Human Services Integration: Results of a GAO Cosponsored	 
Conference on Modernizing Information Systems (31-JAN-02,	 
GAO-02-121).							 
                                                                 
The Personal Responsibility and Work Opportunity Reconciliation  
Act of 1996 replaced the Aid to Families With Dependent Children 
program with a block grant to states that provide Temporary	 
Assistance for Needy Families (TANF). TANF strongly emphasizes	 
work and job replacement and sets a five-year lifetime limit on  
federally funded TANF assistance to adults. To meet information  
needs for welfare reform, information systems must be able to	 
share data across various programs, including TANF, Medicaid, job
training, child care, and vocational rehabilitation. However,	 
previous GAO studies found major gaps in states' information	 
systems. Most of the local TANF administrators in 15 states	 
surveyed by GAO reported that their current systems provide half 
or less of the information needed to manage individual cases,	 
plan appropriate services for the caseload, and monitor overall  
program performance. The administrators are missing information  
because some of the systems used do not share data on these	 
recipients, which constrains the ability of case managers to	 
arrange and monitor the delivery of services. Five states--New	 
Jersey, North Carolina, Oregon, Utah, and Wisconsin--are	 
modernizing their information systems to take advantage of recent
technological advances. These initiatives have expanded their	 
data-sharing capabilities to enhance program management and	 
service integration. Three key challenges confront systems	 
modernization: enhancing strategic collaboration among different 
levels of government, simplifying the cumbersome approval process
for obtaining federal funding for information systems, and	 
obtaining staff expertise in project management and information  
technology.							 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-02-121 					        
    ACCNO:   A02726						        
  TITLE:     Human Services Integration: Results of a GAO Cosponsored 
Conference on Modernizing Information Systems			 
     DATE:   01/31/2002 
  SUBJECT:   Computer matching					 
	     Federal/state relations				 
	     Information systems				 
	     Public assistance programs 			 
	     Strategic planning 				 
	     Systems conversions				 
	     Welfare benefits					 
	     Aid to Families with Dependent Children		 
	     Program						 
                                                                 
	     Food Stamp Program 				 
	     Medicaid Program					 
	     Temporary Assistance for Needy Families		 
	     Program						 
                                                                 

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GAO-02-121
     
United States General Accounting Office

GAO

Report to Congressional Committees

January 2002

HUMAN SERVICES INTEGRATION

Results of a GAO Cosponsored Conference on Modernizing Information Systems

GAO-02-121

Contents

Letter

Summary of Proceedings
Background
Systems Modernization Needed To Better Meet Information Needs

For Human Services Systems Modernization Efforts Are Underway in Several
States Challenges for Systems Modernization Pertain to

Intergovernmental Collaboration, Federal Funding Processes, and Project
Management Participants Proposed Various Actions To Facilitate Systems
Modernization

1

2 4

5 10

16 25

Appendix I Conference Agenda

Appendix II Conference Participants

Appendix III: GAO Contacts and Staff Acknowledgments 40

GAO Contacts 40 Staff Acknowledgments 40

Tables

Table 1: Issues Faced and Responses Taken by States in Developing and
Implementing Their Information Systems Projects 16

Table 2: Federal Funding for Human Services Information Systems by Program,
2002 20 Table 3: Potential Roles of Key Sectors in Facilitating Systems
Modernization 26 Table 4: Actions Proposed by Conference Participants to
Facilitate Systems Modernization 27

Abbreviations

AFDC Aid to Families With Dependent Children
APD advanced planning document
CARES Client Assistance for Re-employment and Economic

Support System GAO General Accounting Office HHS Department of Health and
Human Services HSITAG Human Services Information Technology Advisory Group
PKI Public Key Infrastructure PRWORA Personal Responsibility and Work
Opportunity

Reconciliation Act TANF Temporary Assistance for Needy Families WISDOM
Wisconsin Data for Operational Management

United States General Accounting Office Washington, DC 20548

January 31, 2002

Congressional Committees

Information systems play a central role in the management of human services
programs. Ideally, the systems provide information and tools used by case
managers to assess individual clients, refer them to needed services, and
track their progress. Likewise, information systems have the potential to
provide information used by program administrators to ascertain caseload
characteristics and service needs and determine the extent to which program
objectives are being achieved.

States face new information systems challenges as a consequence of the
sweeping changes brought about by welfare reform. The Personal
Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996
(P.L. 104-193) replaced the Aid to Families With Dependent Children (AFDC)
program with a block grant to states to provide Temporary Assistance for
Needy Families (TANF). TANF has a heightened emphasis on work and job
placement and establishes a 5-year lifetime limit on adults' receipt of
federally funded TANF assistance. To meet information needs for welfare
reform, information systems must be able to share data across the numerous
programs that are being used to help support families' movement to economic
independence, such as TANF, Medicaid, job training, child care, and
vocational rehabilitation. However, previous studies, including those by the
U.S. General Accounting Office (GAO), have identified major gaps in the
capabilities of states' information systems to meet such needs.

To assist congressional oversight and inform our work in the area of
information systems for human services, GAO and the Nelson A. Rockefeller
Institute of Government established a working group of experts from diverse
organizations in March 1998. The group met eight times over 3 years,
culminating in a conference held in Reston, Virginia, on June 28 and 29,
2001, that focused on the critical issues that states face in developing
information systems to support objectives such as integrated service
delivery and performance monitoring across human services programs.
Specifically, the conference examined (1) the capabilities of state
information systems to meet information needs for welfare reform, (2)
initiatives undertaken by states to improve their information systems, (3)
challenges to systems modernization, and (4) strategies to improve state
information systems and facilitate service integration. About 70

Summary of
Proceedings

participants attended the conference, including congressional staff;
federal, state, and local program and information technology managers;
welfare researchers; information system contractors; and representatives of
private, non-profit foundations. The conference featured a mix of paper
presentations and discussions and the development of ideas by participants
in small discussion groups. This report summarizes the conference
proceedings.

Conference presenters maintained that systems modernization is needed
because there are major gaps in the capabilities of states' information
systems to meet information needs for administering and overseeing welfare
reform. With its shift in emphasis from income maintenance to
self-sufficiency, welfare reform has a need for greater data sharing and
systems capability to support new partnerships among diverse service
providers and variations among local operations. However, the majority of
the local TANF administrators surveyed by GAO in 15 states reported that
their current systems provide half or less of the information needed to
manage individual cases, plan appropriate services for the caseload, and
monitor overall program performance. The administrators are missing
information, in part, because some of the systems used by agencies that
serve TANF recipients do not share data on these recipients, which
constrains the ability of case managers to arrange and monitor the delivery
of services. In addition, many states are using large, mainframe systems
that are old, which compounds the difficulty of meeting new information
needs because these systems are limited in their ability to take advantage
of recent innovations in technology. These innovations, such as
Internet-based technologies, offer significant opportunities for improving
the delivery of human services.

Presentations on the systems initiatives in five states-New Jersey, North
Carolina, Oregon, Utah, and Wisconsin-highlighted the approaches these
states are taking to modernize their information systems and benefit from
recent technological advances. While these initiatives are at various stages
and have a multitude of stated objectives, all have expanded their
data-sharing capabilities in order to enhance program management and service
integration-that is, the coordination of services for families and
individuals that are delivered by different programs and agencies in a
manner that appears seamless. To enhance service integration, the state
initiatives are making data from different programs available to case
managers and, in some cases, to program applicants using a single computer
screen. For example, New Jersey's One Ease-E Link initiative provides
hardware and software to counties so they can create county-

level networks comprised of a multitude of public and private service
providers, including nonprofit agencies. The Internet-based system enables
these providers to share recipient information using case management
software and assess applicants' program eligibility by using an
eligibility-screening tool. Three of the five states have also created large
databases, called "data warehouses," that combine data from various program
sources and support program management by generating customized management
reports on topics such as recipients' use of government services over time.

Conference participants identified and discussed at length three key
challenges for systems modernization: enhancing strategic collaboration
among different levels of government, simplifying the cumbersome approval
process for obtaining federal funding for information systems, and obtaining
staff expertise in project management and information technology. With
regard to intergovernmental collaboration, one of the presenters highlighted
the need to find ways to facilitate investments by local, state, and federal
governments together in information systems to achieve a citizen-centered
service delivery model. Other participants focused on the federal government
and highlighted what they viewed as an overemphasis on regulation and an
insufficient effort to help states and localities invest wisely in
technology and learn from best practices. With regard to funding, several
participants maintained that the overall process for obtaining approval for
federal funding-the advanced planning document process-can be slow,
burdensome, and inconsistent with the way modern systems are designed and
implemented. The participants also commented that the cost allocation
component of this process, which requires costs to be properly allocated to
the various programs that benefit from a project, sometimes delays project
implementation and that more guidance is needed on acceptable cost
allocation methodologies. Finally, several participants cited difficulties
that some states have experienced in obtaining sufficient staff expertise in
management of information technology projects and emphasized the importance
of using proven methods of project management in this specialized field to
increase the chances of project success.

Conference participants identified numerous strategies to improve state
information systems and facilitate service integration. By identifying broad
roles that each of the following sectors could play-the Congress, federal
agencies, states and localities, and information technology contractors-
they affirmed that diverse groups can contribute to making progress in this
area. For example, participants suggested that in addition to authorizing
funding for systems demonstration projects, the Congress could play a

Background

broad supportive role in helping to remove barriers and facilitate systems
modernization as it obtains further knowledge of technology trends and the
specific needs of human services systems. In addition, participants
developed more than 20 proposals for actions to facilitate systems
modernization. The majority of these proposals are intended to enhance
collaboration among different levels of government and simplify the approval
processes for obtaining federal funding. However, the list of proposals does
not represent a consensus of participants. Participants brought diverse
perspectives to the issues discussed at the conference and did not have time
to systematically assess the merits or relative priorities of the various
proposals. Nonetheless, the proposals represent a rich source of potentially
useful ideas for improving the development of information systems for human
services and thus merit further analysis and discussion.

