720-5297- RFI WaMS Modernization_with Updates reflected in Addendum 01_09.01.26.docx

1220 Bank Street Richmond, VA 23219 Request for Information (RFI) 720-5297 Waiver Management System

NIGP Commodity Code(s):

Note: This public body does not discriminate against faith-based organizations in accordance with the Code of Virginia, § 2.2-4343.1 or against a supplier because of race, religion, color, sex, national origin, age, disability, sexual orientation, gender identity, political affiliation, or veteran status or any other basis prohibited by state law relating to discrimination in employment.

Virginia Department of Behavioral Health and Developmental Services (DBHDS) is committed to increasing procurement opportunities for small, women-owned, and minority-owned (SWaM) businesses.

Table of Contents

DEFINITIONS / ACRONYMS

INTRODUCTION

The intent of this Request for Information (RFI) is solely to gather information; it is not a formal procurement. Information received may be used for informational and planning purposes. Nothing in this RFI should be construed as intent, commitment, or promise to solicit or procure a solution. Responding to the RFI is not a pre-requisite to submitting a proposal for any subsequent procurement, should a formal solicitation be issued. Suppliers should not provide any confidential or proprietary information. Information submitted in response to this RFI will become the property of the Commonwealth of Virginia.

The Virginia Department of Behavioral Health and Developmental Services (DBHDS) and the Commonwealth of Virginia will not pay for any information herein requested and provided by Supplier. DBHDS and the Commonwealth of Virginia will not be liable for any costs incurred by the Supplier related to this RFI. All such costs are Supplier’s sole responsibility. DBHDS is not at this time seeking proposals and will not accept unsolicited proposals.

Supplier is asked to provide estimated cost within their response for such services described in their RFI response, however, such cost will in no way be used for evaluation or considered as a proposal of a solicitation. Following receipt of responses to this RFI, DBHDS may contact some Suppliers to schedule clarification meetings to gain additional understanding.

PURPOSE

This Request for Information (RFI) is issued to gather data and insights that will assist the Department of Behavioral Health and Developmental Services (DBHDS) in analyzing costs, procedures, and challenges associated with implementing a new waiver management system. In alignment with new transparency and timeliness standards, DBHDS seeks to advance modernization efforts that balance compliance, equity, and outcomes.

Through this RFI, DBHDS aims to:

1. Identify modern technology platforms capable of streamlining operations, improving data quality, enhancing user experience, and integrating with other state and federal systems.

2. Obtain information from qualified vendors and subject matter experts to assist in determining functional, technical, and operational requirements for a future waiver management solution.

3. Evaluate potential implementation approaches, cost structures, and scalability considerations to inform subsequent procurement activities.

4. Establish a foundation for developing a comprehensive solicitation that reflects best practices and supports efficient, person-centered service delivery.

The responses received will inform DBHDS’s market research and guide the development of specifications for future procurement efforts.

PRESENT SITUATION

The Department of Behavioral Health and Developmental Services (DBHDS) is the Commonwealth of Virginia’s central agency for the delivery, reporting and oversight of Community-based Mental Health, Substance Use Disorder, and Intellectual and Developmental Disability support services. DBHDS’s service delivery network is comprised of a Central Office, 40 local Community Services Boards (CSBs), 12 Accredited State Hospital, Rehabilitative, and Training facilities, as well as thousands of private providers all delivering services to both Adult and Minor Child service recipients.

The waiver management process assists individuals and families in receiving services in their home communities and is jointly administered by DBHDS and the Department of Medical Assistance Services (DMAS). DMAS retains program ownership and Medicaid authority, while DBHDS functions as the operational authority under the auspices of DMAS—managing day‑to‑day developmental disabilities (DD) waiver operations, service authorization workflows, waitlist management, provider coordination, and data stewardship required for DD waiver administration.

This dual‑agency structure creates a tightly interdependent operational environment: DMAS sets Medicaid policy, funding rules, and federal compliance requirements, and DBHDS executes statewide operational functions through the Virginia Waiver Management System (WaMS). As a result, WaMS must support both the Medicaid program requirements defined by DMAS and the operational, service‑delivery responsibilities carried out by DBHDS. While DBHDS operates WaMS, the system itself is fundamentally a Medicaid infrastructure asset.

This shared governance model also drives important technical dependencies. WaMS exchanges data with the Medicaid Enterprise System (MES) for eligibility validation, service authorization reconciliation, and claims‑related feedback loops, which are functions that require precise coordination between DBHDS operations and DMAS Medicaid infrastructure. Because WaMS includes both Medicaid and non‑Medicaid components (e.g., Individual and Family Support Program (IFSP) functions), understanding this partnership is essential for determining allowable federal funding, cost allocation, and modernization scope.

