all these sources."

Staff Writer Ethan Butterfield can be reached at ebutterfield@postnewsweektech.com.

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