The conference, whose theme was "Realizing the Promise of Technology:
Modernizing Information Systems for Human Services," was co-sponsored by
GAO, the Rockefeller Institute, the National Health Policy Forum, and The
Finance Project (Welfare Information Network). To promote an informed
dialogue at the conference, invitations were sent to selected individuals
from four key sectors involved in developing information systems for human
services-the Congress, federal agencies, state and local governments, and
information technology contractors-along with research organizations and
foundations. Appendix II lists the names and affiliations of conference
participants. State representatives included those with responsibility for
program management as well as those with expertise in information
technology. Participants from 14 organizations were asked to prepare papers
for presentation at one of three panels-The Need for Systems Modernization,
Possible Approaches for the Future, and State and Local Experiences.
Appendix I contains the conference objectives, agenda, and Web addresses for
each of the papers and briefing charts presented at the conference.
Following the panel presentations, participants were separated into small
groups on the first day to discuss the history, roles, and challenges of
various sectors in systems modernization, and on the second day to propose
actions that would best facilitate systems modernization. Assignments to
each discussion group were made to achieve a mix of participants from
diverse backgrounds.

Systems Modernization Needed To Better Meet Information Needs For Human
Services

Presenters at the conference maintained that state information systems need
to be modernized to better meet new information needs that have arisen from
shifts in the objectives and operations of states' welfare programs.
Research on states' systems has identified major gaps in their capabilities
to support the implementation and oversight of welfare reform. In addition,
many states are using large, mainframe systems that are old, which compounds
the difficulty of meeting new information needs because these systems are
limited in their ability to take advantages of recent innovations in
technology. Innovations, such as Internet technology, offer significant
opportunities for improving the delivery of human services.

Shifts in Welfare Program Objectives and Operations Place New Demands on
Information Systems

With the advent of welfare reform, states' programs for needy families with
children have experienced dramatic shifts in their objectives and
operations, which have created new demands on information systems, according
to GAO assistant director Andrew Sherrill and Rockefeller Institute director
Richard Nathan and senior fellow Mark Ragan.1 PRWORA placed a greater
emphasis on the importance of work and established various signals to
reinforce this emphasis, such as stronger work requirements and a 5-year
time limit on federal TANF assistance to families. The shift from an income
maintenance focus under the prior AFDC program to a service-oriented,
self-sufficiency focus under TANF has significant implications for
information systems. The technology challenge of welfare reform is to
provide the information needed to integrate services to clients and track
their progress towards self-sufficiency. To help needy families prepare for
and obtain work, case managers need detailed information about factors such
as family circumstances, job openings, and support services, which is very
different from the information needed to issue timely and accurate cash
assistance payments.

In many cases, states and localities have enhanced their efforts to partner
with other organizations to serve needy families, which creates demands for
sharing data across organizations. As welfare agencies focus on moving needy
families toward self-sufficiency, workers are drawing on other federal and
state programs, often administered by separate agencies,

1See web addresses in app. I to conference papers by Andrew Sherrill, "The
Capabilities of State Automated Systems to Meet Information Needs in the
Changing Landscape of Human Services," and by Richard Nathan and Mark Ragan,
"Federalism and the Challenges of Improving Information Systems for Human
Services."

to provide a wide array of services. While local welfare agencies typically
determine eligibility for TANF, food stamps, and Medicaid, other programs
that provide key services to TANF clients may be administered by separate
entities, such as housing authorities or education agencies. Most notably,
because TANF has focused welfare agencies on employment, a focus that has
long been the province of state and local workforce development systems,
welfare agencies need to work more closely than before with workforce
development systems. Finally, in many cases state and local welfare reforms
involve a greater effort to partner with community organizations, including
faith-based organizations, to meet the needs of low-income families.

Devolution is another factor that has contributed to the expansion of
information needs for human services. Under PRWORA, states have greater
flexibility in designing and operating their TANF programs and some states
in turn have devolved substantial authority to localities for their TANF
programs. As a result, state information systems will be called upon to
support a potentially more diverse range of local program goals and
operations. Moreover, providing automated support for localities is
typically an evolving process, since local information needs can change as
caseload composition changes, service strategies evolve, or new policy
issues emerge.

Current Information Systems Do Not Fully Support Information Needs for
Welfare Reform

Andrew Sherrill provided an overview of the research done by GAO, in
collaboration with the Rockefeller Institute, on the capabilities of states'
information systems. This research, he said, highlights the need for systems
modernization. In 1999, GAO surveyed state and local program administrators
in 15 states on the overall extent to which their current information
systems met different types of information needs for administering and
overseeing welfare reform.2 GAO focused on three broad types of information
needs: those for case management, service planning, and program oversight.
Agency workers need information for case management to perform the full
range of tasks involved in coordinating the various services provided to an
individual client, such as making referrals to training and monitoring a
client's progress towards

2The states were Arizona, Georgia, Kansas, Minnesota, Mississippi, Missouri,
New Jersey, New York, Ohio, Texas, Utah, Washington, West Virginia,
Wisconsin, and Wyoming. For further information about the methodology and
findings, see U.S. General Accounting Office, Welfare Reform: Improving
State Automated Systems Requires Coordinated Federal Effort, GAO/HEHS-00-48,
(Washington, D.C.: 2000).

employment. Service planning, which is performed by local and state program
administrators, requires aggregate information on the characteristics and
service needs of the caseload to determine the appropriate services that
should be made available for the caseload. Program oversight, which is
performed by program administrators and oversight officials, requires
aggregate information on relevant measures of program performance, such as
job entries and job retention. The majority of the local officials that GAO
surveyed reported that their current systems provided half or less of the
information needed for each of the three types of information needs.
Overall, state officials provided a somewhat higher assessment of system
capabilities but still acknowledged major gaps in some cases.

Andrew Sherrill explained that GAO's in-depth fieldwork at the state and
local level in six states provided more detail about information system
shortcomings. A major shortcoming, cited to varying degrees by officials in
these states, is that some of the systems used by the agencies providing
services to TANF recipients do not share data on these recipients, thus
hampering a case manager's ability to arrange and monitor the delivery of
services in a timely manner. For example, local officials in New Jersey told
GAO that data are not transferred electronically between the labor
department, which tracks attendance of TANF recipients at work activities,
and the welfare department, which imposes sanctions on TANF recipients who
fail to meet work requirements. Consequently, in some cases, TANF recipients
have received sanctions in error because the welfare department's system
could not obtain the needed data in a timely manner from the labor
department's system to verify a recipient's participation in work
activities. Another consequence of the lack of data sharing in the states
GAO studied is that agency workers have had to input data for some items
more than once because the data were not automatically transferred and
updated from one system to another. Multiple entries of the same data not
only reduces the time available for work directly with clients but also
increases the risk of introducing errors into the data contained in
information systems.

The extent to which states have established links among information systems
for human services varies substantially. In the 15 states that GAO surveyed,
the systems that support TANF eligibility determination are, in almost all
cases, linked with the information systems for food stamps, child support
enforcement, TANF work activities, Medicaid eligibility determination, and
transportation subsidies. These links reflect federal mandates and enhanced
federal funding for systems in these programs. In contrast, GAO found that
information systems for other services that

TANF recipients may need to facilitate their movement toward employment,
such as job training, welfare-to-work grant services, vocational
rehabilitation, job listings, and subsidized housing were generally not
linked to systems for determining TANF eligibility. Some state officials and
others attending the conference commented that changed rules governing
interactions between welfare and Medicaid have also presented new demands
for the modification of information systems. Under these rules, TANF
recipients, unlike AFDC recipients, are not automatically eligible for
Medicaid. Not only has more work been required to demonstrate the
eligibility of TANF families for these programs, but more work has also been
required to modify systems so that closures of TANF cases do not generate
automatic closures of Medicaid cases, as has happened in some situations.

A second shortcoming of some information systems, which was voiced
especially at the local level, was the limited ability to obtain data needed
by program managers to meet their particular management challenges. For
example, local officials at one site told GAO that data on the
characteristics of TANF recipients in the state's information system are
often not available in a format that can be easily manipulated, so obtaining
data depends on the technical expertise of the user. Overall, local
officials cited a need for user friendly tools that provide the capability
to generate a locally designed management report. In his comments on the
presentation by Andrew Sherrill, Thomas Gais, director of the federalism
research group at the Rockefeller Institute, said that the gaps in systems
capabilities identified by GAO represent persistent problems that were also
identified in earlier fieldwork by Rockefeller Institute researchers and in
their follow-up fieldwork in 2000.3

Age of Many States' Systems Compounds Difficulty of Meeting New Information
Demands

The results of a survey by the U.S. Department of Health and Human Services
(HHS) cited in GAO's presentation indicate that many states have been using
old information systems. Of the states responding, 26 percent said that the
systems they were using when TANF was enacted in 1996 had first become
operational in the 1970s and 40 percent said that their

3For an overview of the earlier work, see the section on information systems
in Richard P. Nathan and Thomas L. Gais, Implementing the Personal
Responsibility Act of 1996: A First Look (Albany, NY: The Nelson A.
Rockefeller Institute of Government, 1999).

systems had become operational in the 1980s.4 Many of these older systems
are housed in large mainframe computers. The HHS report goes on to point out
that generally accepted information technology standards assume that the
average useful life of a large-scale computer system ranges from 5 to 7
years. Moreover, the report maintains that the age of states' systems has
limited their ability to take advantage of technological improvements
because the underlying equipment and software platforms of these systems do
not lend themselves easily, if at all, to technological advances because of
basic incompatibilities. A conference participant commented that New York's
large mainframe system has not been modernized because it would be costly
and time-consuming. Instead, the state operates a dual system, relying
primarily on its mainframe, but with a separate system developed to meet new
data reporting requirements. Conference presenters from New Jersey, North
Carolina, Oregon, Utah, and Wisconsin noted that their states continue to
use older mainframe systems to varying degrees, using upgrades and
interfaces where possible, although they are developing new systems to
enhance their capabilities.

