State Systems Interoperability and Integration Project (SSIIP)

1. State Systems Interoperability and Integration Project (SSIIP) Information Technology Committee Last updated 2013-08-18

2. Outline • Objectives • Members • Process • Outcomes • Recommendations • Next steps

3. Objectives The Information Technology (IT) committee was tasked to develop technology-related recommendations for the State plan focused on: • Enterprise architecture; • IT initiatives to be leveraged for interoperability; and • Identifying top priorities for data-sharing within California Health and Human Services (CHHS)

4. Members • SSIIP Staff Support: Valerie Barnes (subject matter expert), Linda Hockman, Glenn Freitas • Other SSIIP Staff Participants: Laura Beeman, John DeVere, Richard Gold, Michael Kerr, Bill Parcell, Daniel Stein State Systems Interoperability and Integration Project (SSIIP)

5. Process Initial members of the IT committee: • Educated the committee members on national architecture frameworks • Provided information to guide the development of the Proof of Concept (POC) Request for Demonstration • Assembled and evaluated information related to the As-Is technology landscape within CHHS Agency • Drafted a To-Be vision of interoperability that supports the Administration for Children and Families (ACF) grant goals

6. Process (2) The full IT committee: • Developed IT-related recommendations for the State plan, building on the draft To-Be vision and the roadmap exercise from the first SSIIP Symposium. • Convened three times. Discussions focused on: • Key architectural elements and fundamental ideas/concepts • High-priority processes and capabilities • Identifying data needs to be shared • Recommendations and potential barriers • Leveraging ongoing/upcoming projects • Areas where support is needed from other committees

7. Process: Connections • Governance • Use of architecture • Adopting standards • Adopting concepts • Project reviews • Organizational • Change • Management • Legal • Rules for sharing information • Sharing agreements • Who, when, how to change • Risk mitigation • Information Technology

8. Outcomes: Vision The committee recommends adoption of this vision for the To-Be CHHS Architecture: “Our To-Be architecture will improve the delivery and outcome of health and human services in California. It will be consistent with MITA (Medicaid Information Technology Architecture), NHSIA (National Human Services Interoperability Architecture), and related information sharing standards.”

9. Outcomes: Framework Interoperability Goals MITA and NHSIA Provide a Framework and Roadmap To Achieve Common Goals To-Be As-Is NHSIA and MITA Results • Improved processes • Accessible information • Improved efficiency and effectiveness • Fraud detection and prevention • Improved decisions • Better outcomes • Common business processes • Standard informationexchanges (HITECH EHR, NIEM) • Shared IT services & infrastructure • Comprehensive performance management • Unique business processes • Fragmented information; limited information sharing • Duplicate systems, infrastructure • Limited performance information Improved Health and Human Services Delivery

10. Outcomes: Fundamental ideas and terminology • Core capabilities among programs, organizations, jurisdictions, etc. provide a strong foundation for interoperability • Interoperable systems share information and IT services to efficiently deliver integrated health and human services to the client community • Interoperability can be achieved through frameworks, standards, infrastructures and systems

11. Outcomes: Major To-Be Architecture Elements • Business • Information • Technology • Governance • Options for connections to support County-State health information exchange and other exchanges

12. Reminder: Roadmap of activities: From the May 2013 Symposium

13. Outcomes: Updated Roadmap Updated through committee discussions and development of recommendations

14. Outcomes: Core capabilities Core capabilities provide foundational capabilities or information • Find and get basic and/or summary information about key entities (e.g., person, case, provider, and program) to improve information sharing and enable improved delivery of health and human services • Verify information against authoritative sources to support eligibility, enrollment, and other program-related rules • Collect, aggregate, and analyze key operational performance information across programs, the agency, departments, organizations, and jurisdictions to improve effectiveness and efficiency

15. EA Recommendations 1-3 1. Adopt national standards 2. Support key concepts 3. Consider at every opportunity MITA TECHNOLOGY PROGRAMS NHSIA Capability Viewpoint Business Viewpoint Overview Viewpoint Information Viewpoint VISION Project Viewpoint Systems Viewpoint Infrastructure Viewpoint State Systems Interoperability and Integration Project (SSIIP)

16. EA Recommendations 1-3Timeline • Education & outreach • Assess active projects • Review plans in governance process • Plan for full implementation for all projects and systems • Follow mature governance processes Appreciation of standards Standards in place or realistic plans for adoption 0 – 6 Months 6 Months – 2 Years 2 Years + Bug Fixes State Systems Interoperability and Integration Project (SSIIP)

17. EA Recommendation 4 4. Build on lessons learned • SSIIP proof of concept demonstrations • Federal projects • California counties’ efforts • Other California agencies • Other nationwide or industry organizations. State Systems Interoperability and Integration Project (SSIIP)

18. EA Recommendation 4Timeline • Identify applicable lessons learned • Document process for capturing lessons • Determine how to apply those lessons. • Document a planning process to incorporate • Follow processes Robust process for incorporating lessons learned 0 – 6 Months 6 Months – 2 Years 2 Years + Bug Fixes State Systems Interoperability and Integration Project (SSIIP)

19. EA Recommendation 5 5. Integrate health and human services enterprise architectures for interoperability. • Evaluate; look for synergies • Plan • Adjust and integrate • Test through governance • Follow mature governance processes Integrated architecture 0 – 6 Months 6 Months – 2 Years 2 Years +

20. EA Recommendation 6:Actions for Specific Initiatives/Systems • Influence • CWS NS procurement • Give CWS workers access to eligibility data. Referral for Medicaid • Common solution for info security • “Blue button” • Identify data sharing needs • Integrate consortia systems (SAWS (Statewide Automated Welfare Systems) 0 – 6 Months 6 Months – 2 Years 2 Years + Bug Fixes State Systems Interoperability and Integration Project (SSIIP)

21. EA Recommendation 7 7. Focus on high-priority common processes/capabilities 6 months Core/foundational base of capabilities 6 months – 2 years Build on the core. Remember ACA funding timeline. Longer term Build on the core and initial capabilities.

