PATH M&O RFP Appendix (3).pdf

Table of Contents

Appendix I: Acronyms and Glossary of Terms

Appendix II: Deliverables, Milestones, and Payments

Appendix III: Deliverable and Milestone Dictionary

Appendix IV: Staff Qualifications, Experience, and Responsibilities

Appendix V: Business Areas

Appendix VI: Business and Technical Specifications

Appendix VII: Operations Specifications

Appendix VIII: Optional Specifications

Appendix IX: Service Level Agreements (SLAs)

Appendix X: Performance Measures

Appendix XI: Procurement Library

Appendix XII: Vendor Reference Form

Appendix I: Acronyms and Glossary of Terms

This appendix contains a list of the acronyms used in this RFP. The vendor should use this acronym list as a point of reference. However, the vendor should not interpret this as a comprehensive list of terms, programs, or functionality in scope for this RFP.

Table 6: Acronyms and Terms

Term Definition

ABAWD Able-Bodied Adults Without Dependents

ACA Affordable Care Act

ACF Administration for Children and Families

ACMC Assessment and Case Management Centers

ACT ACT, The Social Security Act

ADAP AIDS Drug Assistance Program

ADH Administrative Disqualification Hearing

AFDC Aid to Families with Dependent Children (Now known as TANF)

AFDC/U Includes AFDC and AFDCU

AFDCU Aid to Families with Dependent Children - Unemployed Parent

AFP Advanced Function Presentation

AG Assistance Group

AGI Adjusted Gross Income

AI Artificial Intelligence

AIDS Acquired Immune Deficiency Syndrome

Alert A notification of an event that requires their attention

AP Absent Parent

APD Advance Planning Document

Applicant An individual who is seeking benefits but has not yet been determined eligible

APTC Advance Premium Tax Credit

ARC-AMPE Acceptable Risk Controls for ACA, Medicaid, and Partner Entities

ARU Automated Response Unit (for EBT). Also called EBT Helpline

ASO Administrative Service Organization

Assistance

Group

The people tied to a case who are eligible to receive benefits.

The income/assets of all persons in the Income Group (IG) is compared to the income/asset limits for the number of persons in the Needs Group (NG). This comparison determines whether those in the Assistance Group (AG) are eligible to receive the benefit.

Term Definition

BC Blade Center

BCF Bureau for Children and Families

BCSE Bureau for Child Support Enforcement (formerly CAO and CSED)

BFU Basic Filing Unit

BMS Bureau for Medical Services (formerly OMS)

BPMN Business Process Model and Notation

BUR Burial Assistance

CAN Social Security Claim Number

CAO Child Advocate Office (formerly CSED, now BCSE)

CAP Corrective Action Plan

Case Lifecycle The complete span of a case, including, but not limited to, intake/assessment, locate, establishment, enforcement, and closure. The lifecycle is considered complete when the case is closed; however, a new lifecycle may begin if a client returns to the system as a part of the new case.

CC Child Care

CCU Claims and Collections Unit

CCWIS Comprehensive Child Welfare Information System

CDCS Children With Disabilities Community Service Program

CEN Continuously Eligible Newborn

CFR Code of Federal Regulations

CFSR Child and Family Service Reviews

CHIP Children’s Health Insurance Program

CHIPRA CHIP Reauthorization Act of 2009

CIM Common Information Model

CICS Customer Information Control System

CIU Criminal Investigations Unit

Client An individual who has been determined eligible for a given benefit program.

Synonym: Member, Beneficiary

Client Portal The online portal that the client uses to apply for benefits and manage their case.

Synonyms: Member Portal, inroads

CLP Common Landing Portal

CMS Centers for Medicare and Medicaid Services

CMV Current Market Value

CNCS Corporation for National and Community Service

COBOL Common Business-Orientated Language

COLA Cost of Living Adjustment

Correspondence Refers to both notices and letters as defined below

COTS Commercial off the Shelf

CP Custodial Parent

CPI Consumer Price Index

CPS Child Protective Services

CS Child Support

CSE Child Support Enforcement

CSED Child Support Enforcement Division (formerly CAO, now BCSE)

CSHCN Children with Special Health Care Needs Program (formerly Handicapped

Children)

CSM Community Services Manager

CSMA Community Spouse Maintenance Allowance

CSR Customer Service Representative (EBT vendor)

CWEP Community Work Experience Program

CWS College Work Study

DA&A Drug Addicts and Alcoholics

DAC Disabled Adult Children

DCA Diversionary Cash Assistance

DDI Design, Development, and Implementation

DEERS Defense Enrollment Eligibility Reporting System

Defect A condition in a software product which does not meet a requirement or Change

Request (as stated in the requirement specifications); a defect is an error in that causes a program to malfunction or to produce incorrect/unexpected results.

DFA Division of Family Assistance (formerly OFS)

DHCP Dynamic Host Configuration Protocol (DHCP)

DMAPS Department of Military Affairs and Public Safety

DoHS Department of Human Services

DRS Division of Rehabilitative Services

EA Emergency Assistance

EBT Electronic Benefits Transfer

EDI Electronic Data Interchange eDRS Electronic Disqualified Recipient System

EFT Electronic Funds Transfer

EIP Employer Incentive Program

Eligibility

Lifecycle

The complete span of a case for an assistance program case. The lifecycle begins with the application process, then moves to the eligibility determination, then to the case maintenance, then to redetermination, and then on to case closure or back to case maintenance depending on the outcome of the redetermination process. The lifecycle is generally considered complete when the client is no longer eligible for benefits and their case is closed.