The continued presence of these older mainframe computers reflects the
historical role of the federal government in funding the development of such
systems in the 1970s and 1980s, according to some conference participants.
The major objectives of these systems were to increase the accuracy of
eligibility determinations and cash payments, reduce error rates, and detect
and deter fraud and abuse in major entitlement programs. While costs for
systems development and operation were shared by the federal government and
states, the federal government provided enhanced funding (i.e., more than 50
percent) in many cases. For example, states could receive federal matching
funds for 90 percent of their development costs for approved welfare,
Medicaid, child support, and certain child care systems. States could also
receive federal matching funds of 75 percent for developing statewide food
stamps systems, and in the early 1990s, for developing child welfare
systems. In the mid-1990s, the federal government eliminated enhanced
federal matching payments for all

4U.S. Department of Health and Human Services, Administration for Children
and Families, Office of State Systems, Report to Congress on Data Processing
and Case Tracking in the Temporary Assistance for Needy Families Program
(Washington, D.C.: HHS, Dec. 1997).

systems except child support and Medicaid management information systems for
claims processing.5

Information system contractors from the Human Services Information
Technology Advisory Group (HSITAG) described various innovations in
technology that they said offer significant opportunities for improving the
delivery of human services.6 Today's personal computers can process more
data at lower costs, making it possible to automate even small service
providers in the local community. Systems can be secured from outsiders
using firewall technologies, and confidential information that is
transferred among agencies can be encrypted, further increasing security.
Telecommunications networks are more widely available, providing greater
opportunities for data sharing among different programs that serve the same
populations. The Internet and World Wide Web provide opportunities to link
program applicants, recipients, case managers, and administrators to each
other and to a wealth of information needed to achieve various objectives.
Graphical user interfaces allow icons or pictures to be used as well as
words, so it is easier to access and navigate systems from the computer
screen, and the data accessible can be expanded to include photographs,
sound clips, and movies that can facilitate program orientation, assessment,
and training. Coding by location and mapping represent new capabilities
available to program planners to target services to families and
neighborhoods. Other technological advances make it possible to store and
retrieve large volumes of data with greater efficiency at less cost than was
possible a decade or more earlier to facilitate meeting reporting
requirements and providing information for program oversight.

Presenters from North Carolina, Oregon, New Jersey, Utah, and Wisconsin
described initiatives that their states had undertaken to modernize
information systems for human services. The initiatives-designed to meet the
unique needs of each state-are in varying stages of implementation and
generally share some common goals, such as enhancing service integration.
The states faced a broad range of issues in developing and

Systems Modernization Efforts Are Underway in Several States

5For historical background on federal financial participation rates, see
U.S. General Accounting Office, Automated Welfare Systems: Historical Costs
and Projections GAO/AIMD-94-52FS, (Washington, D.C.: 1994).

6See app. I for web address for the paper by HSITAG, "Innovations in
Technology and Project Management Practices That Can Improve Human
Services."

implementing their  initiatives, which  reflect the complexity  and scale of
information systems projects.

States' Initiatives Seek to Enhance Service Integration and Program
Management Through Expanded Data Sharing

While the states' initiatives have a multitude of stated objectives, their
central goals generally include providing enhanced automated support for
service integration and program management. Gary Weeks, director of human
services reform at the Annie E. Casey Foundation, discussed his experiences
in promoting service integration as the former director of the Oregon
Department of Human Resources.7 He said that many program recipients fail
because they are among the least prepared to deal with the maze of human
services bureaucracy and case management plans-in some cases multiple plans
for a single recipient. His strategy in Oregon was to create a system in
which each recipient had a single case management plan, based on an initial,
comprehensive assessment and coordinated by a lead case manager who was
supported by information systems that were linked. Creating such a system,
he added, did not require cutting edge technology but rather getting
agreement from all the right people on the recipient data that was most
important, securing access to critical databases, and authorizing case
managers to work with individualized recipient data. Richard Nathan and Mark
Ragan of the Rockefeller Institute echoed this point in their presentation,
arguing that service integration has been a longstanding aim of program
officials, but that the real politics of human services-characterized by
bureaucracies with their own cultures and politics-have made this difficult.
They went on to say that information technology can allow human service
providers to overcome the politics of program proliferation not necessarily
through "one-stops"-co-locating staff from different programs at one-stop
centers-but through "one-screen," that is, making data from different
programs available to a caseworker on a single computer screen.8

With respect to the objective of improving automated support for program
management, three of the states have developed or plan to develop large data
warehouses or smaller data marts, that is, specialized databases that

7Gary Weeks, Integrating Human Services (Albany, New York: The Nelson A.
Rockefeller Institute of Government, 2001), available at
http://www.rockinst.org/publications/pubs_and_reports.html.

8GAO has reviewed the effects of variations in financial eligibility rules
on administrative processes and low-income families' access to federal
programs. See U.S. General Accounting Office, Means-Tested Programs:
Determining Financial Eligibility Is Cumbersome and Can Be Simplified
GAO-02-58, (Washington, D.C.: 2001).

store information from multiple sources in a consistent format, usually for
a specific subject area, and are separate from the databases used for daily
business operations. Using data warehouses or marts, program administrators
can generate customized management reports on request without slowing
routine business transactions, including reports that track recipients' use
of government services over time and respond to varied requests for
information from state legislatures, federal agencies, and research
organizations.

While the information systems initiatives of the five states share similar
broad goals, they vary in terms of stages of development, with North
Carolina in the planning phase, Oregon in the pilot phase, and New Jersey,
Utah, and Wisconsin fully operational. What follows is an overview of some
of the distinctive aspects of each state's initiative.

* Bill Cox, director of information resource management at the state's
Department of Health and Human Services, described North Carolina's
comprehensive planning effort, the Business Process Re-Engineering Project.9
Recognizing that its current mainframe information systems are

at the end of their life cycle, the state developed a model of a
reengineered business process for human services to prepare for the
development of a single, comprehensive statewide information system. This
system would support a wide array of programs, including TANF, Medicaid,
children's health insurance program, food stamps, child care, child support,
child welfare services, and adult services for families. The reengineered
business process is intended to resolve a host of deficiencies with the
current process, such as excessive paper-based processes, little access to
"real-time" data, and minimal communications among agencies and partners. As
part of the reengineering initiative, a contractor working with a team of
state and county officials for 3 months examined current business processes
and concluded that a minimal amount of time is actually spent assisting
applicants and recipients while the majority of time is spent on
administrative tasks. On the basis of the team's recommendations, the state
began implementing its initiative in June 2001, including the development of
a data warehouse.

* Gary Weeks of the Anne E. Casey Foundation outlined Oregon's pilot
initiative that uses information technology to support integrated service

9See  web address in app.  I for paper by  Bill Cox, "Reengineering Business
Processes to Integrate the Delivery of Human Services in North Carolina."

provision at Family Resource Centers in 4 of the state's 36 counties.
Workers from various agencies have been co-located at these centers, where
families and individuals receive an initial comprehensive needs assessment,
a single case management plan is developed with a lead case manager, and
data on the family are available to agencies located at the center. To
provide this shared data, the centers use a software tool called MetaFrame,
which provides access on a caseworker's computer screen to the separate
databases for TANF, child welfare, and mental health and substance abuse
systems. Caseworkers can obtain information from these databases on
eligibility, services received, and case narrative notes in some cases, and
thereby build their own comprehensive file on a client. Gary Weeks noted
that the software tool's capabilities are fairly rudimentary because they do
not provide a single integrated database, but the tool provides caseworkers
access to information in a fairly low-tech and relatively inexpensive
manner. To overcome data confidentiality issues, applicants are asked to
sign a release form at the time of their assessment that authorizes the
sharing of their case file data for program purposes, and about 96 percent
of applicants sign this form.10

* William Kowalski, director of the One Ease-E Link project at the New
Jersey Department of Human Services, explained that a key aim of the
initiative was to employ information technology to support the building of
new cooperative relationships among the diverse providers of human services
in New Jersey and thereby enhance service integration.11 The initiative
seeks to accomplish this by providing hardware and software to counties so
they can create county-level networks comprised of a multitude of public and
private organizations, including nonprofits such as United Way
organizations. Each county network is part of the larger One Ease-E Link
network that includes a website with an eligibility screening tool, case
management software, secure e-mail, discussion forums, document libraries,
and resource directories. This network is also linked to a single database
shared with three state agencies: the Departments of Human Services, Labor,
and Health and Senior Services. The sharing of information is secured behind
a firewall and protected by Public Key

10For information on some of the legal restrictions that can limit the
ability of federal programs to effectively share information with one
another, see U. S. General Accounting Office, Benefit and Loan Programs:
Improved Data Sharing Could Enhance Program Integrity GAO/HEHS-00-119,
(Washington, D.C.: 2000).

11See web address in app. I for William G. Kowalski, "One EASE E-Link: New
Jersey's Pursuit to Establish an Electronic, Multi-Tooled Network for the
Delivery of Coordinated Social, Health and Employment Services."

Infrastructure (PKI) technology that uses digital signatures and encrypts

data.12 Counties that join One-Ease-E Link maintain their networks through
fees they collect from member service providers. One Ease-E Link has been
implemented by 17 of New Jersey's 21 counties and more than 900 local
service providers have become part of the network.

