State of Iowa’s Department of Human Services Quality Assurance Services on Integrated Eligibility System

Iowa selected Public Knowledge® to provide Quality Assurance services and Management experts to improve DHS’s ability to meet Federal ACA and state program eligibility requirements. Public Knowledge® delivered a customized Agile project oversight protocol.

The Situation

The Iowa Department of Human Services (DHS) manages and operates the Integrated Eligibility (IE) systems that process business rules to determine citizens’ eligibility for health and human services benefits, including Medicaid, the Children’s Health Insurance Program (CHIP), the Food Assistance and Family Investment Program (FIP), and other public assistance programs. By 2012, Iowa’s Automated Benefits Calculation System (IABC) had been in continuous operation since the late 1970s, supporting the state’s eligibility and benefit issuance obligations. IABC was outdated and generally unable to meet DHS needs. Further, applicants could not interact directly with the benefit determination system. These problems necessitated the need for numerous manual workarounds. DHS needs Quality Assurance Services to address these limitations and replace IABC. The new system would also have to conform to the program eligibility framework of the Affordable Care Act (ACA).

To address these issues, DHS initiated the Eligibility Integrated Application Solution (ELIAS) Project and began five-year strategy to improve citizens’ eligibility determination experience by improving system accuracy, and to create a platform for future integration of other eligibility programs. To accomplish these goals, DHS sought contracts with a system integration firm, a PMO vendor, an IV&V vendor, and an experienced QA service provider. The QA service provider was tasked with providing QA services and staffing for three project management positions to manage risk, testing, and development to augment existing State roles and positions awarded at QA service provider contract to Public Knowledge®.

While it was not explicit in the solicitation, Public Knowledge® understood that DHS was open to innovative development methodologies and approaches, including Agile or an Agile hybrid. Public Knowledge® recognized that the requested Quality Assurance support was in complete alignment with our technical and functional expertise and fit with Public Knowledge®’s work with refining its oversight protocols from waterfall to Agile-oriented projects.

The Solution

Public Knowledge® delivered three highly accomplished managers, with certifications in test management (ITSQB), risk management (CRISC), and software development (CSM) to head up each of these task areas. Additionally, Public Knowledge® staffed their Quality Assurance team with four full-time QA consultants, with project management, requirements management, data management/conversion, implementation management, organizational change/training, and testing expertise. Public Knowledge® determined that near full-time, on-site support was required, so the QA Team was co-located with the development team at the DHS worksite in Des Moines, IA.

Early in the project, it became clear that the state and system integration vendor would be using an Agile approach to develop the new system and subsystems. It was also clear that all project participants needed to gain a common understanding of Agile, in general, and the modified approach being deployed on ELIAS. We realized that our current Quality Assurance procedures, templates, checklist, and questionnaires needed to be further refined to provide meaningful, timely, and accurate feedback to the SCRUM teams that were poised to release working software every two weeks. Monthly and quarterly feedback would be of very little value in a project with bi-weekly code releases.

Working with the State and the other vendors, Public Knowledge® significantly enhanced its ISO 9001:2008 certified Quality Management methodology (recently re-certified to ISO 9001:2015). The Public Knowledge® Team created Process Guideline (PGLs) to define how certain Agile ceremonies should be conducted. The Quality Assurance team also created a process for reporting and recording findings and for making recommendations called Process Observation Reports (PORs). Public Knowledge® uses PORs immediately following a formal SCRUM/Agile ceremony or an informal meeting/walk-thru to provide near real-time feedback on pros and cons of the process. Finally, the team wrote a basic training program on what Agile is and what it is not. Public Knowledge® used this program to train new staff and to confirm that they held a common understanding of the project’s development approach. The work on this project, including things, PORs, and training materials have been incorporated into Public Knowledge®’s QMS for Agile projects. Combined, we call this SpARC™ (Public Knowledge®’s protocol for Agile in a Regulated Context).

Public Knowledge®’s staff augmentation technical and test managers remained in place for the term of the Quality Assurance Services contract, and became integral players in managing the state’s contractual obligations.

The State acknowledged Public Knowledge®’s contributions to improved processes for the ELIAS project, noting that Public Knowledge®:

• Developed and applied testing rules and standards
• Improved performance testing
• Developed a plan to repurpose environments
• Improved Capacity Management
• Improved Knowledge Transfer processes
• Completed a Process Guidelines (PGL) Compliance Review Plan and Initial Outreach Report to review project compliance with the newly developed PGLs
• Made recommendations for continuous improvements to the PGLs

Throughout the Quality Assurance Services effort, Public Knowledge® developed constructive, collaborative relationships with the State and with the other ELIAS project vendors, to maximize software and project quality. For example, when Public Knowledge® uncovered the issue with the lack of a common understanding of Agile development concepts and metrics, the team immediately escalated this concern to management and began to craft training materials and recommend tools and measures designed to ensure progress was being made.

 The Outcome

Public Knowledge®’s Quality Assurance services were a key factor in a successful ELIAS implementation. Iowa was among the first states to implement an ACA-compliant eligibility system. Public Knowledge®’s effective Agile oversight approach allowed the project to remain on plan and on schedule, and to introduce new features incrementally. The Public Knowledge® technical and test managers maintained critical software quality and development progress. As a testimony to Public Knowledge®’s excellent services, the former Public Knowledge® Technical Manager for ELIAS is now the Chief Information Officer for Iowa DHS.

Ultimately, the ELIAS project was successfully completed with the assistance of Public Knowledge® staff and our customized Agile project oversight methodology. Public Knowledge® leveraged its SpARC™ protocol throughout the course of the project, helping the development teams work at an accelerated pace while ensuring that appropriate corrective actions, planning, and execution/completion tasks were accomplished. Public Knowledge®’s strong Iowa-based team, staffed with certified Quality Assurance professionals, Agile specialists, and Benefits Eligibility subject matter experts led to the enactment of a successful project. Wendy Richman, Division Administrator, commented,

“Thank you and all the Public Knowledge® employees for the assistance and service provided to the ELIAS project over the last five and half years’ has demonstrated a high-level of accountability to the project. Your employees contributed to the success of the ELIAS project. The Public Knowledge® team worked well with DHS and the other vendors on this project. The team put their best work forward from the initial stages of the project’s development to where we are at today so that we could get our work completed on time.”

Public Knowledge® learned a great deal from our tenure on the ELIAS project. Public Knowledge® has taken the improved SpARC™ protocol to our subsequent projects and have used it as an effective way to save time and money for clients that are using an Agile approach for their system modernization and replacement initiatives.