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Legacy SHINES reference document. This page captures a Georgia DHS SHINES interface design as written (vendor spec, typically 2007–2025). It documents the system being replaced, not CRAIG behavior. CRAIG’s current implementation of the same data exchange lives under the craig-exchange API reference and in the design documents. Use this page only when mapping legacy integrations during CRAIG rollout.

Interface Detailed Design Document

IES **Interface

Georgia Department of Human **Services

Statewide Automated Child Welfare Information System

(SACWIS)

04/08/2017

Version 4.0

Table of Contents

General Design (Functional)

Req. #	Validated Requirement
548.2	Send Client Identifier
548.1	Send date of approval for initial funding
548.2	Send Client Identifier
548.3	Send the child’s first name
548.4	Send the child’s middle name
548.5	Send the child’s last name
548.6	Send the child’s suffix
548.7	Send the child’s date of birth
548.8	Send the child’s race
548.9	Send the child’s gender
548.1	Send the child’s citizenship status
548.11	Send the permanent entry date into the USA
548.12	Send the child’s proof of citizenship
548.13	Send the INS number
548.14	Send the child’s country of origin
548.15	Send the child’s social security number
548.16	Send the child’s Medicaid number
548.17	Send the child’s social services case number
548.18	Send the case manager’s first name
548.19	Send the case manager’s last name
548.2	Send the case manager’s phone number
548.21	Send the child’s removal date
548.22	Send the removal type
548.23	Send the date of the first judicial determination
548.24	Send the voluntary placement date
548.25	Send the child’s legal county
548.26	Send the child’s program type
548.27	Send the name of the placement resource where the child is currently placed
548.28	Send whether the child’s placement is with an approved resource
548.29	Send the street address/RFD of the child’s current placement resource
548.3	Send the city of the child’s current placement resource
548.31	Send the county of the child’s current placement resource
548.32	Send the state of the child’s current placement resource
548.33	Send the zip code of the child’s placement resource
548.34	Send the date that the initial authorization of payment was sent to accounting
548.35	Send the mother’s first name
548.36	Send the mother’s last name
548.37	Send the mother’s social security number
548.38	Send the mother’s date of birth
548.39	Send the mother’s race
548.4	Send the mother’s street address/RFD
548.41	Send the mother’s city
548.42	Send the mother’s state
548.43	Send the mother’s zip
548.44	Send the father’s first name
548.45	Send the father’s last name
548.46	Send the father’s social security number
548.47	Send the father’s date of birth
548.48	Send the father’s race
548.49	Send the father’s street address/RFD
548.5	Send the father’s city
548.51	Send the father’s state
548.52	Send the father’s zip
548.53	Send the father type
548.54	Send the marital status type of the child’s parents
548.55	Send whether paternity has been established
548.56	Send whether child support has been court ordered
548.57	Send whether the court order was ordered in another court of competent jurisdiction
548.58	Send the type of court order
548.59	Send the county in which the court order was issued
548.6	Send the state in which the court order was issued
548.61	Send the document type that was submitted
548.62	Send the date the document was submitted
548.63	Send how the document was submitted
548.64	Send a narrative related to additional documentation available in the case record
548.65	Send multiple documents
548.66	Send whether medical assistance was needed for the child within the 3 months prior to removal month
548.67	Send the month(s) prior to removal in which medical assistance was needed
548.68	Send whether the child currently receives any income
548.69	Send the income type
548.7	Send the income amount
548.71	Send the income frequency
548.72	Send if the child has any resources
548.73	Send the resource type
548.74	Send the resource value
548.75	Send the resource frequency
548.76	Send if the child is pregnant
548.77	Send if the pregnancy is verified
548.78	Send if the pregnancy is documented
548.79	Send the estimated pregnancy delivery date
548.8	Send if the child is covered by health insurance other than Medicaid
548.81	Send the name of the health insurance company, if other than Medicaid
548.82	Send the policy number of the health insurance company, if other than Medicaid
548.83	Send the name of the health insurance policyholder
548.84	Send the relationship of the policy holder to the child
548.85	Send the case manager’s fax number
548.86	Send the first name of the person with whom the child was living at removal
548.87	Send the middle name of the person with whom the child was living with at removal
548.88	Send the last name of the person with whom the child was living at removal
548.89	Send the relationship of the person with whom the child was living with at removal
548.9	Send the first name of the legal custodian
548.91	Send the middle name of the legal custodian
548.92	Send the last name of the legal custodian
548.93	Send whether the legal custodian is the same as the person from whom the child was removed
548.94	Send whether the child lived with legal custodian within 6 months prior to the removal date if the legal custodian is not same as the person from whom the child was removed
548.95	Send the months the child lived with the legal custodian within 6 months prior to the removal date
548.96	Send the first name of additional household member living in the removal home
548.97	Send the middle name of additional household member living in the removal home
548.98	Send the last name of additional household member living in the removal home
548.99	Send the date of birth of additional household member living in the removal home
548.1	Send the relationship to child of additional household member living in the removal home
548.101	Send the gender of additional household member living in the removal home
548.102	Send the race of additional household member living in the removal home
548.103	Send the social security number of additional household member living in the removal home
548.104	Send multiple household members living in the removal home
548.105	Send the father’s deprivation type
548.106	Send the mother’s deprivation type
548.107	Send multiple deprivation types per father
548.108	Send multiple deprivation types per mother
548.109	Send the relationship of the person with whom the child was living with at removal
548.11	Send the juvenile court complaint/petition date
548.111	Send the juvenile court order type
548.112	Send whether the initial order contains this language, "contrary to welfare/best interest"
548.113	Send whether an order contains this language, "reasonable efforts to prevent removal", is obtained within the first 60 days of child’s removal
548.114	Send the date of the order addressing "reasonable efforts to prevent removal"
548.115	Send Medicaid application month
548.116	Send the type of income source from the removal home
548.117	Send the gross income amount per month from the removal home
548.118	Send the first name of the recipient of the income source from the removal home
548.119	Send the middle name of the recipient of the income source from the removal home
548.12	Send the last name of the recipient of the income source from the removal home
548.121	Send the Suffix of the recipient of the income source from the removal home
548.122	Send multiple income sources from the removal home
548.123	Send the name of the employer for employment income
548.124	Send the street address/RFD of the employer for employment income
548.125	Send the city of the employer for employment income
548.126	Send the state of the employer for employment income
548.127	Send the zip of the employer for employment income
548.128	Send the phone number of the employer for employment income
548.129	Send multiple employers for employment income
548.13	Send the employment income type
548.131	Send the name of the resource type
548.132	Send the resource dollar value
548.133	Send the first name of the resource owner
548.134	Send the middle name of the resource owner
548.135	Send the last name of the resource owner
548.136	Send the street address/RFD of the real estate resource
548.137	Send the city of the real estate resource
548.138	Send the state of the real estate resource
548.139	Send the zip of the real estate resource
548.14	Send multiple resources
548.141	Send the type of vehicle
548.142	Send the make of vehicle
548.143	Send the model of vehicle
548.144	Send the year of vehicle
548.145	Send narrative on how the household is managing without income and/or resources
548.146	Send whether anyone working in the removal home pays for child care or for the care of a disabled adult living in the home
548.147	Send the name of the provider to whom money for child care or disabled adult care is paid
548.148	Send the amount paid per month to the provider of child care or disabled adult care
548.149	Send multiple providers of child care or disabled adult care
548.15	Send the type of adoption
548.151	Send adoptive mother’s first name
548.152	Send adoptive mother’s last name
548.153	Send adoptive father’s first name
548.154	Send adoptive father’s last name
548.155	Send adoptive family’s street address/RFD
548.156	Send adoptive family’s city
548.157	Send adoptive family’s state
548.158	Send adoptive family’s zip code
548.159	Send the child’s name as it should appear on the Medicaid card post finalization
548.16	Send the date of finalization of adoption
548.161	Send the new social security number post finalization
548.162	Send the approval begin date for adoption assistance benefits
548.163	Send the approval end date for adoption assistance benefits
548.164	Send whether the child is in school
548.165	Send the child’s school status if the child is in school
548.166	Send the child’s educational level if the child is in school
548.167	Send the name of the school if the child is in school
548.168	Send whether the child is eligible for adoption assistance
548.169	Send the type of adoption assistance for which the child is eligible
548.17	Send updated information related to a child’s return home
548.171	Send updated information related to termination of the mother’s parental rights
548.172	Send updated information related to termination of the father’s parental rights
548.173	Send Level of Care
548.174	Receive the Medicaid class of assistance
548.175	Receive the Medicaid Id
548.176	Receive the Medicaid begin date
548.177	Receive the health check referral date
548.178	Receive Mother’s TANF information
548.179	Receive Father’s TANF information
548.18	Receive Mother’s Food Stamps information
548.181	Receive Father’s Food Stamps information
548.182	Receive Child Care Information
548.183	Receive the Case Load number
548.184	Receive the Medicaid denial reason
548.185	Receive the Medicaid end month
548.186	Receive effective begin date of Medicaid eligibility
548.187	Receive effective end date of Medicaid eligibility
548.188	Receive multiple coverage months for Medicaid eligibility
548.189	Receive medically needy first day liability
548.19	Receive the child’s Medicaid eligibility status
548.191	Receive whether the Medically Needy First Day Liability Authorization for Reimbursement form is required
549.1	Send the Client ID for the child
EMPI 1.1	The system shall rename existing CRS references
IES 1.1	The system shall rename existing SUCCESS references.
IESM.1.1	The system shall send Medicaid case eligibility data to the Integrated Eligibility System (IES).
IESM.1.2	The system shall send the following data fields to IES: o Child’s Name - First Name - Middle Name - Last Name o Child Suffix o Gender o Race o Ethnicity o Date of Birth o Social Security Number (SSN) o Citizenship/Alienage Status o Child’s most recent active placement address o Office Location (Street) o SSCM Name o Office City (City) o State (GA) o County (Legal County) o Pregnancy (Y or N) o EMPI ID o Email Address o Date of Submitted o Program Indicator (‘Medicaid’) o Prior Medical Assistance Indicator (Y or N)
IESM.1.3	The system shall prevent the users from sending Medical Referral information to IES, based on the Placement Status.
IESM.1.4	The system shall enable users to transmit Medical Assistance information from SHINES to the Integrated Eligibility System.
IESM.1.5	The system shall send the request to IES for initial Medicaid Class of Assistance (COA) on when IMA page is Submitted IMA page
IESM.1.6	The system shall send 'Foster Parent' name to IES
IESM.1.7	The system shall send ‘Requesting Aid’ indicator to IES
IESM.3.1	The system shall receive the following data fields from the IES application in real-time ( every 15 min): o Application/Tracking Number o EMPI ID o IES Case Number o Response Codes (Medicaid Referral Technical Interface Response) o Response Description
IESM.4.1	The system shall receive the following from IES: o Medicaid ID o EMPI ID

Introduction

Document Purpose

The purpose of this document is to give a detailed functional description of how the Eligibility System interface operates.