* Russell Smith, deputy director of information technology at the Utah
Department of Workforce Services, described Utah's development of the UWORKS
One-Stop Operating System.13 In 1996, the state created the Department of
Workforce Services, which combined 25 programs from 5 different departments
with the goal of merging job training, job development, and welfare-related
services such as TANF, food stamps, and child care into a single efficient
system. The new department inherited various computer systems that had
supported each of the programs and recognized that it needed an integrated
case management system that supported all of its programs. The One-Stop
Operating System was developed to fill this need at nearly 50 one-stop
employment centers throughout the state. The system uses Internet technology
and has linkages with databases for program eligibility, job listings, job
training, labor market information, and unemployment insurance. Job seekers
can access services on their own by using a web browser or obtain help from
state staff at the one-stop centers that offer multiple services under a
single roof. To expand information for program management, the state has
developed a data warehouse that can generate reports in response to on-line
queries.

* Paul Saeman, acting director of the workforce information bureau in
Wisconsin's Department of Workforce Development, explained how his state's
extensive information system has evolved in response to changes in program
objectives and organization.14 The system serves two state

departments that have split responsibility for human services programs.

12For a description of PKI and a discussion of issues involved in its
adoption by the federal government, see U.S. General Accounting Office,
Information Security: Advances and Remaining Challenges to Adoption of
Public Key Infrastructure Technology GAO-01-277, (Washington, D.C.: 2001).

13See web address in app. I for Russell Smith, "Utah's Development of a
One-Stop Operating System."

14See web address in app. I for Paul Saeman, "Wisconsin State System
Initiatives for Eligibility and Work Based Programs."

His department is consolidating TANF and child care with other employment
programs, while the Department of Health and Family Services is expanding
benefit entitlement programs like Medicaid and food stamps. To support
integrated case management and eligibility determination across these
departments and programs, the state has built 22 subsystems that comprise
the Client Assistance for Re-employment and Economic Support System (CARES).
Teams of workers at one-stop job centers use the Case Manager's Desktop
Reference system to access CARES data and monitor participant eligibility
and services received in 6 or more programs. A plan for sharing the CARES
system and developing it in the future was established by the two
departments after many months of negotiation. While CARES supports day to
day program operations, it also feeds information into a series of small
data marts and a larger data warehouse, called the Wisconsin Data for
Operational Management (WISDOM), that are used for planning and reporting
purposes. With the help of WISDOM, knowledgeable state and local users
expect to be able to create hundreds of different reports in almost endless
combinations for programs such as TANF, child care, and food stamps. In
addition, CARES data compiled over time on families served by TANF and other
programs is being inventoried, documented, and stored as part of the
Wisconsin Program and Administrative Data and used for research and
evaluation by state staff and the Institute for Research on Poverty at the
University of Wisconsin.

States Confronted a Broad Range of Issues in Developing and Implementing
Their Initiatives

The information systems initiatives of these states are complex and
large-scale undertakings, and states faced a broad range of issues in
developing and implementing their initiatives. Table 1 summarizes some of
the issues most commonly reported by the state presenters and provides
examples of responses taken to these issues. For example, these issues
include obtaining support for the initiative, training system users,
maximizing the useful life of the system, and managing the project
effectively. These issues are not unique to the human services but are the
general types of issues that arise in large-scale information systems
projects.

    Table 1: Issues Faced and Responses Taken by States in Developing and
              Implementing Their Information Systems Projects

Examples of state agency responses Issues (States indicated in parentheses)

Obtaining support for the project from state's leadership

Present project plans to governor and cabinet in computer slide show (NJ) or
to state executive steering committee (NC) for approval.

Obtaining support for the project from agency staff who will use the system

Include state and local representatives in collaborative planning process
(NJ, NC, OR). Focus first on fixing problems that case managers identify as
the most annoying or time consuming (WI).

Providing adequate training to staff who will use the system

Provide documentation on system so staff can continue to learn on their own
after they
have received training (WI).
Develop skills of selected agency users who will assist their peers and
facilitate cultural
change in agency (NJ, OR).

Obtaining adequate funding for development and operations of state and local
information systems

Provide  state start-up funds;  then collect  user fees from  local provider
agencies (NJ).  Launch pilot projects in  localities to demonstrate value of
the systems (NJ, OR).

Maximizing the system's compatibility with other systems and capability to
support future upgrades Follow industry or state standards governing the
design and deployment of technology investments (NJ, NC, and UT).

Employ Internet  technology with a Web browser  as the user interface rather
than  client  server  technology  with  Windows  or Macintosh  as  the  user
interface (UT).

Minimizing the risk that conversion to the new system will result in the
loss of functions or data

Maintain existing system, resulting in dual systems, during conversion (NJ).
 Pilot the project on a test basis and make adjustments as needed (NJ, OR).

Overseeing  contractors' performance  to  Test applications  yourself rather
than relying on contractor's demonstrations (UT).

maximize  cost effectiveness  of systems  Specify expectations  for funding,
ownership, maintenance, and modifications in the development contract (UT).

Ensuring adequate state management of Hire the best available project
managers and hold them accountable for performance
the project that can survive personnel (UT).
changes Provide clear authority, vision, and sufficient resources to the
project team (OR).

Minimizing adverse effects of competition Emphasize need to serve the same
families to stimulate collaboration rather than
among state agencies for information competition (NJ).

systems resources Place authority to prioritize demands about resources with
a neutral third party (WI).

Challenges for Systems Modernization Pertain to Intergovernmental
Collaboration, Federal Funding Processes, and Project Management

Source: Papers presented at conference by state officials as shown in app.
I.

Conference participants identified and discussed at length three key
challenges for systems modernization: enhancing strategic collaboration
among different levels of government, simplifying the cumbersome approval
process for obtaining federal funding for information systems, and obtaining
staff expertise in project management and information technology. These
challenges were identified in the small group sessions and elaborated in
greater depth in several of the conference papers.

Enhancing Strategic Collaboration Among Federal, State, and Local
Governments

A key challenge to modernization and integration identified by conference
participants is that of achieving greater strategic collaboration across
programs and agencies and among levels of government. This challenge was
articulated in the presentation by Sandra Vargas, Administrator of Hennepin
County, Minnesota, and Costis Toregas, president of Public Technology
Incorporated, who provided a local perspective on information technology
issues.15 Vargas and Toregas reminded other participants of the importance
of including localities when states and federal agencies develop plans for
human service programs and information systems. In their view, the guiding
vision in this area should be that of "local, state, and federal governments
investing and executing together around a citizen-oriented service delivery
model that produces measurable results" and they see technology as the tool
to execute the vision. However, they maintained that what is still missing
is a framework for achieving this vision that is truly collaborative. They
added that greater collaboration could promote such outcomes as information
technology investments that build on one another and work being performed by
the level of government best able to accomplish the task.

Richard Nathan and Mark Ragan of the Rockefeller Institute echoed the need
for more intergovernmental collaboration in their presentation. They
maintained that many of the recommendations that have been made in the last
decade to facilitate systems improvements have expressed a common theme-that
federal agencies should improve and integrate their policies and procedures.
However, in their view, it is not reasonable to expect all solutions to come
from the federal government or that federal changes will necessarily and
quickly result in better state and local information systems. They
maintained that federal, state, and local governments, as well as technology
contractors, all have a role to play in systems modernization for human
services and that improvements are needed in the interactions of these
partners. Nathan and Ragan proposed that an institute for the management of
human services information systems be created that would, among other
objectives, convene federal, state, and

15See web address in app. I for briefing charts by Sandra Vargas and Costis
Toregas, "The Need to Align Federal, State, and Local Technology
Investments: A Local Perspective." Public Technology Incorporated is a
nonprofit national organization dedicated to furthering the use of
technology in cities and counties for both elected officials and
professional managers.

local officials across program areas to discuss ways to remove barriers to
system development.16

Some conference participants commented that the federal government could
play a greater collaborative role in facilitating systems modernization.
They explained that in the 1970s and 1980s, the Congress and federal
agencies had taken the lead in encouraging states to invest in technology to
improve services to needy families. But, they added that they currently see
little coordinated federal effort to help states and localities invest
wisely in technology, learn from the best practices as well as the mistakes
of others, and tailor information systems to meet local needs. Instead, they
are left with the impression that federal agencies primarily regulate rather
than facilitate systems development for human services, and do so in a
narrow context, prescribing details rather than providing broader strategic
guidance.

Another area cited in which the federal government could play an improved
collaborative role pertains to the enactment of legislation that has
implications for state systems. Some conference participants commented that
in certain instances, federal legislation is enacted that does not
anticipate adequately the time and cost required to develop or modify state
information systems. For example, several conference participants noted that
legislative deadlines for systems implementation often follow a "one size
fits all" approach that places all states in competition for a limited
number of private contractors and fails to accommodate differences in state
capabilities. Another participant said that states do not receive sufficient
federal funding for the costs of providing benefits to needy families
through electronic benefit transfers. Several participants also cited the
extensive efforts required of diverse state agencies to re-examine the
privacy and security of their automated data as a result of the passage of
the Health Insurance Portability and Accountability Act of 1996 (P.L.
104-191).

16As described in their paper, other roles of such an institute would
include developing and training state and local system project managers,
showcasing and sharing information about good practices, and facilitating
innovative systems designs at the state and local levels. See "Federalism
and the Challenges of Improving Information Systems for Human Services."

