Next-Generation Aging Services Information System

The Vendor is required to provide system integrators, and other interested parties regarding modernized, integrated information systems capable of supporting the full continuum of aging services operations across the Commonwealth.
- The current technology solution landscape and available vendor capabilities in order to inform the agency’s procurement strategy for a next-generation system to replace and significantly expand upon its current Senior Information Management System (SIMS).
- Sufficient information to determine the most effective procurement approach—whether that involves a single comprehensive platform, a system integrator working with the existing environment, a multi-system approach, or another model.
- The envisioned solution must support the agency’s core operational functions, including but not limited to: Information & Referral (I&R); clinical, financial, and transitional assessments and eligibility determination; case management and care planning; service authorization, delivery, and tracking; provider contracting and management; billing, claims processing, and reimbursement; quality assurance and provider auditing; federal and state reporting.
- The system tracks approximately 100,000+ consumers annually, manages care planning, service authorizations, service deliveries, invoicing, and reimbursement for numerous home and community-based services, supports clinical assessment and eligibility determinations, and supports federal reporting obligations under the Act and Medicaid waiver programs.
- Options Counseling: Person-centered counseling to help consumers and families understand and navigate available long-term services and supports; currently tracked through a combination of call records, journal entries, and activities/referrals rather than a dedicated workflow on a time-limited, short-term basis
- Information & Referral (I&R): Call records (caller, consumer, consumer groups), call history tracking, referral type classification (including agency), internal task assignment and routing (e.g., from I&R to Home Care), topic and outcome logging, and connection to provider resource databases.
- Home Care Program Operations: Consumer intake and eligibility determination, clinical and financial assessments, copayment determination and contribution calculation, service authorization, and client billing
- Case Management Lifecycle: Consumer assessment, goal setting, care plan development, service coordination, advocacy, monitoring, documentation (journal notes, visit records, correspondence logs, and file uploads), crisis intervention, empowerment planning, and case suspension/closure/disenrollment”.
- Limited dedicated Options Counseling workflow capabilities; person-centered counseling sessions tracked through generic call records and journal entries rather than a structured, dedicated process
- ADRC referral exchange functionality exists but has been largely dormant; limited capacity for electronic closed-loop referrals with community partners, hospitals, health plans, and disability organizations
- Resource directory management is cumbersome, with limited ability to maintain current, comprehensive community resource information and match consumers to services based on location, eligibility, and needs
- No integrated screening and triage tools to support the No Wrong Door model and quickly assess consumer needs across multiple program areas
- Limited tracking of I&R outcomes and referral conversion rates, making it difficult to measure whether consumers successfully connected with services.
- System Performance and Stability
• Frequent system freezing, lagging, and crashes that disrupt daily workflows
• Slow load times, excessive clicks, and complex navigation to complete routine tasks
• Pop-up error messages, date rounding errors, and broken data fields
• Limited auto-save and offline functionality resulting in data loss
- Data Quality and Integrity
• Limited ability to configure algorithms supporting end-user directional workflows
• Limited ability to set field-level validation parameters to prompt better data hygiene in real time
• Inconsistent data formats and mismatched consumer records across systems
• Limited ability to configure and extend standardized data definitions and validation checks across programs \
• Conflicting consumer records leading to billing errors and claim denials
• Difficulty assembling a complete, unified consumer profile across programs.