SOURCES SOUGHT
D -- RFI request - Eligibility and Enrollment (E&E) Enrollment System (VA-22-00037430)
- Notice Date
- 1/25/2022 8:52:45 AM
- Notice Type
- Sources Sought
- NAICS
- 541519
— Other Computer Related Services
- Contracting Office
- TECHNOLOGY ACQUISITION CENTER NJ (36C10B) EATONTOWN NJ 07724 USA
- ZIP Code
- 07724
- Solicitation Number
- 36C10B22Q0140
- Response Due
- 2/4/2022 2:00:00 PM
- Archive Date
- 04/05/2022
- Point of Contact
- Heera Polanco, Contract Specialist, Phone: 848-377-5039
- E-Mail Address
-
heera.polanco@va.gov
(heera.polanco@va.gov)
- Awardee
- null
- Description
- OFFICE OF INFORMATION AND TECHNOLOGY 2 FOR INTERNAL USE ONLY OFFICE OF INFORMATION AND TECHNOLOGY Product Engineering (PE) Veterans Experience Services (VES) Eligibility and Enrollment (E&E) Request for Information (RFI) January 25, 2022 | Development, Security and Operations (DSO) Table of Contents VA OIT Request for Information 3 1 Introduction 3 2 Background 3 2.1 Veterans Affairs (VA) Office of Information and Technology (OI&T): 4 2.2 Veterans Health Administration (VHA) Enrollment System: 4 3 Scope and Approach 5 4 Intent and Assumptions 6 5 Veteran Health Administration Enrollment System Major Subsystem 7 5.1 Messaging 7 5.2 Case Management 8 5.2.1 Income Verification Division (IVD) of the Health Eligibility Center (HEC) 8 5.2.2 Income Verification Matching (IVM) 8 6 Enrollment Systems and Services 9 6.1 Veteran Health Administration Enrollment System Infrastructure 9 6.2 Veteran Health Administration Enrollment System Objective 9 7 Veteran Health Administration Enrollment System Additional Information 10 7.1 Veteran Health Administration Enrollment System Back-End 10 7.2 Veteran Health Administration Enrollment System Users 10 7.3 See appendix for more additional information. 10 8 Conclusion 10 Appendix A VES Overview 13 Appendix B Application Architecture 14 Appendix C Software Architecture 15 Appendix D Infrastructure Architecture 17 Appendix E IVM-EDB Process 18 Appendix F IVM High-Level Application Design 19 Appendix G IVM Context Diagram 20 Appendix H Non-Functional Requirements 21 Appendix I Definitions, Acronyms, and Abbreviations 24 VA OIT Request for Information Introduction The Department of Veterans Affairs (VA), Office of Information and Technology (OI&T), Product Engineering (PE), Veterans Experience Services (VES), Eligibility and Enrollment (E&E) product line seeks information on current industry architecture, capability, and technical staffing for a creative, innovative, agile, and responsive next-generation Veterans Health Administration (VHA) Enrollment and Eligibility System. Benefits anticipated are to ascertain commercial practice, streamlined evaluation processes, reduce the cost of contracting for both government and industry, use of Commercial off the Shelf (COTS) for complex business rule engine, automate eligibility determination, low code/no code, test-driven development, containerize code, improve performance and efficiency, standardize processes, robust interoperability practices, and simply sustainment. The VHA Eligibility and Enrollment capabilities are expected to be the primary means to compile military service, demographics, and financial data from VA healthcare facilities and other internal (VA) and external authoritative subsystems to process Veterans' applications for enrollment, support benefits determinations, manage enrollment correspondence and telephone inquiries, share eligibility and enrollment information with non-VA organizations and with the VA healthcare facilities treating the Veteran, and to provide support for national reporting and analysis of Enrollment data. This RFI is for planning purposes only and shall not be considered an Invitation for Bid, Request for Task Execution Plan, Request for Quotation or a Request for Proposal. Additionally, there is no obligation on the part of the Government to acquire any products or services described in this RFI. Your response to this RFI will be treated only as information for the Government to consider. You will not be entitled to payment for direct or indirect costs that you incur in responding to this RFI. This request does not constitute a solicitation for proposals or the authority to enter into negotiations to award a contract. No funds have been authorized, appropriated or received for this effort. Interested parties are responsible for adequately marking proprietary, restricted or competition sensitive information contained in their response. The Government does not intend to pay for the information submitted in response to this RFI. Any information received from a contractor in response to this RFI may be used in creating a solicitation. Any information received which is marked with a statement, such as proprietary or confidential, intended to restrict distribution will not be distributed outside of the Government, except as required by law. Background Veterans Affairs (VA) Office of Information and Technology (OI&T): The mission of OI&T is to collaborate with our business partners to create the best experience for all Veterans. The vision of OI&T is to become a world-class organization that