North Carolina is famous for its high-tech Research Triangle, but lately it seems that state government IT projects are bound for IT’s equivalent of the Bermuda Triangle.
As you may remember from an earlier Risk Factor story on state government IT project snafus, North Carolina rolled out two new major systems, one called NCFast and the other NCTracks. NCFast (North Carolina Families Accessing Services through Technology) is the N.C. Department of Health and Human Services (DHSS) computer system aimed at streamlining the work activities and business processes of the department and county social services agencies so that more time can be spent on helping those requiring public assistance and less on bureaucratic tasks. NCFast was “soft-launched” in mid-July (the system is not scheduled to be completely finished until 2017).
However, since the launch of NCFast, there have been ongoing issues with the US $48 million system that have caused many families on food-assistance to go without their benefits for months at a time. This has, unfortunately, given those families a new perspective of what the “fast” in NCFast means. Within six weeks of the system’s launch, almost 70 000—or nearly 9 percent—of North Carolina’s food-assistance recipients were not receiving their benefits. In response to political uproar created by the rapidly rising number of hungry families who were straining local food-banks, DHHS quickly placed the blame for the lack of benefits squarely on the county social services agencies, pointing specifically to what DHHS claimed was inadequate training on how to use the NCFast system. The county agencies fired back, accusing the state of rolling out a slow and bug-filled case management system that was prone to freezing up or crashing without warning.
About a week ago, it emerged that the county social service agencies had every right to blame the NCFast system for the growing backlog of food-assistance recipients. What's more, the state DHSS department knew NCFast was at fault, too, but decided to keep quiet about it. According to a report by Raleigh TV news station WRAL, while DHSS was publicly blaming the counties for not training their staff on how to use NCFast correctly, its own internal assessment of the situation was contradicting that assertion. The WRAL story states that the DHSS internal assessment showed “only a small minority of counties faced problems with training, staffing, and technical infrastructure.”
In addition, WRAL reports, DHSS eventually discovered what it called a “simple browser compatibility issue” in late August that turned out to be the root cause of many of NCFast’s operational issues. But that discovery was made only after several county agencies reported that NCFast seemed to work better when interfacing to the system with Google Chrome than with Internet Explorer, a fact that DHSS evidently did not investigate on its own.
Since the browser fix has been made, NCFast’s operations have markedly improved, but it has still taken months—along with the hiring of over a 150 temporary workers—to whittle down the backlog of the tens of thousands of families awaiting their food assistance benefit. However, reports of families not properly receiving food-assistance are still being made, albeit not to the magnitude experienced in August or into September. A story this week at the Times-News in Burlington, North Carolina, for instance, reports that the local county social services agency still says “it’s a daily struggle” working with NCFast.
The WRAL story indicates that, even now, North Carolina DHSS officials continue to point to a lack of user training at the county health services agencies rather than software problems in NCFast for initially creating the majority of the family food-assistance backlog. You might at first be surprised by the state’s health services department blatant attempt at shifting the blame away from itself in the face of contrary facts. But the fact that DHSS has an even bigger IT debacle than NCFast on its hands, makes it less surprising.
You see, at the beginning of July, the North Carolina’s DHSS also decided to launch its highly controversial $484 million NCTracks Medicaid claims processing and management system. The agency did this despite a May state audit [pdf] that cast doubt on whether the system—which was $200 million over budget and two years late—was ready to go live. The audit cited, among other issues, the lack of testing or independent verification and validation of key system elements, as well as unresolved privacy and security concerns. For instance, out of a scheduled 834 “critical” priority tests, the audit stated that 123 failed and 285 tests were not even performed.
The DHSS, however, insisted that there was nothing major to worry about, regardless of what the audit reported. The department conceded that there might be an “initial rough patch of 30 to 90 days as providers get used to using the new system,” but that there should be smooth sailing after that. Well, here it is nearly 180 days on, and NCTracks is still desperately trying to smooth out that “rough patch.”
Statistics from November, for example, indicated that NCTracks was still performing at a worse rate than the 25-year old system it had replaced. Furthermore, the Medicaid claims of many of the state’s 77 000 Medicaid providers were still not being paid promptly, or they were being rejected at a rate in some cases 4 times higher than in the past. This was causing financial hardship for countless health care providers, leading some to decide, reluctantly, to quit providing care to Medicaid recipients. The problems with NCTracks has, not unexpectedly, also generated a lot of political heat.
Adding to the political fire last week was the release of another state audit [pdf] showing that some 3200 defects with NCTracks were discovered since it went live in July, and that more than 600 defects were still to be fixed as of 5 November. DHSS recently admitted that most of those defects remain unfixed, but claimed that they don’t affect “most” Medicaid providers. The department wouldn’t, however, give an estimate of how many providers the defects did affect.
The state’s audit also reported that DHSS management still did not have a master plan to track problems or their corrections; DHSS has since promised one would be ready beginning January 2014.
Furthermore, the audit noted that 12 of the 14 critical changes mandated by the state legislature or by the Federal government were not in place by their specified dates. DHHS management promised that the 12 changes will be implemented by 1 March 2014, although one should view that promise with more than a few grains of salt.
Finally, the audit indicated that North Carolina’s financial analysts aren’t sure what the state is spending on Medicaid since NCTracks still can’t account for what the state still owes its 77 000 Medicaid providers.
However, since the day NCTracks has been rolled out and despite all its well-documented problems, DHSS management has continually pushed the optimistic message that “NCTracks is on track” since the system is able to pay at least some number of submitted claims. And like those in charge of NCFast, NCTracks management has continually downplayed NCTracks’ IT problems while—surprise, surprise—insisting that most of the issues being reported are caused by a lack of training at the state’s Medicaid providers. In fact, last week, even as the state audit report was detailing the multitude of problems in NCTracks that should have been addressed before the system was allowed to go live, the state's manager in charge of NCTracks computer systems development congratulated his staff on the “successful launch” of the system.
One would hate to see what an unsuccessful IT project launch looks like in North Carolina.
Well, luckily for us, according to another North Carolina state audit from earlier in the year, there are plenty of opportunities to find out because many, if not most, of the other 82 state IT projects are in questionable shape. Given, too, that the audit stated that “state agency managers are not required to manage IT projects so that the projects meet the initial cost or schedule estimates that are submitted to ITS [Office of Information Technology Services],” NCFast and NCTracks might have plenty company on their voyages into the IT Bermuda Triangle.