Functional Overview

Eligibility System is the state of Georgia’s IV-A (TANF, Food Stamps) and Title XIX (Medicaid) eligibility determination system.

When a child first comes into DFCS custody, the Case Manager will fill out a brief Initial Medicaid Application form within 48 hours. Once this form has been Saved and Submitted[.line-through]# digitally signed #in SHINES, a request will be sent by the SHINES- Eligibility System interface to request the initial Medicaid Class of Assistance (COA), which when returned will be stored for that child in a separate field from SHINES “working” value for COA.

As a business process note, after a child comes into DFCS custody, the Case Manager places the child in an approved placement and fills out the Foster Care Eligibility Initial Application using the following six pages: Application & Background, Age & Citizenship, Removal Household & Deprivation, 3rd Party Health Insurance, and Income & Expenditures. Upon completing the application, the Case Manager submits the application to the Eligibility Specialist wherein the Title IV-E determination is reviewed and confirmed using the Determine Eligibility button on the Eligibility Determination page in SHINES. A Medicaid Eligibi[.line-through]lity Specialist (MES) #[.line-through]#will key in the application information into #[.line-through]#IES, which will calculate the updated Medicaid Class of Assistance. SHINES will send the Medicaid Referral Information to Eligibility System via interface. The Eligibility System will populate Medicaid Application based on the Information sent by SHINES system. The MES worker will process the application in the Eligibility System._ _The MES will then update the Medicaid Class of Assistance manually into SHINES. The value retrieved by the Eligibility System interface for COA will be display only, along with the date the value was received.

Normally, a case manager will enter Income and Resource information for a client during the investigation phase. However, a percentage of SHINES clients will have or have had an existing case in Eligibility System. The interface with Eligibility System will request Income and Resource data for a given client, allowing the case manager to review and update that information with the client.

Request Medicaid Eligibility

Functional Description

Once a client has been screened or registered with the Enterprise Master Person Index (EMPI)), it will have a Client Identifier that Eligibility System will recognize. The screening process will retrieve an existing Client Identifier, and store it for the person in SHINES. See the EMPI Interface Detailed Design for details. Once a Client Identifier has been obtained, the Case Manager may go to the Initial Medicaid page in SHINES. After filling out the mandatory fields, the Case Manager can select to sign the application. Once that has been saved and submitted, a request will be sent to Eligibility System as described in the frequency table in Appendix A. The data on the application is #[.line-through]#not #[.line-through]#sent to #[.line-through]#IES[.line-through], only the Client Identifier for the child and the child’s removal date is sent to Eligibility System on Save and Submit. The data for Medicaid application is sent to Eligibility System when the Case Manager clicks on the Save and Submit button on the Initial Medicaid Application page. The request will be sent to Eligibility System for Medicaid Referral as described in the frequency table in Appendix A. The following data will be sent over to Eligibility System –

o Child’s Name

First Name
Middle Name
Last Name

o Child Suffix

o Gender

o Race

o Ethnicity

o Date of Birth

o Social Security Number (SSN)

o Citizenship/Alienage Status

o Child’s most recent active placement address

o Foster Parent

o Office Location (Street)

o SSCM Name

o Office City (City)

o State (GA)

o County (Legal County)

o Pregnancy (Y or N)

o EMPI ID

o Email Address

o Date Submitted

o Program Indicator (‘Medicaid’)

o Prior Medical Assistance Indicator (Y or N)

o Requesting Aid (Y or N)

The m[.line-through]anual process of the MES worker[.line-through]# keying the data into [.line-through]#IES #[.line-through]#will remain in place. If the Class of Assistance is determined by Eligibility System for the child within 60 days, the Medicaid Eligibility request will automatically return the Class of Assistance and store it in SHINES in a display only field. After 60 days, if there is no COA returned, the Case Manager will receive an email letting her know. At that point, a manual process would be required to obtain the data. Regardless of what value is returned by the IES interface, the MES worker will enter the COA as initially determined by Eligibility System in the comments box on the Initial Medicaid Application page.

Initial Medicaid Application Page

Initial Medicaid Application MES Section. MES worker puts the initial IES COA into the comments box.

Eligibility summary page displaying the COA received from Eligibility System and the date of assistance received.

Process Flow

Table of Fields to send to IES (via Broker) for Medicaid Eligibility and Medicaid Referral

Static/ Dynamic	Required (Yes, No)	Data Name	Description	Possible Value	Type	Length
Dynamic	Y	Transaction ID	Unique id for this request (from SHINES perspective) – Only used by GTA to identify results coming back		Numeric	16
Dynamic	Y	DHR Client Number	ID Retrieved From EMPI		Numeric	9
Static	Y	Request Identifier	What type of request to send IES	REF for Referral	String	3
Dynamic	Y	Request Date	This is actually the Removal Date according to recent IES docs		Date
Dynamic	Y	EMPI ID	ID Retrieved From IES		Numeric	9
Dynamic	Y	FirstName	Child’s First Name.		String	12
Dynamic	N	MiddleName	Child’s Middle Name.		String	12
Dynamic	Y	LastName	Child’s Last Name.		String	22
Dynamic	N	Suffix	Suffix		String	2
Dynamic	Y	DOB	Date of Birth		Date
Dynamic	Y	Gender	Child’s Gender		String	1
Dynamic	N	SSN	Social Security Number		Raw
Dynamic	Y	Race	Child’s Race		String	2
Dynamic	Y	Ethnicity	Child’s Ethnicity		String	2
Dynamic	Y	CitizenshipStatus	Citizenship/Alienage Status		String	3
Dynamic	Y	Placement County	Placement address county from the most recent active placement that is either in COMP, PEND or APRV status in the stage		String	3
Dynamic	Y	Child Address Line 1	‘Street’ field in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.		String	30
Dynamic	N	Child Address Line 2 (ADDR_PLCMT_LINE_2)	‘Street’ field line 2 in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.		String	30
Dynamic	Y	Child Address City	'City' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.		String	20
Dynamic	Y	Child Address State	'State' field from the 'Address/Phone Detail' section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage. If the state is empty or null the system shall send a value equal to “GA”	GA	String	2
Dynamic	Y	Child Address Zip Code	'Zip' field from the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.		Integer	9
Dynamic	Y	DFCSOfficeLoc	DFCS Address Line1 The string between first and second pipe symbols in the 'Office Location' field will be considered as DFCS Address line 1		String	62
Dynamic	Y	SSCM Name	Child’s FCC stage Primary Case Manager as displayed in the Case Manager column on the Case Summary page		String	25
Dynamic	Y	DFCS Office City	Legal DFCS Office City		String	20
Static	Y	DFCS Office State	State field from DFCS Office Address Always a constant value equal to “GA”	GA	String	2
Dynamic	Y	DFCS Office Name	<Child’s legal County from IMA page> appended with the string "County DFCS" e.g. Fulton County DFCS		String	15
Static	Y	Legal County	Legal County responsible for the child’s case. County field on the child’s Initial Medicaid Application page		String	3
Dynamic	N	Pregnancy	Child Pregnant Indicator		String	1
Dynamic	N	Email	Email Address		String	70
Dynamic	Y	Date Submitted	Date SSCM submitted MA application		Date
Static	Y	Program Indicator	Program ID set to ‘Medicaid’, indicates type of data sent to IES	MA	String	2
Dynamic	N	Prior MA Indicator	Prior Medical Assistance Indicator	(Y or N)	String	1
Dynamic	N	Foster Parent	'Legal Name' field on the 'Resource Detail' page of the id_facility tied to the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage. If the Placement is with a Person Foster Parent is the 'Person' field from the 'Placement Name' sub section on the 'Placement Information'		String	45 SHINES will send 45 character long field and webMethods will truncate it to 30 characters before sending it to IES
Dynamic	Y	Requesting Aid	'Y' for Medicaid and 'N' for every other program. For this project it will always be ‘Y’	Y or N	String	1

Static/ Dynamic

Required (Yes, No)

Data Name

Description

Possible Value

Type

Length

Dynamic

Transaction ID

Unique id for this request (from SHINES perspective) – Only used by GTA to identify results coming back

Numeric

Dynamic

DHR Client Number

ID Retrieved From EMPI

Numeric

Static

Request Identifier

What type of request to send IES

REF for Referral

String

Dynamic

Request Date

This is actually the Removal Date according to recent IES docs

Date

Dynamic

EMPI ID

ID Retrieved From IES

Numeric

Dynamic

FirstName

Child’s First Name.

String

Dynamic

MiddleName

Child’s Middle Name.

String

Dynamic

LastName

Child’s Last Name.

String

Dynamic

Suffix

String

Dynamic

DOB

Date of Birth

Date

Dynamic

Gender

Child’s Gender

String

Dynamic

SSN

Social Security Number

Raw

Dynamic

Race

Child’s Race

String

Dynamic

Ethnicity

Child’s Ethnicity

String

Dynamic

CitizenshipStatus

Citizenship/Alienage Status

String

Dynamic

Placement County

Placement address county from the most recent active placement that is either in COMP, PEND or APRV status in the stage

String

Dynamic

Child Address Line 1

‘Street’ field in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

String

Dynamic

Child Address Line 2 (ADDR_PLCMT_LINE_2)

‘Street’ field line 2 in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

String

Dynamic

Child Address City

'City' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

String

Dynamic

Child Address State

'State' field from the 'Address/Phone Detail' section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage. If the state is empty or null the system shall send a value equal to “GA”

String

Dynamic

Child Address Zip Code

'Zip' field from the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

Integer

Dynamic

DFCSOfficeLoc

DFCS Address Line1 The string between first and second pipe symbols in the 'Office Location' field will be considered as DFCS Address line 1

String

Dynamic

SSCM Name

Child’s FCC stage Primary Case Manager as displayed in the Case Manager column on the Case Summary page

String

Dynamic

DFCS Office City

Legal DFCS Office City

String

Static

DFCS Office State

State field from DFCS Office Address Always a constant value equal to “GA”

String

Dynamic

DFCS Office Name

<Child’s legal County from IMA page> appended with the string "County DFCS" e.g. Fulton County DFCS

String

Static

Legal County

Legal County responsible for the child’s case. County field on the child’s Initial Medicaid Application page

String

Dynamic

Pregnancy

Child Pregnant Indicator

String

Dynamic

Email Address

String

Dynamic

Date Submitted

Date SSCM submitted MA application

Date

Static

Program Indicator

Program ID set to ‘Medicaid’, indicates type of data sent to IES

String

Dynamic

Prior MA Indicator

Prior Medical Assistance Indicator

(Y or N)

String

Dynamic

Foster Parent

'Legal Name' field on the 'Resource Detail' page of the id_facility tied to the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage. If the Placement is with a Person Foster Parent is the 'Person' field from the 'Placement Name' sub section on the 'Placement Information'

