For the past twelve months the Western Governors’ Association (WGA) has been working with the General Services Administration (GSA), Hawaii WIC, the Department of Navy (DoN), the Department of Defense DOD), and the Defense Commissary Agency (DeCA) to scope out an interoperable benefits card pilot to test card performance (both for stored data chip and magnetic stripe applications) and network-based data sharing across multiple benefit delivery programs. It has been determined that due to conflicting activities at the proposed Hawaii pilot location, it is not feasible to conduct the pilot in Hawaii at this time. Consequently, WGA proposes an alternative concept for the HPP Phase 2 project.

Because of the current difficulties faced in implementing the project in Hawaii, it is suggested that the current venue for this project be moved from Hawaii to California. The California WIC program currently has a WIC clinic in operation at the Camp Pendleton base. Unlike other state WIC programs, California’s local WIC staff does not perform health exams or laboratory tests to obtain the medical data needed for WIC certification. Rather, California WIC relies on WIC participants to bring health-related data from their private providers to the WIC clinic. Currently, clients bring these results on a paper referral to be used in the WIC certification process. Delays often result between the WIC appointment and the availability of the participant’s health data. WGA proposes to use the HPP Phase 2 web-based Virtual Patient Account (VPA) to help alleviate this bottleneck and test the impact of the HPP VPA on streamlining the delivery of WIC benefits to participants in the Camp Pendleton area.

WGA proposes to provide a pilot in the geographic area of Camp Pendleton to issue Health Passport (HPP) cards to military dependents residing in the target pilot area. The HPP card would carry both the WIC Electronic Benefits Transfer (EBT) application and the Health Passport VPA application, and allow WIC participants that are military dependents to have their health referral data accessible to WIC via the web VPA and allow EBT transactions for the purchase of WIC foods at the Commissary. The pilot would operate within the base at Camp Pendleton with the objective of laying the foundation for rolling out the technological applications to the civilian and retail grocers’ arenas.

California WIC is interested in partnering with the Camp Pendleton Health Center and the Defense Commissary Agency to provide a WIC EBT Health Passport card to military dependents. When the Health Center at Camp Pendleton refers a patient to the WIC clinic at Camp Pendleton, the Health Center would set up a patient account on the secure WIC/HPP web site. This would require merely that the Health Center at Camp Pendleton have a PC and access to the Internet. The clinic data could be entered directly into the web-based virtual account, and could be printed out for the Health Center’s own paper records. The patient would then be referred to the WIC clinic. The Health Center staff could have the option to add, update, or review the medical data in the patient’s web-based virtual account when providing care, as aligned within the Health Insurance Portability and Accountability Act (HIPAA) guidelines. Providers would be issued HPP cards that contain digital certificates. The digital certificates would be used to authenticate the identity of the provider. The HPP VPA would first validate the digital certificate and then determine the provider’s level of access privileges. Use of the virtual patient account by the Camp Pendleton medical providers would be strictly voluntary.

After the WIC participant has been certified at the WIC clinic site and issued food benefits, the participant would redeem these food benefits at the base Commissary. The online model of WIC EBT benefits is of interest to test in this pilot unless it is found to be technically infeasible. An offline approach to WIC EBT will also be analyzed. The online EBT approach involves a download of the WIC participant’s food prescription from the California WIC’s automation system housed at the Health and Human Services Data Center (HHSDC) in Sacramento to the Commissary in San Diego. The offline WIC EBT approach uses the benefits card to directly hold the food prescription data. Regardless of the EBT method that proves most feasible for this pilot, the Commissary would participate in the WIC EBT transaction for military dependents on WIC.

For Health Center patients who are newly referred to the WIC program, WIC staff would access the necessary referral information that was entered by the Health Center staff through the HPP VPA web site.

When the participant is certified by the WIC clinic, a WIC EBT Health Passport card would be issued to the client. Currently, the food prescription for all WIC participants is stored in the Integrated Statewide Information System (ISIS), California WIC’s statewide online automation system. Programming within ISIS would be required to allow for the required food benefit data for the designated WIC participants to be accessible for the EBT pilot project. Both the online and offline EBT solutions would be analyzed for feasibility, with the interest in piloting the online solution, since the existing technological environment that is in operation in California WIC is the online ISIS environment to HHSDC in Sacramento. The Camp Pendleton WIC clinic would issue the WIC EBT HPP card to military dependents enrolled in WIC, teach participants how to use the card in the Commissary, and oversee the accurate food prescription benefits for the pilot participants throughout their WIC certification period.

