A Step Forward in Developing 21st Century Work Supports Systems

Aug 11, 2011

By Abigail Newcomer

On Wednesday, three government agencies released a letter that will help states build the infrastructure needed to create their own unified online eligibility systems for multiple human services programs.  Under the Affordable Care Act (ACA), states are already developing these systems for Medicaid, CHIP, and premium tax credits. The letter explains how child care assistance, food assistance and other programs that provide support to working and low-income families could be included as well. States that develop unified systems will lower administrative costs by streamlining the eligibility screening process and increasing efficiency and are likely to ensure more people who are eligible receive needed services.

The U.S. Department of Health and Human Services' Administration for Children and Families (ACF) and Center for Medicare and Medicaid Services (CMS), and the U.S. Department of Agriculture's Food and Nutrition Service (FNS) jointly issued the letter, which clarifies the allowable uses of enhanced matching funds for Medicaid infrastructure enhancements under the Affordable Care Act.

The letter encourages states to consider the benefits of including eligibility determination for other human services programs in the systems they are creating for state operated Exchanges, Medicaid and CHIP. This would leverage investments in IT systems to better coordinate work supports that help individuals and families make ends meet and keep them healthy.

Through the end of 2015, under the ACA, CMS will reimburse states for 90 percent of the costs they incur as they develop IT systems that help them determine eligibility for certain health insurance programs, tax credits, and cost sharing benefits through the Exchanges. The joint letter explains that these costs are reimbursable at this rate, even if these same IT systems are also used to determine eligibility for other programs. Only the additional costs of including other human services programs in such systems must be allocated to each human services program (and be subject to a less favorable reimbursement rate). These other programs include, but are not limited to: Temporary Assistance for Needy Families (TANF), the Child Care Development Fund (CCDF) and the Supplemental Nutrition Assistance Program (SNAP).

Though it will continue to be challenging for states to meet the deadlines of ACA implementation, let alone include additional human services programs, it is now possible for states to leverage this set of federal resources to develop unified online systems that screen for multiple benefits, increasing program efficiency, lowering administration costs, and increasing the likelihood that those who are eligible for supports actually receive them. This is a great opportunity for states to plan ahead and save money down the road.

The agencies will be providing additional guidance and technical assistance on this issue in the coming months. In the meantime, the Department of Health and Human Services has set up a dedicated email address to field questions. It is costallocation@hhs.gov.

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