22. California Child Welfare Council Statement on Information Sharing and Data Standardization “The Council recommends and urges all information technology efforts involved in the exchange of information regarding children and families served by the child welfare system to: • Establish a common data element vocabulary; • Promote the development, sharing, use, and reuse of information technology processes, applications, data structures, and infrastructures required to enable data exchanges; • Use common frameworks and models, such as the Service-Oriented Architecture (SOA) model, to encourage flexible applications; • Use interoperable standards developed and maintained by Federal entities and intergovernmental partnerships, such as the National Information Exchange Model (NIEM) standard, as the basis for information exchanges; and • Use common or uniform confidentiality/privacy agreements consistent with Federal and State laws.” http://www.chhs.ca.gov/initiatives/Olmstead/Documents/CaliforniaChildWelfareCouncil_2012DataStatement.pdf

23. EA Recommendation 8 8. Focus on high-priority information exchanges to support the high-priority processes/capabilities • Identify near-term candidates • Document process • Build on lessons learned • Identify more • Test process • Adopt standard dictionary • Follow mature governance processes Standard dictionary 0 – 6 Months 6 Months – 2 Years 2 Years +

24. EA Recommendation 9 9. Continue collaboration among organizations that support health and human services across the state and counties to further interoperability. • Enlist sponsors & support • Identify & establish • How to coordinate • Work on recommendations • Build partnerships • Solve problems Forum established 0 – 6 Months 6 Months – 2 Years 2 Years +

25. Challenges: Why haven’t we already done what we recommend? • Culture • Many aspects of business processes really are common; need to overcome perceived uniqueness. • Need to identify how this will make “life” better for clients and staff. • Change is hard. Follow Organizational Change Management process. • Priorities • Must accommodate existing goals, schedules, and funding. • Everyone already has a full-time job; adding new responsibilities (e.g., collaboration, committee work, governance) adds to overload. • Competition with high-priority initiatives (e.g., health benefits exchange)

26. Challenges: Why haven’t we already done what we recommend? (2) • Funding/contracting • Different funding streams. • Availability of funding and match. • How to deal with existing contractual restrictions on sharing components and resources. • Adjust procurement processes to include these recommendations. • Leadership • Need a high-level champion who is outspoken and willing to continue to take the interoperability message to different audiences. • Need business folks involved before making technology changes. Fix the process, then figure out how to automate. See technology as an enabler.

27. Challenges: Why haven’t we already done what we recommend? (3) • Leadership (continued) • Consider linking funding to adoption of standards and to the other recommendations to encourage interoperability. • In governance process, include processes to guide the use of enterprise architecture. • Security • Concerns about protecting information. • Adherence to regulations. • Multiple layers of security. • Follow Legal committee recommendations.

28. Leverage Ongoing/Upcoming IT Initiatives • Enterprise architecture activities at state, agency, department, and county levels • Health Information Exchange (HIE) (for data exchange) • CalHEERS (for eligibility and enrollment) • LEADER Replacement System (for eligibility and partnerships) • Alameda County dashboard (for data integration and business intelligence metrics) • Orange County GFIPM and JUICE (for identity management, access control, and data exchange)

29. Leverage Ongoing/Upcoming IT Initiatives (2) • San Diego County Beacon activities (for education and outreach, common processes, data exchange, and partnerships) • Los Angeles County master person index and GFIPM (for identity management, access control, master data management, and data exchange) • CWS NS (for general system modernization, data exchanges, and to link with eligibility and enrollment processes/systems) • MEDS (for general system modernization and data exchanges)

30. Leverage Ongoing/Upcoming IT Initiatives (3) • CA DMV (for master person index and identity management) • CA IT capital planning process (for governance, leveraging other projects, education and outreach) • California State Innovation Model (for identifying and capitalizing on innovation) • Check for other possibilities • California’s feasibility study reports for other candidate. • Unique student identifier • Systems outside DHHS (e.g., educational, judicial) • Federal hub (for shared components, eligibility data verification) • Federal Parent Locator Service (leverage for child welfare and, potentially, other uses)

31. Next Steps: Within 6 months • Education & outreach re standards and key concepts • Identify applicable lessons learned • Document process for capturing lessons learned • Evaluate architectures; look for synergies • Plan approach for integrating architectures • Influence CWS NS procurement • Give CWS workers access to eligibility data. Referral for Medicaid. • Focus on core/foundational base of capabilities • Identify near-term candidates for information sharing • Document process for adopting standards and implementing an exchange • Enlist sponsors & support for collaborative forum • Identify & establish the forum • Determine how to coordinate with related activities 0 – 6 Months State Systems Interoperability and Integration Project (SSIIP)

32. Next Steps: Highest-Priority Activities • Education and outreach • Work on foundational capabilities • Identity management and access control • Confidentiality and privacy agreements • Master person index • Continue collaboration • Build on lessons learned