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Information Technology Strategic Plan

2012-2015

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Message from DHCS Director – Toby Douglas

The Department of Health Care Services (DHCS) is committed to ensuring its programs deliver superb medical quality and achieve outstanding clinical outcomes. This is accomplished through a focus on improving the health of the population, optimizing quality of care at the patient level and reducing the per capita cost of care.

The current economic issues confronting California demand that we find ways to accommodate a growing number of low-income and disabled individuals with even fewer resources. This drives us to continue to innovate and implement more cost-effective ways of delivering, financing and purchasing health care, while ensuring the highest level of program integrity and health care quality and outcomes.

Federal health care reform, also known as the Affordable Care Act (ACA), is a priority for DHCS. It will offer Californians access to affordable health care insurance, a consumer friendly, streamlined process for enrolling in coverage and an opportunity to improve the quality of health care. We have been an early implementer of the ACA among states. Our Medicaid Section 1115 waiver, granted by the federal government last year, allows us to prepare in advance of the full implementation of health care reform by covering hundreds of thousands more uninsured people, transitioning our most vulnerable beneficiaries into managed care and investing in transforming the state’s safety net delivery system.

In 2010, DHCS awarded the California Medicaid Management Information System (CA-MMIS) contract to provide services and to replace the existing 30-year-old legacy system. CA-MMIS processes payments to providers for medical care to 8.3 million Medi-Cal beneficiaries in the state. Under the CA-MMIS contract, the fiscal intermediary (FI) adjudicates Medi-Cal and non-Medi-Cal claims for the state and performs other FI services to medical program providers, beneficiary members, and federal and state users of the system. The CA-MMIS contract is one of the largest and most complex contracts in state government.

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Message from DHCS CIO and Deputy Director – Chris Cruz The Department of Health Care Services (DHCS) Information Technology Services Division (ITSD) and its Federated partners are pleased to present the Department’s Information Technology (IT) Strategic Plan for Fiscal Years (FY) 2012–2015 and annual performance review. The Plan establishes a new direction for delivering state of the art IT solutions to support DHCS’ mission, which is to provide eligible Californians with access to affordable, high quality health care, including medical, mental health, long-term care, and substance use treatment services. While we have demonstrated considerable success over the last year (See Appendix A for key accomplishments), the advent of Health Care Reform and the Affordable Care Act necessitates we redouble our efforts and increase the efficacy of technology investments. Specifically, our strategic technology investments will focus on delivering tangible, measureable business outcomes. Our focus in 2012-2015, and beyond, will be to enhance, not just enable, business outcomes. This enhanced focus can only deliver the desired results if there is a high level of collaboration between the IT professionals and our business partners. We will be increasing our level of collaboration with the added focus of understanding and enhancing the constituent’s overall experience with DHCS services. IT will bring forward innovative applications of technology designed to exceed the expectations of our internal business partners and the DHCS constituents. Ultimately, how well we innovate and collaborate will determine the extent of IT’s contribution to the overall delivery of DHCS’ services to our constituents. Therefore, we will invest in a deliberate and focused program designed to investigate, develop and apply new business and technology innovations to address the current and future needs of our business partners and constituents. This is an exciting time in both healthcare and technology, and we stand ready as an integral part of delivering affordable healthcare to all Californians.

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Table of Contents 1.0 Strategic Plan Executive Overview ……….......……………… 5

2.0 Business Environment and Implications for IT …………........ 6

3.0 DHCS IT Mission ………………………………………….......... 9

4.0 DHCS IT Capabilities…………………………………………… 10

5.0 DHCS IT Goals and Objectives ………………………............. 14

6.0 Risks and Mitigation Strategies ……………………………….. 17

Appendix A: FY 2011-2012 Key Accomplishments ………………… 19 Appendix B: Supporting DHCS Objectives ………………………….. 20 Appendix C: Alignment with State IT Goals …………………………. 21 Appendix D: Year 2012 - 2013 Priorities and Projects……………. 22 Appendix E: Acronyms…………………………………………………. 23