Simplifying Cumbersome Approval Process for Obtaining Federal Funding

Obtaining approval for federal funding of state information systems
development and operations can be a slow and burdensome process that delays
project implementation, according to various participants at the conference.
Participants cited problems with both the overall approval process for
obtaining funding-the advanced planning document (APD) process-and the cost
allocation component of this process. As shown in table 2, states must
submit required documents under the APD process and receive federal approval
from the relevant federal agency to obtain federal funding for systems
development for Medicaid, food stamps, child welfare and child support
enforcement.17 An APD is not required if TANF funds only are used for a
project, because TANF is a block grant. As part of the APD process, states
submit specific documents, including planning, contracting, and purchasing
documents, which cover needs, objectives, requirements analysis,
alternatives analysis, project management plan, cost benefit analysis,
proposed budget, and any proposed cost allocation. If federal agencies do
not respond within 60 days, approval is automatic. If federal agencies
request further state documentation or clarification, the 60-day clock
starts over when the state's additional documentation is received, so the
actual approval process may take longer. An updated APD is required annually
or more frequently if significant changes are involved.

17Prior written approval under the APD process is required for combined
state-federal expenditures of $5 million or more for systems acquired
through an open competitive process; $1 million or more for systems acquired
through a sole source process; and any amount for systems acquired with
federal funds under the enhanced match, according to 45 C.F.R. Sec. 95.611.

 Table 2: Federal Funding for Human Services Information Systems by Program,
                                    2002

Federal /state funding percentage for information systems

Rules for funding systems

Program Federal agency

Nature of funding

TANF Administration for Children and Families, HHS

                Block grants No state match requireda No APD

Medicaid -eligibility

-claims processing Centers for Medicare and Medicaid Services, HHS

Entitlement 50/50 - system development 50/50 - system operations

90/10 - system development 75/25 - system operations

                                    APD

Child care Administration for Children and Families, HHS

                Block grants No state match required No APD

Child support Administration for  Entitlement 66/34 - system development APD
enforcement Children and Families, 66/34 - system operations

HHS

Food stamps  Food and Nutrition  Entitlement          50/50 - system
                                                        development

            Service, Agriculture                      50/50 - system
                                                         operations

                                 Entitlement          50/50 - system
                                                        development
                                                      50/50 - system
                                                         operations

                                    APD

Child welfare Administration for Children and Families, HHS

                                    APD

Employment  and  Employment  and  Formula No  state  match  required No  APD
training Training Administration, grants

Labor

aWhere no state match is required, there may be limits on the amount of
federal funds that can be spent for administration. However, information
systems under TANF are not subject to the 15-percent limit on administrative
expenditures.

Source: Richard Nathan and Mark Ragan, Nelson A. Rockefeller Institute of
Government, "Federalism and the Challenges of Improving Information Systems
for Human Services."

The current APD process fails to address the fundamental shift that has
occurred in information systems practices over the past 20 years, according
to Jerry Friedman, former executive deputy commissioner at the Texas
Department of Human Services, and John Cuddy, chief information officer at
Oregon's Department of Human Resources.18 In their view, the APD process,
designed to mitigate financial risks and avoid incompatibilities among
systems, was appropriate when states typically worked for 3 to 5 years to
develop mainframe systems that were implemented with a "big bang." Since
then, states have generally shifted from investments in mainframes to
smaller systems that are developed and

18See web address in app. I for paper by Jerry Friedman and John Cuddy,
"Reengineering the Approach by Which the Federal Government Approves and
Monitors the Creation of State Human Services Information Systems." Jerry
Friedman is now the executive director of the American Public Human Services
Association.

implemented incrementally through a series of small, quick projects.
Friedman and Cuddy explained that in the time it takes to obtain federal
funding approval under the APD, states' plans may be obsolete, given the
current fast pace of technological advances. They also noted that the APD
process was intended for systems in which the design and development stage
was distinct from the implementation and operations stage. They maintained
that these distinctions no longer fit state practices, which are iterative,
with one stage overlapping or running concurrently with another and lessons
learned from one project's implementation altering the planning of another.
Friedman and Cuddy concluded that the APD process is not working to the
satisfaction of anyone and that it is time to reengineer the process.
William Kowalski echoed their views, commenting that New Jersey experienced
lengthy delays and altered its plans for the development of a data warehouse
because of difficulties obtaining approval for federal funding under the APD
process.

Rick Friedman of the Centers for Medicare and Medicaid (CMS, formerly the
Health Care Financing Administration) agreed that the APD documentation
appears daunting, but noted that similar documentation is often required for
approval within states. To the extent that the federal requirements are
already addressed in the states' own internal approval processes, Rick
Friedman said that the federal agencies would be willing to review the
documentation previously developed to satisfy the state procurement offices.
If there are additional federal requirements, however, these would still
have to be addressed. In an effort to expedite the APD approval process, his
agency developed a streamlined APD format for use by states interested in
receiving federal financial support for Medicaid-related activities under
the Health Insurance Portability and Accountability Act. The new format
re-packaged existing requirements in a way that simplified the entire
process. He added that North Carolina used this format in making its request
and found it to be considerably easier and more efficient.19

Within the APD process, conference participants identified cost allocation
as a component that may delay federal funding approval and impede

19Another HHS official added that under the APD process, states gain certain
advantages from prior approval of federal funding, such as the ability to
"lock in" the federal shares as borrowers might "lock in " interest rates,
relief from some cash flow problems, and reduced risk that costs will be
disallowed and thus not reimbursed by the federal agencies.

service integration.20 State information systems that support more than one
federal program must have a cost allocation plan approved by the federal
agencies that provide funding. To receive federal approval, the cost
allocation plan must be complete and provide sufficient detail to
demonstrate that the costs are allowable and fairly allocated among the
various federal and state programs that benefit from the project, including
TANF (if applicable). Within the plan, different methodologies are used to
justify the costs for specific objectives, such as eligibility
determination. The allocation of costs that must accompany the APD for
systems development is usually based on different methodologies than the
allocation of costs for systems operations. Federal agencies have not issued
guidance on specific methodologies. The cost allocation plans for systems
development must be approved by each federal agency expected to provide
funding, while the plans for systems operations must be approved by HHS, the
lead federal agency.21

Cost allocation has received more attention from state human services
officials under welfare reform because TANF is now subject to rules
governing cost allocation that did not apply to AFDC.22 AFDC was exempted
from Office of Management and Budget cost allocation rules based on HHS'
interpretation of the legislative history. Under the exemption, AFDC could
be considered the primary program for common costs, such as entering data on
applicants' income and assets, and could cover costs that otherwise would
have been allocated to various programs like Medicaid or food stamps. The
same is not true under TANF. TANF funds may be used to pay for shared
systems only to the extent that the TANF program benefits from the systems,
so they cannot cover common costs, but only a proportion of these costs in
shared systems. As part of

20The Congress has asked GAO to review the APD and cost allocation
requirements for information systems development for child support
enforcement, child welfare, Medicaid, and the food stamp programs.

21The cost allocation plan for systems development is reviewed by each of
the federal agencies that will finance the effort, and within HHS, by the
various program divisions and the State System's Policy Division of the
Administration for Children and Families. The plan for systems operations is
reviewed by HHS's Division of Cost Allocation as outlined in Office of
Management and Budget (OMB) Circular A-87.

22Cost allocation requirements are based on appropriations law at 31 U.S.C.
1301 (a) and further explained in OMB Circular A-87 and "A Guide for State,
Local, and Indian Tribal Governments: Cost Principles and Procedures for
Developing Cost Allocation Plans and Indirect Cost Rates for Agreements with
the Federal Government," available at
http://www.whitehouse.gov/omb/circulars/a087/a087-all.html and
http://www.hhs.gov/grantsnet/state/index.htm.

the transition from AFDC to TANF, HHS requested that states submit new
public assistance cost allocation plans that would take effect July 1999 for
most states.

Some conference participants cited a need for more guidance or flexibility
on acceptable cost allocation methodologies. In his presentation on the
development of Utah's UWORKS project, Russell Smith said that obtaining
approval for the cost allocation plan took considerably more time and effort
than originally estimated. Utah State officials spent 6 months negotiating
an acceptable cost allocation plan with federal officials for the project,
which used funds from Labor's One Stop grants, TANF funds, and food stamp
employment and training funds. Bill Cox identified inflexible cost
allocation methodologies as a problem in his presentation on North
Carolina's Business Process Reengineering Project. He said that while
project costs are commonly allocated based on the size of program caseloads,
the state did not think it was appropriate to use this basis for its
reengineering project. He explained that while the state's TANF caseload has
decreased in recent years, the size of the caseload does not accurately
represent the amount of time that caseworkers actually spend on TANF cases.
The state proposed using a cost allocation methodology based on the amount
of time caseworkers spent on different programs and projects. However, while
the CMS and the Food and Nutrition Service had no comments on this change in
methods, the Administration for Children and Families did have reservations
and indicated that the preferred method is caseloads, according to Cox. Cox
also maintained that more guidance is needed with respect to appropriate
cost allocation methodologies in complex projects with multiple phases.23

Obtaining Staff Expertise in Project Management and Information Technology

In their presentation, Software Productivity Consortium president Werner
Schaer and State Information Technology Consortium president Bob Glasser
highlighted project management as a key challenge for systems
modernization.24 They explained that in their extensive consulting work on a
wide range of state information systems projects, the major problems they
observed have involved issues other than technology. The primary

23For example, Cox raised the issue of how costs should be allocated in a
project in which the first phase of development may benefit only a
particular program, whereas the second phase benefits several programs.

