State HHS Program Software
Civilian software for state Medicaid, child welfare, behavioral health, and HHS programs. Intake, case management, dashboards, document review. Civilian, unclassified, Section 508 / WCAG 2.1 AA by default.
Who we build for
Behind every eligibility screen and case file is a family waiting on care, a benefit, or a child-welfare decision — and the staff serving them are stuck in software that slows them down. We build for the agencies that carry that work: state health-and-human-services (HHS), Medicaid, child-safety (DCS), and health-department (DOH) programs, and the prime contractors who serve them. We fit cleanly inside existing state procurement vehicles and prime task orders.
- State Medicaid agencies — AHCCCS (Arizona’s Medicaid agency), NM HSD (the New Mexico Human Services Department), OHCA (the Oklahoma Health Care Authority), and analog Medicaid agencies in MT, SD, ND, WA, and CA where Native-serving population overlaps
- State Child Safety / Family Services — tools for CCWIS (the federal child-welfare case-management data standard) and ICWA (the Indian Child Welfare Act) Tribal coordination, mobile case management, court reporting workflows
- State Behavioral Health — intake, referral, eligibility, and outcomes reporting modules
- State Department of Education — Tribal education data, BIE-state coordination, federal grant reporting tools
- State Health Departments — community health information systems, public health data dashboards, rural-health-program reporting
Module shapes that fit state HHS programs and procurements
Intake, eligibility & referral workflows
Structured intake, eligibility logic, internal review queues, cross-agency referral with consent capture. Replaces PDF-and-email intake.
Case management add-ons
Light case-management workflow modules that integrate with existing state systems of record. Not a CCWIS replacement — an adjacent module.
Program reporting dashboards
Funding-by-program visualizations, outcomes reporting, federal grant compliance rollups. AI-summarized narrative drafts reviewed by program staff.
Document-to-dashboard pipelines
Document ingestion + LLM-assisted extraction + dashboard + AI-drafted narrative review. See Document-to-Dashboard Workflow for detail.
If we built it for your agency
Three modules shaped to drop into your stack — aligned with the procurement framework you’re already operating in (CMS SMC, CMS Electronic PA Final Rule, 2016 CCWIS rule). The point is to clear contract review on the first pass without surprising your IT team.
Eligibility-screened in one sitting — not a six-week mail loop
Applicants finish identity, household, income, and plan in one flow. The module screens against SNAP, AHCCCS Medicaid, and TANF in the background and tells them what they qualify for before they hit submit. The eligibility-worker call-back queue shrinks because most determinations don’t need a follow-up.
- Auto-screen across programs — applicants don’t re-apply separately to each benefit
- SMC-aligned intake — built around CMS Streamlined Modular Certification outcome metrics, ready for APD alignment
- Most determinations clear without a call-back — staff time goes to edge cases, not the routine 80%
Cut prior auth from 50 minutes to under 5 — without taking the human out
AI reads the request against codified medical-policy criteria, flags missing documentation, and recommends Approve / Pend / Deny with a confidence score. The reviewer makes the call; the AI does the prep. Industry data on AI-assisted PA shows ~10× cycle time reduction in similar shapes — with the human still owning the decision.
- Criteria check against your plan’s medical policy, automatically
- Confidence-scored recommendation — reviewer sees what the AI checked, not just its answer
- CMS Electronic PA Final Rule shape — FHIR PA API-ready when the final rule’s timeline reaches your state
Every ICWA-relevant event in one place — ready for the next court date
Caseworkers see the full chronology — intake, ICWA notification, court hearings, placements, periodic reviews — without flipping between three legacy CCWIS screens. Tribal-state coordination happens inside the system instead of via email and faxed court orders.
- ICWA-aware — preferred placement and Tribal notification timing tracked, not guessed at audit time
- One screen replaces three legacy CCWIS panels — caseworker time goes to the case, not the system
- Court-report generator — pulls from the timeline, doesn’t ask for re-entry the day before the hearing
Common RFP shapes we respond to
If your state-HHS procurement looks like one of these, we ship that. Each shape below maps to a real RFP form currently in market — AHCCCS / NM HSD / OHCA / multi-state CCWIS / CMS Electronic PA Final Rule — with a deliverable and a price band.