String

45 SHINES will send 45 character long field and webMethods will truncate it to 30 characters before sending it to IES

Dynamic

Requesting Aid

'Y' for Medicaid and 'N' for every other program. For this project it will always be ‘Y’

Y or N

String

Table of Fields Returned by Broker via IES (via Broker)

Static/ Dynamic	Required (Yes, No)	Data Name	Description	Possible Value	Type	Length
Dynamic	Y	Transaction ID	ID of the SHINES request Transaction as sent to IES by SHINES		Numeric	16
Dynamic	Y	DHR Child ID	ID from EMPI		Numeric	9
Static	Y	Medicaid Class of Assistance	Code indicated the Medicaid Class of Assistance		String	3
Dynamic		Medically Needy First Day Liability Date	Date that Medicaid benefits kick in		Date
Dynamic		Medically Needy First Day Liability Amount	Amount the client is responsible for paying (Deductible)		Numeric
Dynamic	Y	Benefit Month	The month that this information applies to. SHINES cares about the most recent record currently.		Date (IES has MM YY – transform required)
Static	Y	Client Status	Indicates the status (Active, Pending, Closed, etc.) for this client in the AU		String
Dynamic	Y	Client Status Date	Date associated with Client’s status		Date
Dynamic	Y	Error Code	After the 60 days, if there are still an error, this will be populated		String
Dynamic	Y	Transaction ID	Unique SHINES id for this interface transaction		Numeric	16
Dynamic	Y	Application Number	Application/Ticket Number	Application/Tracking Number will be generated and stored within IES.
Dynamic	Y	EMPI ID	Enterprise Master Patient Index (EMPI ID)		Numeric	9
Dynamic	Y	IES Case Number	Case ID of the case in IES system		Numeric	9
Dynamic	Y	Response Code	Medicaid Referral Technical Response Status	Success/Denial/Errors
Dynamic	Y	Response Description		Response message for the SHINES referral service. Application received successfully include application number (00) Mandatory fields not received - list the fields (10) IES service unavailable (100) webMethods unavailable (101)	String	300

Static/ Dynamic

Required (Yes, No)

Data Name

Description

Possible Value

Type

Length

Dynamic

Transaction ID

ID of the SHINES request Transaction as sent to IES by SHINES

Numeric

Dynamic

DHR Child ID

ID from EMPI

Numeric

Static

Medicaid Class of Assistance

Code indicated the Medicaid Class of Assistance

String

Dynamic

Medically Needy First Day Liability Date

Date that Medicaid benefits kick in

Date

Dynamic

Medically Needy First Day Liability Amount

Amount the client is responsible for paying (Deductible)

Numeric

Dynamic

Benefit Month

The month that this information applies to. SHINES cares about the most recent record currently.

Date (IES has MM YY – transform required)

Static

Client Status

Indicates the status (Active, Pending, Closed, etc.) for this client in the AU

String

Dynamic

Client Status Date

Date associated with Client’s status

Date

Dynamic

Error Code

After the 60 days, if there are still an error, this will be populated

String

Dynamic

Transaction ID

Unique SHINES id for this interface transaction

Numeric

Dynamic

Application Number

Application/Ticket Number

Application/Tracking Number will be generated and stored within IES.

Dynamic

EMPI ID

Enterprise Master Patient Index (EMPI ID)

Numeric

Dynamic

IES Case Number

Case ID of the case in IES system

Numeric

Dynamic

Response Code

Medicaid Referral Technical Response Status

Success/Denial/Errors

Dynamic

Response Description

Response message for the SHINES referral service. Application received successfully include application number (00) Mandatory fields not received - list the fields (10) IES service unavailable (100) webMethods unavailable (101)

String

300

The above table shows the fields of interest return by IES that SHINES will functionally use. See the Technical section for details on all of the data that IES will return.

Table of Fields Returned from IES using inbound tables via Batch Processing (or any other process decided by IES technical team)

Static/ Dynamic	Required (Yes, No)	Data Name	Description	Possible Value	Type	Length
Static	Y	Medicaid ID	Medicaid Identifier			12
Static	Y	EMPI ID	Enterprise Master Patient Index (EMPI ID)

Static/ Dynamic

Required (Yes, No)

Data Name

Description

Possible Value

Type

Length

Static

Medicaid ID

Medicaid Identifier

Static

EMPI ID

Enterprise Master Patient Index (EMPI ID)

The above table shows the fields of interest return by IES to SHINES in a batch processing timeframe.

Error Messages

Reason Code	Message text	Condition
RTO	Request timed out	After 7 days of trying to obtain the COA, the Case Manager will receive an email.

Reason Code

Message text

Condition

RTO

Request timed out

After 7 days of trying to obtain the COA, the Case Manager will receive an email.

System Generated Events

None

System Generated To Dos

None

Request Income and Resources

Functional Description

Once a client has been screened or registered with the Enterprise Master Person Index (EMPI), it will have a Client Identifier that Eligibility System will recognize. The screening process will retrieve an existing Client Identifier, and store it for the person in SHINES. See the EMPI Interface Detailed Design for details. If the client is indeed a pre-existing client, the SHINES user may request previous Income and Resource information from Eligibility System. The Income and Resources List off the Person Detail page will have a new button to retrieve Income information from Eligibility System. When a user presses that button, an inquiry request will be sent to Eligibility System. The user may proceed to other screens while the request is handled in the background. Once Eligibility System completes the inquiry (the frequency of handling requests will be determined by the Georgia Technical Authority (GTA) and the Eligibility System team), the user may return to the Income and Resources screen to view data returned by Eligibility System.

Person Detail Income and Resource List Page

The interface will retrieve two months’ worth of data – current month and prior month. One should note that Eligibility System has a different definition of current and prior than most systems. If the today’s date is February 8, 2007, then the current month is considered to be March and the prior month is considered February. Eligibility System is always working on the coming month as the current month. If any record that comes back already matches a record in the system, that record will be discarded rather than creating duplicate records. It is important to note that Income and Resources is a record of income sources and amounts, but not a record of every payment that a person receives. If a SHINES client is paid $1000 a week for 52 weeks by an employer, there should only be one record in this list for that employer with $1000 as the amount, frequency type as weekly, and a start and end date for that period of employment.

Process Flow

Table of Fields to send to IES (via Broker)

Static/ Dynamic	Required (Yes, No)	Data Name	Description	Possible Value	Type	Length
Dynamic	Y	Transaction ID	Unique id for this request – used by the GTA broker and not SUCCESS itself		Numeric	16
Dynamic	Y	DHR Client Number	ID Retrieved From EMPI		Numeric	9
Static	Y	Request Identifier	What type of request to send IES	INQ for Inquiry	String	3
Dynamic	Y	Request Date	Date of Request, which is date user pressed the button		Date

Static/ Dynamic

Required (Yes, No)

Data Name

Description

Possible Value

Type

Length

Dynamic

Transaction ID

Unique id for this request – used by the GTA broker and not SUCCESS itself

Numeric

Dynamic

DHR Client Number

ID Retrieved From EMPI

Numeric

Static

Request Identifier

What type of request to send IES

INQ for Inquiry

String

Dynamic

Request Date

Date of Request, which is date user pressed the button

Date

Table of Fields Returned by Broker via IES

Static/ Dynamic	Required (Yes, No)	Data Name	Description	Possible Value	Type	Length
Dynamic	Y	Transaction ID	ID of the SHINES request Transaction as sent to IES by SHINES		Numeric	16
Dynamic	Y	DHR Child ID	ID from EMPI		Numeric	9
Static	Y	Income/Resource Identifier	Indicates if this record contains INCOME or RESOURCE data	INC or RES	String	3
Static	Y	Income/Resource Type	Type of INCOME or RESOURCE		String	3
Static	Y	Earned Indicator	Identifies for INCOME it is earned or unearned	E or U	String	1
Dynamic	N	AU Number	Assistance Unit number for IES case if benefit		Numeric
Static	N	AU Type	Type of IES case	Indicator for TANF, Food Stamps, etc.	String
Static	N	AU Status	Status of the Assistance Unit		String
Dynamic	N	Case Load Number	Helps to identify whom in REVMAX is working this case in IES
Dynamic	N	Income Amount	If this is an INCOME record, contains the actual dollar amount		Numeric	10,2
Static	N	Income Frequency	Code to indicate how often client receives this amount of INCOME		String	3
Dynamic	N	Resource Fair Market Value	If this record is for a resource, it contains the “fair market value”. For insurance, this is the cash value		Numeric	10,2
Dynamic	N	Start Date	If this is income, the date the income began		Date
Dynamic	N	End Date	If this is income, the date it stopped.	NULL or blank if still ongoing	Date
Dynamic	N	Source/Employer Name	Name of the resource or name of employer for income		String	20
Dynamic	N	S/E Address Line 1	Line 1 of the address for the resource or employer		String	30
Dynamic	N	S/E Address Line 2	Line 2 of the address		String	30
Dynamic	N	S/E City	City of the resource or employer		String	20
Static	N	S/E State	State of the resource or employer		String	2
Dynamic	N	S/E Zip	Zip Code of resource or employer		String	10
Static	N	Verification Method	How the income or resource was verified		String	20
Dynamic	Y	Benefit Month	The Benefit month this income is associated with – to determine which data is most recent		Date
Dynamic	Y	Error Code	If there was an error, this contains the error code		String

Static/ Dynamic

Required (Yes, No)

Data Name

Description

Possible Value

Type

Length

Dynamic

Transaction ID

ID of the SHINES request Transaction as sent to IES by SHINES

Numeric

Dynamic

DHR Child ID

ID from EMPI

Numeric

Static

Income/Resource Identifier

Indicates if this record contains INCOME or RESOURCE data

INC or RES

String

Static

Income/Resource Type

Type of INCOME or RESOURCE

String

Static

Earned Indicator

Identifies for INCOME it is earned or unearned

E or U

String

Dynamic

AU Number

Assistance Unit number for IES case if benefit

Numeric

Static

AU Type

Type of IES case

Indicator for TANF, Food Stamps, etc.

String

Static

AU Status

Status of the Assistance Unit

String

Dynamic

Case Load Number

Helps to identify whom in REVMAX is working this case in IES

Dynamic

Income Amount

If this is an INCOME record, contains the actual dollar amount

Numeric

10,2

Static

Income Frequency

Code to indicate how often client receives this amount of INCOME

String

Dynamic

Resource Fair Market Value

If this record is for a resource, it contains the “fair market value”. For insurance, this is the cash value

Numeric

10,2

Dynamic

Start Date

If this is income, the date the income began

Date

Dynamic

End Date

If this is income, the date it stopped.