The WaMS is a comprehensive data management platform designed to manage Medicaid waivers and facilitate communication between providers, support coordinators, and DBHDS. WaMS is used to manage the DD waivers, maintaining records of Individual Support Plans (ISPs), and serves as the entry point for service authorizations for DD waiver services. The system automates the authorization process and interfaces with the MES to establish assessment tiers based on individual needs. It also receives data from various Electronic Health Record (EHR) systems through data exchange.

WaMS currently serves more than 40,000 members, and the users of the system along with DBHDS staff include:

· 40 publicly funded Community Services Boards (CSBs), inclusive of support coordinators/case managers

· 4000+ private providers of Medicaid services (including private case managers)

· Department of Medical Assistance Services staff (as needed)

BACKGROUND

DBHDS currently utilizes the WaMS to support administration of Medicaid DD Home and Community-Based Services (HCBS) waivers. WaMS has served as a critical tool for managing waiver enrollment, service authorizations, and provider interactions. However, as program requirements have evolved, the existing system has reached functional and technical limitations that hinder efficiency, data integration, and user experience. Specifically, DBHDS is experiencing challenges around data consistency and validation, streamlined user interface, and interagency data exchange.

DBHDS recognizes the need to modernize WaMS to align with current federal and state technology standards, including interoperability expectations outlined in CMS guidance for Medicaid enterprise systems. Modernization will enable improved data sharing, streamlined workflows, and enhanced reporting capabilities to support program oversight and compliance.

This RFI seeks to gather information that will assist DBHDS in evaluating modernization strategies, identifying potential system architectures, and determining requirements for a future solution that supports person-centered service delivery, transparency, and operational excellence.

MODERNIZATION OBJECTIVES

The Department of Behavioral Health and Developmental Services (DBHDS) seeks to modernize the WaMS to create a more efficient, integrated, and user-centered platform that supports the administration of the Medicaid DD HCBS waivers. Modernization efforts are intended to align with state and federal technology standards, improve data interoperability, and enhance service delivery across all stakeholders.

The objectives of the WaMS modernization initiative include:

· Operational Efficiency: Streamline workflows and reduce administrative burden through improved system navigation and optimized data entry processes.

· Data Quality and Interoperability: Strengthen data integrity through validation and verification and enable secure, real-time data exchange with other local, state and federal systems.

· User Experience: Provide a single intuitive and accessible interface for all system users, inclusive of case managers, providers, individuals receiving services, and their families.

· Transparency and Accountability: Timely reporting, audit readiness, and compliance tracking to meet evolving program and policy requirements.

· Scalability and Sustainability: Implement a flexible architecture that can adapt to future program changes, technology advancements, and growth in service demand.

· Person-Centered Service Delivery: Enable data-driven decision-making and individualized support planning that promotes positive outcomes for individuals served.

· Data Governance and Ownership: Ensure the modernized WaMS supports enterprise‑level integration and secure data transfers with systems such as Critical Incident Management System, MES, and external EHRs. All data, including business rules, data dictionaries, and metadata—must remain the property of DBHDS and the Commonwealth of Virginia. The solution must incorporate robust data governance practices to maintain accurate, appropriate, and compliant data fields while supporting scalability for approximately 75,000 users and up to 1,000 concurrent sessions.

These objectives will guide DBHDS in evaluating potential solutions and inform the development of functional and technical requirements for future procurement activities.

KEY FUNCTIONAL AREAS

To support the objectives outlined above, DBHDS has identified several core functional areas essential to the modernization of the Waiver Management System (WaMS). These areas represent the foundational capabilities required to ensure efficient waiver administration, data integrity, and user-centered service delivery. The table below summarizes these key functions, and the modernization focus for each.

