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NC FAST and Work Support Strategies Operational Readiness Workshop. July – August 2013. Agenda. NC FAST Project Update. July 2013. Project Update. ePASS Document Management Deployment Update Help Desk Schedule Update Training Update County Security Configuration Project 7 Update

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NC FAST and Work Support Strategies Operational Readiness Workshop

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NC FAST and Work Support StrategiesOperational Readiness Workshop

July – August 2013


NC FASTProject Update

July 2013

Project Update


Document Management

Deployment Update

Help Desk

Schedule Update

Training Update

County Security Configuration

Project 7 Update

Project 3 Update

ePASS – Statewide Volumes

The number of FNS Electronic Apps has gone up over 4,000 in a month

Document Management Update

  • Completed functional and detail design documents (integration with NC FAST)

  • Completed County Guidelines document

  • Completed development and testing (integration with NC FAST)

  • FileNet production architecture is readied for configuration

  • Deployed document management capability as part of Project 2&6 Pilot rollout

  • Working on County Sync Guide

  • Working on draft functional and detail design documents for county sync piece

  • Preparing to initiate development of county sync capability

Document Management Update

Document management design document has been posted in FAST Help

A webinar will be scheduled to discuss the design document

A job aid has been posted providing guidance on what should be scanned

Deployment Update

Upgraded NC FAST to P2&6 version of code; a significant upgrade to the base NC FAST system

Working through identified defects; continuing build activities and defect fix activities

Continue to identify and prioritize Cúram tickets

Refining data conversion approach in preparation for Hard Launch

Continue submitting test conditions, scripts, and test data sheets for Business team review

Respond to Business team comments and receive sign-off for test conditions and scripts

Continue to plan and execution of Cycle 3 – Day in the Life execution cycle and Frequency 1,2,3,4,5 scripts

Refining internal team communication protocol to streamline getting updates to the counties

Help Desk Update

Significant increase in call volumes last week

Identified limitation with current phone system causing some calls to roll to voice mail; new phone system on order

If users call the Help Desk and are unable to speak to someone or cannot leave a voicemail message, send your issue via email.

Agents work to resolve tickets in the order in which they are received

NC FAST Help Desk can be reached at or 919-855-3200, Option 3

Help Desk is available Monday – Thursday, 8:00 a.m. – 6:00 p.m. and Friday, 8:00 a.m. – 10:00 a.m., 11:00 a.m. – 6:00 p.m.

Please report only one incident/issue per email.

Help Desk Metrics

P2&6 Schedule Update

P2&6 Training Update

  • Over 40 trainers have gone through Train-the-Trainer

  • Launched the NC FAST Learning Gateway

  • Posted web-based training (WBT) content into Learning Gateway

  • Exposed Pilot counties to preliminary version of classroom training

  • Delivered WBT and instructor-led content to Pilot counties and state office

  • Initiated training of southeast counties

  • Wrapping up development of final classroom training activities

  • Feedback from Pilot and state office delivery has been quite positive

  • Expectations:

    • Use of Captivate simulations

    • Training scenarios

    • Sandbox availability

    • Availability of program subject matter experts

County Security Configuration

User Role:

Inquiry Only

User Role: Eligibility Worker

Project 7 Update

  • Business team continues to work closely with DMA to:

    • Finalize Project 7 requirements

    • Complete documentation for State Plan Amendments (SPA), elected state options, targeted enrollment strategies, and federal hub waiver

  • Design team completed joint design sessions for functionality needed to be ACA compliant; finalizing review and sign-off

    • Intake and assessment for Medicaid/NCHC

    • Integration with federal data hub for account transfers and verifications

    • Eligibility determination/redetermination under MAGI and non-MAGI rules

    • Coordination of appeals processing with FFM

    • Implementation of federal and state mandated reports and notifications

  • Interfaces team began federal data services hub Wave 4 testing with CMS

Project 3 Update

  • Team is composed of Services Business Lead Tracey Duncan, an NC FAST Business Analyst and 3 SMEs from DCDEE

  • Continue to reassess the business requirements

  • Reassessment of the Child Care Subsidy business requirements should be complete in August

  • Requirements for Energy Assistance (CIP and LIEAP) will then be addressed with a SME from Economic Services

  • Fit gap analysis is planned to begin in August, with the goal of beginning functional design in October

  • Deployment is targeted for late 2014

Project 7FFMI

P7 ‘Ecosystem’ & Division of Responsibilities

The New P7 Ecosystem







In-person, by phone, mail-in

Database Interface


State Verification Systems

The New P7 Ecosystem

New Streamlined application for MA

Additional questions required for an MA eligibility determination under current rules and/or FNS

Depending on programs for which the applicant is eligible, benefits may begin at different times

Additional electronic verifications from federal sources may be used

Ineligible applications will be transferred to the FFM/Health Insurance Marketplace for potential Advanced Payment Tax Credit (APTC) or Cost-Sharing Reduction (CSR) eligibility

The New P7 Ecosystem

MA Applications Completed via the DSS


Streamlined Application keyed by caseworker

MAGI Notice Generated and Held by NC FAST.

