Challenge
The mission of the Commonwealth of Pennsylvania Department of Human Services is to improve the quality of life for Pennsylvania’s individuals and families. The agency promotes opportunities for independence through services and support while demonstrating accountability for taxpayer resources. The organization is responsible for managing seven primary offices: Child Development and Early Learning; Children, Youth and Families; Developmental Programs; Long Term Living; Medical Assistance Programs; Office of Income Maintenance; and Mental Health and Substance Abuse Services.
To better serve the citizens of the Commonwealth, DHS launched a major technology modernization project to optimize the performance of its legacy Electronic Client Information System (eCIS). The eCIS suite is the backbone for DHS and supports case processing, determines eligibility, authorizes services and distributes benefits to more than 2.7 million needy Pennsylvanians. Each year, DHS uses eCIS to provide over $850 million of services through Temporary Assistance to Needy Families (TANF), Food Stamps (FS or SNAP), General Assistance (GA), State Blind Pension (SBP), Medical Assistance (MA), Long Term Care (LTC), and supplements to basic Supplemental Security Income (SSI) grants.
As part of the eCIS transformation project, DHS is using the Progress Corticon Business Rules Management System (BRMS) to automate the rules and logic behind the eligibility determination process within its integrated eligibility system. Prior to using Progress Corticon, the business rules guiding eligibility decisions were hard coded in COBOL on the agency’s mainframe and in .NET VisualBasic. As a result, the department was dependent on IT to make any rules modifications – a process that was cumbersome and often took weeks or months to complete. However, time is a luxury the department rarely has when it comes to reacting to frequently changing legislation, policy or other factors like cost of living.
“We don’t often have much lead time to react to these changes,” explains Shirley Monroe, Chief Technology Officer - Human Services, Insurance and Aging, Commonwealth of Pennsylvania. “For example, our fiscal year ends in June and the state has yet to pass a budget. We probably won’t see that for another three to four weeks, but we will be expected to respond to any required changes immediately.”
DHS also sought to optimize the exchange of information between the department and more than 100 entities within the state and federal government for data matching, such as the Pennsylvania Department of Labor and Industry (DLI), Office of Employment Security (OES), the Social Security Administration (SSA), and the Internal Revenue Service (IRS). Prior to Corticon, the system would often raise alerts about potential eligibility conflicts. Caseworkers would then have to manually review each of those actions. With a huge backlog of pending alerts, caseworkers were tied up trying to resolve issues, and eligibility determination for PA’s citizens could be delayed. “It escalated into a huge problem,” explains Monroe. “An audit found that there were many mistakes in both the existing COBOL and manual-based process.”