The California Health and Human Services Agency (CalHHS), Office of Technology and Solutions Integration (OTSI), may have a requirement for Maintenance and Operations (M&O) of the Case Management Information and Payrolling System (CMIPS) and its Payrolling Services Component.

The following is taken from the Request for Information (RFI) and is subject to change upon the release of a formal solicitation.

The California Health and Human Services Agency, Office of Technology and Solutions Integration (CalHHS OTSI), hereinafter referred to as the “CalHHS OTSI” or the “State,” is releasing this RFI to:

• Inform potential bidders about the In-Home Supportive Services (IHSS) program and the CMIPS that supports the IHSS program, and the need for future continuation of the CMIPS M&O services.
• Determine the level of interest in the upcoming procurement to provide System Integration services or to be the payrolling solution subcontractor.
  • Provide System Integration services to manage, maintain, and operate the CMIPS and its payrolling component, or
  • Provide payrolling services as a subcontractor to the System Integrator
• Understand vendor transition needs associated with future CMIPS M&O contract services and its payrolling component.
• Gather information on new trends in case management, reporting, and payrolling services.
• Obtain an initial understanding of new trends in automation such as cloud computing, case management analytics, real-time case management and payroll processing, system and security monitoring and reporting, the use of mobile devices, interactive voice response, timesheet processing, document management, DevOps, etc.

Background

This section presents information on the IHSS program, the CMIPS, and the future CMIPS M&O contract.

Understanding IHSS

The IHSS program was established in 1973 and provides domestic and personal care services to children and adults with disabilities and older adults to keep them safely in their own homes and communities and avoid institutionalization. IHSS is considered a service of Medi-Cal and there is no cap on growth for the program. Any interested individual who meets the eligibility criteria and demonstrates a need for IHSS services must be served.

Some examples of approved IHSS services include domestic and related tasks such as basic house cleaning and meal prep/clean-up; personal care services, such as bed baths, ambulation, and feeding; paramedical tasks that include managing medication and injections; protective supervision and accompaniment; as well as one-time services like yard hazard abatement. This is not a comprehensive list, but the authorization of these services often means the difference between someone staying in their own home and being institutionalized.

IHSS is largely administered by the counties with oversight of California Department of Social Services (CDSS). County social workers perform an annual in-home assessment to determine what IHSS services a recipient needs based on their ability to perform certain tasks.

For purposes of understanding the IHSS program it is important to note:

• An IHSS Recipient is defined as a person receiving in-home care and the approver of their provider’s timesheets. A recipient can have multiple providers assigned to provide services.
• An IHSS provider is defined as the caregiver assigned to and providing services for one (1) or more IHSS recipients. Each provider submits a timesheet for each recipient for each pay period.
• Timesheet is defined as a timecard submitted per pay period (the 1st through the 15th day of the month, and the 16th day through the end of the month) by each provider. Timesheets are not issued until the previous pay period timesheet has been submitted, approved, and processed.

IHSS is a self-directed program and, as such, IHSS recipients are responsible for managing and directing their own care, as well as considered the employer of their provider. In their role as the employer, IHSS recipients are required to schedule, manage, and train their own provider(s) and must approve the provider’s timesheet at the end of each pay period. Each recipient/provider relationship is considered unique and separate for purposes of payrolling and taxation. Currently, there are over 715,000 recipients and 600,000 providers in the IHSS program.

To become an IHSS provider, an individual must complete the provider enrollment process, that includes attending an orientation and passing a background check and be assigned to a recipient’s case. Providers perform services authorized by the IHSS program and submit timesheets at the end of each pay period that must be approved by the IHSS recipient before they can be paid.

The CDSS Adult Programs Division (APD) is the system owner and sponsor of the CMIPS. The CDSS APD oversees the IHSS program for the State of California. The CDSS APD is the subject matter expert (SME) for the IHSS program, including but not limited to the policies, rules, regulations, and business requirements as they apply to the IHSS program. The annual growth rate varies each year, and is anticipated to be approximately 7-10%.

CMIPS Overview

Currently, the CMIPS organization includes CDSS, CalHHS OTSI, and CGI as the primary management team for CMIPS. Other participants include the California Department of Technology (CDT), system users, control agencies, and interface agencies.

• The CDT is the host for the CMIPS production and compatibility testing systems. In coordination with CGI, CDT establishes and maintains the infrastructure for CMIPS, while CGI is responsible for operating and maintaining the CMIPS Application and associated toolsets.
• The CalHHS OTSI and its CMIPS Office provides project management, vendor management and oversight, resolves issues, and manages resources. The CalHHS OTSI CMIPS Office oversees activities associated with the CMIPS Software Development Life Cycle (SDLC) activities, and M&O.
• CGI is the current CMIPS M&O System Integrator and is responsible for the design, development, testing, coordination, implementation, operations, and maintenance of CMIPS.
• The CGI Managed Advantage Services (MAS), is responsible for hosting and maintaining databases for the Advantage Human Resource Management (HRM), Financial Management (FIN), and administrative applications used by the payrolling component of CMIPS.
• The primary end users of CMIPS are IHSS staff located in the State and county offices, CDSS APD, and the Public Authorities. In addition, the California Department of Health Care Services (DHCS) has limited staff who use CMIPS to administer the Waiver Personal Care Services (WPCS) program.
• The IHSS county offices distributed throughout the fifty-eight (58) California counties are responsible for administering the IHSS programs. The county office staff are the principal end users of CMIPS.