provides a seamless, unified Veteran experience through the delivery of state-of-the-art technology. The OI&T delivers available, adaptable, secure, and cost-effective technology services to the Department VA and acts as a steward for all VA's Information Technology (IT) assets and resources. The VA depends on Information Management/Information Technology (IM/IT) systems to meet VA mission and vision to provide veterans the world-class benefits and services they have earned. Veterans Health Administration (VHA) Enrollment System: As a Veteran Business Services E&E product line, VHA Enrollment System (VES) product is the authoritative source for Veterans health care benefits Determination (eligibility). The VES product integrates care facilities and other internal and external authoritative source information with Office of Electronic Health Record Modernization (EHRM). The VES product processes Veteran enrollment applications, manages Veterans' enrollment correspondence and telephone inquiries, shares eligibility and enrollment information with other VA organizations, and supports national reporting and analysis of Enrollment data. The system compiles military service, demographics, and financial data from VA healthcare facilities and other internal (VA) and external authoritative subsystems to process Veterans' applications for enrollment and support benefits determinations. Once compiled, ES shares this information with the VA healthcare facilities treating the Veteran. The VES product defines health benefit plan(s) for which a Client (Veteran, Service Member, and beneficiary) is eligible and combines them to the authority for VA healthcare. The VES product minimizes the Veteran burden to provide proof of military service, financial burden, or other hardship by establishing more robust interoperability practices with other federal agencies (e.g., Social Security Administration (SSA), Internal Revenue Service (IRS), Department of Defense (DoD), and private sector. The E&E product line aligns with 38 C.F.R. § 0.600 that describes VA s Core Values, Characteristics, and Customer Experience Principles and serves as internal guidance for employees of VA. Public Law 101-508 permits VA to verify income data with the IRS and SSA for Veterans receiving VA health care services whose eligibility for medical care is based on income. Revenue collected goes back to Veterans Affairs Medical Centers (VAMCs) to support operational expenses. Scope and Approach The E&E product line requests current industry architecture and technical resources to construct the enrollment and eligibility (VES, Income Verification System-Enrollment Database (IVM/EDB) system as an enterprise service with the following goals as a guide. This request is not intended to predefine or limit the approach and plan of responses and as well as not meant to be prescriptive of a specific approach, solution or plan, but seek to provide relevant guidance on the intended use of the capabilities and on the benefits and value that are expected from use of the solution. Goals Goal 1: Modernize technology (infrastructure platform, security, and architecture) Goal 2: Streamline functionalities Goal 3: Integrate Development methodology (Development Security Operations (DevSecOps, Agile, Scaled Agile Framework® (SAFe®), Information Technology Infrastructure Library (ITIL) framework) Goal 5: Low Code/No Code Goal 6: Test-driven Development Goal 7: Containerized Application and Package Software into Standardized Units for Development, Shipment and Deployment Goal 8: Utilization of commercial off-the-shelf (COTS) tools for rules, risks, reporting, and eligibility processing Goal 9: Simply sustainment and release Goal 10: Reduce the cost of contracting for both government and industry The VA has adopted DevSecOps which defines the how to design, build, and deliver products and services, collaborate with our customers, organize, allocate and manage IT and human resources. The objective of DevSecOps is to deliver value to our customers which requires long term and robust relationships with product stakeholders built on a foundation of trust and understanding. Agile expertise is leveraged to deliver early and often with sustained agility to respond to changing customer needs while maintaining secure delivery pipelines and operational environments. Containers benefits are that containers virtualize the operating system instead of hardware. Containers are more portable and efficient. The objective is to simply code changes and provide releases often to minimize backlog enhancement requests and provide flexibility in the release schedule to meet unplanned congressional mandates to provide services to Veterans. Streamline the eligibility and verification functionalities to operate from the enrollment enterprise systems while maintaining separate databases for sensitive data. Intent and Assumptions The E&E product line is exploring a hosted or managed Enrollment System solution. The VA OIT is responsible for the day-to-day management of enrollment and eligibility services and support for VA. The VA OIT views the sought solution as being a core business system for