NULL or blank if still ongoing

Date

Dynamic

Source/Employer Name

Name of the resource or name of employer for income

String

Dynamic

S/E Address Line 1

Line 1 of the address for the resource or employer

String

Dynamic

S/E Address Line 2

Line 2 of the address

String

Dynamic

S/E City

City of the resource or employer

String

Static

S/E State

State of the resource or employer

String

Dynamic

S/E Zip

Zip Code of resource or employer

String

Static

Verification Method

How the income or resource was verified

String

Dynamic

Benefit Month

The Benefit month this income is associated with – to determine which data is most recent

Date

Dynamic

Error Code

If there was an error, this contains the error code

String

IES Code Mapping Values

Error Messages

Reason Code

Message text

Condition

System Generated Events

None

System Generated To Dos

None

Design Requirements

Validated Functional Requirement Number	Conceptual Design Requirement Number	Conceptual Design Requirement
548.2	548.2.1	Send Client Identifier
548.178	548.178.1	Receive Mother’s TANF information
548.179	548.179.1	Receive Father’s TANF information
548.180	548.180.1	Receive Mother’s Food Stamps information
548.181	548.181.1	Receive Father’s Food Stamps information
548.183	548.183.1	Receive the Case Load number
EMPI 1.1	EMPI 1.1.11	Update all the CRS references in the SUCCESS Interface detailed design to EMPI.
IES 1.1	IES 1.1.5	Rename “SUCCESS” to "IES" in the SUCCESS Interface detailed design.
IESM.1.1	IESM.1.1.1	The system shall have an outbound interface process to send the Medicaid Application Referral data to the IES System.
IESM.1.2	IESM.1.2.1	The system shall send the 'First' name field from the Person Detail Page of the FCC child, 'Person Name' sub-section
IESM.1.2	IESM.1.2.2	The system shall send the 'Middle' name field from the Person Detail Page of the FCC child, 'Person Name' sub-section.
IESM.1.2	IESM.1.2.3	The system shall send the required 'Last' name field from the Person Detail Page of the FCC child, 'Person Name' sub-section.
IESM.1.2	IESM.1.2.4	The system shall send the 'Suffix' field from the Person Detail Page, 'Person Name' sub-section.
IESM.1.2	IESM.1.2.5	The system shall send the 'Date of Birth' field from the Initial Medicaid Application Page, 'Child Information' sub-section.
IESM.1.2	IESM.1.2.6	The system shall send the 'Gender' field from the Initial Medicaid Application Page, 'Child Information' sub-section.
IESM.1.2	IESM.1.2.7	The system shall send the 'Social Security Number' field from the Initial Medicaid Application Page, 'Child Information' sub-section.
IESM.1.2	IESM.1.2.8	The system shall send the non-end dated 'EMPI ID#’ from the Person Detail Page of the FCC child, 'Person Identifiers' sub-section.
IESM.1.2	IESM.1.2.9	The system shall send the 'Race' field from the Person Detail Page of the FCC child, 'Race/Ethnicity Detail' Sub Section.
IESM.1.2	IESM.1.2.10	The system shall send the 'Ethnicity' field from the Person Detail Page of the FCC child, 'Race/Ethnicity Detail' Sub Section.
IESM.1.2	IESM.1.2.11	The system shall send the 'Citizenship Status' field from the Initial Medicaid Application Page, 'Child Information' sub-section.
IESM.1.2	IESM.1.2.12	The system shall send the 'Child Pregnant?' field from the Initial Medicaid Application Page, 'Child Information' sub-section.
IESM.1.2	IESM.1.2.13	The system shall send the date when the 'Save and Submit' button on the Initial Medicaid Application page is clicked.
IESM.1.2	IESM.1.2.14	The system shall prepopulate the 'Program ID' field, with 'Medicaid' as the identifier from SHINES to IES.
IESM.1.2	IESM.1.2.15	The system shall send the 'Prior Medical Assistance' field from the Initial Medicaid Application page, 'Medicaid Information' sub-section.
IESM.1.2	IESM.1.2.16	The system shall send the 'Email' field from the Staff Detail Page, 'Address' module.
IESM.1.2	IESM.1.2.17	The system shall send the 'County' field from the Initial Medicaid Application Page, 'Child Information' sub-section.
IESM.1.2	IESM.1.2.18	The system shall send the 'Office Location' field from the FCC Case Manager’s Staff Detail page, 'Work Information' sub-section.
IESM.1.2	IESM.1.2.18	The system shall send DFCS Address line 1 from the ‘Office Location’ field from the Staff Detail page of the Child’s primary Case Manager
IESM.1.2	IESM.1.2.18a	The string between first and second pipe symbols in the 'Office Location' field will be considered as DFCS Address line 1
IESM.1.2	IESM.1.2.18b	The system shall send SSCM Name from the Child’s FCC stage Primary Case Manager as displayed in the Case Manager column on the Case Summary page
IESM.1.2	IESM.1.2.19	The system shall send the 'Office City' field from the FCC stage Primary Case Manager’s Staff Detail page, 'Work Information' sub-section.
IESM.1.2	IESM.1.2.19a	The system shall send DFCS Office Name as the <Child’s legal County from IMA page> appended with the string "County DFCS"
IESM.1.2	IESM.1.2.19b	The system shall send DFCS Address Zip Code from the ‘Office Location’ field from the Staff Detail page of the Child’s primary Case Manager
IESM.1.2	IESM.1.2.19c	The string after the second pipe symbol in the 'Office Location' field will be considered as Zip Code
IESM.1.2	IESM.1.2.20	The system shall send the 'State' field of 'GA' for Case Manager’s DFCS address
IESM.1.2.23	IESM.1.2.23	The system shall send Child Address Line 1 from the ‘Street’ field in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.
IESM.1.2.24	IESM.1.2.24	The system shall send Child Address Line 2 from the ‘Street’ field line 2 in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.
IESM.1.2.25	IESM.1.2.25	The system shall send Child Address City from the 'City' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.
IESM.1.2	IESM.1.2.26	The system shall send Child Address State from the 'State' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.
IESM.1.2	IESM.1.2.27	The system shall send Child Address State as value equal to "GA" when the 'State' field on the 'Address/Phone Detail' section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage is empty or null.
IESM.1.2	IESM.1.2.28	The system shall send Child Address Zip Code from the 'Zip' field from the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.
IESM.1.5	IESM.1.5.1	The system shall no longer invoke data transmission to the IES interface, upon clicking the 'Sign' checkbox and Save button on the Initial Medicaid Application page.
IESM.1.5	IESM.1.5.2	The system shall send request to IES interface to request the Initial Medicaid Class of Assistance (COA) upon Save and Submit of the Initial Medicaid Application page.
IESM.1.6	IESM.1.6.1	The system shall send the Foster Parent from the 'Legal Name' field on the 'Resource Detail' page of the id_facility tied to the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.
IESM.1.6	IESM.1.6.2	The system shall send the Foster Parent from the 'Person' field from the 'Placement Name' sub section on the 'Placement Information' page of the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage when the child placement is with a person and not with a resource.
IESM.1.7	IESM.1.7.1	The system shall send the Requesting Aid as a constant value equal to “Y” for Medical Referral
IESM.3.1	IESM.3.1.1	The system shall receive the ' Application Number' field from IES interface in real-time (every 15 min).
IESM.3.1	IESM.3.1.3	The system shall receive the 'EMPI ID' associated with 'Application Number' from IES interface in real-time (every 15 min).
IESM.3.1	IESM.3.1.4	The system shall receive a technical response of the Medicaid Referral sent by SHINES, within the Response Code' field from IES in real-time (every 15 min).
IESM.3.1	IESM.3.1.5	The system shall receive response description of the Medical Referral sent by SHINES, within the 'Response Description' field from IES in real-time (every 15min)
IESM.3.1	IESM.3.1.6	The system shall receive IES case number from the IES after the Medical Referral in the 'IES Case Number' field from IES in real-time (every 15min).
IESM.4.1	IESM.4.1.1	The system shall receive the 'Medicaid ID' field from IES using inbound table. in a batch (or any other process decided upon by the IES technical team).
IESM.4.1	IESM.4.1.2	The system shall display the Medicaid ID received from the IES system on the Person Detail page.
IESM.4.1	IESM.4.1.3	Add requirement regarding rules on populating the Medicaid ID to the person detail page.
IESM.4.1	IESM.4.1.4	The system shall receive the 'EMPI ID' field from IES using inbound table. in a batch (or any other process decided upon by the IES technical team).

Validated Functional Requirement Number

Conceptual Design Requirement Number

Conceptual Design Requirement

548.2

548.2.1

Send Client Identifier

548.178

548.178.1

Receive Mother’s TANF information

548.179

548.179.1

Receive Father’s TANF information

548.180

548.180.1

Receive Mother’s Food Stamps information

548.181

548.181.1

Receive Father’s Food Stamps information

548.183

548.183.1

Receive the Case Load number

EMPI 1.1

EMPI 1.1.11

Update all the CRS references in the SUCCESS Interface detailed design to EMPI.

IES 1.1

IES 1.1.5

Rename “SUCCESS” to "IES" in the SUCCESS Interface detailed design.

IESM.1.1

IESM.1.1.1

The system shall have an outbound interface process to send the Medicaid Application Referral data to the IES System.

IESM.1.2

IESM.1.2.1

The system shall send the 'First' name field from the Person Detail Page of the FCC child, 'Person Name' sub-section

IESM.1.2

IESM.1.2.2

The system shall send the 'Middle' name field from the Person Detail Page of the FCC child, 'Person Name' sub-section.

IESM.1.2

IESM.1.2.3

The system shall send the required 'Last' name field from the Person Detail Page of the FCC child, 'Person Name' sub-section.

IESM.1.2

IESM.1.2.4

The system shall send the 'Suffix' field from the Person Detail Page, 'Person Name' sub-section.

IESM.1.2

IESM.1.2.5

The system shall send the 'Date of Birth' field from the Initial Medicaid Application Page, 'Child Information' sub-section.

IESM.1.2

IESM.1.2.6

The system shall send the 'Gender' field from the Initial Medicaid Application Page, 'Child Information' sub-section.

IESM.1.2

IESM.1.2.7

The system shall send the 'Social Security Number' field from the Initial Medicaid Application Page, 'Child Information' sub-section.

IESM.1.2

IESM.1.2.8

The system shall send the non-end dated 'EMPI ID#’ from the Person Detail Page of the FCC child, 'Person Identifiers' sub-section.

IESM.1.2

IESM.1.2.9

The system shall send the 'Race' field from the Person Detail Page of the FCC child, 'Race/Ethnicity Detail' Sub Section.

IESM.1.2

IESM.1.2.10

The system shall send the 'Ethnicity' field from the Person Detail Page of the FCC child, 'Race/Ethnicity Detail' Sub Section.

IESM.1.2

IESM.1.2.11

The system shall send the 'Citizenship Status' field from the Initial Medicaid Application Page, 'Child Information' sub-section.

IESM.1.2

IESM.1.2.12

The system shall send the 'Child Pregnant?' field from the Initial Medicaid Application Page, 'Child Information' sub-section.

