PROVIDER COUNCIL UPDATE MARCH 11, 2011

DDS SYSTEMS DEVELOPMENT PROJECT:

INTEGRATED APPLICATION SUITE FOR COORDINATED CONSUMER SERVICES

Title XIX HCBS (Home and Community Based Services)

Waivers

Agenda

Review Federal planning processProvide DDS statusSummarize Planning APD Review Project BenefitsNext StepsProject Risks related to Requirements DefinitionProvider participation

Federal Planning Process

Federal HHS Advance Planning Documents (APD) Condition for Federal Financial Participation (FFP) Based on approved Cost Allocation Plan (CAP) among

benefitting programs, including Title XIX When enhanced FFP is sought and major procurements are

anticipated, required are Planning APD Implementation APD

Estimated costs for DDS systems development project over five years Range from $35-11MM, depending on which solutions are viable

and how effectively project risks are managed

Federal Planning Process

DDS Status Planning APD drafted Reviewed by DDS Executive Sponsors and Project Steering Under DSS review

Federal Planning Process

DDS Planning APD Expected to answer the Federal questions:

Is the state’s need for the system clear? Does the state have a reasonable plan to plan? Has the state committed to preparing a needs assessment,

feasibility study, alternatives analysis, and cost/benefit analysis? Has the state estimated the costs to plan? Are the estimated planning costs and cost allocation reasonable

for the project? Has the state estimated the project cost?

DDS Planning APD

How DDS answered Is the state’s need for the envisioned system clear?

No systemic capability to improve compliance with HCBS Waiver Assurances

No systemic capability of measuring and improving consumer outcomes

• “Stovepipe” application data are not available to downstream apps in the same “pipeline” without redundant manual effort

• There is no integrated DDS data foundation for comprehensive Title XIX/HCBS Waiver data reporting, access, or update.

A diagram of the current system, “As Is,” illustrates that gaps are system-wide, rather than isolated instances

DDS Planning APD

How DDS answered Does the state have a reasonable plan to plan?

Identified the project risks and feasible ways of managing them:• Strong project governance, including Executive Sponsorship and

Project Steering Committee, and project management

• Executive branch systems development methodology (SDM)

• Reference to the Medicaid Information Technology Architecture (MITA)

• Additional consultant developer resources (at project start) with managed knowledge transfer to state employees (positions filled within 1-2 years)

• State Data Center for production systems support

DDS Planning APD

How DDS answered Does the state have a reasonable plan to plan?

Provided a role-based project plan template for the next phase• Aligned Implementation APD with co-terminus state SDM Business

Requirements phase

• Ensured committed project roles, per SDM project team wheel, for next phase

• Planning phase plan is within budget

DDS Planning APD

How DDS answeredo Has the state committed to preparing a needs assessment, feasibility

study, alternatives analysis, and cost/benefit analysis? Planning APD includes preliminary high-level versions of these

deliverables Project phase plan includes the committed roles and estimated level of

effort related to producing these deliverables Peer state reviews included in phase plan as feasibility assessments for

Connecticut of solutions already considered or implemented in other states (to avoid direct, non-competitive vendor conversations before RFP issuance)

Note: A technology pilot, if needed to assess Fit-Gap of a requirements-based solution can be conducted at start of System Design as Vendor (or Product) Discovery in accordance with state SDM

DDS Planning APD

How DDS answeredo Has the state estimated the costs to plan?

o The costs to plan include estimated costs for -o Planning APD (SDM Business Issues through Next Phase Plan)o Implementation APD (SDM Business Requirements through RFP

Issuance)

DDS Planning APD

How DDS answeredAre the estimated planning costs and cost allocation

reasonable for the project?o Estimated planning costs are reasonable to the extent project risk controls

are in place throughout the next phaseo Alternative cost allocation methods are under review

DDS Planning APD

Next Steps

Joint DDS and DSS Planning APD transmittal to CMS Ensure Cost Allocation Plan approved by CMS (Center for

Medicaid and Medicare Services) DDS Concurrently

Develop Implementation APD (project manager) Codify Business Requirements/Develop RFP (business analyst) Phase 2 completion estimated at 7 months (elapsed)

Business Requirements Phase

Key risks DDS Organization

Loss of state talent may reduce ability for DDS effectively to own and complete business requirements definition.

New owners may not be comfortable codifying a “to be,” and are constrained as a state entity in the ability to “comparison shop” for product research Peer state reviews focused on implemented solutions and lessons learned can inform

sourcing options and their feasibility Reuse of available Requirements, RFPs, Models, and other pertinent documentation from

peer states No-cost competitive product demo opportunities can be structured before or within an RFP

Business Requirements Phase

Key risks DDS Organization

Experienced business owners may know what is needed, but the vision may not be entirely supportable in the context of the overall mission or program Universal prioritization criteria applied to each function at the

program level can ensure transparency and inclusiveness if not unanimity

Key development priorities need to be assessed for their feasibility in terms of resource and technical dependencies as well as benefit, cost, time-to-market, and risks.

