South Carolina Department of Health and Human Services

(SCDHHS)

Member Management Replacement Program (MMRP)

Cúram Global Income Support (CGIS) Project

Architectural Description Document

(ADD)

CGIS28 HCR Integration

MMRP CGIS Project ADD CGIS28 HCR CGIS Integration V3.0 Page 2 of 232

Version Log

The Version Log maintains a record of the changes made to the document during its life cycle.

Whole number versions are reserved to designate that the document has reached an Approved status. Changes/Revisions made to approved documents will continue with decimals numbers, until the document again reaches an Approved status.

Version Date Drafted by Role Description of Change

0.1 8/24/2018 Hasan Faruque

IBM Business Analyst

Initial Draft

0.2 9/17/2018 Hasan Faruque

IBM Business Analyst

Updated based on Internal review.

0.3 9/25/2018 Hasan Faruque

IBM Business Analyst

Used new template and updated based on Internal review.

0.4 9/26/2018 Hasan Faruque

IBM Business Analyst

Added open items and created SharePoint action items.

0.5 10/12/2018 Bindu Gadiparthi

IBM

Functional Analyst

Added Use Cases and RTM Sheet

0.6 10/22/2018 Bindu Gadiparthi

IBM

Functional Analyst

Addressed Review Comments.

0.7 11/20/2018 Bindu Gadiparthi

IBM

Functional Analyst

Addressed Review Comments

0.8 11/21/2018 Ken Haas Functional Business Process Lead

QA Content Review

0.9 12/13/2018 Shreenivas Adapur

IBM

Developer

Initial Draft for TDS Section

0.10 12/18/2018 Shreenivas Adapur

IBM

Developer

Addressing the review comments.

0.11 2/9/2019 Bindu Gadiparthi

IBM

Functional Analyst

Updates for Approval Submission

V1.0 3/29/2019 Erin Coleman

SCDHHS

Process & Artifact Development Manager

Updated version number, watermark, and approval date.

CGIS28 HCR CGIS Integration V3.0 Page 3 of 232

Version Date Drafted by Role Description of Change

V1.1 6/17/2019 Bindu Gadiparthi

IBM

Functional Analyst

1. Updated ADD per approved CRs 48,39,40 and

a. CR48 - Section 4.11 - Medicaid ID – Added

Medicaid ID generation/validation logic when member has Medicaid ID in both MEDS and Cúram.

b. CR39 -Section 4.7 – Added IE tab validations for CGIS R1 and R2 PCATs

c. CR40 – Combined Workspace Spreadsheet has been updated for Appeals User Roles and link to the latest spreadsheet is added in section 4.1.3

d. CR41 – Section 4.22.3- Correction of IC code value and AR OV is added (Section - 4.15.3).

2. Removed the entries from Review and Approval

Log tables.

CGIS28 HCR CGIS Integration V3.0 Page 4 of 232

Version Date Drafted by Role Description of Change

V1.2 6/18/2019 Shreenivas Adapur

IBM

Developer

Updated ADD per approved CR 48

1. Section 5.1 - Common Technical Artifacts-

Updated to specify the use the existing HCR code to include Non-MAGI case type in checkAndCreateMedicaidIDExistInMEDS() method of MMGenerateMedicaidIDGeneratorUtil.java file for Medicaid ID generation/validation logic during program authorization.

2. Section 5.1.15 - Updated Façades section to include MMMAProductDelivery.java class – Added Medicaid ID validation logic when member has Medicaid ID in both MEDS and Cúram during certificate creation & modification.

3. Section 5.1.16 - Updated BPO Method Details for MMISPEvidence.java applyChanges1()– Added Medicaid ID validation logic when member has Medicaid ID in both MEDS and Cúram during apply changes.

4. Section 5.1.21 & 5.1.22 - Updated Service Layer with new MMGenerateMedicaidIDGeneratorUtil.java validateMedicaidIDForNonMagi() & checkAndCreateMedicaidIDExistInMEDS() – Added method to throw validation if both Cúram medicaid ID and meds Medicaid ID are not same using existing doesMedicaidIDExistInCuram() and checkAndCreateMedicaidIDExistInMEDS() methods.

Override checkAndCreateMedicaidIDExistInMEDS() to include Non-MAGI cases for Medicaid ID generation/validation logic during program authorization.

Added preAuthorization() method to MMAuthorizationEventListener.java to specify the call for Medicaid ID generation/validation logic for non-MAGI cases during program authorization.

5. Section 5.1.22- Added streamer classes processRecord() method change to set new Façade Scope object- ‘NonMagiBatchByPassValidation’ for SDX,Bendex,MMA, Buy-In & SVES batches.

V1.3 7/24/2019 Bindu Gadiparthi

IBM

Functional Consultant

Addressed Review Comments from Review Cycle1

CGIS28 HCR CGIS Integration V3.0 Page 5 of 232

Version Date Drafted by Role Description of Change

V1.4 7/24/2019 Shreenivas Adapur

IBM

Developer

Addressing the review comments.

Updated ADD per approved CR 039

1. Section 5.1- Common Technical Artifacts- Updated to specify the use of existing HCR code MMProcessEligibilityDecisionDetails.java to include CR039 changes related to validations of acceptable Coverage types and corresponding QCAT/ Benefit Indicator values while editing the IE tab.

2. Section 5.1.21 &5.1.22- Updated the Service layer with changes for MMProcessEligibilityDecisionDetails.java, checkValidCombination() method to validate whether the selected values of PCAT, QCAT and BenefitIndicator are in allowable combination for Non-MAGI cases. Updated editEligibilityDecisionDetails() to include changes for validation of benefitIndicator value when QMB Indicator is set to ‘Q’.

3. Added Section 5.1.7 Messages & Section

5.1.8 Message Detailed Description to

include MEditIndividualEliglError.xml’s new message ID for validation of benfitIndicator value when QMB Indicator is set to ‘Q’.

V1.5 8/6/2019 Shreenivas Adapur

IBM

Developer

Updated ADD per approved CR 124

1. Section 5.1.10 – DMX Table Details - Updated PAGECONFIG.dmx and USERPAGECONFIG.dmx to include ‘SCBabyNetWorkerRole’.

2. Section 5.1.11 – Security- Updated with changes for ‘SCBabyNetWorkerRole’.

3. Section 5.1.44 Java Classes- Changed nav StateLoader classes to disable ‘InterfaceData’ nav ID and ‘OLV’ nav ID for SCBabyNetWorkerRole user.

4. Section 5.1.30-Updated Workspace configuration Changes to include ‘MMBBNETAPP.app’ changes and its related .tab, .sec files.

5. Section 5.1.32- Updated UIM Configuration changes to add new SCBabyNetHomePage.uim files and its related .properties.

6. Section 5.1.6-Code table Details- Added new code table entry ‘MMBBNETAPP’ in CT_APPLICATION_CODE.ctx

CGIS28 HCR CGIS Integration V3.0 Page 6 of 232

Version Date Drafted by Role Description of Change

V1.6 8/7/2019 Bindu Gadiparthi

IBM

Functional Consultant

Updates Incorporated to the Combined Workspace for SCMMRP UserRoles v1.2 Per approved CRs 121 and 124 (Creation on New User Role – Baby Net Worker Role). Added the updated spreadsheet in section 4.1.3 INT_REQ 1.1.2

V1.7 8/14/2019 Shreenivas Adapur

Bindu Gadiparthi

IBM

Developer

IBM

Functional Consultant

Addressed review comments.