IESM.1.2

IESM.1.2.13

The system shall send the date when the 'Save and Submit' button on the Initial Medicaid Application page is clicked.

IESM.1.2

IESM.1.2.14

The system shall prepopulate the 'Program ID' field, with 'Medicaid' as the identifier from SHINES to IES.

IESM.1.2

IESM.1.2.15

The system shall send the 'Prior Medical Assistance' field from the Initial Medicaid Application page, 'Medicaid Information' sub-section.

IESM.1.2

IESM.1.2.16

The system shall send the 'Email' field from the Staff Detail Page, 'Address' module.

IESM.1.2

IESM.1.2.17

The system shall send the 'County' field from the Initial Medicaid Application Page, 'Child Information' sub-section.

IESM.1.2

IESM.1.2.18

The system shall send the 'Office Location' field from the FCC Case Manager’s Staff Detail page, 'Work Information' sub-section.

IESM.1.2

IESM.1.2.18

The system shall send DFCS Address line 1 from the ‘Office Location’ field from the Staff Detail page of the Child’s primary Case Manager

IESM.1.2

IESM.1.2.18a

The string between first and second pipe symbols in the 'Office Location' field will be considered as DFCS Address line 1

IESM.1.2

IESM.1.2.18b

The system shall send SSCM Name from the Child’s FCC stage Primary Case Manager as displayed in the Case Manager column on the Case Summary page

IESM.1.2

IESM.1.2.19

The system shall send the 'Office City' field from the FCC stage Primary Case Manager’s Staff Detail page, 'Work Information' sub-section.

IESM.1.2

IESM.1.2.19a

The system shall send DFCS Office Name as the <Child’s legal County from IMA page> appended with the string "County DFCS"

IESM.1.2

IESM.1.2.19b

The system shall send DFCS Address Zip Code from the ‘Office Location’ field from the Staff Detail page of the Child’s primary Case Manager

IESM.1.2

IESM.1.2.19c

The string after the second pipe symbol in the 'Office Location' field will be considered as Zip Code

IESM.1.2

IESM.1.2.20

The system shall send the 'State' field of 'GA' for Case Manager’s DFCS address

IESM.1.2.23

The system shall send Child Address Line 1 from the ‘Street’ field in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

IESM.1.2.24

The system shall send Child Address Line 2 from the ‘Street’ field line 2 in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

IESM.1.2.25

The system shall send Child Address City from the 'City' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

IESM.1.2

IESM.1.2.26

The system shall send Child Address State from the 'State' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

IESM.1.2

IESM.1.2.27

The system shall send Child Address State as value equal to "GA" when the 'State' field on the 'Address/Phone Detail' section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage is empty or null.

IESM.1.2

IESM.1.2.28

The system shall send Child Address Zip Code from the 'Zip' field from the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

IESM.1.5

IESM.1.5.1

The system shall no longer invoke data transmission to the IES interface, upon clicking the 'Sign' checkbox and Save button on the Initial Medicaid Application page.

IESM.1.5

IESM.1.5.2

The system shall send request to IES interface to request the Initial Medicaid Class of Assistance (COA) upon Save and Submit of the Initial Medicaid Application page.

IESM.1.6

IESM.1.6.1

The system shall send the Foster Parent from the 'Legal Name' field on the 'Resource Detail' page of the id_facility tied to the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

IESM.1.6

IESM.1.6.2

The system shall send the Foster Parent from the 'Person' field from the 'Placement Name' sub section on the 'Placement Information' page of the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage when the child placement is with a person and not with a resource.

IESM.1.7

IESM.1.7.1

The system shall send the Requesting Aid as a constant value equal to “Y” for Medical Referral

IESM.3.1

IESM.3.1.1

The system shall receive the ' Application Number' field from IES interface in real-time (every 15 min).

IESM.3.1

IESM.3.1.3

The system shall receive the 'EMPI ID' associated with 'Application Number' from IES interface in real-time (every 15 min).

IESM.3.1

IESM.3.1.4

The system shall receive a technical response of the Medicaid Referral sent by SHINES, within the Response Code' field from IES in real-time (every 15 min).

IESM.3.1

IESM.3.1.5

The system shall receive response description of the Medical Referral sent by SHINES, within the 'Response Description' field from IES in real-time (every 15min)

IESM.3.1

IESM.3.1.6

The system shall receive IES case number from the IES after the Medical Referral in the 'IES Case Number' field from IES in real-time (every 15min).

IESM.4.1

IESM.4.1.1

The system shall receive the 'Medicaid ID' field from IES using inbound table. in a batch (or any other process decided upon by the IES technical team).

IESM.4.1

IESM.4.1.2

The system shall display the Medicaid ID received from the IES system on the Person Detail page.

IESM.4.1

IESM.4.1.3

Add requirement regarding rules on populating the Medicaid ID to the person detail page.

IESM.4.1

IESM.4.1.4

The system shall receive the 'EMPI ID' field from IES using inbound table. in a batch (or any other process decided upon by the IES technical team).

Technical Design

Technical Overview

The SUCCESS application runs as a COBOL application in a mainframe environment using DB2 as the database. The application consists of approximately 50 mainframe screens to enter the information for a client. SUCCESS does interface with other applications via text files produced or processed by COBOL batch applications.

The SUCCESS application is hosted by GTA and is developed, hosted, and maintained by DHR.

SACWIS will write outgoing information into separate interfacing tables for income and resource requests. The GTA webMethods broker will access those tables directly via JDBC support, convert them into webMethods objects, and then send them to SUCCESS. The current plan is that the broker will invoke a CICS transaction via web services. However, the webMethods broker will handle that transformation and transport for SHINES, so this transformation will be documented by GTA and is transparent to SHINES.

The technical decision taken is that the interface will not be synchronous. The end user of SHINES is not waiting on a response from the SUCCESS system before proceeding to the next step. SHINES will write out the database records for transmittal as soon as the income request button has been pressed. How often the broker picks up these records will be decided by the business needs and implemented by GTA. The SUCCESS system is only available to run online transactions from 7am to 7pm. SUCCESS is down daily from 7pm to 7am, and even longer stretches over the weekend. This is due to heavy batch processing and application updates. This further drove the design to using an outbound, asynchronous database table on the SHINES side.

SHINES will need to host a web service for the response to these transactions. There will be one web services for handling inbound income and resource information. The GTA webMethods broker will be invoking these SHINES web services when it picks up outgoing responses from the SUCCESS system. SUCCESS is currently a batch-oriented architecture on their side, but SUCCESS is creating CICS transactions for this interface that GTA will create a web service for access. The SHINES side is architected to support the SUCCESS Architecture. If the business need dictates that outbound table processing should be executed more often it will involve a small configuration change done by the GTA, with no code changes needed on the SHINES side or SUCCESS.

SUCCESS will return more fields (and sometime more rows) of data than SHINES can currently make use of. The SHINES web services need to filter out the data as needed. Future versions of SHINES may store and display the additional data.

In summary, the outgoing messages will be handled by basic inserts into a new database table that other applications can subscribe to. The SHINES application code writes out messages to the table; therefore, there is no performance impact to the live SHINES application if there are delays relaying a message out to the SUCCESS application on the mainframe. SHINES will be creating records in real-time. Incoming messages will be processed in real-time via web service invocations that will hook into the SHINES Enterprise Java Bean layer.

Request Medicaid Eligibility

Technical Description

The SHINES application will insert a row into the IES_INI_MEDICAID_OUTBOUND_ENC table when the SHINES user “signs” the Initial Medicaid page. The GTA webMethods broker will pick up these requests with an Oracle OCI JDBC driver connecting into the SHINES Oracle 10g2 database. The broker will post these requests to the SUCCESS application. The broker will then pick up responses from SUCCESS, and post them to SHINES via a web service invocation. SHINES will then update the Class of Assistance in the ELIBILITY table. Due to a potential time lag between the user signing the Initial Medicaid application in SHINES and SUCCESS having a determination ready, the interface broker will send the same request to SHINES as described in Appendix A. If the 60 days are exceeded, an email will be sent to the Case Manager.

This interface uses the database table mechanism for outbound messages due to the fact that the SUCCESS application is only available a maximum of 12 hours a day. It is scheduled to go down every night for batch processing from 7pm to 7am the next morning. At month end, SUCCESS is unavailable for 36 hours. During this time, SHINES users can still be filling out and signing the Initial Medicaid application, and the process should not be restricted to SUCCESS up time.

As with Income and Resources, one SHINES request may result in multiple corresponding transactions from GTA (via SUCCESS), because SUCCESS can return:

Multiple Class of Assistance records for a person (in theory only one is active, but there can be pending and many closed for the client) in the same benefit month

The interface is returning data for up to 5 benefit months (current, ongoing, and 3 previous months)

Message Description

The message is simply the fields needed to request Medicaid eligibility data, and the inbound message(s) contain Medicaid Class of Assistance with additional unused fields coming back from SUCCESS.

Table of Fields in SHINES going out to SUCCESS

Attribute/Logical Role Name	Nullable?	Data Name	Description	Type	Length
ID_IES_INI_MEDICAID_OUTBOUND	N	Transaction ID	Unique id for this request (from SHINES perspective) – Only used by GTA to identify results coming back	Numeric	16
	N	DHR Client Number	ID Retrieved From EMPI	Numeric	9
	N	Request Identifier	What type of request to send IES	String	3
	N	Request Date	This is actually the Removal Date according to recent IES docs	Date
NM_PERSON_FIRST	N	FirstName	Child’s First Name.	String	12
NM_PERSON_MIDDLE	Y	MiddleName	Child’s Middle Name.	String	12
NM_PERSON_LAST	N	LastName	Child’s Last Name.	String	22
CD_PERSON_SUFFIX	Y	Suffix	Suffix	String	2
DT_PERSON_BIRTH	N	DOB	Date of Birth	Date
CD_PERSON_SEX	N	Gender	Child’s Gender	String	1
NBR_PERSON_ID_NUMBER	Y	SSN	Social Security Number	Raw
CD_RACE	N	Race	Child’s Race	String	2
CD_ETHNICITY	N	Ethnicity	Child’s Ethnicity	String	2
CD_CITIZENSHIP_STATUS	N	CitizenshipStatus	Citizenship/Alienage Status	String	3
CD_PLACEMENT_COUNTY	N	Placement County	Placement address county from the most recent active placement that is either in COMP, PEND or APRV status in the stage	String	3
ADDR_PLCMT_LINE_1	N	Child Address Line 1	‘Street’ field in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.	String	30
ADDR_PLCMT_LINE_2	Y	Child Address Line 2 (ADDR_PLCMT_LINE_2)	‘Street’ field line 2 in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.	String	30
ADDR_PLCMT_CITY	N	Child Address City	'City' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.	String	20
ADDR_PLCMT_STATE	N	Child Address State	'State' field from the 'Address/Phone Detail' section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage. If the state is empty or null the system shall send a value equal to “GA”	String	2
ADDR_PLCMT_ZIP_CODE	N	Child Address Zip Code	'Zip' field from the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.	Integer	9
ADDR_DFCS_OFFICE_LINE_1	N	DFCSOfficeLoc	DFCS Address Line1 The string between first and second pipe symbols in the 'Office Location' field will be considered as DFCS Address line 1	String	62
NM_CASE_MANAGER	N	SSCM Name	Child’s FCC stage Primary Case Manager as displayed in the Case Manager column on the Case Summary page	String	25
ADDR_DFCS_OFFICE_CITY	N	DFCS Office City	Legal DFCS Office City	String	20
CD_ADDR_DFCS_OFFICE_STATE	N	DFCS Office State	State field from DFCS Office Address Always a constant value equal to “GA”	String	2
ADDR_DFCS_OFFICE_NAME	N	DFCS Office Name	<Child’s legal County from IMA page> appended with the string "County DFCS" e.g. Fulton County DFCS	String	15
CD_LEGAL_STATUS_COUNTY	N	Legal County	Legal County responsible for the child’s case. County field on the child’s Initial Medicaid Application page	String	3
IND_PREGNANCY	Y	Pregnancy	Child Pregnant Indicator	String	1
TXT_PERSON_EMAIL	Y	Email	Email Address	String	70
DT_SUBMITTED	N	Date Submitted	Date SSCM submitted MA application	Date
IND_REQ_AID	Y	Prior MA Indicator	Prior Medical Assistance Indicator	String	1
NM_RESOURCE_LEGAL	Y	Foster Parent	'Legal Name' field on the 'Resource Detail' page of the id_facility tied to the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage. If the Placement is with a Person Foster Parent is the 'Person' field from the 'Placement Name' sub section on the 'Placement Information'	String	45 SHINES will send 45 character long field and webMethods will truncate it to 30 characters before sending it to IES