· Predefined validation criteria

· Interactive online forms

· Offline forms with a data sync feature

· Document attachment and upload

· Automated notifications and alerts

· Workflow progress trackers

· Configurable business rules and audit trails to ensure compliance and transparency

· Document attachment and upload

· Bidirectional provider data exchange between DMAS and DBHDS

· Integration with Licensing to confirm provider eligibility to be authorized and bill for service

· Validation and verification of service procedure coding (e.g. ICD-10 codes)

· Bidirectional feed that provides billing against authorized hours

· Dashboards and Key Performance Indicators (KPI) metric reporting

· Multi-Factor Authentication (MFA)

· Roles: Admin, Quality, User, Super User

· EHR systems (varied)

· DMAS MES

· Licensing System

· Critical Incident Management System

· HCBS Compliance Portal

· HCBS Grievance System

· Enterprise Data Warehouse

· Data Governance

· Change Management

SUBMISSION PROCESS

ISSUE DATE:

Wednesday, August 19, 2026 at 4pm EST

DUE DATE/TIME:

Friday, October 9, 2026 at 5pm EST

SINGLE POINT OF CONTACT:

Denise.Jackson@dbhds.virginia.gov

SUPPLIER CONTACT INFORMATION

Please provide your company’s contact information in the table below.

COMPANY NAME

COMPANY MAILING ADDRESS

COMPANY WEBSITE ADDRESS

NAME OF CONTACT PERSON

CONTACT PERSON E-MAIL ADDRESS

CONTACT PERSON TELEPHONE #

List of primary service offerings (that might serve local or state governments)

Years company has been in existence

Years of Government experience (Federal, State)

Headquarters location

SUPPLIER RESPONSE QUESTIONS

To support DBHDS in evaluating potential approaches for modernizing the Waiver Management System (WaMS), respondents are asked to provide detailed and comprehensive information addressing the areas outlined below. Responses should clearly describe the vendor’s capabilities, methodologies, and experience, and should offer sufficient depth to enable DBHDS to assess alignment with the modernization objectives and functional needs identified in this RFI.

A. System Capabilities

1. Describe how your proposed solution supports core Waiver Management functions inclusive of:

a. Beneficiary enrollment capture,

b. Eligibility validation, and verification

c. Service billing system integration Enter your response here, enlarging the box as needed. Reference any attachments.

2. Describe how your proposed solution supports core waiver management functions inclusive of:

a. Service Authorization workflow, inclusive of:

i. SA application management,

ii. Support Coordinator/Service Authorization alignment and assignment,

iii. SA Deadline and Progress management

b. Slot allocation and management; inclusive of:

i. Reserve Slot availability tracking (ex. In real time)

ii. Reserve Slot assignment

iii. Management Reporting and Activity audit trails Enter your response here, enlarging the box as needed. Reference any attachments.

3. Describe how your proposed solution supports core waiver management reporting functions inclusive of:

a. Provider Management Reporting

b. Service Authorization (SA) application progress reporting

c. Reconciliation Tracking of Service Authorization awards (SA) in alignment with Individual Support Plan (ISPs)

d. Beneficiary Waitlist monitoring

e. Slot Assignment, Slot Release history

f. Ad Hoc Reporting functions and

g. Dashboard support.

Enter your response here, enlarging the box as needed. Reference any attachments.

4. Do any of the proposed components require third‑party licensing or external support services?

Enter your response here, enlarging the box as needed. Reference any attachments.

5. Which of the core functions and/or components would be configurable by the DBHDS Administrator? (e.g. Business Rules, Security Roles, Letter(s)/Form(s), Documents).

Enter your response here, enlarging the box as needed. Reference any attachments.

6. Explain how your system ensures data accuracy, interoperability, and real-time exchange with other state and federal systems (ex. Virginia’s DMAS Medicaid Enterprise System (MES)).

Enter your response here, enlarging the box as needed. Reference any attachments.

7. Describe examples of configurable workflows and business rules within your solution that can be tailored to evolving program needs. Include capabilities such as multi‑language support and e‑signature functionality as applicable.

Enter your response here, enlarging the box as needed. Reference any attachment

8. Describe the platform’s standard capabilities for validating, monitoring, and improving data quality. Include capabilities for configurable validation rules, data-quality measurements, duplicate detection, exception reporting, monitoring dashboards, remediation tracking, and export of data-quality rules and results.

Identify which capabilities are native, configurable by DBHDS, customized, or subject to additional licensing or services.

Enter your response here, enlarging the box as needed. Reference any attachment

9. Explain how your solution responds to and incorporates government policy changes, and describe the mechanisms used to ensure compliance with stated implementation deadlines.

Enter your response here, enlarging the box as needed. Reference any attachment

10. Describe how your solution can be implemented and used on mobile devices (e.g., phones on Android/iOS and tablets).

Enter your response here, enlarging the box as needed. Reference any attachment

B. Data Management, Integration and Customization

1. Describe the standard capabilities the platform provides to enable DBHDS to independently govern Commonwealth data throughout its lifecycle. Include how DBHDS can access, manage, report on, integrate, retain, archive, audit, and export its business data, metadata, lineage, governance artifacts, configuration information, and audit history using standard platform capabilities.