EOB Explanation of Benefits

EOL End-of-Life ePHI electronic Protected Health Information

EPSDT Early and Periodic Screening, Diagnostic, and Treatment

ESABPS Unemployment Compensation Benefit System

ESB Enterprise Service Bus

ESW Economic Service Worker

FACTS Families and Children Tracking System (FACTS)

FA Family Assistance

FCR Federal Case Registry

FCS Food and Consumer Services (Now FNS)

FDA Food and Drug Administration

FDSH Federal Data Services Hub

FedRAMP Federal Risk and Authorization Management Program

FEFU Front-End Fraud Unit

FEMA Federal Emergency Management Agency

FFM Federally Facilitated Marketplace

FFP Federal Financial Participation

FHA Federal Housing Authority

FI Countable SNAP Income

FIDM Financial Institution Data Match

FIPS Federal Information Processing Standards

FISMA Federal Information Security Management Act

FMA Family Maintenance Allowance

FMAP Federal Medical Assistance Percentages

FmHA Farmers Home Administration

FNS Food and Nutrition Services (formerly FCS)

FPL Federal Poverty Level

FPLS Federal Parent Locator Service

FSS Family Support Specialist

FTE Full-Time Employees

FTROP Federal Tax Refund Offset Program

FTI Federal Tax Information

FVO Family Violence Option

GA for DA General Assistance for Disabled Adults (Program discontinued 7/1/96)

GAXOM General Accounting Expenditure Off System Miscellaneous

GLF Group Living Facilities

GSYP Governor's Summer Youth Program

HCB Home and Community Based Waiver

HCFA Health Care Financing Administration (now CMS)

HHS Health and Human Services

HIPAA Health Insurance Portability and Accountability Act of 1996

HL7 Health Level Seven International standards

HSS Homeless Shelter Standard

HTTP Hypertext Transfer Protocol

HTTPS Hypertext Transfer Protocol Secure

HUD Housing and Urban Development

IAM/SSO Identity and Access Management/Single Sign-On

ICF/MR Intermediate Care Facility/Mentally Retarded

ICPC Interstate Compact on the Placement of Children

IDT Inter-Disciplinary Team

IE Integrated Eligibility

IEEE Institute of Electrical and Electronic Engineers

IES Integrated Eligibility Solution

IEVS Income and Eligibility Verification System

IFM Investigations and Fraud Management

IG Income Group

ILC Issuance-Limited County

IIU Institutional Investigative Unit

IM Income Maintenance

IMM Income Maintenance Manual

Income Group The individuals tied to a case whose income/assets are counted when determining eligibility for benefits.

The income/assets of all persons in the Income Group (IG) is compared to the income/asset limits for the number of persons in the Needs Group (NG). This comparison determines whether those in the Assistance Group (AG) are eligible to receive the benefit.

IPACT Interstate Paternity Acknowledgement Certification Transmission

IPsec Internet Protocol Security

IPV Intentional Program Violation

IRS Internal Revenue Service

ISO International Organization for Standardization

IV-A Title of the Social Security Act defining TANF services

IV-D Title of the Social Security Act defining Child Support services

IV-E Title of the Social Security Act defining Foster Care services

IVR Interactive Voice Response

JOBS Job Opportunity and Basic Skills Program

JOIN Joint Opportunities for Independence

JTPA Job Training Partnership Act (now WIA)

KPI Key Performance Indicator

Letter This is any worker communication to a client or third party that is not a Notice

(e.g., does not contain a decision)

LIEAP Low Income Energy Assistance Program

LIS Low Income Subsidy

LTC/AC Long Term Care/Alternative Care

MAGI Modified Adjusted Gross Income

MARS-E Minimum Acceptable Risk Standards for Exchanges

MDT Multi-Disciplinary Treatment Team

MEP Message Exchange Patterns

MES Medicaid Enterprise Systems

Message There are several potential definitions for the term message, depending on the context within which the term is used:

- A system-generated message as an alert

- A voice message for purposes of making contact with a client, participant, or State worker

- A notification of potential actions to be taken through electronic means

MIPPA Medicare Improvements for Patients and Providers Act

MAS Minimum Acceptable Score

MDM Master Data Management

MITA Medicaid Information Technology Architecture

MMM MITA Maturity Model

MNIL Medically Needy Income Level (formerly PIL)

MODIFY Mentoring and Oversight for Developing Independence with Foster Youth

MOM Microsoft Operations Manager

MPA Medicare Premium Assistance

MPA Medicare Premium Assistance (QMB, SLIMB, QI-1)

MR/DD Mentally Retarded/Developmentally Disabled

MRT Medical Review Team

MSP Medicare Savings Plans (QMB, SLIMB, and QI-1)

M-WIN Medicaid Work Incentive Network

M&O Maintenance and Operations

NACHA National Automated Clearing House Association

NAMRS National Adult Maltreatment Reporting System

NCIC National Crime Information Center

NCP Non-custodial parent

Needs Group The individuals whose needs are considered in the application process. The number of individuals in the Needs Group determines the eligibility thresholds used to determine eligibility for the case.

The income/assets of all persons in the Income Group (IG) is compared to the income/asset limits for the number of persons in the Needs Group (NG). This comparison determines whether those in the Assistance Group (AG) are eligible to receive the benefit.