Attribute/Logical Role Name

Nullable?

Data Name

Description

Type

Length

ID_IES_INI_MEDICAID_OUTBOUND

Transaction ID

Unique id for this request (from SHINES perspective) – Only used by GTA to identify results coming back

Numeric

DHR Client Number

ID Retrieved From EMPI

Numeric

Request Identifier

What type of request to send IES

String

Request Date

This is actually the Removal Date according to recent IES docs

Date

NM_PERSON_FIRST

FirstName

Child’s First Name.

String

NM_PERSON_MIDDLE

MiddleName

Child’s Middle Name.

String

NM_PERSON_LAST

LastName

Child’s Last Name.

String

CD_PERSON_SUFFIX

Suffix

String

DT_PERSON_BIRTH

DOB

Date of Birth

Date

CD_PERSON_SEX

Gender

Child’s Gender

String

NBR_PERSON_ID_NUMBER

SSN

Social Security Number

Raw

CD_RACE

Race

Child’s Race

String

CD_ETHNICITY

Ethnicity

Child’s Ethnicity

String

CD_CITIZENSHIP_STATUS

CitizenshipStatus

Citizenship/Alienage Status

String

CD_PLACEMENT_COUNTY

Placement County

Placement address county from the most recent active placement that is either in COMP, PEND or APRV status in the stage

String

ADDR_PLCMT_LINE_1

Child Address Line 1

‘Street’ field in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

String

ADDR_PLCMT_LINE_2

Child Address Line 2 (ADDR_PLCMT_LINE_2)

‘Street’ field line 2 in the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

String

ADDR_PLCMT_CITY

Child Address City

'City' field on the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

String

ADDR_PLCMT_STATE

Child Address State

String

ADDR_PLCMT_ZIP_CODE

Child Address Zip Code

'Zip' field from the ‘Address/Phone Detail’ section on the child’s most recent active placement that is either in COMP, PEND or APRV status in the stage.

Integer

ADDR_DFCS_OFFICE_LINE_1

DFCSOfficeLoc

DFCS Address Line1 The string between first and second pipe symbols in the 'Office Location' field will be considered as DFCS Address line 1

String

NM_CASE_MANAGER

SSCM Name

Child’s FCC stage Primary Case Manager as displayed in the Case Manager column on the Case Summary page

String

ADDR_DFCS_OFFICE_CITY

DFCS Office City

Legal DFCS Office City

String

CD_ADDR_DFCS_OFFICE_STATE

DFCS Office State

State field from DFCS Office Address Always a constant value equal to “GA”

String

ADDR_DFCS_OFFICE_NAME

DFCS Office Name

<Child’s legal County from IMA page> appended with the string "County DFCS" e.g. Fulton County DFCS

String

CD_LEGAL_STATUS_COUNTY

Legal County

Legal County responsible for the child’s case. County field on the child’s Initial Medicaid Application page

String

IND_PREGNANCY

Pregnancy

Child Pregnant Indicator

String

TXT_PERSON_EMAIL

Email Address

String

DT_SUBMITTED

Date Submitted

Date SSCM submitted MA application

Date

IND_REQ_AID

Prior MA Indicator

Prior Medical Assistance Indicator

String

NM_RESOURCE_LEGAL

Foster Parent

String

45 SHINES will send 45 character long field and webMethods will truncate it to 30 characters before sending it to IES

Table of Fields of Interest coming back to SHINES from GTA via SUCCESS as XML

Static/ Dynamic	Required (Yes, No)	Data Name	Description	Possible Value	Type	Length
Dynamic	Y	Transaction ID	ID of the SHINES request Transaction as sent to IES by SHINES		Numeric	16
Dynamic	Y	DHR Child ID	ID from EMPI		Numeric	9
Static	Y	Medicaid Class of Assistance	Code indicated the Medicaid Class of Assistance		String	3
Dynamic		Medically Needy First Day Liability Date	Date that Medicaid benefits kick in		Date
Dynamic		Medically Needy First Day Liability Amount	Amount the client is responsible for paying (Deductible)		Numeric
Dynamic	Y	Benefit Month	The month that this information applies to. SHINES cares about the most recent record currently.		Date (IES has MM YY – transform required)
Static	Y	Client Status	Indicates the status (Active, Pending, Closed, etc.) for this client in the AU		String
Dynamic	Y	Client Status Date	Date associated with Client’s status		Date
Dynamic	Y	Error Code	After the 60 days, if there are still an error, this will be populated		String
Dynamic	Y	Transaction ID	Unique SHINES id for this interface transaction		Numeric	16
Dynamic	Y	Application Number	Application/Ticket Number	Application/Tracking Number will be generated and stored within IES.
Dynamic	Y	EMPI ID	Enterprise Master Patient Index (EMPI ID)		Numeric	9
Dynamic	Y	IES Case Number	Case ID of the case in IES system		Numeric	9
Dynamic	Y	Response Code	Medicaid Referral Technical Response Status	Success/Denial/Errors
Dynamic	Y	Response Description		Response message for the SHINES referral service. Application received successfully include application number (00) Mandatory fields not received - list the fields (10) IES service unavailable (100) webMethods unavailable (101)	String	300

Static/ Dynamic

Required (Yes, No)

Data Name

Description

Possible Value

Type

Length

Dynamic

Transaction ID

ID of the SHINES request Transaction as sent to IES by SHINES

Numeric

Dynamic

DHR Child ID

ID from EMPI

Numeric

Static

Medicaid Class of Assistance

Code indicated the Medicaid Class of Assistance

String

Dynamic

Medically Needy First Day Liability Date

Date that Medicaid benefits kick in

Date

Dynamic

Medically Needy First Day Liability Amount

Amount the client is responsible for paying (Deductible)

Numeric

Dynamic

Benefit Month

The month that this information applies to. SHINES cares about the most recent record currently.

Date (IES has MM YY – transform required)

Static

Client Status

Indicates the status (Active, Pending, Closed, etc.) for this client in the AU

String

Dynamic

Client Status Date

Date associated with Client’s status

Date

Dynamic

Error Code

After the 60 days, if there are still an error, this will be populated

String

Dynamic

Transaction ID

Unique SHINES id for this interface transaction

Numeric

Dynamic

Application Number

Application/Ticket Number

Application/Tracking Number will be generated and stored within IES.

Dynamic

EMPI ID

Enterprise Master Patient Index (EMPI ID)

Numeric

Dynamic

IES Case Number

Case ID of the case in IES system

Numeric

Dynamic

Response Code

Medicaid Referral Technical Response Status

Success/Denial/Errors

Dynamic

Response Description

String

300

Method Narrative

After the case manager retrieves a EMPI ID from CRS for a client, they can go the Initial Medicaid page for that client, fill in the needed data and digitally sign the page. The user will get a message saying “Request Submitted”, and the user can then move on to other screens in SHINES. Signing the Initial Medicaid application will create a single row in the IES_INI_MEDICAID_OUTBOUND_ENC table.

The webMethods broker will pick up the transactions and change the status/date on the outbound table. Once the broker delivers the message to SUCCESS, it will update the status/date more time. When results are made available by SUCCESS, the broker will invoke the web service on the SHINES application. If SUCCESS has no information for the client, it will set the status to SND (Send No Data). The webMethods broker will retry the request as described in Appendix A. If no data is returned, an email will be sent to the address in the TXT_PERSON_EMAIL field. If data is returned, the web service will access the EJB layer to update the rows in the ELIGIBILITY table.

Error Handling

Error codes are written by the webMethods broker into the CD_ERROR field. The broker is responsible for retries, and if needed, emails are sent by the broker to administrators to notify them of problems in this interface.

Field Level Errors

If a field in a record to be extracted has a validation error, that row will be skipped, CD_ERROR and DT_PROCESS updated, and an email should be sent to the application administrators by the broker.

Row Level Errors

The broker should update CD_ERROR and DT_PROCESS if possible. Regardless, the broker should send an email to application administrators.

Process Level Errors

The most likely process level errors will be network and other communications errors. The interface broker will handle retries, and send emails to application administrators as needed. The interface broker will request the Medicaid data once a day until a value is returned or when the retry period expires, whichever comes first. This is typically due to a delay in data being entered into SUCCESS, as opposed to a technical error. This is a business process error, and when it happens, the interface broker will send an email to the case manager.

Triggering/Scheduling

The user will digitally sign the Initial Medicaid application which creates a request to SUCCESS to retrieve Medicaid eligibility data for the client.

Matching Criteria

SUCCESS also leverages the Client Repository System (CRS) to manager client information. Therefore, the CRS ID (URN) is the primary identifier for all clients/child’s information sent to SUCCESS.

Dependencies

All clients/child(ren) CRS identifiers are captured during the Investigation (INV) stage. Therefore, prior to sending the eligibility application to SUCCESS, all CRS identifiers must be present for SUCCESS to understand the client/child(ren) information.

Request Income and Resources

Technical Description

The SHINES application will insert a row into the INCOME_RESOURCE_OUTBOUND table when the SHINES user presses the appropriate button on the Income and Resources screen. The GTA webMethods broker will pick up these requests with an Oracle OCI JDBC driver connecting into the SHINES Oracle 10g2 database. The broker will post these requests to the SUCCESS application. The broker will then pick up responses from SUCCESS, and post them to the SHINES via a web service invocation. SHINES will then update the INCOME_AND_RESOURCES table. It is important to note that a single request can result in multiple inbound messages for that client.