24See web address in app. I for paper by Werner Schaer and Robert Glasser,
"Lessons Learned Helping Organizations Make Smart Information Technology
Decisions."

causes of these problems are a lack of wide-ranging management experience
with information technology, a lack of management experience with large and
complex systems, and insufficient user participation in project processes.
They added that most firms that are dependent on software development for
their core business have learned significant lessons about how to manage the
development and deployment of large, complex software systems. Yet in their
view, the states, as a general rule, are very early on this learning curve
and could benefit from the lessons that the industry has learned.
Information technology contractor representatives from HSITAG echoed these
themes in their presentation. For example, they explained that HSITAG
members have encountered situations in which states have chosen proven
program managers but failed to provide training to help them become
successful managers of information technology projects. HSITAG presenters
emphasized that as systems projects grow to span multiple programs and
increase in complexity, it is important to use proven methods for promoting
regular communication among project stakeholders, predicting system impacts,
and defining and achieving results. Georgia chief information officer Larry
Singer commented that the project management challenges faced by states are
similar to those described in GAO testimony on the information system
challenges facing the federal government.25

Some states have found it difficult to attract and retain staff with the
necessary expertise in information technology because these specialists
command high salaries and technology is changing so rapidly.26 For example,
due to government salary limits, it is hard to compete for database analysts
who can earn $150 to $200 an hour in the private sector, according to
Russell Smith. Private contractors also may face staffing problems, lacking
the expertise required for specific work they have agreed to undertake or
reassigning experienced staff to other work before projects are completed.

25See U.S. General Accounting Office, Electronic Government: Federal
Initiatives Are Evolving Rapidly But They Face Significant Challenges
GAO/T-AIMD/GGD-00-179, (Washington, D.C.: 2000) and Electronic Government:
Challenges Must Be Addressed With Effective Leadership And Management
GAO-01-959T, (Washington, D.C.: 2001).

26GAO's prior work reported that states have encountered long-standing
problems in recruiting and retaining information technology staff. See
GAO/HEHS-00-48.

Participants Proposed Various Actions To Facilitate Systems Modernization

Conference participants identified numerous strategies to improve state
information systems and facilitate service integration. By identifying broad
roles that each of the following sectors could play-the Congress, federal
agencies, states and localities, and information technology contractors-
they affirmed that diverse groups can contribute to making progress in this
area. In addition, participants developed more detailed proposals of actions
that could be taken to address challenges for systems modernization and
facilitate service integration. The majority of these proposals pertain to
the challenges of enhancing collaboration among different levels of
government and simplifying approval processes for obtaining federal funding.

Different Sectors Can Play Roles in Systems Modernization

Table 3 summarizes conference participants' suggestions about the roles that
different sectors could play in facilitating systems modernization and some
of the challenges associated with fulfilling these roles. For example, in
addition to authorizing funding for systems demonstration projects, the
Congress could play a broad supportive role in helping remove barriers and
promoting systems modernization as it obtains additional knowledge of
information systems trends and needs. A key challenge in fulfilling these
roles is how organizations should target their efforts to better inform the
Congress of needs and trends in this area. Beyond their roles as regulators,
federal agencies could help states work together to develop information
systems and share their models with other states. State and local
governments, which are on the front lines of system design and operation,
could facilitate progress by developing model information systems and
testing innovative system linkages. Information technology contractors could
use their unique perspectives and expertise to play a range of educational
roles, such as helping states and localities improve their management of
information systems projects.

Table 3: Potential Roles of Key Sectors in Facilitating Systems
Modernization

 Sector Potential roles in facilitating systems modernization Challenges in
                           fulfilling these roles

Congress Providing greater overall support by obtaining additional knowledge
of information systems trends and needs, and the implications of federal
legislation with respect to the need to modify information systems.

Authorizing greater flexibility in the allocation of costs for information
system projects.

Authorizing funds for information system demonstration projects.

How to stimulate and maintain congressional interest in this technical area
that will bridge turnover in congressional leadership and staff.

How external organizations should target their efforts to better inform the
Congress.

Federal agencies Facilitating states working together in developing
effective information systems and sharing their models with other states.

Allowing states greater flexibility in developing
information systems.
Developing certification processes for state information
systems.

How to provide or contract for technical assistance to states, given limited
federal resources in this area.

State and local governments

Developing model, client-centered information systems.

Testing  innovative service  delivery and  information system  links through
demonstration projects.

How to disseminate information about these model
systems to other states and localities.
How to also meet other objectives, such as federal
reporting requirements, while focusing on meeting
client needs.

How to maintain a base of expertise in information
technology that can sustain projects through
turnovers of agency staff and leadership.

Information technology contractors

Educating human service organizations about how information technology can
help solve their problems. Contributing to improving state and local
management of information systems projects. Serving as independent advisors
to states and helping provide an overall vision for meeting their
information systems needs.

Serving as a third-party messenger to help obtain the support of state
legislators or executive leadership for information systems projects.

How to overcome concerns about using public funds for information systems
rather than program purposes.

How information technology contractors, which are a community of
competitors, can work together for the common good.

How to overcome cultural differences between the private and public sectors
so they can work together more effectively.

How to avoid unrealistic expectations by clients about the development and
capabilities of information systems.

        Source: Small-group discussions of conference participants.

                           Conference Participants
                          Offered Varied Proposals

Conference participants, working in small discussion groups, proposed
numerous actions to address systems modernization and facilitate
improvements in state information systems for human services. These
proposals are summarized in table 4. The proposals vary in their scope and
specificity, and also whether or not they would require legislative or
regulatory changes to be implemented. Some of the proposals are described
more fully in papers presented at the conference. However, the list of
proposals does not represent a consensus of participants. Participants
brought diverse perspectives to the issues examined at the

conference and did not have time to discuss each proposal in detail or
systematically assess the merits or relative priorities of the various
proposals. Nonetheless, this list of proposals represents a rich source of
potentially useful ideas for improving the development of information
systems for human services and thus merits further analysis and discussion.

 Table 4: Actions Proposed by Conference Participants to Facilitate Systems
                               Modernization

Enhancing strategic collaboration among federal, state, and local
governments

*  In  light  of  upcoming reauthorizations  for  several  programs, hold  a
congressional  hearing  on   integrated  information  technology  for  human
services.

* Focus attention of the Congressional Internet Caucus Advisory Committee on
information technology needs in human services

*  Inform federal and state political leaders  about the positive impacts of
information   technology  for   the  health   and  human   services    
*  Create an  institute  for the  management of  human  services information
systems.

* Establish federally funded  demonstration projects for information systems
that seek to integrate state and local human services

* Shift  the federal role in  information systems management from  that of a
regulator to a facilitator

* Harmonize outcome measures across federal agencies toward common goals

* Develop  measures of success  for systems development that  are related to
serving customers and could be used for various systems

*  Stagger  federal  deadlines  for  the implementation  of  required  state
information systems  so not all  states and their contractors  face the same
deadline

* Require  that federal  laws and regulations include  a statement assessing
their impact on costs for state information systems in line with Title II of
the Unfunded Mandates Reform Act of 1995.

Simplifying the cumbersome approval process for obtaining federal funding

* In the short term, provide relief from APD requirements within current
laws and regulations

*  Replace  the  APD  process  with  a  process wherein  states'  plans  for
information systems become components of their broader program plans

b

* Replace  the APD  process with a  process that relies  on certification of
state  capacity  to  manage information  systems,  whereby  states that  are
certified receive less federal oversight and more flexibility.c

d

* Use a principled negotiation process to create a replacement for the APD
process.

* Create a federal block grant for human services information systems.

* Develop a new approach to cost allocation.

Obtaining staff expertise in project management and information technology

* Develop a set of best practices for the procurement of information
technology contractors.

* Allow states to use state procurement rules in states that are certified.

* Develop a project management curriculum and certification process for
health and human services professionals.

                               Miscellaneous

* Promote investment in Internet infrastructure.

* Develop and disseminate a repository of best practices of the use of
technology in the health and human services.

* Design information systems with a focus on service delivery and let data
and outcomes be a necessary byproduct.

e

* Eliminate the prohibition on the use of federal funds for proprietary
applications software developed for human services programs.

aFor more information on this law, see U.S. General Accounting Office,
Unfunded Mandates: Reform Act Has Had Little Effect on Agencies' Rulemaking
Actions GAO/GGD-98-30, (Washington, D.C.: 1998).

bCarnegie Mellon University's Software Engineering Institute has developed
several capability maturity models for assessing an agency's information
technology strengths and weaknesses and developing plans for improvement.
For more information on such models and an example of their application, see
U.S. General Accounting Office, Air Traffic Control: Immature Software
Acquisition Processes Increase FAA System Acquisition Risks, GAO/AIMD-97-47,
(Washington, D.C.: 1997).

cThis proposal is elaborated in the conference paper by Jerry Friedman and
John Cuddy. See web address in app. I.

dAs outlined in the conference paper by Friedman and Cuddy, principled
negotiation is a process in which the relevant parties identify their
underlying interests and work together to generate options that satisfy
their interests.

eSee 45 CFR Sec. 95.617 (a), (b), and (c) requiring that state or local
governments have ownership rights to software, modifications, and associated
documentation developed with federal funds. However, proprietary
operating/vendor software packages that are provided at established catalog
or market prices and sold or leased to the general public are not subject to
these public ownership requirements. Federal funds are not available for
proprietary applications software developed specifically for the public
assistance programs covered under this subpart. A federal official at the
conference explained that the prohibition is designed to prevent duplicate
federal funding for software development.

Source: Small-group discussions of conference participants. Proposals may
not represent the views of all or most participants in these groups.

Many of the proposals pertain to enhancing strategic collaboration among
different levels of government and these proposals present various
approaches to this objective. For example, several proposals focus on
informing federal or state political leaders about, and involving them in,
issues related to systems modernization, such as by holding a congressional
hearing on integrated information technology for human services. Other
proposals would create a forum for intergovernmental collaboration by
creating an institute for the management of human services information
systems or establishing federally funded systems demonstration projects to
integrate state and local services. Other proposals are intended to minimize
the occurrence of perceived adverse effects on state information systems
resulting from federal legislation.