NEICE National Electronic Interstate Compact Enterprise (NEICE)

NEMT Non-Emergency Medical Transportation

NF Nursing Facility (formerly nursing home)

NG Needs Group

NIEM National Information Exchange Model

NILC Non-Issuance-Limited County

NIST National Institute of Standards and Technology

Not Applicable When used in the context of the Procurement Library Source field in the requirements tables contained in this appendix, Not Applicable indicates that the requirement was sourced directly from State subject matter experts during Joint

Requirements Planning sessions or identified through some other means that did not allow the State to reference a specific source document.

Notice This term refers to the Notice of Decision. The Notice is the prescribed printed communication from the office to the client. Notices are typically generated for both evaluated and determined Assistance Groups (AGs).

Notification A system-generated notice that is sent to a client or applicant either through mail or email to notify of any pending or potential actions to be taken on the case

NPA Non-Public Assistance

NSLP National School Lunch Program

NwHIN Nationwide Health Information Network

NYTD National Youth in Transition Database

OASIS West Virginia Statewide ERP Solution

OCSE Federal Office of Child Support Enforcement

OFS Office of Family Support (now DFA)

OJT On-the-Job Training

OLE Outside Living Expenses

OMCFH Office of Maternal, Child and Family Health (formerly Office of Maternal and

Child Health)

OMG Object Management Group

OMIS Office of Management Information Services

OMS Office of Medical Services (Now BMS)

ORW Operational Report Workbook

OSA Office of Shared Administration

OSCAR Online Support Collection and Reporting

OSI Open Systems Interconnection

OWASP Open Web Application Security Project

The Open Web Application Security Project is an online community which creates freely available articles, methodologies, documentation, tools, and technologies in the field of web application security

PA Public Assistance

PAAS Physicians Assured Access System

PAC Pickle Amendment Coverage

PARIS Public Assistance Reporting Information System

PASS Plan for Achieving Self-Support

PDP Prescription Drug Plan

Pend According to West Virginia business rules, the term pend refers to a situation when an applicant has applied for benefits or reported a change in circumstance, and the worker/solution determines that additional information is required before a decision on the case can be made.

PHI Protected Health Information

PIC Private Industry Council

POA&M Plan of Action & Milestones

PMBOK Project Management Body of Knowledge

PMI Project Management Institute

PMO Project Management Office

PMP Project Management Professional

PNE Paternity Not Established

POC Period of Consideration

POE Period of Eligibility

PPTP Point-to-Point Tunneling Protocol

PRC Personal Responsibility Contract

Programmer For the purpose of this RFP, the State defines a programmer as a specific member of the vendor team that develops functionality for the solution.

PRWORA Personal Responsibility and Work Opportunity Reconciliation Act of 1996

PWE Primary Wage Earner

QC Qualifying Child

QDWI Qualified Disabled Working Individual

QHP Qualified Health Plan

QI Qualified Individual

QI-1 Qualified Individual-1

QI-2 Qualified Individual-2 (Program Discontinued December 31, 2002)

QMB Qualified Medicare Beneficiary

QUICK Query Interstate Cases for Kids

QR Qualified Recipient (Discontinued December 31, 1997)

RAPIDS Recipient Automated Payment and Information Data System

RD Regional Director

RESA Report on Economic Services Activity

RFP Request for Proposal

RHIOs Regional Health Information Organizations

RHS Rural Housing Service

RRB Railroad Retirement Board

RSDI Retirement, Survivors, and Disability Insurance

SAVE Systematic Alien Verification for Entitlement Program

SCA School Clothing Allowance

SDLC Software Development Life Cycle

System Development Life Cycle

SDX State Data Exchange

SFU Standard Filing Unit

SGA Substantial Gainful Activity

SIEM Security information and event management (SIEM). Software products and services combining security information management (SIM) and security event management (SEM). SIEM technology provides real-time analysis of security alerts generated by network hardware and applications.

SLA Service Level Agreement

SLIMB Specified Low-Income Medicare Beneficiary

SMA State Medicaid Agency

SME Subject Matter Expert

SNAP Supplemental Nutrition Assistance Program (formerly known as the Food Stamp

Program)

SNAP

Employment and

Training (E&T)

Supplemental Nutrition Assistance Program Employment and Training

SOA Service Oriented Architecture

SOAP Simple Object Access Protocol

SOC Service Organization Control

Social Services West Virginia defines Social Services as any assistance programs that relate to the following programs:

- Child Care Subsidy

- Child Care Licensing

- Child Protection Services

- Adoption and Foster Care

- Adult Protection Services

SOLQ State Online Query for SSA Information

Solution This is the E&E platform that we are writing the RFP to procure. Synonyms:

system, E&E system, module

SOW Statement of Work

SP NIST Special Publication

Specification Any business, technical, or operational requirement of the vendor

SPI Support Payment Information

SQL Structured Query Language

SRM Standards Reference Manual Part III Chapter 6 figure 6-1

SSA There are multiple acronyms for SSA, depending on context:

Social Security Administration

Single Streamlined Application

SSH Secure Shell

SSI Supplemental Security Income

SSN Social Security Account Number

SSP There are multiple acronyms for SSP, depending on context:

System Security Plan

Self-Sufficiency Plan

SS-A Self-Assessment

SUA Standard Utility Allowance

Support Give assistance to; enable to function or act.