Updated with list of security group names for ‘SCBabyNetWorkerRole’

Addressed Review Cycle 1 comments from the State team.

1. Added details on the BabyNet user role in section 4.1.3 - INT_REQ 1.1.3

2. Created AI-922 for core ops team to assign user roles identified by DHHS to be configured to BabyNet User role group.

V1.8 1/28/2020 Chetan Nagaraj

Business Analyst

Accepted all changes and deleted the comments

V1.9 2/12/2020 Chetan Nagaraj

Business Analyst

The following requirements are updates as a part of CR186(Doc-Only):

INT_REQ_1.9.5.4

INT_REQ_1.22.19

V1.10 2/26/2020 Chetan Nagaraj

Business Analyst

Accepted the changes and deleted the comments https://team.scdhhs.gov/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Combined%20Workspace%20for%20SCMMRP%20UserRoles%20v1.2.xlsx https://team.scdhhs.gov/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Combined%20Workspace%20for%20SCMMRP%20UserRoles%20v1.2.xlsx

CGIS28 HCR CGIS Integration V3.0 Page 7 of 232

Version Date Drafted by Role Description of Change

V1.11 2/27/2020 Chetan Nagaraj

Business Analyst

Updated the functional section of the ADD as a part of the R14R2 changes.

Modified:

Section 4.7.1

INT_REQ1.9

INT_REQ1.9.6

INT_REQ1.9.7

INT_REQ1.19.1.2

INT_REQ1.19.4.1

INT_REQ1.19.4.2

INT_REQ1.19.4.2.1

INT_REQ1.19.6.1

INT_REQ1.19.13

Added:

R2_INT_REQ1.19.1.1.1

R2_INT_REQ1.19.1.1.2

R2_INT_REQ1.19.1.1.3

R2_INT_REQ1.19.7

R2_INT_REQ1.19.7.1

R2_INT_REQ1.19.7.2

R2_INT_REQ1.19.8

R2_INT_REQ1.19.8.1

R2_INT_REQ1.19.8.2

R2_INT_REQ1.19.4.2.3

V1.12 03/03/2020 Chetan Nagaraj

Business Analyst

As a part of CR207, marked Section 4.21 as out of scope and cancelled all the requirements under that section.

V1.13 03/06/2020 Shreenivas Adapur

IBM

Developer

Updated below sections in Technical Design for

R14R2 changes:

• 5.1 Common Technical Artifacts

• 5.1.29 Global Configuration Changes

• 5.5.1 MMCaseClosureChunker Detailed

Design

CGIS28 HCR CGIS Integration V3.0 Page 8 of 232

Version Date Drafted by Role Description of Change

V1.14 03/19/2020 Shreenivas Adapur

IBM

Developer

Updated below sections in Technical Design for as per CR207 to remove OnBase refence number development:

OnBase Reference Number development will remain until it is removed by PROD-7430, but will not be tested as the functional requirements are no longer valid

• 5.1 Common Technical Artifacts

• 5.1.1 Sequence Diagram

• 5.1.5 Code Tables

• 5.1.6 Code Table Details

• 5.1.15 Façades

• 5.1.16 BPO Method Details

• 5.1.21 Service Layer

• 5.1.22 Service Layer

• 5.1.32 UIM Configuration Changes

• 5.1.34 Server Interfaces Details

• 5.1.44 Java Classes

• 5.2.1 Cúram Unit testing Scenarios

V1.15 3/21/2020 Tiffany Ortega

IBM BA Lead Marked the following requirement as removed per

CR210:

INT.REQ 1.22.14

Updated the following requirement per CR210:

INT.REQ 1.22.15

V1.16 3/28/2020 Tiffany Ortega

IBM BA Lead Updated the Combined Workspace for SCMMRP UserRoles spreadsheet per CR192.

V1.17 4/1/2020 Chetan Nagaraj

Business Analyst

Responded to state review comments on R14R2 changes. Updated the Combined Workspace spreadsheet.

Added INT.REQ 1.22.15.1 based on review comment on CR210.

V1.18 4/20/2020 Chetan Nagaraj

Business Analyst

Incorporated the review comments from Review cycle 2.

Added requirements:

R2_INT_REQ1.9.5.5:

R2_INT_REQ1.9.5.6:

R2_INT_REQ1.19.1.1.3:

Updated the combined workspace spreadsheet to include the register Service Supplier option for select user roles.

CGIS28 HCR CGIS Integration V3.0 Page 9 of 232

Version Date Drafted by Role Description of Change

V1.19 04/23/2020 Ashish Lirani

IBM

developer

Updated section 5.1 Common technical Artifacts to include the new technical design changes for R1 4 R2 changes.

Updated Section 5.1.21 Service layer to include the new informational message for LTC related PCATs Updated 5.5 Batch Development 5.5.18 to include the case closure related changes.

V1.20 06/20/2020 Ashish Lirani

IBM

developer

Updated Section 5.1.22 customized the Application Search in a way that it returns result for Application Form number

V1.21 7/3/2020 Tiffany Ortega

IBM BA Lead The following requirement was updated per CR245:

INT_REQ1.15.5

V1.22 7/27/2020 Tiffany Ortega

IBM BA Lead Updates to the template; grammar and spelling checks for formal approval.

V1.23 8/11/2020 Sita Garaga

IBM Business Analyst

Updates to the Common Workspace for SCMMRP UserRoles spreadsheet per CR262

V2.0 8/24/2020 Erin Coleman

SCDHHS

Process & Artifact Development Manager

Updated the version number, watermark, and date to reflect approval. Removed all comments and accepted all track changes.

V2.1 11/09/2020 Sita Garaga

IBM Business Analyst

Added the following requirements per CR297

R2_INT_REQ1.13.1:

R2_INT_REQ1.13.2:

V2.2 11/20/2020 Harsha Pammi

IBM

Developer

Updated the below Technical sections per CR297:

5.1.14 Facades

5.1.16 Service Layer

V2.3 1/5/2021 Sita Garaga

IBM Business Analyst

Updated the following requirements per CR322

R2_INT_REQ1.13.1:

R2_INT_REQ1.13.2:

V2.4 1/11/2021 Sita Garaga

IBM Business Analyst

Updated the following requirement to address the review comment.

R2_INT_REQ1.13.1:

V3.0 4/11/2021 Erin Coleman

SCDHHS

Process & Artifact Development Manager

Updated version number, watermark, and approval date.

CGIS28 HCR CGIS Integration V3.0 Page 10 of 232

The Review Logs maintains a record of the State personnel that performed reviews leading up to the document reaching an Approved status. These reviews do not represent final approval of the document. The Approvals are recorded in the Approval Log Section.

Functional Review Log

The Functional Review Log maintains a record of the State personnel that performed the review of the functional design, confirming the understanding of the design. That the design meets the requirements, business requirements as described and is testable.

SCDHHS Role First Review Date / Reviewer Name

Second Review Date / Reviewer Name

Third Review Date / Review Name

Business Analyst Upendra K.- 3/22/20- Reviewed R14R2 Updates.

Upendra K.- 3/22/20- Reviewed CR207 Updates.

Upendra K.- 3/22/20- Reviewed CR210 Updates.

