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January Exchange Board Meeting #1: Solicitation Update and Incorporating Comments on the IT Vendor RFP

The Exchange Board held their monthly meeting in Sacramento yesterday (agenda). This meeting was focused on the recent draft of a Request for Proposals (RFP) for an IT vendor (note: the future IT system has been dubbed “CalHEERS”). Next week, the Board will host another meeting to solicit comments on HHS’s recent bulletin on Essential Health Benefits.

Peter Lee provided an update on the Exchange’s contracting process. There are a number of major issues before the Exchange at the moment. Their two immediate focuses are communication support/an assisters strategy and health plan management and delivery reform.

Communications Support for Outreach and Education Plan/Assisters Program

In November 2011, the Board approved a solicitation and in December 2011, delegated a $900,000 award for communications support. This effort is a joint partnership with the Exchange, DHCS, and MRMIB, and has involved various input from stakeholders. The goal of the communications project is to develop a statewide marketing, outreach and education strategy and plan to reduce the number of uninsured Californians. The strategy will ensure eligible individuals are aware of their options, assist individuals with applying for and retaining coverage, and develop consumer-friendly and culturally appropriate outreach strategies. The grant will fund initial marketing/communication support and branding/design for CHBE, including coordinating its various program with the overall outreach theme. This grant will also be used to develop a plan for implementing an Assisters Program.

Proposals from vendors are due on January 30, 2012. The selected vendor will begin work on March 1, 2012.

Health Plan Management and Delivery System Improvement

In November 2011, the Board approved a solicitation and delegated a $600,000 award for health plan management and delivery system improvement. The goal of the project is to develop standards and process for certification and selection of QHPs for the Exchange, timeline, process and solicitation packages for QHP selection and recommend strategies for using Exchange programs to improve health delivery systems.

Proposals are due on January 30, 2012. The selected vendor will begin work on March 1, 2012.

Below is a working timeline for health plan strategy and delivery reform.

CalHEERS Solicitation Update

During the open comment period (December 20-December 30, 2011), 1,343 stakeholder comments from 36 organizations were received regarding the draft RFP for an IT vendor. Comments included compliments on various aspects of the solicitation, corrections needed (i.e. verbiage, references), clarification requests (i.e. processes) and policy issues (i.e. other program functions). Stakeholders requested clarification on the integration of health and non-health service programs and existing systems (such as special health programs an non-health programs like CalFresh). They wanted assurance that there would be appropriate language access, assister program functions and a first class user experience. Stakeholders also emphasized the importance of privacy and security requirements to protect consumers and clarification on a governance structure for CalHEERS and MEDS functionality integration. As a result of the comments, additional statements were added to various sections (see specific additions in this presentation).

The Board also received approximately 430 vendor responses. Comments included recommendations to improve the overall solicitation and questions about the process.

Below is a working timeline for the development of CalHEERS.

Enrollment and Eligibility Estimates

A UC Berkeley/UCLA team is in the process of conducting a review on 2014 enrollment estimates. The report will use a health policy simulation model that predicts behaviors based on policy changes. It will be available February 2012.

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