SVES There are multiple acronyms for SVES, depending on context:

State Verification Exchange System

State Verification Eligibility System

System User A user of the system on the State side. Synonyms: worker, county worker

System Analyst For the purpose of this RFP, the State defines a systems analyst as a specific member of the vendor team

TA Technical Architecture

TANF Temporary Assistance for Needy Families (Formerly AFDC)

TCP/IP Transmission Control Protocol/Internet Protocol

TEFAP Temporary Emergency Food Assistance Program

Title XIX Section of the Social Security Act dealing with Medicaid

Title XX Section of the Social Security Act dealing with Social Services Programs

T-MSIS Transformed Medicaid Statistical Information System

TLS Transport Layer Security

TM Transitional Medicaid

TPL Third-Party Liability

TSRG Technology Standards Reference Guide

UCI Unemployment Compensation Insurance

UML Unified Modeling Language

UMWA United Mine Workers of America

UPV Unintentional Program Violation

USDA United States Department of Agriculture

VA Department of Veterans’ Affairs

VECS Vendor Employee Confidentiality Statement

Vendor The entity providing the services defined in this RFP to the State. Synonyms:

contractor, service provider

VM Virtual Machine

VISTA Volunteers in Service to America

VQ Voluntary Quit

W&T Work and Training

W3C World Wide Web Consortium

WC Workers' Compensation

West Virginia business rules

These are the policies of the State that govern a specific program or subject area.

Synonyms: State Policy, program requirements, program policy.

WIA Workforce Investment Act (formerly JTPA)

WIC Women, Infants, and Children Program

WIN Winning Intercept Network

WSRP Web Services for Remote Portlets

WtW Welfare to Work

WV West Virginia (State)

WVOT West Virginia Office of Technology

WV PATH West Virginia People’s Access to Help

XHTML Extensible Hypertext Markup Language

XML Extensible Markup Language

Appendix II: Deliverables, Milestones, and Payments

This appendix provides a comprehensive inventory of all deliverables, milestones, and associated project phases, along with corresponding payment details.

Table 7: Deliverables, Milestones, and Project Phase List

ID Type Title Project Phase

% of Project

Deliverable and

Milestone Cost

M001 Milestone Completion of Project

Kickoff

Project Planning and

Transition 10%

D001 Deliverable Transition Plan Project Planning and

Transition

D002 Deliverable Project Charter Project Planning and

Transition

D003 Deliverable Stakeholder

Management Plan

Project Planning and

Transition

D004 Deliverable Facility Management

Plan

Project Planning and

Transition

D005 Deliverable Staffing Management

Plan

Project Planning and

Transition

D006 Deliverable Documentation

Management Plan

Project Planning and

Transition

D007 Deliverable Training Management

Plan

Project Planning and

Transition

D008 Deliverable Testing Management

Plan

Project Planning and

Transition

D009 Deliverable Deliverable Dictionary Project Planning and

Transition

D010 Deliverable Communication

Management Plan

Project Planning and

Transition

D011 Deliverable Risk and Issue

Management Plan

Project Planning and

Transition

D012 Deliverable Change Management

Plan

Project Planning and

Transition

ID Type Title Project Phase

% of Project

Deliverable and

Milestone Cost

D013 Deliverable

Security, Privacy, and

Confidentiality

Management Plan

Project Planning and

Transition

D014 Deliverable Configuration

Management Plan

Project Planning and

Transition

D015 Deliverable

Disaster Recovery and

Business Continuity

Plan

Project Planning and

Transition

D016 Deliverable Data Quality and

Governance Plan

Project Planning and

Transition

D017 Deliverable System Back-Up and

Record Retention Plan

Project Planning and

Transition

D018 Deliverable Turnover and Closeout

Management Plan

Project Planning and

Transition

D019 Deliverable Weekly Project Status

Report Template

Project Planning and

Transition

D020 Deliverable Monthly Project Status

Report Template

Project Planning and

Transition

D021 Deliverable Weekly Project Status

Report

Project Planning and

Transition

D022 Deliverable Monthly Project Status

Report

Project Planning and

Transition

D023a Deliverable Operational Support

Plan

Project Planning and

Transition

D023b Deliverable Incident Management

Plan

Project Planning and

Transition

D023c Deliverable Problem Management

Plan

Project Planning and

Transition

D023d Deliverable Service Request

Management Plan

Project Planning and

Transition

D024e Deliverable System Change

Management Plan

Project Planning and

Transition

D025f Deliverable Release Management

Plan

Project Planning and

Transition

D024 Deliverable Capacity Management

Plan

Project Planning and

Transition

Deliverable and

Milestone Cost

D025 Deliverable

Adaptive Maintenance, Availability, and

Performance

Management Plan

Project Planning and

Transition

M002 Milestone Completion of Project

Management Plan

Project Planning and

Transition

10%

M003 Milestone Completion of

Transition

Project Planning and

Transition

40%

D026 Deliverable

Requirements

Traceability Matrix

(RTM)

Solution Documentation

D027 Deliverable Business Process

Models Solution Documentation

D028 Deliverable Detailed System Design

(DSD) Document Solution Documentation

D029 Deliverable Data Dictionary Solution Documentation

D030 Deliverable Data Models Solution Documentation

D031 Deliverable Reports Inventory Solution Documentation

D032 Deliverable Correspondence and

Forms Inventory Solution Documentation

D033 Deliverable Interface Inventory Solution Documentation

D034 Deliverable System Security Plan

(SSP)