Traditional determination/ additional program requested?

Answer additional questions for

traditional MA

(and FNS, if requested)






Enroll in MAGI program

Enroll in Traditional MA and/or FNS

Send application to FFM

If eligible for FNS but not for traditional MA, enroll in FNS and MAGI. Note: benefits will begin on different dates.

Benefits under MAGI programs will not begin until January 1, 2014.

MA Applications Completed via ePASS

Streamlined Application keyed by applicant

Applicant registers for NCID

MAGI Notice Generated and Held by NC FAST.

Traditional determination/ additional program requested?

Answer additional questions for

traditional MA

(and FNS, if requested)






Enroll in MAGI program

Enroll in Traditional MA and/or FNS

Send application to FFM

If eligible for FNS but not for traditional MA, enroll in FNS and MAGI. Note: benefits will begin on different dates.

Benefits under MAGI programs will not begin until January 1, 2014.

MA Applications Completed via the FFM

Seeking Financial Assistance?

Full determination requested?

Streamlined Application completed through FFM

Enrolled in QHP of choice




Potentially MA eligible?

Calculate APTC/CSR




Application transferred to NC FAST

Key Points

Beginning October 1, 2013 – the Streamlined Application will always be completed FIRST when applicant is seeking Medical Assistance.

To receive a determination based on ‘traditional’ rules (between 10/1/2013 and 12/31/2013) and/or to apply for FNS in addition to MA, additional questions will need to be answered.

Regardless of the entry point, the Medicaid/NCHC determination will ultimately be done in NC FAST.

Benefits under MAGI programs will not begin until January 1, 2014

As of January 1, 2014 – MAGI rules become the standard for most Family & Children’s MA programs.

Applicants who do not qualify for Medicaid/NCHC may still be eligible for APTC/CSR (federal subsidies) to help pay for insurance and should utilize the FFM/Health Insurance Marketplace.

P7 Division of Responsibilities: DHHS/FFM/FFMI

Health Insurance Marketplace

Health Insurance Marketplace

Customer Assistance


If a customer requires assistance completing the streamlined application for Medicaid/NCHC while at the local DSS, they are assisted by the caseworker.

If a customer requires assistance completing the streamlined application for Medicaid/NCHC while using ePASS, they are advised to call the DHHS Customer Service Center.

If a customer requires assistance completing the streamlined application for Medicaid/CHIP while using the FFM, they are advised to call the Federal Call Center and/or Navigator.


Customer Assistance


  • Provide customers with information that assists with the following:

  • submitting the eligibility application

  • clarifying distinctions in QHPs

  • making informed decisions during the health plan selection process

  • Can assist in all different types of marketplaces

  • State-based Marketplace

  • State Partnership Marketplace

  • Federally-facilitated Marketplace

  • Funded through State and Federal grants

Must complete comprehensive training to become a navigator.

Customer Assistance

Certified Application Counselors

  • Serve many of the same functions as Navigators including:

  • Providing education to customers

  • Assistance completing applications

  • Organizations can apply online to be designated by the Marketplace to certify application counselors. Some examples of organizations include:

  • Social service agencies

  • Hospitals

  • Community health centers

  • No funding mechanism available for this program

Must complete comprehensive training to be a Certified Application Counselor.

Customer Assistance



  • Role: To assist the customer in applying for an insurance affordability program

    • Can be a person or organization

    • May assist with Streamlined application completion, or complete on behalf of the applicant

    • Explaining APTC/CSRs or insurance options to customers

  • Navigators are not responsible for:

    • Assisting customers with ‘Traditional’ MA applications

    • Explaining North Carolina DMA policy

    • Contacting the DSS

      It has not been determined if Navigator’s will be assisting customers with ePASS (Streamlined) applications

DSS Caseworkers

  • Role: Take applications for Medical Assistance (and FNS/SNAP, if applicable)

    • Will manage integrated cases in NC FAST (Income Support and/or Insurance Affordability)

    • May refer ineligible applicants to the Health Insurance Marketplace as an alternative to Medicaid/NCHC

  • Caseworkers are not responsible for:

    • Helping customers navigate the FFM/Health Insurance Marketplace

    • Helping customers complete the application on the FFM/Health Insurance Marketplace

    • Explaining specific details regarding APTC/CSRs or insurance options to customers

      Consider having the website and/or phone number for the Health Insurance Marketplaceto give customers a place to start.