Enter your response here, enlarging the box as needed. Reference any attachments.

2. What features are available in the solution that interface or integrate (bidirectional communication) with other tools and technologies, and would this occur in real-time (or near real-time), or at specified intervals?

Enter your response here, enlarging the box as needed. Reference any attachments.

3. What technologies does the solution support for integration with third-party systems?

Enter your response here, enlarging the box as needed. Reference any attachments.

4. Describe, integration standards, monitoring capabilities, error handling, reconciliation, and any technical, licensing, volume, or cost limitations.?

Enter your response here, enlarging the box as needed. Reference any attachments.

5. Would any part of the solution require the use of third-party modules or components (e.g., business intelligence software, or a dashboard/reporting engine, AI widget(s))? If yes, please describe, and would the third-party modules or components require a separate paid License?

Enter your response here, enlarging the box as needed. Reference any attachments.

6. Explain how your system supports integration with Medicaid enterprise components and other state data systems.

Enter your response here, enlarging the box as needed. Reference any attachments.

7. Because for DBHDS all data/metadata must be exportable without restriction, please describe available APIs, Reporting, Retention and Archival support, Data portability, Customer Ownership of governance information, and Any licensing, technical or contractual limitations associated with these capabilities.

Enter your response here, enlarging the box as needed. Reference any attachments.

8. Describe your approach to system scalability and sustainability to accommodate future program growth and technology changes.

9. Describe your largest implementation. What features and challenges stood out?

C. Security and Compliance

1. Detail how your solution complies with federal, state and industry best practices and security standards, including HIPAA and CMS interoperability and accessibility requirement guidelines, (e.g. Section 508) Enter your response here, enlarging the box as needed. Reference any attachments.

2. Describe your approach to identity management (ex. MFA), role-based access, and protection of protected health information (PHI) and personal identifiable information (PII).

Enter your response here, enlarging the box as needed. Reference any attachments.

3. Describe any capabilities the solution allows for segregating sensitive data from non-sensitive data to include record level as well as field/column-level segregation record-levels.

Enter your response here, enlarging the box as needed. Reference any attachments.

4. D. Implementation Approach

1. Provide an overview of your implementation timelines, including: (1) the general duration for deploying a basic solution, (2) best‑case and worst‑case timelines for solutions requiring customization or integration, and (3) the typical duration for implementing changes or enhancements.

Enter your response here, enlarging the box as needed. Reference any attachments.

2. Outline your recommended implementation strategy, including phases, timelines, and resource requirements.

Enter your response here, enlarging the box as needed. Reference any attachment

3. What skills (rudimentary and specialized, if any) are required to implement the solution? Describe the roles on your implementation team (e.g. Project Manager, Tester, Trainer, Data Analyst) Enter your response here, enlarging the box as needed. Reference any attachments.

4. Describe your approach to data migration from legacy systems, including risk mitigation and validation processes.

Enter your response here, enlarging the box as needed. Reference any attachment

5. Describe the type and duration of training required to implement and maintain the solution.

Enter your response here, enlarging the box as needed. Reference any attachments.

6. Which deployment options are normally offered for such a solution? Please describe, including how solution upgrades are handled.

(Check all that apply, and describe)

Licensed (Hosted by/at DBHDS)

Software-as-a-Service (SaaS)

Managed Service (Describe the particular “flavor(s)” offered)

Outsourcing

Hybrid or Other (Describe)

7. What pricing models or methodologies (i.e., which pricing approaches or structures are normally offered for this type of solution (flat fees, charges per module or sub-system, per order, per transaction, per seat, etc.)?

E. Post-Implementation, Support and Maintenance

1. Identify key success factors and lessons learned from similar modernization projects.

Enter your response here, enlarging the box as needed. Reference any attachments.

2. Describe your approach to system scalability and sustainability to accommodate future program growth and technology changes.

Enter your response here, enlarging the box as needed. Reference any attachments.

3. What resource utilization is required for ongoing operations and maintenance of the solution? (e.g., Systems Engineer - 50%, Applications Manager – 100%, etc.)

Enter your response here, enlarging the box as needed. Reference any attachments.

4. Describe your process for managing and supporting customized solution components during product releases. Include details on the approaches, tools, and staffing required to perform regression testing and to validate that existing functionality remains intact.

Enter your response here, enlarging the box as needed. Reference any attachments.

5. Provide a description of the training needed to implement and maintain the proposed solution, specifying the duration of each training component and detailing available ongoing user training options.

