Nebraska Department of Health and Human ServicesP.O. Box 95044Lincoln, NE 68509(402) 471-2306www.hhs.state.ne.us

N-FOCUSNebraska Family Online Client User System

Presented as part of the NGA Webcast Series:

Making the Most of Limited Resources: State Options to Help Low-Income Workers Achieve Self-Sufficiency

Webcast 1: Using Technology and Public-Private Partners to Help Low-Income Workers

Hosted by:The National Governors Association Center for Best

Practices, with the U.S. Department of Health and Human Services

May 13, 2003

The N-FOCUS concept

• N-FOCUS is an acronym for

Nebraska Family On-line

Client User System

• N-FOCUS integrates—into

one automated system—

NHHSS programs that had

previously been maintained

individually

• The system automates the

handling of client, resource,

and payment information for

these programs

IEVEA

FC PAYSVP

*JOBS is now Employment

First

PAECWIS

FSPJOBS*

N-FOCUS

Key System Design Characteristics

• Single access worker

• Interactive interview

• Client/server technology

• Case check-out

(download) and check-in

(upload)

• Seamless access to

information

• Multi-tasking

• Expert system

technology

• Client assistance rule

base

• “What If” processing

• On-line policy and help

• Free-form narratives

• Alerts

• To-do lists

• On-line edits

• The N-FOCUS functional

and technical design

supported existing needs

and future enhancement

and growth

• The system would put

appropriate tools and

processing power into the

hands of N-FOCUS users

• The ultimate goal was to

improve the delivery and

management of services

for Nebraska citizens

1999-presentMaintenance, growth, additional functionality to support new programs and changes in policy

Initial development crossed several administrations and policy initiatives

Information Strategy Planning (4/91-11/91)

Analysis (12/91-5/92)

FAMIS Planning APD Submitted (3/92)

N-FOCUS Implementation APD Submitted (4/93)

N-FOCUS RFP Release (8/93)

N-FOCUS Contract Finalized (3/94)

Design (5/94-3/96)

Site Preparation, HW/SW Installation (11/94-1/96)

Construction (2/95-3/96)

Pilot Test (Beatrice) (6/96-7/96)

Statewide Training (7/96-10/97)

Statewide Conversion/Implementation (8/96-12/98)

1991

1992

1993

1994

1995

1996

1997

1998

N-FOCUSCWIS

(e.g., central registry, risk assessment)

Nebraska’s child welfare information system (CWIS) was added

• Child Welfare Information

System (CWIS)

development was a

separate, parallel effort

• CWIS functions were

added to N-FOCUS in

1998

• The two systems share

common elements

ArchitectureMethodology

ClientsProvidersServices

PaymentsInterfaces

N-FOCUS: Source of Funding

• N-FOCUS: $41.9M 1991 - 199835% (~$14.7M) from State General Funds

65% (~$27.2M) from Federal (FAMIS)

– State staff (HHSS and CDP): $ 8.6M

– Contractor services: $22.1M

– Contractor hardware/software: $ 8.0M

– CPU and network and State software: $ 3.2M

• CWIS: $16.9M 1995 - 199825% (~$4.2M) from State General Funds

75% (~$12.7M) from Federal (AFCARS/SACWIS)

– State staff (HHSS and CDP): $ 3.0M

– Contractor services: $10.9M

– Contractor hardware/software: $ 2.5M

– CPU and network and State hardware/software: $ 0.5M

Combined funding:State General Funds:~$18.9MFederal: ~$39.9MTotal: $58.8M

Welfare Reform/ Employment

First

Single AccessWorkers Managed

Care

Partnership5 Agencies

Merge

KidsConnection

• Other initiatives had an

impact on N-FOCUS, its

users, and their work

environments

• System design and work

environment structure must

be able to accommodate

continual change and

enhancement

• N-FOCUS flexibility and

project structure make it

possible to overcome

challenges introduced by

external factors

External factors had an impact on the N-FOCUS system

Other post-implementation initiatives are complete or underway

• Expert System Redesign Phase

2 - Rewrite financial rule base

• EBT - Electronic Benefits

Transfer for food stamp program

• Incorporation of Developmental

Disabilities ECHO system

functionality

• Upgrade to Pentium

workstations

• External/internal requests for

access (resources)

• Move to newest versions of

software development tools

• Administration for Children and

Family - CWIS review

• Youth treatment correctional

facilities

• Purge/Archive/Retrieval

• Reporting

• Training

• Interfaces with Nebraska Child

Support System (CHARTS)

• System enhancement and

growth is an ongoing

process

• Since implementation, the

N-FOCUS project team has

worked continually to keep

the system current on

business and technological

levels

N-FOCUS Today

Today, N-FOCUS...