  • Role: Provide an eligibility determination for MAGI and non-MAGI programs and issue benefits when applicable

    • Will notify case worker via a task in a designated work queue when an application is received from ePASS or the FFM

    • Will notify applicant of eligibility result and/or when their application is transferred to the FFM

  • NC FAST is not responsible for:

    • Providing an eligibility determination for APTC/CSR

    • Notifying customers of insurance plan options

    • Enrolling customers in QHP

DMA Update

Lunch and Work Support Strategies Update

P7: Managing Applications & CasesStreamlined App / Multiple Dispositions & Integrated Cases / The Evidence Broker / Impacts to the Universal Worker

Streamlined Application Demonstration

Note: The following includes preliminary screen shots which are subject to change.

Streamlining the Process

What is the Streamlined Application?

  • A simplified application used to apply for all Insurance Affordability programs

  • Used whether applying via the FFM, ePASS, or the DSS

  • Will be the first application used when the customer is seeking Medical Assistance

Getting Started with the application.

Customer must agree to privacy statement before continuing.

The first page of the streamlined application gathers details about the primary applicant.

The second page gathers additional details about the primary applicant.

Are there any other people in the household?

Enter details about the additional household member.

Enter additional details about the household member.

Review the household member summary. Are there more people to add?

How are the household members related?

Identify the tax filers in the household.

Identify the tax dependents in the household.

Review the Household Summary. Make changes if necessary before continuing.

Indicate household members who earn income.

Enter income details.

Are there any income deductions that can be deducted on an income tax return.

Review expected annual income.

Similar income information is collected for additional household members (if applicable).

Additional household information is collected, beginning with details on medical bills.

Indicate household members who are tobacco users or are incarcerated.

Additional questions are asked to determine if household members qualify under MAGI.

Review the summary screen and make necessary changes before continuing to next screen.

Documentation needed from the customer displays before the application is submitted.

Streamlined Application Demonstration Q&A


Potential for Multiple Dispositions




MA and/or FNS



Identical information prepopulates on the Non-MAGI application

The application process for all MA programs will start with the streamlined application after October 1, 2013.

  • Coverage for the MAGI based determinations does not begin until January 1, 2014

  • Customers should be given the opportunity to see if they currently qualify for a MA program under the traditional (non-MAGI based) rules

    Result: During the single application process, an Authorization/Disposition will need to be completed for the Streamlined and ‘traditional’ MA and/or FNS application(s).

Potential for Multiple Integrated Cases

‘Streamlined’ Medical Assistance Application

Insurance Affordability (Integrated Case)



Product Delivery Case

Identical information populated from MAGI application



Income Support Application

(P26 Interview Questions)

Income Support (Integrated Case)



Product Delivery Case

The Evidence Broker

  • The Evidence Broker is the functionality within NC FAST that allows evidence to be transferred from one integrated case to another

  • With multiple integrated cases there will be two types of evidence, identical and non-identical

    • Identical evidence is evidence that is used in the same way and is the same evidence type in both integrated cases

    • Non-identical evidence is evidence that is not used in the same way in both integrated cases

  • Once enabled, the Evidence Broker will broadcast the identical information so that it can be then used on the other “target” integrated case

  • Caseworkers will be able to accept or reject the evidence in the target case either manually piece by piece or in bulk at once

  • When evidence is entered in one case that could be broadcast to the other integrated case, the caseworker will receive a task informing them that they have evidence to accept or reject

Incoming Evidence: Identical

Note: These screens are subject to change

Incoming Evidence: Non-Identical

Note: These screens are subject to change

Impacts to the Universal Worker

  • One Case Worker

    • Customers will still have the ability to apply for multiple programs at the same time with one caseworker, whether there is a MAGI-based program involved or not.

  • Reception, Tasks, Work Queues

    • Other universal worker functionality associated with P2&6 such as work queues, reception, and tasks will remain essential to the NC FAST process.

  • Potential Multiple Dispositions

    • After completing the MAGI application, the customer may continue on to the Non-MAGI (and/or FNS) questions to see if he or she is eligible for Medical Assistance (or FNS) prior to 1/1/14. Therefore, a caseworker may have two dispositions to complete.

  • Potential Multiple Integrated Cases

    • One caseworker will be able to manage both integrated cases through the use of the evidence broker, which will allow identical information to be shared amongst these cases.

Breakout Discussion:Communication Strategies

The “Woodwork” Group

  • Increased awareness of the Affordable Care Act is expected to bring potential customers out of the woodwork.

    • Those who are currently eligible but not enrolled: DMA research suggests that 69,683 individuals will gain coverage in 2014.

    • Those who would potentially be eligible under a Medicaid expansion: Approximately ½ million additional applicants who will not be eligible may still want to apply.

    • Expect an impact, not only to numbers of Medicaid applicants, but to other programs as well.

Estimated Medicaid Expansion Population in 2014

Breakout Session Report Out:Communication Strategies Highlights

Questions and Answers

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