Solution Documentation

D035 Deliverable Safeguard Security

Report (SSR) Solution Documentation

D036 Deliverable User Documentation Solution Documentation

D037 Deliverable Training Materials Solution Documentation

D038 Deliverable System Integration Test

Cases Solution Documentation

D039 Deliverable System Integration Test

Results Solution Documentation

D040 Deliverable Regression Test Cases Solution Documentation

D041 Deliverable Regression Test Results Solution Documentation

Deliverable and

Milestone Cost

D042 Deliverable Load/Stress Test Cases Solution Documentation

D043 Deliverable Load/Stress Test Results Solution Documentation

D044 Deliverable User Acceptance Test

Cases Solution Documentation

D045 Deliverable User Acceptance Test

Results Solution Documentation

D046 Deliverable Capacity Analysis

Report Solution Documentation

D047 Deliverable Cut Over Play Book Solution Documentation

D048 Deliverable Report Distribution

Schedule Solution Documentation

D049 Deliverable Solution Health

Monitoring Plan Solution Documentation

M004 Milestone Completion of Solution

Documentation Phase Solution Documentation

10%

D050 Deliverable

Federal Certification and

Review Management

Plan

Certification -

D051 Deliverable ACF Certification

Documentation Certification -

M005 Milestone Completion of Child

Support Certification Certification 20%

M006 Milestone Turnover and Closeout Project Closeout 10%

The State will divide payment of the M003 Completion of Transition milestone across each transition release/event proposed by the vendor in the D001-Transition Plan, which will result in successful transition from the current vendor to the award vendor of specified functionality/modules/etc. The following examples illustrate potential milestone payment breakdowns:

• Example 1: The vendor proposes two transition releases. In this example, the State intends to break down the M003 milestone payment in the following manner:

Milestone Total Milestone Payment Transition 1

Payment

Transition 2

Payment

Completion of Transition 40% 20% 20%

• Example 2: The vendor proposes four transition releases. In this example, the State intends to break down the M003 milestone payment in the following manner:

Milestone Total Milestone

Payment

Transition

1 Payment

Transition

2 Payment

Transition

3 Payment

Transition

4 Payment

Completion of Transition 40% 10% 10% 10% 10%

The description for each deliverable and milestone is detailed in Appendix III: Deliverable and

Milestone Dictionary. Payment will be made only after the State has formally accepted the completed work, based upon acceptance criteria agreed upon with the vendor. Partial payments will not be issued for incomplete or partial work.

The State will provide, to the best of its ability, up-to-date copies of all deliverables noted in the

“Solution Documentation” Project Phase. The vendor is expected to update each deliverable in the

“Solution Documentation” Project Phase, ensuring accuracy with the current PATH solution. The

State expects the vendor to maintain these deliverables and keep the deliverables up to date per the requirements of this RFP.

Appendix III: Deliverable and Milestone Dictionary

The deliverable dictionary provides a high-level description of each deliverable and milestone included in this RFP. To the extent practicable, the vendor should describe their approach to

Human Centric Design (HCD) and User Experience (UX) best practices in all relevant deliverables.

Table 8: Deliverable and Milestone Dictionary

ID Type Deliverable Name Description

M001 Milestone Completion of Project

Kickoff

Complete when the State accepts the project has kicked off successfully.

D001 Deliverable Transition Plan

Should provide the approach and schedule the awarded vendor plans to take to facilitate the transfer of knowledge, responsibilities, and technical resources from the current vendor, while minimizing impact to the system and delivery of services.

D002 Deliverable Project Charter

Should provide the business need, assumptions, constraints, understanding of the project, and the services that will be provided.

D003 Deliverable Stakeholder Management

Plan

Should provide the approach that the vendor plans to use to manage stakeholder engagement during the project, including stakeholder communication

D004 Deliverable Facility Management Plan

Should provide the approach that the vendor plans to use to identify, lease, establish, and maintain project facilities

D005 Deliverable Staffing Management Plan

Should provide the approach that the vendor plans to take to staff the project and maintain compliance with all staffing requirements set forth in:

• RFP Appendix IV Staff Qualifications, Experience, and Responsibilities, Table 9: Key Staff

• RFP Appendix VI, Table 12: Business and Technical Specifications

• RFP Appendix VII, Table 13:

Operations Requirements

D006 Deliverable Documentation

Management Plan

Should provide the approach that the vendor plans to use to manage project documentation, including, but not limited to:

- Documentation types include deliverables, meeting materials, and artifacts

- Use, access, and management of document repositories

ID Type Deliverable Name Description

- Approach to version control on all project documentation

- Approach to HCD and UX Best Practices in all relevant deliverables

D007 Deliverable Training Management Plan

Should provide the approach the vendor plans to take to training state trainers (i.e. “Train the

Trainer”) and updating training materials

(D036 and D037).

D008 Deliverable Testing Management Plan

Should provide the vendor's approach to conducting and supporting each phase of testing.

D009 Deliverable Deliverable Dictionary

Should provide a list of all project deliverables and include the following elements for each deliverable:

- Deliverable Number

- Deliverable Title

- Purpose

- Description

- Initial acceptance criteria based on requested content in RFP

D010 Deliverable Communication

Management Plan

Should provide the approach the vendor plans to use to manage communications during the project and include the following elements:

- Audience

- Tools

- Standing Project Meetings (purpose, audience, frequency)

- Reporting

- Maintenance of contact list

- Time frame and frequency of communications

- Required project communications

D011 Deliverable Risk and Issue

Management Plan

Should provide the approach the vendor plans to use to manage risks and issues on the project and contain the following elements:

- Risk and issue management tools

- Data sources that support risk and issue management

- Roles and responsibilities

- Criticality and probability measures

- Escalation measures

- Mitigation techniques and corrective action plan methodology

D012 Deliverable Change Management Plan Should provide the approach the vendor plans to use to conduct change management on the project and include:

- Change management tools

- Establishment of a change control board

- Regularly scheduled change control meetings

- Process used to document change requests on the project

- Align with the change management objective in Section 4.2.1.2, of this RFP

D013 Deliverable

Security, Privacy, and

Confidentiality

Management Plan

Should provide the approach the vendor plans to use to manage security, privacy, and confidentiality during the project. This plan should establish the approach for complying with all federal and State security mandates.