Business Requirements Phase

Key risks SDM Process

Vision-driven - “getting requirements” can tailspin into excessive ideation (recognized as “analysis paralysis”). Business owners often benefit from concrete examples of

codified requirements (such as prototypes or product demos) Vendor-driven – Competing marketplace choices can be difficult

to sort through. Stable, clear requirements are needed for objective “score card”

comparison among products (like a consumer reports)

Business Requirements Phase

Key risks Technology

Over-specification – designing how the system should do what it is supposed to do before clarifying what the system should do Stating requirements as process objectives, rather than system

behaviors, can help. (This requires that business analysts also be effective application designers.)

Under-evaluation - defining requirements inadequately to the purpose of objectively evaluating competing fulfillment claims. Process objectives, like organizational ones, need to be

S.M.A.R.T! (specific, measurable, assignable, realistic, and time-bound)

How DDS Providers Can Help

Participate in overall and functional requirements definition Structured, phased approach Focus on potential benefits to consumers and families Manageable team size and dynamics

Stay informed on the project Project milestones and progress Program-level prioritization and its impact on specific projects Regional and state opportunities to leverage common

solutions

DDS Project Phase Team

DDS Project Steering Committee

Joseph Drexler, Director, Operations CenterDeborah Duval, Waiver Policy and EnrollmentJadwiga Goclowski, Ph.D., Continuous Quality ImprovementBeth McArthur, Business ManagerDoreen McGrath, Health ServicesSiobhan Morgan, Case ManagementKrista Pender, Audit, Billing, and Rate SettingKathryn Reddington, Autism, Employment, and Family SuppotJames Ritchey, Operations CenterJoshua Scalora, Operations CenterDavid Sokolow, Quality Management ServicesMark Warzecha, Information Technology

DDS Project Phase Team

DDS Business Requirements Leads Functional Subject Matter Experts (SMEs)

Functional/ Business Area

Applications

Subject Matter Experts

Business Lead

Eligibility for DDS Services DDS Eligibility DDS Eligibility Unit Regional Intake

Marsha Cohen Steve Zuckerman

Individual Consumer Planning

LON Case Notes Individual Plan Clinical Supports Electronic Case File

Case Management Providers Families Clinical Staff Autism Staff Siobhan Morgan

Resource Allocation/Waiver Management PRAT Waiver Management

PRAT Managers Resource Management Waiver Planning/Policy Autism Staff Deb Duval

Consumer Safeguards

PRC/HRC Incident Management Medication Administration

Providers Clinical Staff Med Cert Coordinators Abuse/Neglect Coordinators QI/QM Families Autism Staff

Jadwiga Goclowski Dan Micari

QSR/Certification & Licensing QSR Licensing and Certification

Case Management Providers QM Resource Management Families Autism Staff Dan Micari

Budgeting, Billing, Service Documentation and Service Management

IP6 Provider Billing Service Documentation

Case Management Resource Management Families Operations Providers DDS Fiscal Fiscal Intermediaries Autism Staff Joe Drexler

DDS Project Phase Team

DDS HCBS Waiver Integrated Application Suite

State of Connecticut, DOITSystem Development Methodology (SDM)

Document Name: Project WheelsSTD, COTS, RAD, LITEPage 1

* Staffed from the Business

Support/Consulting Roles:Business Division Director (BDD): <Name Required>DOIT Enterprise Architect:Financial Advisor :

TECHNOLOGYPARTNERS

BUSINESS PARTNERS

Beth McArthur,Business ManagerTim Deschenes-Desmond,

Business Requirements Lead

S. Niedzielska, consultantTechnology Manager

Name, Test Lead

Name,Production Support Lead

Beverly Bellisio,Infrastructure

Lead

*Area(s),Subject Matter Expert (SME)

Areas

Susan Klick,Development Lead

*Name,Business Process Lead

Mary DiPietro,Security Lead

S. Niedzielska,Procurement Lead

Mary DiPietro,Network Lead

Required

Current Phase: Business RequirementsPSC – Project Steering Committee

Executive Sponsors

Required

Required

Required

*Tim Deschenes-Desmond,Deployment Lead

RequiredRequired

Required

Kathryn DuPree, DC, Vincent O”Connell, CFO

DDS Contacts

For more information on the Advance Planning Document Project

Business Leads

Beth McArthur – Beth.McArthur@ct.gov

Tim Deschenes-Desmond – Tim.Deschenes-Desmond@ct.gov

Phone: 860-418-6058