CMIPS is the technical solution that supports the IHSS program. Its key business functions include:

• Maintaining and displaying data related to IHSS recipients, cases and providers including but not limited to demographics, eligibility, status, authorizations, disaster preparedness, payroll, etc., that is entered by county staff;
• Processing program referrals, applications, and applying IHSS program requirements (forms, timeframes, etc.) to initiate IHSS cases;
• Determining eligibility and calculating authorized hours for IHSS services based on assessment data entered by county staff after an in-home assessment is completed;
• System-generated forms and correspondence for IHSS recipients and providers related to case eligibility and program rules;
• Tracking provider enrollment and eligibility;
• Provider maintenance, including the assigning of providers to cases as designated by IHSS recipients, placing providers on leave, and ending a provider’s eligibility based on program rules;
• Processing of provider timesheets, travel claim forms and sick leave claim forms;
• Payroll processing, including calculating payments, payroll deductions, share-of-cost deductions, applying tax rules at both the state and federal level that impact both employee and employer paid taxes, and funding management;
• Electronic Services Portal (ESP), online system used by IHSS recipients and providers to approve and submit timesheets electronically, as mandated by the IHSS program. ESP offers self-service functionality to providers and recipients.
• Telephone Timesheet System (TTS), Interactive Voice Response (IVR) system used by IHSS recipients and providers to approve and submit timesheets over the telephone;
• Electronic Visit Verification (EVV) Mobile Application that is used by IHSS providers to check in and out at the beginning and ending of each work shift as mandated by the 21st Century Cures Act;
• CMIPS CommsHub, which is not only the portal where system users access CMIPS, but also a repository for documents, training materials, user guides and other documents needed by the county and State for the administration of the IHSS program;
• Reporting and data downloads used by counties and the State to administer the IHSS program;
• Quality assurance and program integrity functionality to support both county and State staff;
• Back Office functions including, but not limited to, overpayments, garnishments, direct deposit, and taxes.

CMIPS provides for the following:

• Case Management function keeps track of over 715,000 active recipients as well as pending applicants, terminated recipients, pending providers, and terminated providers;
• Provider Management and payrolling functions support over 600,000 eligible providers;
• Timely and accurate payroll payments of over $14.8 billion per year;
• Supports approximately 6,800 CMIPS end users across the fifty-eight (58) California counties, the CDSS, the DHCS, and the CalHHS OTSI CMIPS Office;
• Secure file exchanges with more than one hundred and ten (110) interface partners, including all California counties; and
• Processes timesheets, travel claim forms, and sick leave claim forms
• Active recipient and provider growth rates and provider annual payments may vary from year to year but are anticipated to grow annual 7-10%.

Next CMIPS M&O Contract

Under the direction of CDSS, CalHHS OTSI has contracted with CGI Technologies and Solutions, Inc. for the M&O of CMIPS and CGI Managed Advantage for the Payrolling Services Component. The contract for CMIPS M&O is set to expire on June 30, 2025, unless the State elects to extend the term by up to three (3) one (1) year extensions, and the contract for the Payrolling Services Component is set to expire on September 14, 2026. The State intends to conduct a procurement process that will allow for uninterrupted services during the transition of services to a new CMIPS M&O and Payrolling Services Component contract. The new contract will provide for the continued maintenance, operation, and improvement of CMIPS and its Payrolling Services Component, in addition to providing a technologically modern system with the flexibility to meet the needs of the IHSS program, while staying current with emerging technologies and standards.

The intended term of the next contract is seven (7) years with the option of three (3) one (1) year extensions.

Because IHSS is one of the most dynamic social services programs in the State, the next contract will also include a range of potential system enhancements because of:

• IHSS Program changes, including Federal and State mandates.
• State and/or county business process or system improvement changes.
• Interface changes (e.g., new and/or updates).
• Infrastructure changes (e.g., upgrades, new components).
• Reports and forms changes.
• Commercial-off-the-shelf (COTS) Software upgrades and application changes.
• Cloud Service changes.
• Service and System Delivery process improvement activities.

CMIPS Architecture

The CMIPS consists of two primary components: (1) the Case Management (CM) System and (2) the Payrolling System.

The CM System provides the functions to support a case, its providers, and recipients throughout the case lifecycle through the performance of case management, recipient management, provider management, forms management and processing, and client notice delivery functions, reporting through the Cúram, SAP Business Objects, and Business Automation Workflow (BAW) COTS packages. CM also provides data to Back Office staff for standard reports and provides CMIPS Users with an environment to develop and print ad hoc reports.
The payrolling system calculates provider’s base and overtime payments from the hours worked for each recipient, rate of pay, applicable taxes, benefit or labor organization and health benefit deductions and applicable garnishments using the CGI Advantage COTS package, processes timesheets and supporting information provided by the CM System to disburse payments to providers.