This plan should also include the following elements:

- Vendor's approach to conducting penetration testing

- Account management

- Role-based security (including complete solution role matrix)

- Audit controls and logging

- Incident response plan

- A description of how the vendor plans to use

IDS, IPS, Security Information Event

Management (SIEM), and malicious software detection.

- Annual update process

- Data breach reporting processes

- Align with the related procedures in State plans provided in Procurement Library

- Approach to completing SSP, SPR, POA&M, and other artifacts tied to federal reviews

D014 Deliverable Configuration Management

Plan

Should provide the approach the vendor will take to managing solution configuration during the project

D015 Deliverable Disaster Recovery and

Business Continuity Plan

Should provide the approach the vendor plans to use to restore operations following a disaster event. The plan should include the following elements:

a. Backup and protection plans and procedures, to include files, software, hardware, and network connectivity

b. Description of any proposed alternate hot site(s), including proposed plans and procedures for failover testing

c. Description of off-site storage procedures, including a detailed schedule for back-up operations and any proposed clustering methodology for high availability

d. Proposed recovery time and recovery point objectives

e. Risk analysis and risk mitigation for each core business process

f. Processes and procedures for testing and reporting of the DR/Business Continuity Plan to include:

i. Failover/fallback functionality ii Back-up/recovery functionality, including

Recovery Point Objective and Recovery Time

Objective.

iii. Business Continuity

iv. Process for updating the plan (as necessary) through the life of the contract

D016 Deliverable Data Quality and

Governance Plan

Should provide the approach the vendor plans to use to manage program data and records in the system. The plan should include:

- Executive Summary

- Functional and Organizational Infrastructure

- Technical Infrastructure

- Policies and Procedures

- Data Quality Management

D017 Deliverable System Back Up and

Record Retention Plan

Should provide the approach the vendor will use to conduct system back-ups and ensure that all records are retained on a schedule that aligns with State and federal regulations. The plan should include the following elements:

- Detailed schedules, to ensure that data maintained on the system or in other system/manual files is properly and routinely purged, archived, and protected from loss, unauthorized access, or destruction, in accordance with all relevant State policies and procedures

- Retention methodology for all data and records associated with each of the project phases described herein

D018 Deliverable Turnover and Closeout

Management Plan

Should provide the approach the vendor plans to use to transition the operations and maintenance of the system to the new vendor or State when the contract comes to a close.

The plan should include the following elements:

- Knowledge transfer to new vendor and/or

State staff

- Delivery of project documentation

- Job shadowing

- Transfer of assets (software, hardware, furniture)

- Escrow

- All data

- Certificates of destruction

- Project Closeout Report

D019 Deliverable Weekly Project Status

Report Template

Should establish the template for a weekly project status report.

D020 Deliverable Monthly Project Status

Report Template

Should establish the template for a monthly project status report.

D021 Deliverable Weekly Project Status

Report

Each Weekly Status Report submitted by the vendor ties to this deliverable.

D022 Deliverable Monthly Project Status

Report

Each Monthly Status Report submitted by the vendor ties to this deliverable.

D023a Deliverable Operational Support Plan

Should define the Vendor’s approach for providing day-to-day operational support for the WV PATH system. The plan should describe how the Vendor will support system operations, coordinate with the State’s ticket intake process, and ensure timely resolution of operational issues and service requests while maintaining system availability and performance.

D023 b Deliverable Incident Management Plan

Should outline the approach the vendor will use to manage the resolution of incidents related to the WV PATH system. This plan ensures efficient and effective handling of incidents to minimize their impact on operations and maintain service quality.

D023c Deliverable Problem Management Plan

Should outline the approach the vendor will use to identify, address, and mitigate underlying issues that cause incidents in the

WV PATH system. This plan ensures effective root cause analysis and implementation of corrective actions to prevent recurring problems and reduce their impact.

D023 d Deliverable

Service Request

Management Plan

Should define the approach the vendor will use to efficiently handle and fulfill Service

Requests (SRs) for the WV PATH system.

This plan ensures a streamlined, consistent process for managing service requests while maintaining transparency and efficiency.

D023e Deliverable System Change

Management Plan

Should provide the approach the vendor plans to use to conduct change management on the project and include:

- Change management tools

- Establishment of a change control board

- Regularly scheduled change control meetings

- Process used to document change requests on the project

- Align with the change management objective in Section 4.2.1.2 of this RFP

D023f Deliverable Release Management Plan

Should define the vendor's structured process for managing the release of changes, updates, and enhancements to the WV PATH system.

This plan ensures that all software and configuration item releases, including minor releases, emergency updates, and hot fixes, are conducted with minimal business disruption while maintaining high quality and compliance.

D024 Deliverable Capacity Management Plan

Should outline the vendor's approach to managing and forecasting the capacity requirements of the WV PATH system to meet current and future business and technical needs. This plan ensures optimal resource utilization and scalability to maintain system performance and availability.

D025 Deliverable

Adaptive Maintenance, Availability, and

Performance Management

Plan

Should outline the vendor's methodology for ensuring the WV PATH system operates effectively and reliably through adaptive maintenance, availability management, and performance optimization. This plan provides a structured approach to maintaining system functionality, availability, and performance throughout its lifecycle.