Business Analyst Upendra Koyagura 7/18/2019- Reviewed updates for CRs- 39, 40, 41, 48.

Upendra Koyagura 8/2/2019- Reviewed updates for CRs- 39, 40, 41, 48.

Upendra Koyagura 2/18/20- Reviewed updates for CR186.

Testing Manager

Product Manager

Technical Lead 7/19/2019 Renjan Bhasi Completed review of FDS for CR 39, 40, 41 and 48.

8/7/2019 Renjan Bhasi Completed review of CR 39, 48.

DDI Manager

Documentation Specialist

Process & Artifact Development Manager

3/17/2020 Erin Coleman

4/2/2020 Erin Coleman

4/30/2020 Erin Coleman

Technical Lead Renjan Bhasi 3/19/2020 (CR207 and R1-4-R2)

(R1-4-R2)

5/5/2020 R1-4-R2

Technical Lead 9/1/2020 Sudheer Arimbra CR262 Reviewed the spreadsheet - No comments

Technical Lead 1/6/2021 Sudheer Arimbra CR322 Reviewed -Added a comment

CGIS28 HCR CGIS Integration V3.0 Page 11 of 232

Technical Review Log

The Technical Review Log maintains a record of the State personnel that performed the review of the technical design, confirming the technical approach appropriately addresses the functional design.

SCDHHS Role First Review Date / Reviewer Name

Second Review Date / Reviewer Name

Third Review Date / Review Name

Technical Lead 7/19/2019 Reviewed the TDS changes for CR 48.

8/7/2019

Completed review of CR 39, 48.

Technical Lead Renjan Bhasi

(CR207)

Technical Lead 5/5/2020

Completed R1-4-R2 changes.

6/19/2020 Renjan Bhasi Completed R1-4-R2 changes.

Technical Lead Sudheer Arimbra CR297

– Added a few comments

Sudheer Arimbra

12/4/2020 CR297 –

Resolved and Update the comments

12/8/2020 Sudheer Arimbra CR297 – resolved comments

CGIS28 HCR CGIS Integration V3.0 Page 12 of 232

The IBM Approval Review Logs capture the IBM Project Team personnel that reviewed the completed ADD. The Functional and Technical Design Sections have been reviewed by the IBM team. The documented design, functional and technical components are understood as documented and can be validated through the Use Cases defined. This signifies that the section/document is ready for SC personnel review and Approval.

IBM Approval Review Log

Functional Design Section

IBM Functional Design Approval Review – v3.0

Role Name Date Comments

CGIS Project Manager Courtney Stevens 3/23/2021 Approved v2.4 to v3.0

CGIS BA Lead Tiffany Ortega 3/23/2021 Approved v2.4 to v3.0

CGIS Testing Lead Brian Grieves 3/23/2021 Approved v2.4 to v3.0

CGIS Business Analyst Sita Garaga 3/23/2021 Approved v2.4 to v3.0

CGIS Development Lead Vijay Mujumdar 3/23/2021 Approved v2.4 to v3.0

CGIS Development Team Lead Pranav Kumar 3/23/2021 Approved v2.4 to v3.0

Technical Design Section

IBM Technical Design Approval Review – v3.0

Role Name Date Comments

CGIS Development Lead Vijay Mujumdar 3/23/2021 Approved v2.4 to v3.0

CGIS Development Team Lead Pranav Kumar 3/23/2021 Approved v2.4 to v3.0

CGIS28 HCR CGIS Integration V3.0 Page 13 of 232

The Approvals Section captures the Approval of the current Approved Major version (whole number per PMP). The approval tables will be copied to the Approval Appendix when changes are made that require a subsequent round of Approvals.

Approval Logs

Functional Design Section

The Functional Design Section captures the State personnel that reviewed and approved the functional design. Confirming that the design is understood, fulfills the requirements and is testable.

Functional Design Approval v3.0

Role Name Date Approvals (✓)

SCDHHS Business Analyst Upendra Koyagura 3/29/21 FDS Approved.

SCDHHS Product Manager Abhishek Sahu 4/7/2021 Approved V2.1

SCDHHS Technical Lead Renjan Bhasi

SCDHHS DDI Manager Tim Cozine 4/7/2021 Approved V2.1

SCDHHS Process and Artifact Development Manager

Erin Coleman

4/11/2021 ADD Approved

Technical Design Section

The Technical Design Section captures the State personnel that reviewed and approved the technical design. Confirming that the technical approach to fulfilling design is understood fulfills the requirements.

Technical Design Approval v3.0

Role Name Date Approvals (✓)