• Issues $37.5 million in benefits and payments

each month

• Supports 2,426 users, with both internal and

external access

• Handles more than 200,000 master case data

files

• Tracks data for more than 600,000 individual

clients and others

N-FOCUS today is a

mature, reliable system

that has become an

indispensable tool for our

users

N-FOCUS users

Single Access Workers

Child Welfare

Specialists

Resource Development

Workers

• The typical N-FOCUS user

is a professional

caseworker skilled in the

government policies of one

or more areas of public

assistance (e.g., Child

Welfare, ADC, Food

Stamps, Medicaid)

• Their clients are Nebraska

residents, whom they serve

from agency offices around

the state

• They also use N-FOCUS to

coordinate resources to

support their clients

Programs Covered

• Aid to Dependent Children/Medicaid (ADC)

• Assistance to the Aged; Blind (AABD)

• Adult Protective Services (APS)

• Child Care (CC)

• Children & Family Services/Medicaid (CFS)

• Emergency Assistance (EA)

• Employment First (EF)

• Food Stamp Program (FSP)

• Former Ward/Medicaid (FW)

• Independent Living/ Medicaid (IL)

• Juvenile Court (JC)

• Medical (MED)

• Refugee Resettlement Program (RR)

• Subsidized Adoption - Grant only (SA)

• Subsidized Adoption/Medical (SA/Med)

• Subsidized Guardianship (SG)

• Subsidized Guardianship/Medical (SG/Med)

• Social Services for Aged & Disabled (SSAD)

• Social Services for Children & Families (SSCF)

• Traumatic Brain Injury (TBI)

• Waiver: Adults with Disabilities (AD)

• Waiver: Adults with Developmental Disabilities (ADD)

• Waiver: Children with Developmental Disabilities (CDD)

• Waiver: Developmental Disabilities Case Management (DDCM)

• Waiver: Early Intervention (EI)

• Waiver: Katie Beckett Plan

N-FOCUS automates

benefit/service delivery and

case management for more

than 25 Health and Human

Services System programs

N-FOCUS functions include:

• Client/case intake

• Eligibility determination

• Case management

• Service authorization

• Benefit payments

• Claims processing and

payments

• Provider contract

management

• Management and

government reporting

• Interfaces with federal and

other state organizations

N-FOCUS Service Authorization

ClientInformation

AlertsNarrativeAssignmentsAgency Staff PersonOffice Position ManagementNotices

IntakeAllegations

Case RegistrationCase Person

Case ManagementEligibility/Benefit Calculation

Organization ManagementHome Studies

LicensingService CatalogService Approval

PaymentsClaims

OverpaymentsIssuance

ResourceInformation

PaymentInformation

N-FOCUS/CWIS and Interfaces

N-FOCUS/CWIS

MMIS(NE Medicaid Management

Information System)

BCBSBlue Cross Blue Shield

CHARTS(Children Have A

Right To Support - NE Child Support

System)

ManagedCareUIB

Unemployment Insurance Benefits file

NDNHNational Directory of New Hires

Nebraska New Hire

JUSTICEDistrict court automated system

FPLSFederal Parent Locator Service(SSA - Social Security Admini-

stration; EVS - Enumeration Verification System)

FIDMFinancial Institution Data Match

FCRFederal Case Registry

DMVDepartment of Motor Vehicles

Douglas County District Court

SEWState Employer Wage

SVESState Verification and Exchange

System

SDXState Data Exchange SSI

TOPFS Tax Offset Program

HCFAHealth Care Financing

Administration

IRSFor 1099 Information

IWDIRS Wage Data

TPLThird Party Liability

IUCUnemployment Compensation

BDEBendex - Social Security, Forty

Quarters, Prisoner Match

Policy Cabinet

N-FOCUS Business and Technical

Support Team

N-FOCUSUserGroup

N-FOCUS Steering

Committee

Project Direction

• The User Group provides

important feedback and

direction from the field

• The N-FOCUS business

and technical support team

interprets and implements

system functions and

technology

• The N-FOCUS Steering

Committee helps set future

direction for the project

• The Policy Cabinet

provides high-level

oversight

Closing Comments

• N-FOCUS was the first Nebraska state project to make use of the power

and flexibility allowed with client/server and expert systems technology

• The system gave public assistance staff needed communication (e-mail)

and word processing capabilities

• N-FOCUS interfaces to Federal and other State systems

• A wide range of reports are generated and distributed

• The project established a department-wide focus and allows case

management in a single system

• User involvement is emphasized to meet business needs

• Maintainability and reusability were key design elements

• N-FOCUS better positions Nebraska to add new programs and take

advantage of changes in technology