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Prior to 2001, if you were an Arizona woman in need of WIC assistance, you might have had to wait for days to get an appointment with a WIC nutrition counselor and a check to help pay for food. Now, under the Arizona in Motion system developed by CMA, you can get the help you need - today. Overwhelming pressure generated by growing WIC caseloads, archaic computer systems, and changes in USDA mandates moved Arizona to look for the vendor that could handle a modernization project for a state of their size. On August 19, 1998, they awarded the contract to CMA Consulting Services.

The Task

Between 1994 and 1997 the WIC population served in Arizona had grown by 23,000 participants, a full 25 percent, and the numbers were continuing to grow. To process a WIC client, agency staff had to manually fill out paper-based applications, health questionnaires, and risk assessments and then send them on to a contractor in Kansas for data entry. A biweekly batch process uploaded the new data to the check printing system, but agency workers had no online access to information, relying instead on paper documents returned from the contractor.

The paper system was filled with inaccuracies, required redundant manual data entry on multiple forms, and necessitated voiding a full 25 percent of the pre-printed checks. Worse, the amount of time agency workers spent on paperwork and its inherent errors and inefficiencies meant there was less time to provide nutrition counseling to their WIC clients.

Arizona entrusted CMA with creating their new system. They wanted the system to:

• Reduce paperwork.
• Improve services to WIC clients.
• Improve client flow and processing.
• Improve staff morale while boosting productivity.
• Reduce problems related to current batch operations.
• Provide flexibility in software changes.
• Enhance fiscal accountability.
• Respond to current and pending Federal and State reporting requirements.

All while reducing operational costs. In addition, the system needed to function at both the State and local agency levels creating the need for two modules: a central client server module to support state level operations and a PC/LAN-based clinic module to support local site, service-delivery activities. This required installation of LANs and automation hardware in 80 clinic sites, database servers in 20 local agencies (main data sites), a state-wide data communications network to support state-wide processing, and a laptop solution for 16 temporary satellite sites.

How CMA Made the Difference

CMA set to work. Using the WIC system they had built and implemented for Hawaii as a baseline environment saved Arizona valuable development time and costs. The Hawaii transfer system contained 300 screens and 300 reports built upon 360 Oracle tables and 3,582 fields. Seven functional modules from the transfer system would satisfy all of Arizona's requirments. These were Enrollment and Certification, Appointment Scheduler, Food Instrument Processing, Operations Management, System Administration, Financial Management, and Vendor Management.

The development phase began in November 1999. Seventeen programmers spent 10,000 hours on development resulting in 20 new system components and 200 new reports to support Arizona's caseload, which was five times bigger than that of Hawaii. The fully-integrated system design revolved around USDA mandates and requirements and included such enhancements as automated growth charts, participant care plans, online SOAP (Subjective Objective Assessment Plan) notes, a food package matrix, food instrument production options, USDA financial and caseload reports, and over 80 vendor risk analysis and compliance reports to detect fraud.

Throughout the project CMA kept Arizona well-informed, starting with a two-day presentation of the transfer system. They participated in application design sessions with 30 WIC staff and produced 4,000 pages of specifications explaining the proposed system's screens and reports. CMA produced a quarterly newsletter that was sent to all WIC clinics and provided demos at multiple WIC Nutrition Education Conferences. CMA also set up a PVCS Tracker version control database to record results of the state User Acceptance Testing. During rollout, CMA participated in daily conference calls to assure that any implementation issues were handled promptly. They also provided training to WIC staff that was rated 'Exceptional' in 99% of the reviews, and helped WIC staff achieve system proficiency within one week.

By August 2001, the last of the Arizona counties had gone live with the Arizona in Motion system. The extremely successful implementation entailed installation of Local Area Networks in 80 permanent clinics, T1 line installations to twenty county sites, the acquisition and deployment of approximately 530 PCs (desktops and laptops), 189 Food Instrument MICR Printers, 20 data base servers, and numerous data communications devices. Over 475 staff members were successfully trained, and the data for 128,000 active clients successfully converted.

CMA - Problem Solved.

The Arizona in Motion solution developed by CMA is one of only four solutions nation-wide that are 100% USDA FReD-compliant. Because the system was designed for easy maintenance, Arizona's operational costs for contractor maintenance were reduced by 30%. WIC staff overtime costs were reduced by as much as 88%. Within five months of the final implementation, voided food instruments were reduced from 24% to 3%. Local agency WIC Directors and WIC clients have reported substantial improvements in the timeliness of service delivery; the time that was spent handling mountains of paperwork is now used to counsel pregnant women and mothers in healthy nutrition.

In 2002, the project received the Arizona Governor's Spirit of Excellence award, an award program charged with recognizing State agencies that employ innovative operational solutions resulting in improved customer service, increased productivity, and/or decreased costs for State government.

CMA continues to provide WIC System Maintenance for the AIM Application to the present day providing Customer Care support, system modifications and enhancements to the AIM system. Recent innovations include:

• Enhanced data collection and reporting on breastfeeding.
• Vendor cost containment enhancements.
• Implementation of new Risk Codes.
• Implementation of new Race and Ethnicity classifications.
• Immunization Tracking.
• Migration of the AIM Application from a distributed client server architecture to a centralized web-enabled Citrix environment.
• Upgrade of the AIM databases to Oracle 10g.
• Implementation of a redundant, failsafe architecture utilizing dual production servers with failover standby capability.

Enhancements currently on the drawing board for near term consideration include:

• CSFP enhancements
• Farmers Market Module
• Web-based Vendor Module
• Electronic Signature Pad
• Stock Inventory Tracking Enhancements

We continue working closely with the Arizona Department of Health to ensure that the AIM WIC application is up-to-date with the latest technology and USDA requirements.