Driving Section 508 compliance: Transforming CMS healthcare access

Overview

The U.S. healthcare system is among the most complex in the world, with multiple stakeholders, regulatory intricacies, varied payment models, a blend of public and private funding, and challenges related to data standardization and interoperability. At the center of efforts to address these complexities is the Centers for Medicare & Medicaid Services (CMS), which plays a crucial role in simplifying processes, enhancing healthcare quality, improving access to care, and fostering a more patient-centered and efficient healthcare system for over 100 million beneficiaries, many of whom have disabilities.

Within CMS, the Center for Medicaid and CHIP Services (CMCS) leads the formulation, coordination, integration, and implementation of national program policies and operations for Medicaid, the Children’s Health Insurance Program (CHIP), and the Basic Health Program (BHP). CMCS is responsible for producing and publishing documents and resources on the Medicaid.gov website, which beneficiaries rely on for essential guidance and access to benefits. By law, these resources must comply with Section 508 accessibility standards before they are made publicly available.

While CMS, along with its departments, including CMCS, is legally required to meet Section 508 accessibility standards, its commitment to accessibility goes beyond regulatory compliance. CMS strives to be a model employer of individuals with disabilities and is dedicated to ensuring equitable access to its programs and services, in line with Section 504 of the Rehabilitation Act of 1973. Furthermore, CMS is committed to providing an exceptional user experience for all beneficiaries, with accessibility as a foundational element.

Goal

The goal of this project is to help the Center for Medicaid and CHIP Services (CMCS) achieve Section 508 compliance for its documents, ensuring accessibility for all beneficiaries, especially those with disabilities. By leveraging accessibility checking tools and a user-friendly remediation process, the project reduces the backlog of noncompliant documents, streamline document delivery, and creates a sustainable framework for ongoing compliance, while enhancing the user experience and meeting tight deadlines.

Challenge

CMCS produces and distributes thousands of documents each year, sharing them directly with beneficiaries and posting them on CMCS-managed websites. These documents are essential in helping beneficiaries understand and utilize their benefits. Many of these materials have been in circulation for decades, creating ongoing challenges for CMCS as it strives not only to ensure 508 compliance, but also to promote equal access and provide the best possible user experience, especially for those with disabilities.

As beneficiary needs grow and evolve, the requirements around document creation and sharing also continue to grow. For example, CMCS often faces stringent deadlines to deliver documents to other government agencies (such as the White House) within a mere three hours.

Solutions

Building on our extensive experience in 508 compliance and remediation, Sky Solutions’ Human-Centered Design Center of Excellence (CoE) has led 508 remediation initiatives for several federal agencies. These efforts have significantly advanced the accessibility goals of these agencies, helping establish modernized processes and frameworks that ensure long-term compliance and an improved user experience.

For CMCS, Sky leverages deep expertise in Section 508 Standards and Web Content Accessibility Guidelines (WCAG) 2.0, along with a strong understanding of Medicaid policies and processes, and a Digital-First approach to modernization and process improvement. This approach ensured successful 508 compliance remediation that meets both expectations and requirements.

Sky assessed various alternative solutions from an accessibility perspective and selected Section 508 automated testing tools to deliver compliant products in a timely manner. Sky developed a user-friendly, efficient document remediation process for CMCS, enabling easy submission and retrieval of documents. This modernized process, combined with our expertise and tools, effectively reduced the legacy document backlog. It also provides a sustainable framework, allowing CMCS to manage increasing remediation demands, adapt to tighter deadlines, and uphold CMS’ commitment to accessibility going forward.

Technologies/Methodologies

  • 508 Compliance
  • Human Centered Design
  • WCAG
  • DPA
  • Digital Transformation
  • Center of Excellence
  • Microsoft application suite

Outcome

The new, streamlined Section 508 compliance process significantly enhanced consistency, strengthened confidence in deliverables, and enhanced the quality of all documents and templates. Sky Solutions not only met but exceeds CMCS’ 508 remediation needs, furthering CMS’s mission to ensure accessible healthcare benefits for all beneficiaries.

Some of the key outcomes include:
  • Eliminates accessibility barriers by making content easily accessible to the public and beneficiaries with disabilities
  • Improves efficiency by reducing document remediation time from 12 hours to just 2 hours, even under tight deadlines
  • Provides seamless Section 508 remediation across CMCS, including the Operations Services Group (OSG) and State Demonstrations Group (SDG)
  • Establishes standardized operating procedures for 508 compliance, improving consistency and reliability across deliverables
  • Enhances quality assurance by integrating artifact test results to reinforce confidence in deliverables and maintain high standards through proven quality control practices.
  • Leverages automation tools and strong project management to optimize workflows
  • Exceeds CMCS’ specific 508 requirements and underscores our support for CMS’ mission to ensure accessible benefits for all beneficiaries