Technical Lead Renjan Bhasi

SCDHHS MMRP ADD

CGIS28 HCR CGIS Integration V2.0 Page 14 of 232

Table of Contents

1 Introduction

1.1 Background

1.2 Purpose

1.3 Scope

1.4 Key References

1.5 Definitions and Acronyms

1.6 Key Assumptions

2 Conceptual Flow - N/A

2.1 Conceptual Flow Narrative - N/A

3 Requirement Matrix

3.1 Requirement Modifications - N/A

4 Functions

4.1 Combined Workspace

4.1.1 Design Description

4.1.2 Functional Output

4.1.3 Design Details

4.1.4 Screen Flow

4.1.5 Screen Mockups

4.1.6 Business Rules -N/A

4.1.7 User Roles – N/A

4.1.8 Data Fields – N/A

4.1.9 Links – Navigation – N/A

4.1.10 Links – Functions/Actions

4.1.11 Validation – N/A

4.1.12 Notifications and Tasks – N/A

4.1.13 Other – N/A

Table of Contents

CGIS28 HCR CGIS Integration V3.0 Page 15 of 232

4.2 Person Registration Process (Same as HCR)

4.2.1 Design Description

4.2.2 Functional Output

4.2.3 Design Details

4.2.4 Screen Flow

4.2.5 Screen Mockups

4.2.6 Business Rules – N/A

4.2.7 User Roles - N/A

4.2.8 Data Fields – N/A

4.2.9 Links – Navigation – N/A

4.2.10 Links – Functions/Actions

4.2.11 Validations – N/A

4.2.12 Notifications and Tasks - N/A

4.2.13 4.2.13 – Other – N/A

4.3 Person Identification Reference Number (Same as HCR)

4.3.1 Design Description

4.3.2 Functional Output

4.3.3 Design Details

4.3.4 Screen Flow

4.3.5 Screen Mockups

4.3.6 Business Rules - N/A

4.3.7 User Roles - N/A

4.3.8 Data Fields – N/A

4.3.9 Links – Navigation – N/A

4.3.10 Links – Functions/Actions – N/A

4.3.11 Validation – N/A

CGIS28 HCR CGIS Integration V3.0 Page 16 of 232

4.3.12 Notifications and Tasks - N/A

4.3.13 Other – N/A

4.4 Person Search and Match Process (Same as HCR)

4.4.1 Design Description

4.4.2 Functional Output

4.4.3 Design Details

4.4.4 Screen Flow - N/A

4.4.5 Screen Mockups

4.4.6 Business Rules - N/A

4.4.7 User Roles - N/A

4.4.8 Data Fields – N/A

4.4.9 Links – Navigation – N/A

4.4.10 Links – Functions/Actions

4.4.11 Validations – N/A

4.4.12 Notifications and Tasks - N/A

4.4.13 Other – N/A

4.5 Person Home Page (OOTB)

4.5.1 Design Description

4.5.2 Functional Output

4.5.3 Design Details

4.5.4 Screen Flow - N/A

4.5.5 Screen Mockups

4.5.6 Business Rules - N/A

4.5.7 User Roles - N/A

4.5.8 Data Fields – N/A

4.5.9 Links – Navigation – N/A

CGIS28 HCR CGIS Integration V3.0 Page 17 of 232

4.5.10 Links – Functions/Actions – N/A

4.5.11 Validation – N/A

4.5.12 Notifications and Tasks - N/A

4.5.13 Other – N/A

4.6 Tab Titles

4.6.1 Design Description

4.6.2 Functional Output

4.6.3 Design Details

4.6.4 Screen Flow - N/A

4.6.5 Screen Mockups - N/A

4.6.6 Business Rules - N/A

4.6.7 User Roles - N/A

4.6.8 Data Fields – N/A

4.6.9 Links – Navigation – N/A

4.6.10 Links – Functions/Actions – N/A

4.6.11 Validation – N/A

4.6.12 Notifications and Tasks - N/A

4.6.13 Other – N/A

4.7 Individual Eligibility Tab (Same as HCR)

4.7.1 Design Description

4.7.2 Functional Output

4.7.3 Design Details

4.7.4 Screen Flow - N/A

4.7.5 Screen Mockups

4.7.6 Business Rules - N/A

4.7.7 User Roles - N/A

CGIS28 HCR CGIS Integration V3.0 Page 18 of 232

4.7.8 Data Fields – N/A

4.7.9 Links – Navigation – N/A

4.7.10 Links – Functions/Actions – N/A

4.7.11 Validation – N/A

4.7.12 Notifications and Tasks - N/A

4.7.13 Other – N/A

4.8 Client Communications (Existing)

4.8.1 Design Description

4.8.2 Functional Output

4.8.3 Design Details

4.8.4 Screen Flow - N/A

4.8.5 Screen Mockups

4.8.6 Business Rules - N/A

4.8.7 User Roles - N/A

4.8.8 Data Fields - N/A

4.8.9 Links – Navigation – N/A

4.8.10 Links – Functions/Actions – N/A

4.8.11 Validation – N/A

4.8.12 Notifications and Tasks - N/A

4.8.13 Other – N/A

4.9 MAGI and Non-MAGI New Applications (Modified)

4.9.1 Design Description

4.9.2 Functional Output

4.9.3 Design Details

4.9.4 Screen Flow - N/A

4.9.5 Screen Mockups

CGIS28 HCR CGIS Integration V3.0 Page 19 of 232

4.9.6 Business Rules - N/A

4.9.7 User Roles - N/A

4.9.8 Data Fields – N/A

4.9.9 Links – Navigation – N/A

4.9.10 Links – Functions/Actions – N/A

4.9.11 Validation – N/A

4.9.12 Notifications and Tasks - N/A

4.9.13 Other – N/A

4.10 Person Merge (Modified)

4.10.1 Design Description

4.10.2 Functional Output

4.10.3 Design Details

4.10.4 Screen Flow – N/A

4.10.5 Screen Mockups

4.10.6 Business Rules - N/A

4.10.7 User Roles - N/A

4.10.8 Data Fields – N/A

4.10.9 Links – Navigation – N/A

4.10.10 Links – Functions/Actions – N/A

4.10.11 Validation – N/A

4.10.12 Notifications and Tasks - N/A

4.10.13 Other – N/A

4.11 Medicaid ID (Modified)

4.11.1 Design Description

4.11.2 Functional Output

4.11.3 Design Details

CGIS28 HCR CGIS Integration V3.0 Page 20 of 232

4.11.4 Screen Flow - N/A

4.11.5 Screen Mockups

4.11.6 Business Rules - N/A

4.11.7 User Roles - N/A

4.11.8 Data Fields – N/A

4.11.9 Links – Navigation – N/A

4.11.10 Links – Functions/Actions – N/A

4.11.11 Notifications and Tasks - N/A

4.11.12 Other – N/A

4.12 Budget Group (Same as HCR)

4.12.1 Design Description

4.12.2 Functional Output

4.12.3 Design Details

4.12.4 Screen Flow – N/A

4.12.5 Screen Mockups

4.12.6 Business Rules - N/A

4.12.7 User Roles - N/A

4.12.8 Data Fields – N/A

4.12.9 Links - Navigation – N/A

4.12.10 Links – Functions/Actions – N/A

4.12.11 Validation – N/A

4.12.12 Notifications and Tasks - N/A

4.12.13 Other – N/A

4.13 Authorized Representative Batch Process (Same as HCR)

4.13.1 Design Description

4.13.2 Functional Output

CGIS28 HCR CGIS Integration V3.0 Page 21 of 232

4.13.3 Design Details

4.13.4 Screen Flow – N/A

4.13.5 Screen Mockups – N/A

4.13.6 Business Rules - N/A

4.13.7 User Roles - N/A

4.13.8 Data Fields – N/A

4.13.9 Links – Navigation – N/A

4.13.10 Links – Functions/Actions – N/A

4.13.11 Validation – N/A

4.13.12 Notifications and Tasks - N/A

4.13.13 Other – N/A

4.14 Authorized Representative Search Screen (Same as HCR)

4.14.1 Design Description

4.14.2 Functional Output

4.14.3 Design Details

4.14.4 Screen Flow

4.14.5 Screen Mockups

4.14.6 Business Rules - N/A

4.14.7 User Roles - N/A

4.14.8 Data Fields – N/A

4.14.9 Links – Navigation – N/A

4.14.10 Links – Functions/Actions – N/A

4.14.11 Validation

4.14.12 Notifications and Tasks - N/A

4.14.13 Other – N/A

4.15 Authorization Details Evidence (Same as HCR)

CGIS28 HCR CGIS Integration V3.0 Page 22 of 232

4.15.1 Design Description

4.15.2 Functional Output

4.15.3 Design Details

4.15.4 Screen Flow

4.15.5 Screen Mockups

4.15.6 Business Rules - N/A

4.15.7 User Roles - N/A

4.15.8 Data Fields – N/A

4.15.9 Links – Navigation - N/A

4.15.10 Links – Functions/ Actions – N/A

4.15.11 Validation – N/A

4.15.12 Notifications and Tasks - N/A

4.15.13 Other – N/A

4.16 HCR/CGIS Case Search (Modified)