The CM component is currently hosted at the CDT data center located at the Gold Camp facility in Rancho Cordova, California, with plans for future migration to Amazon Web Services (AWS). The payroll component is a hosted system located in a CGI data center in Phoenix, Arizona. The two system components are connected by 20 megabits per second (Mbps) Multiprotocol Label Switching (MPLS) circuit.

The primary functions of CMIPS are case management for IHSS recipients, payrolling service for providers, reporting, and customer support for system end users, and data exchange with interface partners.

For a full list of requirements, please refer to the Request for Information (RFI) in the Related Documents section of this opportunity.

Scope

Transition of Maintenance and Operations Services

System Maintenance

• Maintain software and software licenses
• Maintain interfaces
• Execute software upgrades
• Monitor application, database and network operation and performance
• Maintain system security in accordance with the State guidance
• Maintain and support systems environments (develop, test, production, etc.)
• Conduct capacity planning and management
• Participate in backup and recovery processes
• Maintain disaster recovery processes
• Conduct forms support

Operations support

• Data entry correction
• Create and send letters and notices to clients
• Maintain CMIPS M&O user website
• Stakeholder support

Timesheets, Travel Claim Forms, Sick Leave Claim Forms processing

• Receive, store, and process timesheets, travel claim forms, and sick leave claim forms

Payroll processing

• W-2 processing
• Prepare tax filings and payments
• Conduct tax withholding management (e.g., W-4, DE 4)
• Conduct warrant management
• Process direct deposit requests

Service Desk

• CMIPS Service Desk supports county and State users
• IHSS Service Desk supports provider and recipient inquires regarding TTS, ESP, direct deposit, garnishments, EVV, etc.
• Primary responsibilities are related to inbound calls. Some outbound calling is necessary for follow-up on customer questions that cannot be immediately answered.

Project management

• Conduct project initiation
• Develop and execute Project Master Work Plan
• Develop and execute Master Work Plan (for transition)
• Conduct risk and issue management
• Conduct quality management
• Conduct schedule management
• Conduct communication management
• Conduct cost management
• Conduct staffing management
• Support third-party verification and validation audits
• Conduct project closeout

Change management

• Implement approved service requests
• Conduct requirements management
• Business process analysis

Configuration management

• Correct defects
• Work authorizations for change requests
• Exception releases/emergency fixes
• Provide configuration item linkage

System test and evaluation

• Develop and execute Master Test Plan
• Develop Testing Scripts
• Conduct testing

Documentation management

• Develop and maintain all CMIPS deliverables

Business services migration

• Identify operational processes that will change as a result of transition
• Prepare transfer of and change to operational processes and activities from CMIPS M&O to CMIPS M&O and Payrolling Component

RFI Questions

Based on your role, please respond to the questions below.

General Questions

1. Please indicate whether or not your company would consider bidding on a CMIPS M&O and its Payrolling Services Component RFP for services described in Sections 5-8 of this RFI. If you are not interested in bidding, please tell us why.
2. Please describe your company’s experience and expertise with Federal and/or State social services programs.
3. What is your company’s experience in working with a solution that is built upon multiple COTS products, when one or more of the COTS products have been customized? What challenges are there in taking over such a solution?
4. Please describe your company’s experience and expertise in managing and maintaining Cloud Services environments and applications for large case management and/or payrolling systems. What challenges are there in taking over such a solution?
5. Please describe your company’s experience and expertise in providing Systems Integration (SI) of a large public service system that handles case management, payrolling, reporting, customer service, etc. What challenges are there in taking over the system integration role from a previous system integrator on a large complex system?
6. Please describe your company’s experience and expertise in change management, release management, and applying DevOps for large systems.
7. Please describe your company’s experience and expertise in data synchronization, monitoring and reporting such as for a large Case Management system component with a large payrolling system component.
8. Please describe your company’s experience and expertise in large systems test automation and associated test data masking for a large complex system.
9. Please describe your company’s experience and expertise in large system capacity and performance management, monitoring and tuning. What challenges are there in taking over such a solution?
10. Please describe your company’s experience and expertise with large system security management (user, network, data, etc.), including monitoring, reporting, maintenance, and remediation to ensure system is kept secure.
11. Please describe your company’s experience and expertise with large system interface management capability that includes data exchanges with other systems and external data exchange partners.
12. Please describe your company’s experience and expertise in managing and administrating the capacity, performance and tuning of a large complex system? What challenges are there in taking over such a solution?
13. Describe features of your solution that conform to the ADA as additionally interpreted by the Supreme Court’s Olmstead decision [Americans with Disabilities Act, 42 U.S.C. Section 12101, et seq.; 28 CFR part 35 (Title II)] Olmstead [Olmstead v. L.C. 527 U.S. 581 (1999)] and address needs of special populations of providers and recipients such as developmental disabilities and visual/hearing disabled.
14. Please share any feedback, suggested requirements, or other information your company would consider important for the State to consider with respect to the procurement of M&O for Case Management and Payrolling Services.