enrollment, eligibility determination, sustaining and managing all enrollment and eligibility data for VA healthcare facilities treating the Veteran and sharing with external entities. The VA OIT shall retain ownership rights of all data contained in the solution database at no extra cost. The VA takes the position that outsourcing a critical function to a third party that may be located out of the jurisdiction of the laws of the United States is not in the government s best interests. Outsourcing to off-shore locations decentralizes operations, making communications and management more difficult. Communications barriers might prove problematic between the VA and the possible vendor or outsourcers located overseas, such as in Asia and Europe, who operate in different time zones, which, in turn, require the VA, the vendor company, the outsourcer or all to operate during non-standard U.S. business hours. The work transition of the functions into and out of these relationships presents significant probability of operational difficulties. When the outsourcer is overseas, cultural and language incompatibilities could become an issue, and the necessity of complying not only with U.S. laws, but also with international laws, treaties and regulations, becomes critical. As these parties or outsourcers often perform like, or same, services on behalf of competitors, the extent to which these entities have access to confidential information and trade secrets may be a major security issue. Outsourcing or operating out of U.S jurisdiction may create a dependency by the vendor on their outsourcer. This creates a risk that VA might consider the vendor company unable to change the outsourcer at some point in the future, thus, giving the outsourcer, or their new partners, proprietary information and bargaining advantage in any future contracts or relationships. The VA anticipates certain modules/systems in use within VA may require interfaces or interoperability to a telecommunications expenses management solution. These modules and systems are as follows: Financial Management System (FMS) , VA s funding and accounting systems, governed in VA Financial Policies and Procedures, Volume I, Chapter 4, Financial Management Systems https://www.va.gov/finance/docs/va-financialpolicyvolumeichapter04.pdf Financial Services Center (FSC) , VA FSC, Mandatory Electronic Invoice Submission. The Department of Veterans Affairs published a final rule in the Federal Register on November 27, 2012 to require contractors to submit payment requests in electronic form in order to enhance customer service, departmental productivity, and adoption of innovative information technology, including the appropriate use of commercial best practices. The rule is effective December 27, 2012. Vendor Electronic Invoice Submission Methods - Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below: 1.The VA s Electronic Invoice Presentment and Payment System The FSC uses a third-party contractor, Tungsten, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/US/en/veterans-affairs/ to begin submitting electronic invoices, free of charge. 2. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI Web site: http://www.x12.org/ Veteran Health Administration Enrollment System Major Subsystem The VES consists of two major sub-systems or modules: Messaging Case Management Messaging The messaging sub-system provides a seamless bi-directional interface with external VHA and non-VHA systems for data exchange of Veterans information. The VES application communicates to VistA and Veteran Benefit Administration (VBA) via the HealthConnect Integration Engine. Communication from VES to HealthConnect are Health Level 7 (HL7) messages sent over the Java Messaging Service (JMS). In addition, VES communicates with other applications via web-service calls. Case Management The case management sub-system is an intranet web-based application that provides authorized VHA case representatives at HEC with a web interface to easily track, maintain, and manage cases associated with Veteran benefits. Also, the Income Verification Matching Enrollment Database (IVM-EDB) creates cases when the total gross household income is reported to the VHA by Veterans and is below the established thresholds when the amount reported to the IRS/ SSA exceeds established income thresholds. As a result, IVM-EDB generates letters which are mailed to Veterans and Spouses informing them of their rights to dispute the income reported by IRS/SSA. See appendix K. Income Verification Division (IVD) of the Health Eligibility Center (HEC) The IVD of the HEC is responsible for the verification process of Veterans annual means tests conducted at VA healthcare facilities. Household income information of non-compensable 0% Service Connected (SC) and non-service connected (NSC) Veterans without special eligibility is matched with the person s income records maintained by the IRS and SSA. The Income Verification (IV) staff verifies total household annual income to determine a Veteran s eligibility or care on the income of the previous year. When the total income exceeds an established means test threshold, the Veteran