4.16.1 Design Description

4.16.2 Functional Output

4.16.3 Design Details

4.16.4 Screen Flow - N/A

4.16.5 Screen Mockups

4.16.6 Business Rules - N/A

4.16.7 User Roles - N/A

4.16.8 Data Fields – N/A

4.16.9 Links – Navigation – N/A

4.16.10 Links – Functions/Actions – N/A

4.16.11 Validation – N/A

4.16.12 Notifications and Tasks - N/A

CGIS28 HCR CGIS Integration V3.0 Page 23 of 232

4.16.13 Other – N/A

4.17 Print MAGI and Non-MAGI Application PDF (OOTB)

4.17.1 Design Description

4.17.2 Functional Output

4.17.3 Design Details

4.17.4 Screen Flow - N/A

4.17.5 Screen Mockups

4.17.6 Business Rules - N/A

4.17.7 User Roles - N/A

4.17.8 Data Fields – N/A

4.17.9 Links – Navigation – N/A

4.17.10 Links – Functions/ Actions – N/A

4.17.11 Validation

4.17.12 Notifications and Tasks - N/A

4.17.13 Other – N/A

4.18 Non-MAGI Batch Process

4.18.1 Design Description

4.18.2 Functional Output

4.18.3 Design Details

4.18.4 Screen Flow - N/A

4.18.5 Screen Mockups - N/A

4.18.6 Business Rules - N/A

4.18.7 User Roles - N/A

4.18.8 Data Fields – N/A

4.18.9 Links – Navigation – N/A

4.18.10 Links – Functions/ Actions – N/A

CGIS28 HCR CGIS Integration V3.0 Page 24 of 232

4.18.11 Validation – N/A

4.18.12 Notifications and Tasks - N/A

4.18.13 Other – N/A

4.19 Case Closure Batch (Modified)

4.19.1 Design Description

4.19.2 Functional Output

4.19.3 Design Details

4.19.4 High Level Process Flow for Case Closure Batch: (Modified)

4.19.5 Screen Mockups - N/A

4.19.6 Business Rules - N/A

4.19.7 User Roles - N/A

4.19.8 Data Fields – N/A

4.19.9 Links – Navigation – N/A

4.19.10 Links – Functions/ Actions – N/A

4.19.11 Validation

4.19.12 Notifications and Tasks - N/A

4.19.13 Other – N/A

4.20 Case Reference Number (Same as HCR)

4.20.1 Design Description

4.20.2 Functional Output

4.20.3 Design Details

4.20.4 Screen Flows - N/A

4.20.5 Screen Mockups - N/A

4.20.6 Business Rules - N/A

4.20.7 User Roles - N/A

4.20.8 Data Fields – N/A

CGIS28 HCR CGIS Integration V3.0 Page 25 of 232

4.20.9 Links – Navigation – N/A

4.20.10 Links – Functions/ Actions – N/A

4.20.11 Validation

4.20.12 Notifications and Tasks - N/A

4.20.13 Other – N/A

4.21 OnBase Integration (Out of Scope)

4.21.1 Design Description

4.21.2 Functional Output

4.21.3 Design Details

4.21.4 Screen Flows - N/A

4.21.5 Screen Mockups - N/A

4.21.6 Business Rules - N/A

4.21.7 User Roles - N/A

4.21.8 Data Fields – N/A

4.21.9 Links – Navigation – N/A

4.21.10 Links – Functions/ Actions – N/A

4.21.11 Validation – N/A

4.21.12 Notifications and Tasks - N/A

4.21.13 Other – N/A

4.22 EDD (Eligibility Decision Details) Table

4.22.1 Design Description

4.22.2 Functional Output

4.22.3 Design Details

4.22.4 Screen Flows - N/A

4.22.5 Screen Mockups - N/A

4.22.6 Business Rules - N/A

CGIS28 HCR CGIS Integration V3.0 Page 26 of 232

4.22.7 User Roles - N/A

4.22.8 Data Fields – N/A

4.22.9 Links – Navigation

4.22.10 Links – Functions/ Actions – N/A

4.22.11 Validation – N/A

4.22.12 Notifications and Tasks - N/A

4.22.13 Other – N/A

5 Technical Design

5.1 Common Technical Artifacts

5.1.1 Sequence Diagram

5.1.2 Events - N/A

5.1.3 Event Class Details - N/A

5.1.4 Domain Definitions - N/A

5.1.5 Code Tables

5.1.6 Code Table Details

5.1.7 Messages

5.1.8 Message Detailed Description

5.1.9 DMX - N/A

5.1.10 Security

5.1.11 Security Details

5.1.12 Model

5.1.13 Interfaces - N/A

5.1.14 Façades

5.1.15 Entity Layer

5.1.16 Service Layer

5.1.17 POD Definitions

5.1.18 Java Script Changes- N/A

CGIS28 HCR CGIS Integration V3.0 Page 27 of 232

5.1.19 CSS Changes - N/A

5.1.20 Global Configuration Changes

5.1.21 Wizard Changes

5.1.22 Menu Details - N/A

5.1.23 Evidence Configuration Changes

5.1.24 Renderers - N/A

5.1.25 Key Words (Hover Values) - N/A

5.1.26 Help Content - N/A

5.1.27 Links – Navigation N/A

5.1.28 Links – Functions/Action N/A

5.1.29 Validation - N/A

5.1.30 Workflow - N/A

5.1.31 Web Service - N/A

5.1.32 Java Classes

5.1.33 Task and Work queues - N/A

5.1.34 Reports - N/A

5.1.35 Unit Testing Scenarios - N/A

5.1.36 Cúram Unit Testing Scenarios

5.1.37 ESB Unit Testing Scenarios - N/A

5.1.38 Data Retention - N/A

5.1.39 Persistence Requirements - N/A

5.1.40 Backup Requirements

5.1.41 Archiving and Purging Requirements - N/A

5.1.42 Data Validation Checks

5.1.43 Security Considerations - N/A

5.1.44 Event Sequence Diagram - N/A

CGIS28 HCR CGIS Integration V3.0 Page 28 of 232

5.1.45 Coding Specifications

5.1.46 Table Names

5.1.47 Cúram Batch Component Technical Design - N/A

5.1.48 Batch Methods - N/A

5.1.49 Entity Classes - N/A

5.1.50 Entity Methods - N/A

5.1.51 Input/ Output Structs

5.1.52 Input/ Output Attributes

5.1.53 Technical Dependencies - N/A

5.1.54 Source-to-Target Mapping - N/A

5.1.55 System Properties - N/A

5.1.56 Page Parameter Details

5.1.57 Links/Action Controls

5.1.58 Lists/Inline Page Details - N/A

5.1.59 Cluster Details - N/A

5.1.60 Other - N/A

5.2 ESB Development - N/A

5.2.1 Outbound – N/A

5.2.2 Inbound – N/A

5.2.3 Supporting Details: Record Layout – N/A

5.2.4 ESB Operational – N/A

5.3 Rules Development- N/A

5.3.1 Rules (Rules Area) – N/A

5.3.2 Table of Values – N/A

5.4 Batch Development

MMCaseClosureChunker Detailed Design

CGIS28 HCR CGIS Integration V3.0 Page 29 of 232

5.4.1 Batch Overview

5.4.2 Functional Summary

5.4.3 Batch Specifications

5.4.4 Data Retention- N/A

5.4.5 Batch Classes

5.4.6 Batch Methods

5.4.7 Input Table Names

5.4.8 Output Table Names

5.4.7 MMAuthRepFileGenerationChunker Detailed Design

5.4.7.1 Batch Overview

5.4.7.2 Functional Summary

5.4.7.7 Input Table Names

5.4.7.8 Output Table Names

5.5 Non-Functional Requirements – N/A

5.5.1 Accessibility – N/A

5.5.2 Availability – N/A

5.5.3 Development Resource – N/A

5.5.4 Evolution – N/A

5.5.5 Globalization – N/A

6 Integration Points/Dependencies

7 Use Cases

7.1 Combined Workspace

7.2 MAGI /Non-MAGI Application Submission

7.3 MEDS Eligibility Check

7.4 Person Page display of Pending/Current cases should be sortable

7.5 Admin user role should be able to configure Tabs and Pods

7.6 MEDICAID ID

CGIS28 HCR CGIS Integration V3.0 Page 30 of 232

8 Appendices

8.1 Appendix A: Action Item Matrix

8.2 Appendix B: Out of Scope Requirements

8.3 Appendix C: Comment/Resolution Log

8.4 Appendix D: Approval History

CGIS28 HCR CGIS Integration V3.0 Page 31 of 232

1 Introduction

1.1 Background

The South Carolina Department of Health and Human Services (SCDHHS) currently uses HCR

Cúram case management system and intends to implement the Cúram Global Income Support

(CGIS) system to process the Non-MAGI cases which are currently being handled by the

Medicaid Eligibility Determination System (MEDS).