Modular E&E module · CMS SMC
RFP language: “Modular eligibility-and-enrollment component meeting CMS Streamlined Modular Certification (effective 2026-07-01) with APD-aligned outcomes and metrics.”
What we ship: E&E intake module + SMC Intake Form alignment + CMS outcome-metric mapping + 90/75/50% match-preserving documentation.
Posture: CMS SMC-aware →
CCWIS intake / case-management module
RFP language: “CCWIS module covering intake, case management, visitation reporting, court records, and Tribal-state coordination per 2016 CCWIS final rule.”
What we ship: Intake workflow + case timeline + ICWA-aware flagging + Tribal-state data exchange + court-report generator.
Cross-line: Tribal coordination →
AI-enabled prior authorization workflow
RFP language: “FHIR-based electronic prior-authorization API + AI decision support against codified medical-policy criteria, per CMS Electronic PA Final Rule.”
What we ship: FHIR PA API + medical-policy criteria engine + AI recommendation with confidence + human-in-loop approve/pend/deny.
ICWA / Tribal-state CCWIS coordination
RFP language: “Tribal-state data exchange tool for ICWA notifications, kinship-placement tracking, and Tribal social-services coordination.”
What we ship: Tribal-state portal + ICWA notification queue + kinship-preference tracking + audit log.
Behavioral health intake & referral
RFP language: “Behavioral health intake portal with eligibility checking, level-of-care screening, and referral coordination with consent capture.”
What we ship: Intake portal + ASAM level screening + eligibility checks + referral with consent.
Provider credentialing modernization
RFP language: “Provider credentialing application workflow with 120-day SLA tracking, revalidation cycle automation, and managed-care-org coordination.”
What we ship: Application workflow + SLA timer + revalidation cycle + MCO data exchange.
Compliance posture
- Civilian / unclassified — no DoD / cleared work; CUI-aware via NIST SP 800-171 alignment (self-assessment in flight)
- Section 508 / WCAG 2.1 AA conformant by default, not retrofitted
- HIPAA / BAA-ready when engagement touches PHI
- FedRAMP-Moderate inherited via AWS GovCloud or Azure Government when state agency requires
- Tribal data sovereignty principles applied when state-Tribal compact data is in scope
For the detailed compliance posture see Certifications.
Tribal-state compact & ICWA / Title IV-E software
Where state HHS work meets Tribal-coordination requirements, our Native-serving deployments give us the cultural and regulatory context most generic civic-tech subs lack.
ICWA / Title IV-E coordination tools
Software supporting Indian Child Welfare Act (ICWA) compliance workflows, Title IV-E Tribal foster care reporting, and state CCWIS Tribal-coordination modules. The 2016 CCWIS final rule explicitly permits "optional electronic data exchanges between CCWIS and tribal systems" — the integration shape we build.
Tribal-state Medicaid compact tools
Software supporting state Medicaid agency consultation with Tribal Health Programs under ACOM-style Tribal Consultation Policies (AHCCCS's policy requires 45-day public-comment + Tribal consultation periods on substantial policy changes). Workflows for member-communication and benefit-status notification that respect Tribal data sovereignty.
State HHS / IHS handoff workflows
Workflows for state HHS programs that serve Tribal members alongside IHS / 638-contract Tribal Health Programs — eligibility verification, referral routing, dual-coverage navigation, BIA / BIE coordination where program scope crosses agency lines.
CMS Streamlined Modular Certification (SMC) modules
OlenArc engagements fit the CMS SMC framework that became mandatory effective July 1, 2026 (per CMS SHO 25-003). State Medicaid agencies must procure in modular pieces to preserve 90/75/50% enhanced federal match. Our 4–12 week module-scoped sprints align with SMC certification documentation requirements.
How we engage
- Direct as state vendor — registered on Arizona Procurement Portal (APP), Alaska state vendor system, and additional state portals on request
- Sub to existing state prime — when a state prime (Accenture, NTT Data, CNSI/Acentra, CSG, EY) needs niche AI / portal / intake capability that isn't in their stack
- Discovery sprint first — 3–6 weeks fixed-price discovery before any production build; reduces risk on both sides
State HHS RFP in flight?
Send us the solicitation number or scope summary. We'll respond with a fit read, named-team capability statement, and BAA-ready security packet outline within two business days.