RD411 - Quarterly Report on the eHHR Program (Formerly known as the Health Care Reform Program) - December 19, 2012


Executive Summary:
1. Executive Summary

The eHHR Program Office was formed to manage the Health and Human Services Secretariat projects initiated under the American Recovery and Reinvestment Act (ARRA), the Patient Protection and Patient Affordability Act (PPACA), and the Medicaid Information Technology Architecture (MITA). The eHHR Program’s vision is to collectively improve healthcare and human services for Virginians by providing access to the right services for the right people at the right time and for the right cost. While the initial focus is on interoperability within the HHR Secretariat, later phases will enable far broader use of the technology to promote increased interoperability throughout the Commonwealth. With this broader focus, the name of the initiative was changed from the Health Care Reform Program to the eHHR Program to underscore that the value and benefits extend beyond Health Care Reform. The eHHR Program relies on a close collaboration across several Secretariats, including HHR, Technology, Transportation, and General Services. Multiple agencies are involved to break down individual silos and align with federal direction. CMS has pointed to Virginia as an example for other states planning their future IT landscapes.

As the eHHR Program Sponsor, William A. Hazel Jr., M.D. will provide leadership, keep the program aligned with the strategy and portfolio direction, govern program risk and ensure continuity of sponsorship. A Program Oversight Committee (POC), chaired by Dr. Hazel, provides eHHR Program oversight and direction. The POC will also assist in issue resolution at their level of authority and approve Change Requests.

This document reports the progress made by the eHHR Program to implement new information technology systems to address requirements in the ARRA, the PPACA, and MITA. This document will describe the progress of programs and projects under the HHR Secretariat.

1.1. Progress and Expenditures

All projects in the Execution phase are progressing on schedule and within budget. Planning being done for projects in the Initiation phase is also progressing on schedule. More detail will be known about the final schedule for these projects once more detailed planning is complete.

• Total number of projects (excluding HBE): 15
• Number of projects in the Initiation phase: 06
• Number of projects in the Execution phase: 09

The vendor procurement contract for Eligibility Modernization (EM) is finalized and the vendor will start work mid-December, 2012. One of the first tasks is to finalize the schedule for the three projects under EM. The vendor has committed to the federally mandated dates of:

• October 01, 2013 for modernized Eligibility Determination (MAGI specific) and Health Benefits Exchange (HBE);

• October 01, 2013 for an interface between Medicaid/CHIP Eligibility Determination IT systems and HBE Eligibility Determination IT systems; and

• January 01, 2014 for MAGI health coverage under Medicaid/CHIP or under a Qualified Health Plan (QHP) purchased via the HBE.

Required under PPACA, MAGI uses Adjusted Gross Income as determined under the federal income tax, plus any foreign income or tax-exempt interest that a taxpayer receives. A Modified AGI (MAGI) will be used to determine financial eligibility for Medicaid and CHIP services.

More detailed information about progress and expenditures can be found in section 3. This includes:

• Specific content for each initiative, ARRA, PPACA and MITA;
• A table listing the related projects, along with
* Project Description
* Resource Utilization Breakdown: and
* Status
• A table listing budget information as well as planned and actual expenditure for each project.

1.2. Prioritizing Project Resources Across the Program

The eHHR Program Office is the focal point to ensure that lower level agency program management offices and individual projects prioritize project resources across eHHR. Project schedules and deliverables are developed in coordination with eHHR, based on the program level objectives and deliverables each individual project is chartered to produce. Project priorities, resource usage and resource availability is coordinated and negotiated between eHHR and the various programs to ensure the overall goals and objectives for the program are met. More detail about this can be found in section 4.

1.3. Coordinated Approach the Program Management Across All Projects

The eHHR Program Office is accountable for ensuring that a coordinated approach to program management is undertaken using formal structures and processes across all lower level agency program management offices and projects. This begins with an organizational hierarchy under which all lower level agency program management offices and projects report to eHHR. It is supported by a group of operational governance plans developed by eHHR and used by the lower level agency program management offices and projects under eHHR. These plans are based on industry standard program and project management methodologies that are approved by VITA PMD. This helps facilitate a consistent set of processes to be used across all lower level agency program management offices and projects, reducing confusion, uncertainty and ambiguity. It also sets clear expectations about how the projects should be managed. More detail about this can be found in section 5.

1.4. Program Governance and Communication

The eHHR Program Office is accountable for ensuring that program governance and communication activities are sufficient to achieve benefit and stakeholder management objectives. This is done by continuously monitoring and verifying that the work being done by the all lower level agency program management offices and projects meets the overall goals and objectives of eHHR. A program level Quality Management Plan is utilized at the project level to verify adherence to processes defined in the operational plans mentioned in the section above. The Risk and Issue Management Plan documents and tracks the information required to effectively manage eHHR Program risks and issues. The aim of risk and issue management is to manage risks and issues at the appropriate program or project level. Risks and issues are input and maintained in a central repository allowing everyone easy access to all eHHR risks and issues across all lower level agency program management offices and projects involved. The POC is informed of eHHR Program level risks and issues for their assistance and guidance, as appropriate. The eHHR Program Operational Communications Plan outlines the communication approach of how project information is communicated to help motivate, involve, and inform project stakeholders. More detail about this can be found in section 6.

1.5. Program Change Management

The eHHR Program Office processes and procedures ensure that any changes in program and project-level objectives and resource needs are identified. eHHR developed a program level Change Management Plan with the primary purpose of documenting and tracking the information required to effectively manage program/project change from program/project charter approval to final delivery of each project within the eHHR Program. Change requests are input and maintained in a central repository allowing everyone easy access to all proposed eHHR changes across all lower level agency program management offices and projects involved. The POC is informed of eHHR Program level changes for their assistance, guidance and approval, as appropriate. More detail about this can be found in section 7.