The proposals related to improving the federal funding process also
encompass a wide range of approaches, ranging from making incremental
changes to the APD process to creating a federal block grant for human
service information systems. Several proposals call for replacing the APD
process-in one case with a process in which states' information systems
plans would be reviewed as a component of their overall program plans and in
another with a process based on states' certified capacity to manage
information systems. Another proposal suggests a negotiating procedure that
could be used to develop an acceptable replacement for the APD process.

There is an effort underway to implement changes to address one of the broad
challenges identified by conference participants: simplifying the

approval process for obtaining federal funding. Partly in response to a
recommendation in GAO's April 2000 report on information systems, a
federal interagency group has been established and is focusing its
attention on the APD process.27 Rick Friedman of the CMS, who chairs the
group, gave conference participants a status report on the work of the
group. He said that the interagency group includes representatives from
five HHS offices and the U.S. Department of Agriculture's' Food and
Nutrition Service. The group has met several times to examine the APD
process, has consulted with state officials, and has formulated some
recommended changes, but the proposed changes have not been approved
by the respective federal agencies.

We are sending copies of this report to appropriate congressional
committees; the Secretary of Health and Human Services; the Secretary of
Agriculture; the Secretary of Labor; and other interested parties. We will
also make copies available to others on request. If you or your staff have
any questions concerning this report, please call me at (202) 512- 7215.
Other GAO contacts and staff acknowledgments for this report are listed
in appendix III.

Sigurd Nilsen
Director, Education, Workforce and

Income Security Issues

27GAO recommended that a federal interagency group be established to
identify, and develop implementation plans for, federal actions that would
facilitate states' efforts to improve their information systems for federal
programs that serve low-income families. The report said that the group
should consider actions in several areas, such as disseminating information
on best practices for managing information technology; reviewing, and
modifying as needed, the APD process; and facilitating links among the
automated systems used by different state and local agencies through such
means as supporting demonstration projects and coordinating data reporting
requirements for different programs. See GAO/HEHS-00-48.

List of Recipients

The Honorable Tom Harkin, Chairman
The Honorable Richard G. Lugar, Ranking Minority Member
Committee on Agriculture, Nutrition, and Forestry
United States Senate

The Honorable Max Baucus, Chairman
The Honorable Chuck Grassley, Ranking Minority Member
Committee on Finance
United States Senate

The Honorable Joseph I. Lieberman, Chairman
The Honorable Fred Thompson, Ranking Minority Member
Committee on Governmental Affairs
United States Senate

The Honorable Edward M. Kennedy, Chairman
The Honorable Judd Gregg, Ranking Minority Member,
Committee on Health, Education, Labor, and Pensions
United States Senate

The Honorable Larry Combest, Chairman
The Honorable Charles Stenholm, Ranking Member
Committee on Agriculture
House of Representatives

The Honorable John A. Boehner, Chairman
The Honorable George Miller, Ranking Member
Committee on Education and the Workforce
House of Representatives

The Honorable W. J. "Billy" Tauzin, Chairman
The Honorable John D. Dingell, Ranking Member
Committee on Energy and Commerce
House of Representatives

The Honorable Dan Burton, Chairman
The Honorable Henry A. Waxman, Ranking Member
Committee on Government Reform
House of Representatives

The Honorable Bill Thomas, Chairman
The Honorable Charles B. Rangel, Ranking Member
Committee on Ways and Means
House of Representatives

The Honorable Patrick Leahy, Co-Chair
The Honorable Conrad Burns, Co-Chair
The Honorable Robert Goodlatte, Co-Chair
The Honorable Rick Boucher, Co-Chair
U.S. Congressional Internet Caucus

                        Appendix I: Conference Agenda

Realizing The Promise Of Technology: A Conference On Modernizing Information
Systems For Human Services

                Sponsored by: U.S. General Accounting Office
              The Nelson A. Rockefeller Institute of Government
                        National Health Policy Forum
              Welfare Information Network (The Finance Project)
                  June 28 and 29, 2001 in Reston, Virginia

                           CONFERENCE OBJECTIVES

With its heightened emphasis on employment and time-limited assistance,
welfare reform significantly expanded the information needed to support
activities ranging from integrated service delivery by front-line
caseworkers to program performance monitoring by administrators and
oversight agencies. To meet such needs, automated systems must be able to
share data across the numerous programs that serve low-income families, such
as Temporary Assistance for Needy Families, Medicaid, child care, job
training, vocational rehabilitation, and child welfare. For three years,
members of the GAO / Rockefeller Institute Working Seminar on Social Program
Information Systems have met regularly to study system capabilities,
obstacles to modernization, and strategies to facilitate progress. In April
2000, GAO issued a report that identified major gaps in the capabilities of
state automated systems to meet information needs for welfare reform.

This conference will build on prior work by providing diverse perspectives
on key issues and options. To help develop a literature in this area, the
presenters at this conference will write papers that we plan to publish,
along with an overview of conference proceedings. Attendance will be by
invitation only, and conference participants will include congressional
staff, federal and state program and information technology managers,
welfare researchers, information technology vendors, and others. A key
objective will be to tap this collective expertise by having participants
take part in breakout sessions each day. Participants will consider
proposals for actions that could be taken in four key sectors to facilitate
systems modernization: the Congress, federal agencies, states and
localities, and information technology vendors. We will then determine the
level of consensus for these proposals. By documenting current knowledge and
highlighting collaboratively developed proposals-an action agenda-the report
issued from this conference should provide the Congress, Administration, and
states and localities with timely suggestions pertinent to the
reauthorization of welfare.

Appendix I: Conference Agenda

                                   AGENDA

JUNE 28 
8:00-9:00 CONTINENTAL BREAKFAST

9:00-9:10 WELCOME AND CONFERENCE OVERVIEW Cynthia Fagnoni, General
Accounting Office (GAO), and Richard Nathan, Rockefeller Institute of
Government

9:10-10:00 THE NEED FOR SYSTEMS MODERNIZATION Chair: Barbara Blum, Research
Forum on Children, Families, and the New Federalism

The Capabilities of State Automated Systems to Meet

Information Needs in the Changing Landscape of Human

Services

Andrew Sherrill, GAO

http://www.gao.gov/special.pubs/GAO-02-121/ap1.pdf

Briefing charts: http://www.gao.gov/special.pubs/GAO-02ï¿½

121/ap2.pdf

The Need to Align Federal, State, and Local Technology

Investments: A Local Perspective

Sandra Vargas, County Administrator, Hennepin County,

Minnesota, and Cost is Toregas, Public Technology

Incorporated

http://www.gao.gov/special.pubs/GAO-02-121/ap3.pdf

Reactor: Thomas Gais, Rockefeller Institute of Government

10:00-10:10 Break

10:10-12:00 POSSIBLE APPROACHES FOR THE FUTURE Chair: Judith Moore, National
Health Policy Forum

Re-engineering the Approach by Which the Federal Government Approves and
Monitors the Creation of State Human Services Information Systems

Jerry Friedman, Texas Department of Human Services, and

John Cuddy, Oregon Department of Human Resources

http://www.gao.gov/special.pubs/GAO-02-121/ap4.pdf

Appendix I: Conference Agenda

Briefing charts: http://www.gao.gov/special.pubs/GAO-02ï¿½121/ap5.pdf

Federalism and the Challenges of Improving Information Systems For Human
Services

Richard Nathan and Mark Ragan, Rockefeller Institute of Government
http://www.gao.gov/special.pubs/GAO-02-121/ap6.pdf Briefing charts:

Innovations in Technology and Project Management Practices That Can Improve
Human Services

Representatives from the Human Services Information Technology Advisory
Group

http://www.gao.gov/special.pubs/GAO-02-121/ap8.pdf Briefing charts:
http://www.gao.gov/special.pubs/GAO-02ï¿½121/ap9.pdf

Lessons Learned Helping Organizations Make Smart Information Technology
Decisions

Werner Schaer, Software Productivity Consortium, and Robert Glasser, State
Information Technology Consortium

http://www.gao.gov/special.pubs/GAO-02-121/ap10.pdf Briefing charts:
http://www.gao.gov/special.pubs/GAO-02ï¿½121/ap11.pdf

Reactors: Joseph Leo, Science Applications International Corporation, and
Bruce Eanet, Employment and Training Administration, U.S. Department of
Labor

12:00-1:30 LUNCH

The Oregon Experience and Looking to the Future

Gary Weeks, Director of Human Services Reform, Annie E. Casey Foundation
(former director of the Oregon Department of Human Resources)

http://www.rockinst.org/publications/pubs_and_reports.ht ml

1:30-3:00 BREAKOUT SESSIONS

Appendix I: Conference Agenda

Participants are divided into the following groups to
discuss the historical involvement, role, and special
challenges of that sector in facilitating systems
modernization.