M002 Milestone Completion of Project

Management Plan

Complete when all component project management plan deliverables for the Project

Planning and Transition phase of the project have been approved by the State.

M003 Milestone Completion of Transition

Complete when the incumbent vendor completes all tasks in the Transition Plan and certifies that the WV PATH solution has been successfully transitioned from the current vendor to the incumbent vendor.

D026 Deliverable Requirements Traceability

Matrix (RTM)

Should establish traceability for the solution requirements from the outset of the project.

The RTM continues to be updated and maintained over the course of the project.

D027 Deliverable Business Process Models

Should provide a step-by-step workflow for each business process supported by the solution.

D028 Deliverable Detailed System Design

(DSD) Document

Should provide the solution design of all technical and functional elements of the system.

D029 Deliverable Data Dictionary

Should provide a complete inventory of all data elements that exist in the solution, a definition, data type, and table location for each element

D030 Deliverable Data Models

Should provide the conceptual, logical, and physical data models that determine the structure of the data in the solution.

D031 Deliverable Reports Inventory

Should provide a complete inventory of all reports supported by the solution. The inventory should include a unique ID, title, description, frequency, retention, and audience for each report.

D032 Deliverable Correspondence and Forms

Inventory

Should provide a complete inventory of all correspondence and forms generated by the solution. Correspondence includes both letters

(informational) and notices (decisions and changes to client accounts). The inventory should include a unique ID, title, description, related program.

D033 Deliverable Interface Inventory

Should provide a complete inventory of external interfaces in the solution. The inventory should include a unique ID, title, description, source/destination, inbound/outbound, data classification, format, transmission method/medium, frequency, and format/standard.

D034 Deliverable System Security Plan (SSP)

The mapping for how the vendor solution meets all security controls that are applicable to the solution. Based on the template provided by CMS, this plan details the security controls and measures in place to protect the system from potential threats, safeguard sensitive data, and ensure compliance with relevant security standards and regulations.

D035 Deliverable Safeguard Security Report

(SSR)

The IRS-mandated mapping for how the vendor meets all IRS Publication 1075 Security

Requirements that are applicable to the solution. Based on the template provided by the IRS.

D036 Deliverable User Documentation

This consists of all supporting documentation that the vendor makes available to system users to support specific business processes. This might include desk-level procedures, user guides, and other job aides.

D037 Deliverable Training Materials

Includes all materials that the vendor will use to support training, including slide decks, lesson plans/curriculums, agendas, and any other materials that the vendor will present to trainees.

D038 Deliverable System Integration Test

Cases

The test cases that the vendor intends to use to verify solution functionality at the system-test level. This deliverable should be produced for any/all relevant system releases.

D039 Deliverable System Integration Test

Results

The test results verifying solution functionality at the system-test level. This deliverable should be produced for any/all relevant system releases.

D040 Deliverable Regression Test Cases

The cases that the vendor intends to use to verify solution functionality during regression testing. This deliverable should be produced for any/all relevant system releases.

D041 Deliverable Regression Test Results

The results verifying solution functionality during regression testing. This deliverable should be produced for any/all relevant system releases.

D042 Deliverable Load/Stress Test Cases

The test cases that the vendor intends to use to verify solution functionality during load/stress testing.

D043 Deliverable Load/Stress Test Results The test results verifying solution performance during load/stress testing.

D044 Deliverable User Acceptance Test

Cases

The test cases that the State intends to use to verify solution functionality during UAT. This deliverable should be produced for any/all relevant system releases.

D045 Deliverable User Acceptance Test

Results

The test results verifying solution functionality during UAT. This deliverable should be produced for any/all relevant system releases.

D046 Deliverable Capacity Analysis Report

This report analyzes the workload that the solution can handle in its designed configuration to allow the State to plan whether there may be a need to expand capacity in the future if new programs are rolled into the solution, or the client base expands significantly.

D047 Deliverable Cut Over Play Book

Should provide a detailed task by task schedule of the activities to be completed during the cut over from the legacy systems to the new solution at go-live. This deliverable should be produced for any/all relevant system releases.

D048 Deliverable Report Distribution

Schedule

Should provide the schedule for executing all reports.

D049 Deliverable Solution Health Monitoring

Plan

Describes the vendor's approach to monitoring, maintaining, and enhancing the solution, including adherence to SLAs as defined in

Appendix IX.

M004 Milestone Completion of Solution

Documentation Phase

Complete when all Solution Documentation deliverables have been submitted by the vendor and approved by the State, and the documentation fully reflects the current functional, technical, security, data, and operational design of the WV PATH solution.

D050 Deliverable Federal Certification and

Review Management Plan

Provides the approach that the vendor will use to support all federal reviews required throughout the project.

D051 Deliverable ACF Certification

Documentation

All supporting documentation required to support the ACF Certification process.

M005 Milestone Completion of Child

Support Certification

Complete when the WV PATH solution has successfully met all federal Child Support certification requirements and the State has received formal certification approval from the

Administration for Children and Families

(ACF).

M006 Milestone Turnover and Closeout

Complete when the vendor completes planning and execution of all closeout activities when the contract comes to an end.