Enter your response here, enlarging the box as needed. Reference any attachments.

6. Describe your post‑implementation support model, including your system update and release schedule.

Enter your response here, enlarging the box as needed. Reference any attachments.

7. Explain your help desk/support staffing model, specifying whether the model relies on full-time dedicated staffing, contract staff or by shared resources within your help desk organization.

Enter your response here, enlarging the box as needed. Reference any attachments.

8. Describe how your help desk/support staff addresses a high call volume situation that may arise from an emerging or a known issue.

Enter your response here, enlarging the box as needed. Reference any attachments.

9. Indicate the average first‑contact response time for a reported issue.

Enter your response here, enlarging the box as needed. Reference any attachments.

10. Describe how the vendor would support DBHDS upon contract expiration, termination, or transition to another solution. Identify any limitations or conditions associated with data return, continued access, transition assistance, or destruction.

F. Closing

1. What else should we know about your solution or its implementation?

Enter your response here, enlarging the box as needed. Reference any attachments.

2. What additional features, enhancements, or emerging national trends that relate to this product or to other solutions your organization is developing?

Enter your response here, enlarging the box as needed. Reference any attachments.

3. What additional features, enhancements, or emerging national trends are relevant to this product or to other solutions your organization is developing?

Enter your response here, enlarging the box as needed. Reference any attachments.

4. Provide any available client references for similar projects and specify whether they may be contacted for verification or additional information.

Thank you for responding to this Request for Information.

CONFIDENTIALITY/FREEDOM OF INFORMATION/RIGHTS RESERVED

The Virginia Freedom of Information Act, § 2.2-3700 the Code of Virginia, guarantees citizens of the Commonwealth and representatives of the media access to public records held by public bodies, public officials, and public employees. All materials submitted by Supplier shall be handled in accordance with the Freedom of Information Act and any other laws and regulations applicable to the disclosure of documents submitted under this RFI. In no event shall DBHDS, the Commonwealth, or any of their agents, representatives, consultants, directors, officers or employees be liable to a Supplier for the disclosure of any materials or information submitted in response to this RFI that is not properly marked Confidential, as specified below.

DBHDS may disclose the contents of all responses to this RFI, except the parts that may be treated as exempt or excluded in accordance with the Freedom of Information Act. Each Supplier, by submitting a response to this RFI, consents to such disclosure and expressly waives any right to contest such disclosure under the Freedom of Information Act.

If a Supplier has special concerns about information which it desires to make available to DBHDS but which it believes constitutes a trade secret, proprietary information, or other information exempted from disclosure, such Supplier shall specifically and conspicuously designate that information by placing “CONFIDENTIAL” in the header or footer of each such page affected, and in a separate letter explain why that material should be exempt from public disclosure. Blanket designations that do not identify the specific information shall not be acceptable and may be cause for DBHDS to treat the entire response as public information. DBHDS will not advise a submitting party as to the nature or content of documents entitled to protection from disclosure under the Freedom of Information Act or other applicable laws, as to the interpretation of such laws, or as to definition of trade secret. The provisions of the Freedom of Information Act or other laws shall control in the event of a conflict between the procedures described above and the applicable law.

GENERAL INSTRUCTIONS

SUPPLIER SUBMISSION REQUIREMENTS:

This solicitation is an RFI; DBHDS will only accept responses electronically through eVA. Responses will be received until the closing date and time specified in the solicitation. It is the Supplier’s responsibility to ensure that responses are received timely. The eVA system allows for the secured and sealed electronic submission of responses. The Supplier shall make no other distribution of the response. Responses submitted elsewhere, including to other state or federal agencies, will not be accepted. Mailed, faxed or emailed responses will not be accepted.

Suppliers are solely responsible for reviewing, complying, and returning a complete and responsive response. Changes to the solicitation’s forms or formats are prohibited except where clearly instructed and permitted.

Suppliers must be registered in eVA to submit an electronic response. For more information on how to respond to a solicitation:

A. Go to eVA - Virginia's eProcurement Marketplace - eVA B. Scroll down and click on “Supplier Training” C. Click on “Viewing and Responding to Solicitations” video, under Sourcing If a Supplier needs assistance submitting an electronic response, the Supplier should contact eVA Customer Care prior to the closing date and time.

Prior to the due date, the Supplier should:

Check the status of the solicitation on Virginia Business Opportunities search by the solicitation by number for any updates, changes, amendments, cancellations, etc.; and Complete all attachments, amendments, exhibits, product information, etc. and attach the Supplier’s electronic submission.

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