Message Description

The message is simply the fields needed to request (inquiry) income data going out, and the inbound message(s) contain income or resource data coming back from SUCCESS.

Table of Fields in SHINES going out to SUCCESS

Attribute/Logical Rolename	Domain	Datatype	Null	Definition	Use in Interface
ID_INCOME_RESOURCE_OUTBOUND	ID	NUMERIC(16, 0)	N	Unique Transaction ID	The broker should sent this id back for correlation purposes
DT_LAST_UPDATE	DT_LAST_UPDATE	DATE	N	Date of insert or last update	Internal use
INTERFACE_STATUS		VARCHAR(3)	N	Status of this record with regards to the interface - NEW, INP (In Process), SNT (Sent), ERR (Error)	Updated by the interface broker
DT_PROCESS		DATE	Y	Date that this record was picked up by the interface (In Process) or sent by the interface (Sent) or errored out (Error)	Updated by the interface broker
CD_ERROR		VARCHAR(10)	Y	If there was an error sending this record, an error code as to why is stored here.	Updated by the interface broker
ID_INITIATOR	ID	NUMERIC(16, 0)	N	ID_INITIATOR references ID_PERSON in the PERSON table. This is the SHINES user that requested the Income information. The user should be in the EMPLOYEE table as well.	Internal use – auditing purposes to track who is making income requests
DT_INC_REQUESTED		DATE	Y	This is the date that the income and resource information was requested	Date of request – send to target system
CD_TARGET_SYSTEM		VARCHAR(4)	Y	Target system for the Medicaid request record. NULL can be used if the information can be provided to anyone subscribing to Income requests for information from SHINES. Otherwise, it can specific a specific external system such as "SUC" for SUCCESS.	Used to identify who the broker should send message too. Default is everyone interested.
ID_PERSON	ID	NUMERIC(16, 0)	N	ID of the person for whom Medicaid data is being requested. This is the SHINES ID, and for internal use only.	Internal use
NBR_CRS_ID		NUMERIC(9, 0)	N	This is a nine digit identifier from Georgia’s Client Registration System, a central repository for clients being served by Medicaid, TANF, Food Stamps, DFCS, and child support cases. This identifier is also known to SUCCESS, the state’s benefit system. This ID serves as a cross-system identifier with external systems.	Sent to target system
CD_REQ_IDENT		VARCHAR(3)	N	Identifies the type of request. All entries in this table should be "INQ" for Inquiry.	Sent to target system

Attribute/Logical Rolename

Domain

Datatype

Null

Definition

Use in Interface

ID_INCOME_RESOURCE_OUTBOUND

NUMERIC(16, 0)

Unique Transaction ID

The broker should sent this id back for correlation purposes

DT_LAST_UPDATE

DATE

Date of insert or last update

Internal use

INTERFACE_STATUS

VARCHAR(3)

Status of this record with regards to the interface - NEW, INP (In Process), SNT (Sent), ERR (Error)

Updated by the interface broker

DT_PROCESS

DATE

Date that this record was picked up by the interface (In Process) or sent by the interface (Sent) or errored out (Error)

Updated by the interface broker

CD_ERROR

VARCHAR(10)

If there was an error sending this record, an error code as to why is stored here.

Updated by the interface broker

ID_INITIATOR

NUMERIC(16, 0)

ID_INITIATOR references ID_PERSON in the PERSON table. This is the SHINES user that requested the Income information. The user should be in the EMPLOYEE table as well.

Internal use – auditing purposes to track who is making income requests

DT_INC_REQUESTED

DATE

This is the date that the income and resource information was requested

Date of request – send to target system

CD_TARGET_SYSTEM

VARCHAR(4)

Target system for the Medicaid request record. NULL can be used if the information can be provided to anyone subscribing to Income requests for information from SHINES. Otherwise, it can specific a specific external system such as "SUC" for SUCCESS.

Used to identify who the broker should send message too. Default is everyone interested.

ID_PERSON

NUMERIC(16, 0)

ID of the person for whom Medicaid data is being requested. This is the SHINES ID, and for internal use only.

Internal use

NBR_CRS_ID

NUMERIC(9, 0)

This is a nine digit identifier from Georgia’s Client Registration System, a central repository for clients being served by Medicaid, TANF, Food Stamps, DFCS, and child support cases. This identifier is also known to SUCCESS, the state’s benefit system. This ID serves as a cross-system identifier with external systems.

Sent to target system

CD_REQ_IDENT

VARCHAR(3)

Identifies the type of request. All entries in this table should be "INQ" for Inquiry.

Sent to target system

Table of Fields coming back to SHINES from GTA via SUCCESS as XML

Static/ Dynamic	Required (Yes, No)	Data Name	Data Type	Length	Transformation Rules
Dynamic	Y	Transaction ID	Numeric	16
Dynamic	Y	DHR Child ID	Numeric	9
Static	Y	Income/Resource Identifier	String	3
Static	Y	Income/Resource Type	String	3
Static	Y	Earned Indicator	String	1
Dynamic	N	AU Number	Numeric
Static	N	AU Type	String
Static	N	AU Status	String
Dynamic	N	Case Load Number
Dynamic	N	Income Amount	Numeric	10,2
Static	N	Income Frequency	String	3
Dynamic	N	Resource Fair Market Value	Numeric	10,2
Dynamic	N	Start Date	Date
Dynamic	N	End Date	Date
Dynamic	N	Source/Employer Name	String	20
Dynamic	N	S/E Address Line 1	String	30
Dynamic	N	S/E Address Line 2	String	30
Dynamic	N	S/E City	String	20
Static	N	S/E State	String	2
Dynamic	N	S/E Zip	String	10
Static	N	Verification Method	String	20
Dynamic	Y	Benefit Month	Date		SUCCESS has YYYYMM
Dynamic	Y	Error Code	String

Static/ Dynamic

Required (Yes, No)

Data Name

Data Type

Length

Transformation Rules

Validation Rules

Default

Dynamic

Transaction ID

Numeric

Dynamic

DHR Child ID

Numeric

Static

Income/Resource Identifier

String

Static

Income/Resource Type

String

Static

Earned Indicator

String

Dynamic

AU Number

Numeric

Static

AU Type

String

Static

AU Status

String

Dynamic

Case Load Number

Dynamic

Income Amount

Numeric

10,2

Static

Income Frequency

String

Dynamic

Resource Fair Market Value

Numeric

10,2

Dynamic

Start Date

Date

Dynamic

End Date

Date

Dynamic

Source/Employer Name

String

Dynamic

S/E Address Line 1

String

Dynamic

S/E Address Line 2

String

Dynamic

S/E City

String

Static

S/E State

String

Dynamic

S/E Zip

String

Static

Verification Method

String

Dynamic

Benefit Month

Date

SUCCESS has YYYYMM

Dynamic

Error Code

String

Method Narrative

After the case manager retrieves a CRS ID from CRS for a client, they can go the Income and Resources screen for that client and press a button on that page labeled “Get Income/Resource From SUCCESS”. The user will get a message saying “Request Submitted”, and the user can then move on to other screens in SHINES. Pressing the button will create a single row in the INCOME_RESOURCE_OUTBOUND table. The ID_INITIATOR will be the ID_PERSON of the Case Manager who pushed the button. CD_TARGET_SYSTEM will be “SUC” for SUCCESS (or NULL for all subscribers). ID_PERSON is the SHINES ID for the client and is used only for internal verification. NBR_CRS_ID is the most important field since it contains the identifier for the client that SUCCESS understands. CD_REQ_IDENT will be “INQ” for inquiry.

The webMethods broker will pick up the transactions and change the status/date on the outbound table. Once the broker delivers the message to SUCCESS, it will update the status/date one more time. When results are made available by SUCCESS, the broker will invoke the web service on the SHINES application. It is very likely that the body will contain multiple rows of income data for the one request. The web service will access the EJB layer to insert the rows into the INCOME_AND_RESOURCES table.

The Inbound web service on SHINES side receives the response from GTA for the requested Income Resource information. The inbound service try to identify the existing income resource information based on CD_INC_RSRC_INCOME, CD_INC_RSRC_TYPE, DT_INC_RSRC_FROM, DT_INC_RSRC_TO, ID_PERSON, ID_INC_RSRC_WORKER, TXT_INC_RSRC_SRC_ADDR_ZIP from the INCOME_AND_RESOURCE table. If any record available in the table with those matched parameters web service will update the existing record with income resource information that came from GTA. If there are no matching records available in INCOME_AND_RESOURCE table the Inbound Web service will insert a new record into INCOME_AND_RESOURCE table for the person who requested Income Resource information.

Error Handling

Field Level Errors

If a field in a record to be extracted has a validation error, that row will be skipped, CD_ERROR and DT_PROCESS updated, and an email should be sent to the application administrators by the broker.

Row Level Errors

The broker should update CD_ERROR and DT_PROCESS if possible. Regardless, the broker should send an email to application administrators.

Process Level Errors

The most likely process level errors will be network and other communications errors. The interface broker will handle retries, and send emails to application administrators as needed.

Triggering/Scheduling

The user will press a button on the Income and Resources page whose sole intent is to create a request to SUCCESS to retrieve Income and Resources data for the client.

Matching Criteria

SUCCESS also leverages the Client Repository System (CRS) to manager client information. Therefore, the CRS ID (URN) is the primary identifier for all clients/child’s information sent to SUCCESS.

Dependencies

All clients/child(ren) CRS identifiers are captured during the Investigation (INV) stage. Therefore, prior to sending the income request to SUCCESS, all CRS identifiers must be present for SUCCESS to understand the client/child(ren) information.

Open Discussion Points

Point#

Description

Resolution/Comments

Status (Open, In Progress, Resolved)

Appendix A: Frequency Table

SHINES outbound status	Frequency	Frequency
SHINES outbound status	SUCCESS1 - Medicaid Eligibility	SUCCESS2 - Income and Resource
NFD	Retry for 60 calendar days, once a day (at 7:00 AM) during regular scheduled days.	N/A
RTO	Hourly during regular scheduled days	Every 5 mins during regular scheduled days
ERR	Hourly during regular scheduled days	Every 5 mins during regular scheduled days
NEW	Hourly during regular scheduled days	Every 5 mins during regular scheduled days
SNT	Updated by GTA after successfully delivering data to SUCCESS	Updated by GTA after successfully delivering data to SUCCESS
CLS	Updated by GTA after unsuccessfully trying to deliver data to SUCCESS for 60 days	N/A

SHINES outbound status

Frequency

SHINES outbound status

SUCCESS1 - Medicaid Eligibility

SUCCESS2 - Income and Resource

NFD

Retry for 60 calendar days, once a day (at 7:00 AM) during regular scheduled days.

