Case Study: State of California, Department of Health Care Services (DHCS)

State of California, Department of Health Care Services (DHCS) (formerly Department of Health Services (CDHS)

Technical Assessment of the Consortium IV (C-IV) Welfare System.

The CDHS Payment Systems Division requested the assistance of PCG Technology Consulting (PCG TC, formerly Eclipse Solutions, Inc.) to perform an IV&V technical assessment of the CA-MMIS system. The assessment included evaluating the viability of the technical architecture of the system, assessing aspects of HIPAA compliance progress, including enterprise security and NPI, assessment of the organizational structure, and evaluation of specific business processes.

PCG TC worked closely with the CDHS and the CA-MMIS Systems Integrator to conduct a detailed risk- and standards-based assessment of the CA-MMIS Enterprise Architecture including:

• Technical Architecture
• Application Architecture
• Data Architecture
• Software Engineering Standards
• Application Development Languages & Tool
• Source Code Analysis

As part of the technical assessment, PCG TC developed sub-system evaluation criteria, designed to assess the relative value of replacing or keeping key CA-MMIS sub-systems.  The assessment was facilitated by PCG TC,  with the participation of the CDHS and the CA-MMIS Systems Integrator.

PCG TC also conducted an organizational assessment related to staffing levels and recommended levels of education and certification.

The 6-month assessment was successfully completed and resulted in a number of key findings and recommendations.

Key findings included:

• The CA-MMIS system was estimated to have approximately 15,000 function points – larger than 90% of all IT applications worldwide;

• The CA-MMIS system had significantly exceeded the average lifespan for a system its size – the core of system being approximately 30 years old;

• The application change backlog was estimated to be approximately $100 million;

• It was estimated that it would take approximately seven (7) years to replace the system.

Key recommendations included:

• CDHS should immediately start planning the replacement of the system;

• CDHS should seek a commercially available, customizable, and proven solution over developing a new system;

• CDHS should work within the Federal Medicaid Information Technology Architecture (MITA) framework to maximize federal funding and support;

PCG TC’s findings and recommendations have been validated and embraced by the CDHS.  As of October 2009, the department, now called the Department of Health Care Services, is in the process of procuring a new CA-MMIS system.