Appendix IV: Staff Qualifications, Experience, and Responsibilities

Key Staff:

Table 9: Key Staff

Staff Title Certifications Experience Responsibilities

PATH

Account

Manager

N/A A total of eight years of experience in:

1. Management of an organizational unit within a Human Services Department in a

U.S. state or territory; and/or

2. Management of an organizational unit within a Human Services Department that is performing operations that are of similar scope to the services that West Virginia has requested; and/or

3. Experience in other large healthcare integrated eligibility setting or agency contracted with the state/territory responsible for the performance of the same.

The Account Manager serves as a liaison with the DoHS during all phases of the contract.

The Account Manager is available and responsive to

DoHS requests for consultation and assistance.

The Account Manager:

• Attends in person, upon DoHS request, meetings and hearings of Legislative Committees and interested governmental bodies, agencies, and officers

• Manages the integration across human services programs serviced by the E&E enterprise

• Is responsible for establishing and maintaining a positive client relationship. Provides timely and informed responses to DDI, operational, and administrative inquiries that arise

• Delegates authority to the Deputy Account Manager when not able to be available

• Meets with State staff or such other person as DoHS may designate on a regular basis to provide oral and written status reports and other information as required

Staff Title Certifications Experience Responsibilities

PATH Deputy

Account

Manager/

Operations

Manager

N/A A total of four years of experience in:

1. Management of an organizational unit within a Human Services Department in a

U.S. State or territory; and/or

2. Management of an organizational unit within a Human Services Department that is performing operations in a state that are of similar scope to the services that West

Virginia has requested; and/or

3. Experience in other large healthcare-integrated eligibility setting or agency contracted with the state/territory responsible for the performance of the same.

The Deputy Account Manager fills the role of Account

Manager in that person’s absence. The Deputy Account

Manager plays an active role in day-to-day management of the Account so as to be knowledgeable and aware of all issues, concerns, and requirements, including integration management amongst the various programs served by, and the components that make up, the eligibility enterprise.

The Deputy Account Manager also serves as the

Operations Manager, managing staff assigned to all operational business activities and day-to-day operations of the integrated eligibility enterprise.

The Deputy Account Manager assists with oversight of the modernized E&E DDI and supports federal reviews including gate post reviews, CMS, State, and/or federal certification processes and any other federal review requirements.

PATH Project

Manager

Project Management Professional

(PMP) Certification

A total of four years of experience in project management of an IT project(s) that encompassed the full system development life cycle from initiation through post implementation within a human services department or health insurance marketplace in a U.S. state or territory.

The Project Manager leads the vendor’s project management activities for implementation of the modernized eligibility solution and all projects/enhancements initiated during Operations. The

Project Manager also acts as the main point of contact for the State regarding implementation, as well as

Maintenance and Operations project management activities.

Support of any federal gatepost reviews, including CMS, State, and/or federal certification processes.

PATH Line of

Business

Manager(s)

N/A Four years of health and human services program management experience.

Knowledgeable in quality assurance/control procedures, strong documentation and reporting background, demonstrated proactive problem management skills, and experience with change and incident management.

One of the four years of experience should be maintenance and operations experience in the solution and/or functionality being bid.

The Line of Business Manager(s) is responsible for managing all configuration activities for development, modification, and enhancement of the system components and/or applications under their supervision.

• Requirements gathering for maintenance and operations and modifications of the proposed solution.

• Modifications include, but are not limited to, routine system maintenance, changes resulting from updates to eligibility business rules, and changes required to remain compliant with federal regulations and standards.

• Enhancements include, but are not limited to, changes initiated by the bureau to achieve strategic objectives, implement new programs, and mature business capabilities.

PATH System

Manager

N/A A total of eight years of experience that can consist of any combination of the below:

1. Manager of an organizational unit within a human services agency in a U.S.

state or territory; and/or

2. Manager of an organizational unit within an integrated eligibility engagement performing operations in a U.S. state or territory; and/or

3. Experience in another large healthcare eligibility determination organization.

The Systems Manager is responsible for planning, developing, testing, implementing, and maintaining the

West Virginia IES, as well as assisting with management of the E&E Modernization DDI and any required federal reviews.

The Systems Manager will oversee the conversion of

West Virginia's existing eligibility data for import into the modernized solution. The Systems Manager will also be responsible for all aspects of the data conversation, including, but not limited to, design, development, testing, and implementation of the data conversation approach throughout DDI and Operations.

Test Manager N/A A minimum of four years of experience within the last eight years, managing the complete testing lifecycle on an integrated eligibility or related COTS-based solution

The Test Manager is responsible for overseeing all testing of the solution. The Test Manager will be responsible for facilitating State involvement in the testing effort, executing testing in a timely manner, resolving defects deployment. identified during testing, and providing dashboard level reporting on the testing effort to the State team.

Security

Manager

Certified Information Systems

Security Professional (CISSP) or

Certified Information Systems

Auditor (CISA) Certification

Minimum of five years of IT security work experience, including infrastructure/network and multi-platform environments with similar scope to the services that West Virginia has requested.

Experience should demonstrate familiarity with technical and risk assessment techniques, tools, and practices, and experience working with federal security and privacy requirements.

The Security Manager is responsible for ensuring that the architecture of the solution supports the State's security needs and that security is a primary focus during solution design, development, and implementation. The Security

Manager will integrate with the rest of the vendor management team to ensure that any concerns or incidents related to security at emerge during DDI or Operations are conveyed to the State in a timely manner and will take the lead in development solutions to any such issues.

The Security Manager should be the vendor single point of contact for supporting Security Audits.

Change

Control

Manager

N/A A total of four years of experience as follows:

• Experience working as an IT change control lead or manager for a vendor of

HHS systems, state HHS agency, and/or large…