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upon analysis of updated data inputs and case details.

They can evaluate information from disparate sources such as the applica- tion itself and third-party data used to verify application information against each set of rules to establish eligibility for each program. They can also be used to manage workflow, trig- gering processes for steps such as data verification, follow-up with clients, enrollment in health plans, and notifi- cation of changes in benefits. For health and human service pro- viders, this automation of routine work can help standardize processes for more consistent results, resulting in operational efficiencies that reduce the need for duplication, and allow eligibility workers to re-direct their time and focus on complex cases that need individualized attention and support. Mark Allen founded Corticon in 2000, which was acquired by Progress in 2011. protect the status quo. Difficult budgets require setting priorities and making cuts; legislators have their own ideas about money. Navigating those conflicts and moving forward requires constructive cooperation, and confidence in the CEO is vital. Our constitutional system of sepa- ration of powers created the healthy tension of checks and balances. The model for state governments was the U.S. Constitution, in which the legisla- tive branch is created in Article One, with the powers to pass laws, raise revenues, and set budgets. The execu- tive branch comes next, in Article Two. It behooves the prudent CEO to always remember this order. Doug Racine is the former secretary of the Vermont Department of Human Services, a former Vermont state senator, and was the 77th lieutenant governor of Vermont.

Enhancing Enrollment and Eligibility Processing By using a rules-based approach to support automated workflow and decision support, a BRMS can enhance virtually all the functions and activi- ties associated with the process of enrollment and eligibility manage- ment, including: Online screening: Business rules are used to verify eligibility for one or more programs. Applying for benefits: Business rules can validate the data needed for a given program in real-time. Benefit simulation: Business rules can calculate “what if” benefit amounts based on selected programs and criteria. Eligibility determination and benefit calculation: Business rules can determine the proper benefits. Overpayments and underpayments: Business rules can automatically deter- mine over- or underpayments based someone will be held accountable. CEOs operate in highly political envi- ronments and politics are not for the faint of heart! Many CEOs acknowledge that they had to learn to appreciate that the concerns of legislators are dif- ferent from theirs, but still legitimate. Legislators are elected officials who must respond to their constituents as well as to those who often speak for them: advocates and lobbyists. Legislators deal with the constant conflict of clashing philosophies, ideas, and priorities. They are called upon to respond to crises and issues that attract media attention. The problems of the CEO can seem minor in comparison. On the other hand, legislators are often perceived to be unaware of the daily challenges involved with managing a large organization. They do not always appreciate the LEGISLATURE continued from page 5

The Impact on Citizens and Providers

Business rules management systems, though largely invisible to citizens, are already having a tremendous impact on their experience, shortening other- wise lengthy processes. In some cases, they are achieving real-time eligibility and enrollment, where citizens are able to receive determination and be enrolled in benefits programs during the same session in which they sub- mitted their application, and even entirely online. For health and human service agencies, modernized systems are achieving efficiencies throughout the enrollment process, automating what would otherwise be manual. For example, the BRMS can be pro- grammed with rules from multiple health and human service programs. difficulties of working with antiquated IT or a staff stressed by recent position cuts. They have high expectations of what can be done with limited budgets. Getting to a place of greater understanding and better results requires the foundation of effective relationships. Today’s CEOs are operating in volatile and constantly changing economic, social, and political environments. Adaptability and trans- formational change are the norms. The path forward is strewn with challenges and risks. Replacing legacy IT systems can cost tens, even hundreds of millions of dollars. There are always uncer- tainties, stories of IT failures, and setbacks; legislators become skep- tical. Integration of services means change, which can be threatening to employees, community partners, and recipients; legislators are asked to

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