N/A

RTO

Hourly during regular scheduled days

Every 5 mins during regular scheduled days

ERR

Hourly during regular scheduled days

Every 5 mins during regular scheduled days

NEW

Hourly during regular scheduled days

Every 5 mins during regular scheduled days

SNT

Updated by GTA after successfully delivering data to SUCCESS

CLS

Updated by GTA after unsuccessfully trying to deliver data to SUCCESS for 60 days

N/A

SHINES outbound status	Frequency
SHINES outbound status	IES – Medicaid Referral
NFD	Retry for 60 calendar days, once a day (at 7:00 AM) during regular scheduled days.
RTO	Every 15 min during regular scheduled days
ERR	Every 15 min during regular scheduled days
NEW	Every 15 min during regular scheduled days
SNT	Updated by GTA after successfully delivering data to IES
CLS	Updated by GTA after unsuccessfully trying to deliver data to IES for 60 days

SHINES outbound status

Frequency

SHINES outbound status

IES – Medicaid Referral

NFD

Retry for 60 calendar days, once a day (at 7:00 AM) during regular scheduled days.

RTO

Every 15 min during regular scheduled days

ERR

Every 15 min during regular scheduled days

NEW

Every 15 min during regular scheduled days

SNT

Updated by GTA after successfully delivering data to IES

CLS

Updated by GTA after unsuccessfully trying to deliver data to IES for 60 days

Document Change Log

Date	Author	Change Description
12/01/2017	David Fink	Updated IES to 'Eligibility System' per request from Felecia Fulton
5/18/2017	Ashwini Rege	CR 256 Changes – Updated IESM.1.2.26, added IESM.1.2.27 and added IESM.1.2.28
5/15/2017	Ashwini Rege	CR 256 Changes - Added SSCM and removed EMPI ID from IESM.1.2. Added IESM.1.6 Updated Table of Fields to send to IES Removed IESM .1.2.8 and IESM 1.2.18. Added IESM.1.2.18, IESM.1.2.18a, IESM.1.2.18b, IESM.1.2.19, IESM.1.2.19am IESM.1.2.19b, IESM.1.2.19c, IESM.1.2.23, IESM.1.2.24, IESM.1.2.25, IESM.1.2.26 and IESM.1.2.27
5/3/2017	Ashwini Rege	Removed following requirements from this design and added to ‘Initial Medicaid Application’ design IESM.1.2.21 IESM.1.2.22 IESM.1.3.1 IESM.1.3.2 IESM.1.4.1
03/28/2016	Ashwini Rege	Updated requirements IESM.1.5.2, IESM.3.1.1, IESM.3.1.3, IESM.3.1.4, IESM.4.1.1 and IESM.4.1.4 for clarification as suggested by the dev team. Added frequency table for IES Medicaid Referral in appendix A.
12/09/2016	Ashwini Rege	IES Medicaid Referral updates as per level 2 comment review– Updated requirement IESM.1.2, IESM.1.2.21, IESM.1.2.22, IESM.1.3.1, IESM.1.3.2
11/28/2016	Ashwini Rege	Added requirement IESM.1.2.21 as per 11/28 comment review meeting. Updated 1.3.2 with error message Added placement address field in section 1.2.3
10/26/2016	Ashwini Rege	Accepted track changes and highlighted SOW 9 –IES Medicaid Referral Project Updated the following sections 1.0 General Design 1.1 Introduction 1.1.2 Functional Overview 1.2.1 Functional Description Replaced IMPACT page mock up with SHINES mock up for Eligibility Summary page 1.2.2 Table of Fields Returned by Broker via IES 1.2.4 Table of Fields to send to IES (via Broker) 1.4 Design Requirements
9/29/2016	Derrick Moss	Cleanup this Detail Design document by removing all the highlighted references and will began tracking changes with Track Changes going forward. SOW 9 – Version 4.0 (IES Medicaid Referral) Updated: 1.0 General Design 1.1 Introduction 1.1.2 Functional Overview 1.2.1 Functional Description 1.2.2 Table of Fields Returned by Broker via IES 1.2.4 Table of Fields to send to IES (via Broker) 1.3.1 Functional Description 1.3.3 Table of Fields to send to IES (via Broker) 1.3.4 Table of Fields Returned by Broker via IES 1.4 Design Requirements
03/22/2016	Christine Nguyen and Roshanda Minor	Added IES Code Mapping Values to section 1.3.5
05/01/2016	Roshanda Minor	Version 3.0, IES – Updated: 1.0 General Design 1.1 Introduction 1.2.1 Functional Description 1.2.2 Table of Fields Returned by Broker via IES 1.2.4 Table of Fields to send to IES (via Broker) 1.3.1 Functional Description 1.3.3 Table of Fields to send to IES (via Broker) 1.3.4 Table of Fields Returned by Broker via IES 1.4 Design Requirements
02/23/2016	Roshanda Minor and Pamela Gifford	Version 2.0, EMPI – Updated: 1. General Design 1.2 Request Medicaid Eligibility 1.2.3 Table of Fields to send to SUCCESS (via Broker) 1.2.4 Table of Fields Returned by Broker via SUCCESS 1.3.1 Functional Description 1.3.3 Table of Fields to send to SUCCESS (via Broker) 1.3.4 Table of Fields Returned by Broker via SUCCESS 1.4 Design Requirements
09/14/2007	Michael Chillman	Updated requirements
08/9/2007	Srinivasa Rao Dodda	Update to Success Medicaid Outbound table added a column ID_EVENT
05/08/2007	John Ramspott	Update to correct field names and new data fields, and documenting that SUCCESS is a CICS transaction being invoked by a web service exclusively.
04/19/2007	John Ramspott	Update to include new fields based on SUCCESS final SRS.
03/30/2007	Dinesh Jayapalan	Added Screen mock-up showing the COA from SUCCESS and the date it was received
03/02/2007	John Ramspott	Updates from State
02/08/2007	John Ramspott	Radical shift in functional and technical
08/20/2006	Srinivas Somayajula	Added Functional Section. (Section 1.0)
08/01/2006	John Ramspott	Initial Document Creation

Date

Author

Change Description

12/01/2017

David Fink

Updated IES to 'Eligibility System' per request from Felecia Fulton

5/18/2017

Ashwini Rege

CR 256 Changes – Updated IESM.1.2.26, added IESM.1.2.27 and added IESM.1.2.28

5/15/2017

Ashwini Rege

CR 256 Changes - Added SSCM and removed EMPI ID from IESM.1.2. Added IESM.1.6 Updated Table of Fields to send to IES Removed IESM .1.2.8 and IESM 1.2.18. Added IESM.1.2.18, IESM.1.2.18a, IESM.1.2.18b, IESM.1.2.19, IESM.1.2.19am IESM.1.2.19b, IESM.1.2.19c, IESM.1.2.23, IESM.1.2.24, IESM.1.2.25, IESM.1.2.26 and IESM.1.2.27

5/3/2017

Ashwini Rege

Removed following requirements from this design and added to ‘Initial Medicaid Application’ design IESM.1.2.21 IESM.1.2.22 IESM.1.3.1 IESM.1.3.2 IESM.1.4.1

03/28/2016

Ashwini Rege

Updated requirements IESM.1.5.2, IESM.3.1.1, IESM.3.1.3, IESM.3.1.4, IESM.4.1.1 and IESM.4.1.4 for clarification as suggested by the dev team. Added frequency table for IES Medicaid Referral in appendix A.

12/09/2016

Ashwini Rege

IES Medicaid Referral updates as per level 2 comment review– Updated requirement IESM.1.2, IESM.1.2.21, IESM.1.2.22, IESM.1.3.1, IESM.1.3.2

11/28/2016

Ashwini Rege

Added requirement IESM.1.2.21 as per 11/28 comment review meeting. Updated 1.3.2 with error message Added placement address field in section 1.2.3

10/26/2016

Ashwini Rege

Accepted track changes and highlighted SOW 9 –IES Medicaid Referral Project Updated the following sections 1.0 General Design 1.1 Introduction 1.1.2 Functional Overview 1.2.1 Functional Description Replaced IMPACT page mock up with SHINES mock up for Eligibility Summary page 1.2.2 Table of Fields Returned by Broker via IES 1.2.4 Table of Fields to send to IES (via Broker) 1.4 Design Requirements

9/29/2016

Derrick Moss

Cleanup this Detail Design document by removing all the highlighted references and will began tracking changes with Track Changes going forward. SOW 9 – Version 4.0 (IES Medicaid Referral) Updated: 1.0 General Design 1.1 Introduction 1.1.2 Functional Overview 1.2.1 Functional Description 1.2.2 Table of Fields Returned by Broker via IES 1.2.4 Table of Fields to send to IES (via Broker) 1.3.1 Functional Description 1.3.3 Table of Fields to send to IES (via Broker) 1.3.4 Table of Fields Returned by Broker via IES 1.4 Design Requirements

03/22/2016

Christine Nguyen and Roshanda Minor

Added IES Code Mapping Values to section 1.3.5

05/01/2016

Roshanda Minor

Version 3.0, IES – Updated: 1.0 General Design 1.1 Introduction 1.2.1 Functional Description 1.2.2 Table of Fields Returned by Broker via IES 1.2.4 Table of Fields to send to IES (via Broker) 1.3.1 Functional Description 1.3.3 Table of Fields to send to IES (via Broker) 1.3.4 Table of Fields Returned by Broker via IES 1.4 Design Requirements

02/23/2016

Roshanda Minor and Pamela Gifford

Version 2.0, EMPI – Updated: 1. General Design 1.2 Request Medicaid Eligibility 1.2.3 Table of Fields to send to SUCCESS (via Broker) 1.2.4 Table of Fields Returned by Broker via SUCCESS 1.3.1 Functional Description 1.3.3 Table of Fields to send to SUCCESS (via Broker) 1.3.4 Table of Fields Returned by Broker via SUCCESS 1.4 Design Requirements

09/14/2007

Michael Chillman

Updated requirements

08/9/2007

Srinivasa Rao Dodda

Update to Success Medicaid Outbound table added a column ID_EVENT

05/08/2007

John Ramspott

Update to correct field names and new data fields, and documenting that SUCCESS is a CICS transaction being invoked by a web service exclusively.

04/19/2007

John Ramspott

Update to include new fields based on SUCCESS final SRS.

03/30/2007

Dinesh Jayapalan

Added Screen mock-up showing the COA from SUCCESS and the date it was received

03/02/2007

John Ramspott

Updates from State

02/08/2007

John Ramspott

Radical shift in functional and technical

08/20/2006

Srinivas Somayajula

Added Functional Section. (Section 1.0)

08/01/2006

John Ramspott

Initial Document Creation

Note: A new row explaining document changes must be added to the Document Change Log for each revision. The Document Change Log must be maintained in reverse chronological order. The most recent changes are on the top of the list.

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