1.2 Purpose

The purpose of this document is to outline how HCR and CGIS integration will be developed for

MMRP Cúram. SCDHHS is currently using Cúram HCR module and at present, the Non-MAGI cases are processed in the MEDS. The addition of the CGIS module to MMRP now will encompass all Medicaid applications (MAGI and Non-MAGI) for processing in Cúram. This integration will combine what is referred to as the split family, currently administered in two separate systems, to be processed in Cúram. The case workers will have one consistent platform to manage both CGIS and HCR cases.

The intended audiences for this document are:

• MMRP Subject Matter Experts (SMEs)

• MMRP Cúram – Business Analyst

• MMRP Cúram – Architecture team

• MMRP Cúram – Solution Developers

• MMRP Cúram – Testing Team

1.3 Scope

• Combined Workspace configuration

• Combined Workspace features like Person Registration, Search & Match process, Case

Search, Person Merge process

• Medicaid ID & Budget Group generation logic

• Customization of existing batch processes to accommodate Income Support cases.

1.4 Key References

This section lists any key documents that might be helpful in understanding the detailed functionality. All referenced documents will be available in State SharePoint site and/or Jira.

Document Name Location

Common Rules ADD MMRP CGIS Global Program Rule ADD - Common Non-Financial and Financial https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS%20Global%20Program%20Rule%20ADD%20-%20Common%20Non-Financial%20and%20Financial%20v1.7.docx?d=w96f1700a577c4e69806e52461dd2af17&csf=1&web=1&e=DYL1Gc https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS%20Global%20Program%20Rule%20ADD%20-%20Common%20Non-Financial%20and%20Financial%20v1.7.docx?d=w96f1700a577c4e69806e52461dd2af17&csf=1&web=1&e=DYL1Gc

CGIS28 HCR CGIS Integration V3.0 Page 32 of 232

Document Name Location

CGIS Program Alignment

ADD

Program Alignment ADD

CGIS Notices Design MMRP CGIS Global Notices

CGIS Annual Review MMRP CGIS Annual Review Process

Global IEG Script MMRP CGIS Global IEG

Authorize Rep Design Authorize Representative

All CGIS Designs and Interface location in State SharePoint.

CGIS Interface and All Designs

HCR Designs Link HCR Design Documents

CGIS Program Rules ADD Program Rules ADD

SCMMRP Approach Medicaid

ID

MMRP Medicaid ID Approach Document

Security Groups Definition Assignments V1.0.xlsx

Security Group definition assignments

1.5 Definitions and Acronyms

Term Meaning

AC Application Case

ACR Annual Case Review

ADD Architectural Description Document

AR Authorized Representative

Bendex Beneficiary Data Exchange System, an interface with the Social Security Administration to obtain SSA benefit and Medicare information for Medicaid applicants and recipients.

BRD Business Requirements Document

CGIS Cúram Global Income Support

CoC Change of circumstance - Any change in an Individual's/Household's information which potentially impacts eligibility.

CoI Change of information - Any change in an Individual's/Household's information which will not impact eligibility.

CRCF Community Residential Care Facility

DAC Disabled Adult Children

DHHS Department of Health and Human Services

DOB Date of Birth

DOD Date of Death

DSS Department of Social Services

DWW Disabled Widows/Widowers https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS24%20Global%20Program%20Alignment%20ADD%20V1.0.docx?d=w957e1eee651343c4ab44311bd1b4e8a5&csf=1&web=1&e=45Rajl https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS23%20Global%20Notices%20ADD%20v1.13.docx?d=w928907f6b6d94db494c7413b04d1c3f7&csf=1&web=1&e=CyCuOU https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS2%20Annual%20Review%20ADD%20v1.5.docx?d=w4e898f5ba7094b57862eec1eec4ab02f&csf=1&web=1&e=TY2Bat https://schhs.sharepoint.com/:w:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS22_Global_IEG_ADD%20v1.29.docx?d=w5f252b33a34544b4a885cbd997a8091e&csf=1&web=1&e=wHqDEr https://team.scdhhs.gov/pmo/ProjectRepository/1211207/_layouts/WordViewer.aspx?id=/pmo/ProjectRepository/1211207/Business%20Process%20Modeling%20Documents/HCR%20Tracks/In%20Production/Track%20HCR4%20-%20Authorized%20Representative%20Fixes/Approved%20Documents/Authorized%20Representative%20FDS%2012.3.docx&Source=https%3A%2F%2Fteam%2Escdhhs%2Egov%2Fpmo%2FProjectRepository%2F1211207%2FBusiness%2520Process%2520Modeling%2520Documents%2FForms%2FType%2520of%2520Track%2Easpx%3FGroupString%3D%253B%2523HCR4%2520Authorized%2520Representative%2520Fixes%253B%2523Unknown%253B%2523%26IsGroupRender%3DTRUE&DefaultItemOpen=1&DefaultItemOpen=1 https://schhs.sharepoint.com/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Forms/AllItems.aspx?newTargetListUrl=%2Fsites%2F1211207%2FCGIS%20Business%20Requirements%20and%20Design%20Documents&viewpath=%2Fsites%2F1211207%2FCGIS%20Business%20Requirements%20and%20Design%20Documents%2FForms%2FAllItems%2Easpx&viewid=7c1889c0%2D5952%2D461e%2D8f78%2D14f1ad0782b8 https://schhs.sharepoint.com/sites/1211207/Business%20Process%20Modeling%20Documents/Forms/Type%20of%20Track.aspx https://team.scdhhs.gov/pmo/ProjectRepository/1211207/_layouts/WordViewer.aspx?id=/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS25%20-%20Program%20Rules%20-%20Shared%20Processes%20ADD.docx&Source=https%3A%2F%2Fteam%2Escdhhs%2Egov%2Fpmo%2FProjectRepository%2F1211207%2FCGIS%2520Business%2520Requirements%2520and%2520Design%2520Documents%2FForms%2FAllItems%2Easpx%3FGroupString%3D%253B%2523CGIS25%2520Program%2520Rules%253B%2523In%2520Review%253B%2523%26IsGroupRender%3DTRUE&DefaultItemOpen=1&DefaultItemOpen=1 https://team.scdhhs.gov/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20Medicaid%20ID%20Approach%20Document.docx https://schhs.sharepoint.com/:x:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Security%20Groups%20Definition%20Assignments%20V1.0.xlsx?d=w80628c5cdae245c991cc810764589434&csf=1&web=1&e=0De3Ad

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Term Meaning

ES Essential Spouse

EWW Early Widows/Widowers

FBR Federal Benefit Rate

FDS Functional Design Specification – ADD Section used to explain and confirm how requirements are being met.