It is the intent of WGA to incorporate in the planning and analysis of this project the applicability of the processes and the technologies that are tested out in this pilot to other civilian, retail, and state environments. The web-based Virtual Patient Account has potentiality to be accessed by other public and private health providers that interface with military and WIC-eligible populations. Other state health programs in California, such as Immunizations and Children’s Medical Services, in the future may have interest in the EBT technology for the communication and storage of health information that is possible with smart card technology. The retail grocers’ community has interest in the WIC EBT technology since this process streamlines the current paper check WIC transaction at the retail level and promotes friendlier customer service at the check-out lines. It is apparent with the successful implementation of this pilot project that much will be learned for direct applicability in several different environments that are of interest to not only WGA, but to other key federal and state stakeholders as well.

This first task would involve finalizing the specific programs to participate in the project. This task would involve meeting on Feb. 13/14 with the following potential partners:

Defense Commissary Agency (DeCA)

California WIC – State staff and staff from Local Agency in Camp Pendleton area

Camp Pendleton Health Center staff

Camp Pendleton Commissary staff

DoD WIC Overseas

These meetings would address each partner’s objectives, needs, concerns, and barriers. As a result of these meetings, the existing Concept of Operations would be revised, specific MOU wording would be proposed and all partners would agree upon the scope of the pilot. The specific partners would be selected.

Deliverables: Revised Concept of Operations, Signed MOUs from participating programs and paper for Technology Board.

Key Decision: Commitment of Program to Investigate Participation

This task would involve site visits to determine the specific requirements of each of the partners. These visits would include a survey of the available technical platform for the participant, as well as interviews/group sessions with program and technical staff. The existing technical platform for each of the partners would be examined and any upgrades required would be identified. As a result of these interviews, functional and technical requirements for each partner would be documented.

Deliverables: Requirements Document

Key Decision: Commitment of Programs to Proceed with Card Platform Design

This task would involve the translation of the requirements into a proposed design for the card platform, the HPP Virtual Patient Account application, and the WIC EBT application. Additionally, the PKI module will be designed, as will all required interfaces to relevant legacy systems (e.g., WIC’s ISIS System, Commissary EPS, Banking System, etc.). At this point the following functional and technical issues will be addressed:

Preference for online versus offline WIC EBT

Partner preference for interfacing to Virtual Patient Account of use of web-based HPP Application

Preference for adapting components from the existing Phase 1 HPP application versus building a new application from scratch

Approach for card issuance and maintenance

Approach to HPP virtual patient account

Approach to WIC EBT processing

Required interfaces to the HPP virtual patient account and WIC EBT applications

Card platform specifications

Card design

PKI specifications and module design

Selection of hardware platform

This phase will be a watershed, as the technical solutions will be finalized and participants will be required to commit to going ahead with the project as designed or dropping out at this point.

Deliverables: Card Specifications, Card Design, WIC EBT Application Design, Card Management Design, HPP Virtual Patient Account Design, Interface Control Documents, PKI Design, Operating Agreements that specify roles and responsibilities, Feasibility Study Report for state control agency approval, Advance Implementation Planning Document for USDA approval

Key Decision: Final Commitment to be Pilot Participant by updating signed MOU.

During this task the implementation planning will be finalized. This will include the planning for roll-out, readiness assessment visits, acquisition of equipment, planning for the HPP Virtual Patient Account and WIC EBT host(s), card procurement, and customer service/training planning. Testing plans will be developed.

Additionally, the partners will each design a new or revise their existing patient flow to utilize the new process and ensure that the integration across the partners is properly utilized.

Deliverables: Implementation Plan, Training Plan, Testing Plan

Key Decisions: Roll-Out Approach, Participant Staffing Needs

During this phase, components of the existing HPP application that will be incorporated into HPP Phase 2 will be ported to the open platform. New components of the HPP Phase 2 system will be developed and tested. Internal and acceptance testing will be planned and conducted during this phase.

Additionally, the legacy system interfaces and PKI components of this project will be developed and integrated during this phase. The PKI will be tested with the HPP Virtual Patient Account application. The legacy system interfaces to both the WIC EBT and HPP VPA applications will be tested.

Deliverables: WIC EBT application, HPP Virtual Patient Account, Card Management System, PKI Module, Test Scripts/Test Results

Key Decision: Agreement to Roll-Out Application

During this phase the tested applications would be installed at the partner sites. The program/retailer staff would be trained in the use of the applications. Customer training materials would be delivered. Customer services would be set up. Cards would be delivered to the sites. The WIC EBT Processing site and Virtual Patient Account hosts would be installed. The pilot operations would run for six months.

Deliverables: Training Conducted, Systems Installed, Customer Service Hotline Installed

Key Decision: Pilot operational evaluation, Pilot Expansion Decision

Page last updated 01/26/2001