may be responsible for healthcare copayments. Income Verification Matching (IVM) Income Verification Matching (IVM) is Web-based application that is used to manage case workload for IVM. The IVD of the HECis responsible for the verification process of Veterans annual means tests conducted at VA healthcare facilities. Household income information of non-compensable 0% SC and NSC Veterans without special eligibility is matched with the person s income records maintained by the IRS and SSA. The IV staff verifies total household annual income and bases a Veteran s eligibility or care on the income of the previous year. When the total income exceeds an established means test threshold, the Veteran may be responsible for healthcare copayments. The following secured databases are in use for IVM: The IVM-EDB database stores the non-Federal Tax Information (FTI) data, such as Veteran, spouse, and dependent demographic data, Eligibility Data, Veteran self-reported financial (income test) data, etc. The FTI database stores the Veteran and spouse FTI data received from the IRS and SSA periodically via a batch job. This database is also used to store income test data collected because of working the IVM cases, since this income test data can contain FTI data co-mingled with self-reported income data from the Veteran. Enrollment Systems and Services The ES is a collection of systems and services that helps automate the VHA operational activities related to healthcare eligibility and enrollment determination including income verification for VA s health benefits that are tied to financial needs assessments. The ES enrollment and eligibility data is housed in an ORACLE database. Also, ES is an enterprise level web application that s comprised with systems and services that: enable HEC and Veterans Health Information Systems and Technology Architecture (VistA) registration clerks to track and manage the Veteran healthcare enrollment process. interface with a M (Massachusetts General Hospital Utility Multi-Programming System \[MUMPS\])-based system at each medical center to support patient registration activities. interface with a self-service application that enables Veterans to create a personalized Veteran health benefit handbook online. interface with a web service that provides a summary of Veteran s enrollment and eligibility information to other VA systems. interface with a web service interface that receives and routes benefit applications such as 1010EZ for processing within the enrollment system. Veteran Health Administration Enrollment System Infrastructure The VES comprised systems were developed using different sets of tools and technologies and are deployed on their own infrastructure. The only exception to this is VES and the Veteran s enrollment and eligibility information web service, which are all deployed on the same infrastructure. The enrollment system is hosted in Amazon Web Service (AWS) government Cloud. Veteran Health Administration Enrollment System Objective The objective for proposed solution functions and characteristics are to lead to increased efficiency in delivering products and services to Veterans, consolidation of processes/systems into one, rapid development and releases, and reduced sustainment cost. Veteran Health Administration Enrollment System Additional Information Veteran Health Administration Enrollment System Back-End The VES will provide back-end enhancements to legislative changes, web services, health care support, online and mobile Veterans applications, military duty status change, and reports. Veteran Health Administration Enrollment System Users Primary users of the VES are staff members from HEC across the country. The users are competent in the use of the existing ES application to the extent that new functionality is introduced, or that changes that affect the usability of the application are realized, the users will require training to ensure that each user understands the steps needed to successfully execute required responsibilities. Specifically, it is anticipated that users will require training to manage Veteran information within a new ES, including, but not limited to, searching, adding, modifying, and requesting Veteran data as follows: Demographics Eligibility and Enrollment Financial Assessment Military Registration History Military Service information See appendix for more additional information. Conclusion This RFI will allow companies in the healthcare industry to introduce new, high value commercial products and services to establish processes to improve services to Veterans, improves performance, simplify sustainment, and release, and reduce cost to taxpayers. The RFI for an enrollment and eligibility enterprise system is requested to be no more than 10 pages (not to include title page, table of content). Responses are due no later than 5:00pm EST on Friday, February 4, 2022, via email to Heera Polanco, Contract Specialist at heera.polanco@va.gov and Kathryn Pantages, Contracting Officer at Kathryn.Pantages@va.gov. Please note Enrollment and Eligibility Enterprise System RFI in the subject line of your response. Mark your response as Proprietary