FMV Fair Market Value

FPL Federal Poverty Level

GH General Hospital

HCR Health Care Reform

IC Integrated Case

IEG Script Intelligence Evidence Gathering Script

IT Income Trust

KB Katie Beckett, also known as TEFRA

LOC Level of Care

MAO Medical Assistance Only

MAO-NH Medicaid Assistance Only-Nursing Home

MMIS Medicaid Management Information System

MMRP Member Management Replacement Program

NF Nursing Facility

NH Nursing Home

OSS Optional State Supplementation

PAC Pass- Along Children

PCAT Payment Category

PDC Product Delivery Case

QDWI Qualified Disabled and Working Individuals

QMB Qualified Medicare Beneficiaries

RAP Refugee Assistance Program

SC MPPM South Carolina Medicaid Policy and Procedures Manual

SCDHHS South Carolina Department of Health and Human Services

SCSRS South Carolina State Retirement System

SDX State Data Exchange

SGA Substantial Gainful Activity

SLMB Specified Low-Income Medicare Beneficiaries

SME Subject Matter Expert

SSA Social Security Administration

CGIS28 HCR CGIS Integration V3.0 Page 34 of 232

Term Meaning

SSI Supplemental Security Income

SSN Social Security Number

SVES State Verification and Exchange System

TDS Technical Design Specification – ADD Section used to explain and confirm how/what technical changes are needed to meet requirements.

TEFRA Tax Equity and Fiscal Responsibility Act (Katie Beckett Children)

TMA Transitional Medical Assistance

TPL Third Party Liability

VA Veterans Administration

WD Working Disabled

WF Workflow

1.6 Key Assumptions

1. The features of the integration will be as close as possible to Cúram OOTB features with very minimal customization

2. Any changes to the MAGI and Non-MAGI Eligibility rules will not be accounted for in this design. Any needed updates to Non-MAGI Program rules will be handled by

Program Rules ADD and updates to MAGI Program rules will be handled through the

HCR development team.

3. Any Rules or Policy related to Certification/Coverage Period will be addressed in the

Program Alignment Track.

4. Person search and match will continue to return relevant results as defined in PROD-

736.

5. CGIS interface requirements with MMIS and other systems need to be integrated with

HCR batches as part of this project implementation.

6. Annual review for split household will continue to be done separately for MAGI and

Non-MAGI.

https://team.scdhhs.gov/pmo/ProjectRepository/1211207/_layouts/WordViewer.aspx?id=/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/MMRP%20CGIS25%20-%20Program%20Rules%20-%20Shared%20Processes%20ADD.docx&Source=https%3A%2F%2Fteam%2Escdhhs%2Egov%2Fpmo%2FProjectRepository%2F1211207%2FCGIS%2520Business%2520Requirements%2520and%2520Design%2520Documents%2FForms%2FAllItems%2Easpx%3FGroupString%3D%253B%2523CGIS25%2520Program%2520Rules%253B%2523In%2520Review%253B%2523%26IsGroupRender%3DTRUE&DefaultItemOpen=1&DefaultItemOpen=1 https://schhs.sharepoint.com/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Forms/AllItems.aspx?newTargetListUrl=%2Fsites%2F1211207%2FCGIS%20Business%20Requirements%20and%20Design%20Documents&viewpath=%2Fsites%2F1211207%2FCGIS%20Business%20Requirements%20and%20Design%20Documents%2FForms%2FAllItems%2Easpx&viewid=7c1889c0%2D5952%2D461e%2D8f78%2D14f1ad0782b8 https://devtools.scdhhs.gov/jira/browse/PROD-736

CGIS28 HCR CGIS Integration V3.0 Page 35 of 232

2 Conceptual Flow - N/A

The flows captured within this section provide a high-level overview of the processes. Please refer to the Function section for detailed requirements.

Note: This ADD does not require the depiction of process flows. No process flows are included.

2.1 Conceptual Flow Narrative - N/A

# Action # Action Label Narration

CGIS28 HCR CGIS Integration V3.0 Page 36 of 232

3 Requirement Matrix

The mapping from business requirement to functional requirement is documented in Integration

RTM located on JIRA.

3.1 Requirement Modifications - N/A

This section will document any subsequent changes to the RTM that may later be required as discovered through development, test execution, bug fix develop or training activities.

Note: This section is used to highlight requirement changes, changes required to be addressed in by this design will be included in the Function Section as well as the RTM document and Jira.

Requirement

ID

Business Rule ID

Description System Feature

Date Updated

In Scope (Yes or No)

N/A https://cuihhsiutl10.clemson.edu/plugins/servlet/com.easesolutions.jira.plugins.requirements/coverage?prj=CGISS#243&HCR%20Integration%20RTM&true https://cuihhsiutl10.clemson.edu/plugins/servlet/com.easesolutions.jira.plugins.requirements/coverage?prj=CGISS#243&HCR%20Integration%20RTM&true

CGIS28 HCR CGIS Integration V3.0 Page 37 of 232

4 Functions This section describes the details of the system functionality.

4.1 Combined Workspace

4.1.1 Design Description

The Combined Workspace will be implemented in the Worker portal, where user roles provide or restrict, access both MAGI and Non-MAGI module case. When granted access to both modules will allow caseworkers to work seamlessly between the on applications for both modules. The workspace also permits supervisors to allocate resources between the two modules based on workload.

4.1.2 Functional Output

Combined Workspace will be accessible for SC MMRP Cúram Worker portal users, based on their user roles.

4.1.3 Design Details

INT_REQ1.1: User roles defined by SCDHHS will have access to a Combined Workspace where they will be able to access both MAGI and Non-MAGI applications and Cases.

INT_REQ1.1.1: User roles defined by SCDHHS to have access to Combined Workspace will be able to continue performing all the current activities and also can access Non-MAGI cases using a single login.

INT_REQ 1.1.2: All current and future production user roles will be able to access Magi and

Non-MAGI case information as defined in the security user roles spreadsheet.

The link to spreadsheet below provides a list of user roles existing in current production that have access to the Combined Workspace and various tabs each user role can access. The spreadsheet also describes the layout of the workspace for each user role: Combined Workspace for SCMMRP User Roles v1.1

Combined Workspace for SCMMRP UserRoles v1.3

INT_REQ 1.1.3: Per CR124, a new user role 'Baby Net Worker Role' is configured. This user role will have similar access levels as an Eligibility worker role except that the BabyNet Worker

Role will not have Read or Write access to the Interface Data Tab on Person Page or Integrated

Case.