Group 1: The Congress
Moderator/Reporter: Elaine Ryan, American Public Human
Services Association, and Gregory Benson, Rockefeller
Institute of Government

Group 2: Federal Agencies
Moderator/Reporter: Rick Friedman, Centers for Medicare
and Medicaid Services, and Richard Roper, The Roper
Group, New Jersey

Group 3: States and Localities
Moderator/Reporter: Lorrie Tritch, Iowa Department of
Human Services, and Michael Rich, Emory University

Group 4: Information Technology Vendors Moderator/Reporter: Vicki Grant,
Supporting Families After Welfare, and Robert Stauffer, Deloitte & Touche
Consulting Group

3:00-3:15 Break

3:15-5:00 PLENARY SESSION: REPORTS FROM BREAKOUT GROUPS AND DISCUSSION OF
THEIR IDEAS

Discussion Leader: Barry Van Lare, Welfare Information Network

5:15-6:30 RECEPTION

6:30 DINNER

Appendix I: Conference Agenda

JUNE 29 
8:00-9:00 CONTINENTAL BREAKFAST

9:00-10:35 STATE AND LOCAL EXPERIENCES Chair: Sigurd Nilsen, GAO

Wisconsin's System Initiatives for Eligibility and Work-
Based Programs

Paul Saeman, Wisconsin Department of Workforce
Development http://www.gao.gov/special.pubs/GAO-02ï¿½
121/ap12.pdf
Briefing charts: http://www.gao.gov/special.pubs/GAO-02ï¿½
121/ap13.pdf
http://www.gao.gov/special.pubs/GAO-02-121/ap14.pdf
http://www.gao.gov/special.pubs/GAO-02-121/ap15.pdf

One Ease E-Link: New Jersey's Pursuit to Establish an
Electronic, Multi-Tooled Network for the Delivery of
Coordinated Social, Health And Employment Services

William Kowalski, New Jersey Department of Human Services

http://www.gao.gov/special.pubs/GAO-02-121/ap16.pdf Briefing charts:
http://www.gao.gov/special.pubs/GAO-02ï¿½121/ap17.pdf

Utah's Development of a One-Stop Operating System Russell Smith, Utah
Department of Workforce Services

http://www.gao.gov/special.pubs/GAO-02-121/ap18.pdf Briefing charts:
http://www.gao.gov/special.pubs/GAO-02ï¿½121/ap19.pdf

Reengineering Business Processes to Integrate the Delivery of Human Services
in North Carolina

Bill Cox, North Carolina Department of Health and Human Services

http://www.gao.gov/special.pubs/GAO-02-121/ap20.pdf Briefing charts:
http://www.gao.gov/special.pubs/GAO-02ï¿½121/ap21.pdf

Reactor: Rachel Block, Centers for Medicare and Medicaid Services

Appendix I: Conference Agenda

10:35-10:45 BREAK

10:45-12:00 BREAKOUT SESSIONS

Participants are divided into the same four groups in which
they participated the previous day. Building on their
previous discussions, they develop proposals for actions
that could be taken to facilitate systems modernization.
However, participants are not limited to any particular
sector (e.g., federal agencies) in developing their proposals.

Group 1
Moderator/Recorder: Sheri Steisel, National Conference of
State Legislatures, and Jono Hildner, Hildner and
Associates

Group 2
Moderator/Reporter: Jan Lilja, Food and Nutrition Service,
U.S. Department of Agriculture, and Eileen Sweeney,
Center on Budget and Policy Priorities

Group 3
Moderator/Reporter: Evelyn Ganzglass, National
Governors' Association, and Costis Toregas, Public
Technology Incorporated

Group 4
Moderator/Reporter: Catherine Born, University of
Maryland School of Social Work, and Mark Ragan,
Rockefeller Institute of Government

12:00-1:00 LUNCH

1:00-2:30 PLENARY SESSION: REPORTS FROM BREAKOUT GROUPS AND DISCUSSION OF
THEIR PROPOSALS

                  Discussion Leader: Cynthia Fagnoni, GAO

2:30 ADJOURN

                    Appendix II: Conference Participants

Brenda Aguilar, Office of Information and Regulatory Affairs, U.S. Office of
Management and Budget

Robin Arnold-Williams, Executive Director, Utah Department of Human Services

Gregory  M.  Benson,  Jr.,  Executive Director,  New  York  State Forum  for
Information Resource Management,  Rockefeller Institute, State University of
New York

Rachel  Block, Deputy  Director, Center  for Medicaid and  State Operations,
U.S. Centers for Medicare and Medicaid Services

Barbara Blum, Director, Research Forum on Children, Families, and the New
Federalism
National Center for Children in Poverty, Columbia University
Catherine E. Born, Research Associate Professor, University of Maryland
School of Social Work

Constance Brines, National Industry Director, Social Services, Oracle
Service Industries (HSITAG)

  Bart Broz, Executive Assistant, Office of Management Information Systems,
                     Texas Department of Human Services

Elizabeth Caplick, Intern, Education, Workforce, and Income Security Issues,
U.S. General Accounting Office

Jeremy  Cox,  Senior  Analyst,  Education, Workforce,  and  Income  Security
Issues, U.S. General Accounting Office

Bill Cox, Director, Division of Information Resource Management,
North Carolina Department of Health and Human Services
John Cuddy, Chief Information Officer, Oregon Department of Human Resources

Colleen Daly, Director of Office of State Systems, U.S. Department of Health
and Human Services

Randolph Desonia, Senior Research Associate, National Health Policy Forum

James T. Dimas, Senior Associate, Annie E. Casey Foundation

Marc Dreilinger, Director of MIS Planning, New York State Office of
Temporary & Disability Assistance

Martin Dunning, Operations Manager, State and Local Government, Sun
Microsystems, Inc. (HSITAG)

Bruce Eanet, Administrator for Technology and Information Services,
Employment and Training Administration,
U.S. Department of Labor
Patricia Elston, Senior Analyst, Education, Workforce, and Income Security
Issues, U.S. General Accounting Office

   Cynthia M. Fagnoni, Managing Director, Education, Workforce, and Income
              Security Issues, U.S. General Accounting Office

Gene Falk, Specialist in Social Legislation, Congressional Research Service,
The Library of Congress

Jerry Friedman, Executive Director, American Public Human Services
Association

Rick Friedman, Director, Division of State Systems, U.S. Centers for
Medicare and Medicaid Services

Thomas Gais, Director, Federalism Research Group, Rockefeller Institute,
State University of New York

Evelyn Ganzglass, Director, Employment and Social Services Policy Studies,
National Governors' Association Center on Best Practices
Robert Glasser, President, State Information Technology Consortium

Melinda Gish, Analyst in Social Legislation, Congressional Research Service,
The Library of Congress

Vicki Grant, Deputy Director, Supporting Families After Welfare

Gale Harris, Assistant Director, Education, Workforce, and Income Security
Issues, U.S. General Accounting Office

Norman Heyl, Senior Information Systems Analyst, Information Technology,
U.S. General Accounting Office

Jono Hildner, President, Hildner and Associates

Sean Hurley, Director, Data Collection and Analysis Division, Administration
for Children and Families-OPRE
U.S. Department of Health and Human Services
Judy Miller Jones, Director, National Health Policy Forum

April Kaplan, Program Manager, Welfare Information Network, The Finance
Project

Rachel Kelly, Analyst in Social Legislation, Congressional Research Service,
The Library of Congress

William G. Kowalski, Director, One Ease-E Link, New Jersey Department of
Human Services

Linda Lambert, Assistant Director, Information Technology, U.S. General
Accounting Office

                    Appendix II: Conference Participants

Brenda Aguilar, Office of Information and Regulatory Affairs, U.S. Office of
Management and Budget Erin Lee, Program Director for Information Technology,
National Governors' Association

    Joseph J. Leo, Vice President, Civilian Government Programs, Science
 Applications International Corporation Susan Lerman, Senior Principal, AMS
 (HSITAG) Janice G. Lilja, Acting Deputy Administrator for Management, Food
     and Nutrition Service, U.S. Department of Agriculture Judith Moore,
     Co-Director, National Health Policy Forum Richard Nathan, Director,
     Rockefeller Institute of Government, State University of New York

Zoe Neuberger, Policy Analyst, Center on Budget and Policy Priorities

 Sigurd Nilsen, Director, Education, Workforce, and Income Security Issues,
                       U.S. General Accounting Office

Lee Posey, Policy Specialist, National Conference of State Legislatures

  Mark Ragan, Senior Fellow, Rockefeller Institute, State University of New
               York Michael Rich, Professor, Emory University

                 Richard Roper, President, The Roper Group

Elaine Ryan, Director of Governmental Affairs, American Public Human
Services Association

    Paul Saeman, Acting Director, Workforce Information Bureau, Wisconsin
                    Department of Workforce Development

Sandra C. Salter, Manager of Information Systems Unit, Delaware Department
of Health and Social Services

Werner Schaer, President and CEO, Software Productivity Consortium

    Suzanne Scherr, Industry Solutions Executive, Electronic Data Systems
                                  (HSITAG)

Melissa Seeley, Intern, U.S. Office of Management and Budget

Andrew Sherrill, Assistant Director, Education, Workforce, and Income
Security Issues , U.S. General Accounting Office

Bard Shollenberger, Director of Government Relations, Children and Family
Services, Lockheed-Martin/IMS

Larry Singer, Chief Information Officer, State of Georgia

Russell Smith, Deputy Director, Workforce Information Technology, Utah
Department of Workforce Services

Reuben Snipper, Statistician/Policy Analyst, Office of Assistant Secretary
for Planning and Evaluation,
U.S. Department of Health and Human Services
Robert Stauffer, Deloitte Consulting (HSITAG)

Shay Stautz, Staff Director, National Association of State Chief Information
Officers

Rae Ann Steinly, Information Systems Specialist, American Public Human
Services Association

Sheri Steisel, Senior Director, Human Services Committee, National
Conference of State Legislatures

Eileen Sweeney, Director of State Low-Income Initiatives Project, Center on
Budget and Policy Priorities

Costis Toregas, President, Public Technology Incorporated

Lorrie Tritch, Deputy Director for Administration, Iowa Department of Human
Services

Barry Van Lare, Executive Director, Welfare Information Network

Sandra Vargas, County Administrator, Hennepin County, Minnesota

Gary Weeks, Director of Human Services Reform, Annie E. Casey Foundation

Matt Weidinger, Staff Director, Ways and Means Subcommittee on Human
Resources
U.S. House of Representatives

Appendix III:GAO Contacts and Staff Acknowledgments

GAO  Contacts Andrew  Sherrill, (202)  512-7252, [email protected]  Patricia
Elston (202) 512-3016, [email protected]

Staff Elizabeth Caplick  also helped arrange the conference that resulted in
this report.

Acknowledgments

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