Information if the information is considered business sensitive. The email file size shall not exceed 10 MB. Interested Vendors shall at a minimum, provide the following information in the initial paragraph of the submission: Name of Company Address Point of Contact Phone Number Fax Number Email address Company Business Size and Status For VOSB and SDVOSBs, proof of verification in VIP. NAICS code(s) Socioeconomic data Data Universal Numbering System (DUNS) Number Existing Contractual Vehicles (GWAC, FSS, or MAC) 8.1 INFORMATION: If, in your capacity as a subject matter expert (SME), you deem a critical component has been overlooked or omitted, or more information should be supplied, addressed, or covered, please provide. Provide any required Service Level Agreement(s) Provide three (3) Customer references, which are of comparable scope to VA OIT s Telecommunications spending and requirements. Describe the average implementation process, milestones, and timelines at contract award. Describe your services that are part of the implementation and what you expect of VA. 8.2 HOSTED OR MANAGED MODEL: How do you suggest it be delivered? On VA premises? Vendor premises? And how would it be managed? What is the standard timelines for implementation? 8.3 SOLUTION PRICING: Implementation Services Training Costs Management Fees Hosting Fees Licensing Fees Other Fees Vendor Pricing must be complete Appendix A VES Overview A.1 VES Overview Diagram Figure 1 VES Overview Appendix B Application Architecture B.1 VES Application Architecture Diagram Figure 2 VES Application Architecture Diagram Appendix C Software Architecture C.1 VES Modules C.1.1 Framework Module The Framework Module provides essential design patterns and structure to the entire VES Application. It also provides the integration points with third-party libraries such as Hibernate, Struts, ILOG, Spring, and Log4j. The Framework Module is used by a majority of the other VES Modules. C.1.2 Common Module The Common Module represents the classic J2EE business logic layer and is the core of the VES Application. This module contains the service layer, business processes, data transfer objects, rule services, and data access components. The Common Module is used by a majority of the other VES Modules are to process or retrieve veteran data. C.1.3 User Interface Module The UI Module represents the presentation layer for the VES Application. The UI module is built on top of the Apache Struts Framework. The UI module builds on the foundation of a typical struts-based solution and adds on many new features such as pagination, seamless integration with the business tier, and security integration. The UI Module is the portion of the VES Application that users directly interact with. C.1.4 Messaging Module The Messaging Module is a set of services that provides support for passing messages between distributed applications in a reliable, asynchronous, loosely coupled fashion. This task is accomplished by encapsulating messages that are sent between a sender and a receiver. Currently, the messaging module supports asynchronous communication with other internal VHA services through Java Messaging Services (Publish and Subscribe Model) protocols and batch processing. The messaging module performs both as a provider and a consumer. As a provider, the module can fire messages to other internal systems. While as a consumer, it subscribes to topics from other external systems. C.1.5 Service Module The Service Module is a set of SOAP Web Services that provides Enrollment and Eligibility data to external systems from the VES Application. C.1.6 Workflow Module The Workflow Module manages automation of the VES core functionalities. This module is used by the UI Module and offers the following set of capabilities: Inbound Services The inbound services group is the set of case management capabilities such as case creation, searching for a specific case, assigning a case. This service is consumed by the UI module when the HEC user performs a certain set of case management functionality. Workflow Cases The workflow cases encapsulate the data elements required for workflow case management. These set of classes are Business Object Model (BOM) classes for the workflow management engine. C.1.7 Reporting Module The Reporting Module is a framework built on top of Jasper for generating PDF or CSV reports from the VES Application. Jasper is an open-source reporting engine written in Java and requires a report template to generate reports in multiple formats from many data sources. The report template is in XML form containing the report definition and is generated visually using iReport visual builder. This module provides both on-demand and scheduled reporting capabilities and runs asynchronously in order not to slow down the VES Application. The module uses triggers and Messaging Module to run the reports in a separate thread and the quartz framework for scheduling of the reports. This module is comprised of two components: The UI component is used to configure the front end for the reports The backend component is used to configure the report template to use the data access object (DAO) that is used for data retrieval to populate the report. C.2 VES Data Store The data collected by VES is stored in Administrative Data Repository (ADR) located within the same environment that the VES Application is running. Data is not stored in any other external data source outside VA. Data stored is Veteran s data demographics, income, military service, eligibility factors, enrollment determination. The database access: create, read, update, delete (CRUD). Appendix D Infrastructure Architecture D.1 VES Infrastructure Architecture Diagram Figure 3 Infrastructure Architecture Diagram Appendix E IVM-EDB Process E.1 IVM-EDB Process Figure 4 VES IVM/EDB Appendix F IVM High-Level Application Design F.1 IVM Bidirectional Flow Figure 5 High Level ESR IVM Bidirectional Flow Appendix G IVM Context Diagram G.1 IVM Context Diagram Figure 6 IVM Context Diagram Appendix H Non-Functional Requirements H.1 Processing Requirements Table 1 Processing requirements ID Requirement 1 The VES shall support >= 1200 concurrent users 2 The VES shall support >= 700,000 HL7 message processed during a four (4) hour period, to include acknowledgements and query messages. 3 The VES shall process HL7 message types ORF Z-07 and ORU Z-07 within 30 seconds 4 The VES shall process the following HL7 message types within 15 seconds ORU Z-11 QRY Z-11 ORF Z-11 QRY Z-10 ORU Z-09 ORU Z-05 5 The web-based response time for user interface shall be = 11,466 self-service applications through Veterans Online Health (VOA) Application. 9 The VES shall support >= 16 enrollment applications per hour. 10 The VES web service shall support >= 275 concurrent requests. 11 The IVM bi-directional interface shall share >= 5000 records per = 95% daily, with a target goal of 99% availability. 2 The system shall average 99.5 % hourly response times for User Interface Web response in = 95% daily 8 The system shall provide a disaster recovery system for fail-over of the enrollment system and supporting systems from the primary site in Austin, TX, to the secondary site in Hines, IL. 9 The system fail-over service shall be activated within 12 hours of notification by VHA or due to internal decision made by OIT with notification to all relevant parties. H.3 Sensitivity Requirements Table 3 Sensitivity requirements ID Requirement Rating Confidentiality The system shall have protection from unauthorized disclosure of information. High Integrity The system shall have protection from unauthorized, unanticipated, or unintentional modification or destruction of information. Moderate Availability The system shall ensure that system resources (data, computer programs and equipment, network connectivity) are accessible and operational, at the required level of performance, when they are needed. High H.4 Security Requirements Table4 Security requirements ID Requirement 1 The system shall have the ability to integrate with the web-based enterprise-level authentication services using Computer Associates (CA) SiteMinder provided by Identity and Access Management (IAM). 2 The system shall only be accessible to HEC users. 3 The system shall be avail to the public. 4 The system shall have the flexibility to expand its user base to the public. 5 The system shall have the flexibility to integrate with any of the enterprise portals. 6 The system shall have accessibility via Secure hypertext transfer protocol (HTTP). 7 The system shall have the flexibility to access data via other approved security protocol for IVM, to include the list below. HTTP- within the VA network Computer-assisted insulin protocol (CAIP)- within the VA network Minimum Lower Layer Protocol (MLLP)- within the VA network Appendix I Definitions, Acronyms, and Abbreviations I.1 Terms\Acronyms Table 5 Terms\Acronyms Acronym or Term Definition AAC Austin Automation Center ADR Administrative Data Repository. A centralized database repository for person identity, demographics, eligibility, and enrollment data. ADR stores administrative data for the ES system. AET Automated Eligibility. Supports queries from third-party insurance companies through Emdeon clearinghouse. AITCAustin Information Technology Center BOM Business Object Model CA SiteMinder Computer Associates (CA) SiteMinder is an enterprise infrastructure product that enables centralized, secure Web access management. CAIP Computer-assisted insulin protocol CDW Corporate Data Warehouse. A national repository comprising of data from several VHA clinical and administrative systems. The CDW s objective is to provide data and tools to support management decision making, performance measurement and research objectives. CCN Community Care Network CMS Content Management System Container A container is a standard unit of software that packages up code and all its dependencies so the application runs quickly and reliably from one computing environment to another. COTS Commercial off -the-shelf CPR Cardiopulmonary resuscitation DAO Data Access Object DAS Data Access Services DevOps Development and Operations DevSecOps Development, Security, and Operations DoD Department of Defense DSO DevSecOps EAI E...
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