Note: The scope of CR124 (introducing BabyNet Worker Role) is limited to defining the

Workspace. Assignment of users to this user role in production will be dealt by the Core Ops team.

https://team.scdhhs.gov/pmo/ProjectRepository/1211207/_layouts/xlviewer.aspx?id=/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Combined%20Workspace%20for%20SCMMRP%20UserRoles%20v1.1.xlsx&Source=https%3A%2F%2Fteam%2Escdhhs%2Egov%2Fpmo%2FProjectRepository%2F1211207%2FCGIS%2520Business%2520Requirements%2520and%2520Design%2520Documents%2FForms%2FAllItems%2Easpx%3FGroupString%3D%253B%2523CGIS28%2520HCR%2520Integration%253B%2523In%2520Review%253B%2523%26IsGroupRender%3DTRUE&DefaultItemOpen=1&DefaultItemOpen=1 https://team.scdhhs.gov/pmo/ProjectRepository/1211207/_layouts/xlviewer.aspx?id=/pmo/ProjectRepository/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Combined%20Workspace%20for%20SCMMRP%20UserRoles%20v1.1.xlsx&Source=https%3A%2F%2Fteam%2Escdhhs%2Egov%2Fpmo%2FProjectRepository%2F1211207%2FCGIS%2520Business%2520Requirements%2520and%2520Design%2520Documents%2FForms%2FAllItems%2Easpx%3FGroupString%3D%253B%2523CGIS28%2520HCR%2520Integration%253B%2523In%2520Review%253B%2523%26IsGroupRender%3DTRUE&DefaultItemOpen=1&DefaultItemOpen=1 https://schhs.sharepoint.com/:x:/r/sites/1211207/CGIS%20Business%20Requirements%20and%20Design%20Documents/Combined%20Workspace%20for%20SCMMRP%20UserRoles%20v1.3.xlsx?d=wc8fcf7a234ea4ef584ff641bac04a8d2&csf=1&e=Cm3xL2

CGIS28 HCR CGIS Integration V3.0 Page 38 of 232

4.1.4 Screen Flow

CGIS28 HCR CGIS Integration V3.0 Page 39 of 232

4.1.5 Screen Mockups

4.1.5.1 Screen: Combined Workspace View (Modified)

The combined workspace view for the different user roles is defined in the Combined Workspace spreadsheet referenced in requirement INT_REQ 1.1.2 above.

4.1.6 Business Rules -N/A

4.1.7 User Roles – N/A

4.1.8 Data Fields – N/A

4.1.9 Links – Navigation – N/A

4.1.10 Links – Functions/Actions

# Screen Label Description Element Type

New/ Modified/ Delete

Description/Comments

1 Search for an Application Case…’

Changing to ‘Search for MAGI application …’

Hyperlink Modified Modified from ‘HCR’ to ‘MAGI’

2 Search for an IS application…’

Changing to ‘Search for Non-

MAGI

application…’

Hyperlink Modified Modified from ‘IS to ‘non-

MAGI

4.1.11 Validation – N/A

4.1.12 Notifications and Tasks – N/A

4.1.13 Other – N/A

4.2 Person Registration Process (Same as HCR)

4.2.1 Design Description

The current Person Registration process will be common to both HCR and CGIS modules. The user will be able to invoke the 'Registration' process from the shortcuts tab and enter the person details. Upon entering the required details, Person Search and Match process will be invoked based on the results of which the person would either be registered as a 'Prospect' Or as a new

'Person'.

The existing code from HCR for Person Registration will be used in the combined workspace.

CGIS28 HCR CGIS Integration V3.0 Page 40 of 232

4.2.2 Functional Output

From the Worker Portal shortcuts tab, the user will invoke the 'Registration' script the user will enter the person details which include First Name, Last Name, DOB, Gender, address and

SSN(Optional). Upon entering the details, the system will initiate a 'Person Search & Match' process to identify if the person record already exists in Cúram. Based on the Person Search &

Match results, the person that is being registered will be either marked as 'Prospect' OR an

'Active Person' record. If an exact match is found after the user completes the Registration process, the existing user record will be used.

4.2.3 Design Details

INT_REQ1.2: All current customization for HCR will be implemented in CGIS. Integration team will ensure that the latest HCR production code around Person Registration Process is used for implementation.

INT_REQ1.2.1: System shall provide user with ability to initiate the registration process for a person from Caseworker Portal.

INT_REQ1.2.2: Upon launching the registration process wizard, the user will be prompted to enter the person details, which include FirstName, Last Name, DOB, Gender, Address as

Mandatory fields, and SSN – as Optional.

INT_REQ1.2.3: Upon entering the required person details, the system shall trigger a Person

Search and Match process to identify if a person record already exists for the member in Cúram.

INT_REQ1.2.4: When an exact match is found in the system, the system shall display the existing person record with an informational message on the page as below:

Message: "The Information you have entered is an exact match to an existing Person Record.

That record will now be displayed".

INT_REQ1.2.5: When an Inconclusive match is found, the system shall create a person record for the member and mark the record as 'Prospect'.

INT_REQ1.2.6: When no match is found, the system shall register the member.

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4.2.4 Screen Flow

4.2.5 Screen Mockups

4.2.5.1 Screen: Person Match - Exact Match Found

(Existing)

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4.2.5.2 Screen: Person Match - Prospect Match Found

(Existing)

4.2.5.3 Screen: Person Registration Screen 1(Existing)

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4.2.5.4 Screen: Person Registration Screen 2(Existing)

4.2.6 Business Rules – N/A

4.2.7 User Roles - N/A

4.2.8 Data Fields – N/A

4.2.9 Links – Navigation – N/A

4.2.10 Links – Functions/Actions

4.2.11 Validations – N/A

4.2.12 Notifications and Tasks - N/A

4.2.13 4.2.13 – Other – N/A

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4.3 Person Identification Reference Number (Same as

HCR)

4.3.1 Design Description

Cúram OOTB generates a unique person reference number upon registration or submission of application. The same ID will be used across HCR and CGIS. This ID will remain the same when eligibility changes from MAGI to Non-MAGI or vice-versa.

4.3.2 Functional Output

When a member is registered in the system either as a Prospect or an active person record, the system will generate a Unique Identification number, which will be saved as an 'Identification ' evidence type on the person evidence page.

4.3.3 Design Details

INT_REQ1.3: The system shall generate a unique person reference number when a person record is created in Cúram, as defined by the OOTB logic.

INT_REQ1.3.1: The unique reference number will be stored at person page level evidence of type 'Identifications' and will be referred to as 'Reference Number'.

INT_REQ1.3.1.1: The system shall generate the unique reference number, even when the member is marked as 'Prospect'.

INT_REQ1.3.2: The reference number is never subject to change once it is established. It will not be changed when the person eligibility is moved from MAGI to Non-MAGI or Vice Versa.

INT_REQ1.3.3: The person reference number will remain the same even when the member is moving from being eligible to Ineligible or Vice Versa.

INT_REQ1.3.4: The person reference number shall remain the same when a new MAGI or Non-

MAGI application is submitted for an existing person in Cúram.

4.3.4 Screen Flow

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4.3.5 Screen Mockups

4.3.5.1 Screen: Person Reference Number (Existing)

4.3.6 Business Rules - N/A

4.3.7 User Roles - N/A

4.3.8 Data Fields – N/A

4.3.9 Links – Navigation – N/A

4.3.10 Links – Functions/Actions – N/A

4.3.11 Validation – N/A

4.3.12 Notifications and Tasks - N/A

4.3.13 Other – N/A

4.4 Person Search and Match Process (Same as HCR)

4.4.1 Design Description

Both CGIS and HCR are going to use the current HCR Person Search and Match Process. This will be implemented by using the latest production code for HCR. This provides a single Person

Search and Match platform for both HCR and CGIS.

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Person Match criteria in Cúram determines whether a member will be registered as a new person

(no match), a prospect record (potential match), or matched to an existing person record (full match). For more details and the requirements for the person match, please refer to JIRA PROD-

736.

4.4.2 Functional Output

When an application is submitted, the system shall initiate…