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State Health-Care Entity Seeks IT Help With Crucial System

In a request for offer, the California Department of General Services on behalf of the California Department of Health Care Services seeks IT modernization strategy and planning for a system that impacts millions of Californians.

The state’s business manager and its largest health-care purchaser want to hear from IT companies that can assist in modernizing aspects of a system that’s vital to many Californians.

In a request for offer (RFO) released Friday, the California Department of General Services (DGS) on behalf of the California Department of Health Care Services (DHCS) is seeking responses from technology vendors capable of assisting them with “Medi-Cal Enterprise Systems (MES) Modernization Strategy and Planning Services.” Among the takeaways:

  • DHCS seeks “eligible firms” with a valid IT consulting services master contract service agreement (MSA) with DGS. DHCS defines the MES as “the business areas and processes that support the administration of Medi-Cal programs and the collection of systems and technical components used in the management and support of Medi-Cal programs,” according to the RFO. It also includes external projects and systems such as the California Statewide Automated Welfare System (CalSAWS); the Case Management, Information and Payrolling System (CMIPS); and the California Healthcare Eligibility, Enrollment and Retention System (CalHEERS).” MES components have, in some cases, the department said, “overlapping functionality with varying business rules, gaps in functionality, the inability to adopt to changing and evolving programs, (and) partially automated support for business processes.” Their updating and modernization is, generally, a continuous process, a “transition from separate, siloed efforts to a single, holistically managed, transformation-focused approach ... supporting a higher degree of interoperability among systems while maximizing value and minimizing burden on Medi-Cal beneficiaries and providers.”
  • The existing MES has “redundant functionality” with gaps; “hard-coded and inflexible business rules, and other issues and inefficiencies.” The system, generally, needs “automated solutions, especially those that are modular and extensible.” Its challenges make DHCS “unable to keep up with the changing and evolving needs of programs with automated support to meet the critical health-care demands of California” — a deficiency that, if continued, will result in “service outages.” The department will create “in iterations a holistic future state MES architecture, road map(s), and governance bodies that prioritize business needs and drive the technology modernization.”
  • The MES Modernization Strategy will include, at a minimum, a modernization road map with “high-level, strategic” goal sequencing and prioritization; a product/module portfolio for each business area; and an IT product delivery governance framework. Scope will include “all existing systems and subsystems that support the Medi-Cal enterprise.” The vendor chosen must “liaison with DHCS Enterprise Architecture and MITA Technical Architecture teams.” Deliverables include an approach – a “high-level concept of the modernization direction”; a strategy – a “moderately detailed plan” for accomplishing the approach; “detailed methods and processes for doing system identification, interdependency documentation, enterprise service opportunities”; and a product modernization road map prioritizing systems and capturing “ongoing products as they are identified.”
  • Respondents must have experience with at least three completed IT projects in the last 10 years. More specifically, respondents must have five years’ experience “modernizing complex legacy systems” via iterative replacement or iteratively developed strategy; working with Medi-Cal, Medicare, Medicaid, Centers for Medicare and Medicaid Services health care, or public health data and systems; developing road maps and recommendations for large modernizations; and doing analysis and identifying business and technical imperatives.
  • The precise contract value is unclear. The contract term is expected to be 36 months with up to two one-year extensions at state discretion. Questions are due by Feb. 16. Offers are due by 2 p.m. March 2 and will be evaluated March 3-16, with key interviews March 17-23. Dates for the notice of award and contract start are to be determined.
Theo Douglas is Assistant Managing Editor of Industry Insider — California.