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1.0 Strategic Plan Executive Overview DHCS serves more than 8.3 million beneficiaries annually and invests approximately $60B in public funds to provide health care services to low-income families, children, pregnant women, seniors and persons with disabilities. The DHCS IT Strategy sets aggressive goals that we believe are necessary to meet the challenge to preserve and improve the health status of all Californians. Our focus is to enhance overall DHCS existing and/or planned delivery through the strategic investment in technology. We will utilize innovation, collaboration and apply a laser focus on the business outcomes desired by our internal business partners and ultimately exceed the expectations of our constituents. We will accomplish this by developing five core capabilities, which will drive our goals and objectives. These capabilities are necessary to support the overall DHCS mission, as well as develop a technology and business platform which will focus on key business outcomes; e.g., lower the cost per capita for care. The five strategic goals focus on optimizing the use of resources, developing a comprehensive understanding of our constituents’ needs, turning the department’s information into an enterprise asset, leveraging radical innovation and developing our workforce. We have identified six risk areas and provided the appropriate mitigation approaches for each. The major risk we see is to try to do too much, too fast and as a result fail to provide the overall support that the Department needs. We have a mitigation approach which leverages the relative independence of the five strategic goals and minimizes the potential of putting the organization in the position of trying to ―boil the ocean.‖

In conclusion, we believe this strategy document provides the requisite focus to enhance DHCS’ overall delivery, while mitigating the risk of large scale disruptions in service.

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2.0 Business Environment and Implications for IT Our Director, Toby Douglas, cogently captures our focus by saying, ―Our vital mission is to preserve and improve the health status of all Californians, a goal we pursue through an array of important health care programs and services.” In a ―normal‖ environment, this mission is challenging. However, our ―new normal‖ environment adds additional challenges:

The current economic issues confronting California demand that we find ways to accommodate a growing number of low-income and disabled individuals with even fewer resources,

The Department is committed to reducing the per capita cost of care,

Develop a consumer friendly, streamlined process for offering Californians affordable healthcare as part of the ACA, -- including potential unforeseen challenges for managing care at the patient level,

Uncertainty in funding due to future Federal and State fiscal positions,

A large number of the DHCS staff will be eligible for retirement in the next 3-5 years.

DHCS provides in excess of 50 major programs and services to support the citizens of California. The breadth and depth of services drive a high level of complexity in managing the information. This complexity is increased as new processes and methods of communicating to constituents are incorporated into the DHCS delivery mix; e.g., social media, collaboration, remote access, mobile, etc. The State of California is positioned to be a leader in health care reform and for DHCS this will be a transformative era. The strategic future state of DHCS information technology is shaped by two national initiatives: Medicaid Information Technology Architecture (MITA) and the Affordable Care Act (ACA). Both MITA and the ACA describe a future where costs are brought under control and quality can be measured and improved. MITA includes integrating business, information and technological approaches to build future management information systems. The vision is to have these systems be capable of sharing information across organizational boundaries based on nationally recognized data exchange standards. MITA is the leverage point for DHCS to meaningfully engage in critical health care reform initiatives such as HIT/HIE and health care transparency. ACA has many provisions that directly impact DHCS in terms of increased number of beneficiaries, so designing and building scalable IT support systems will be a big part of the Department’s IT activities for the next three years.

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Based on the business environment, we see the following implications for IT:

Information Technology is a Strategic Investment: As a baseline, every IT investment needs to closely examine the cost of technology relative to the effect it has on a business outcome – in particular, how the business outcome is perceived and valued by our business partners and our constituents. There needs to be a ―direct line of sight‖ between the cost of the technology, the capability developed and the business outcome.

Constituent-Focused Solutions: This focus changes the playing field for solutions development, because, in general, solutions designed to address specific constituent needs are unique, and therefore, don’t lend themselves to big computational systems. Solutions that are focused on improving the constituent experience are typically not the same as solution that utilize the information from the constituent interactions to develop predictive analytical models to influence a particular business outcome. The latter solutions are by their very nature, large computational solutions.

Coordinated Approach to Information Management: The IT Department and its business partners need to focus on the key pieces of information necessary for managing business outcomes. This does not imply centralized data management. Rather, it stresses managing the ―context‖ of the data, so there aren’t conflicts between the same data drawn from difference sources. Further, this also implies a coordinated effort in the evolution of information management from reactive to predictive. Finally, there is a need for collaboration across programs, services and agencies to enhance the desired business outcomes. This information may have alternate forms; e.g., video, voice, etc. which is not conducive to traditional information management techniques.

Robust, Focused Innovation: Cost and service drivers necessitate the need for innovation management, A sound management plan will assess the maturity of DHCS technical innovation. This will allow DHCS to create an effective, repeatable, and long lasting approach of implementing and maintaining technical innovations that are appropriate for the current industry trends and modernization needs for the department.

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Flexible Delivery Organization: The large percentage of DHCS staff which will be eligible for retirement within 3-5 years implies the organization needs multiple channels for delivery of services. This also implies the need for ―bench strength‖ and cross-training in critical technology areas.

These implications to IT will also have significant impact to Information Security and Enterprise Architecture. DHCS is responsible for protecting extremely large volumes of personally identifiable information, and the Department must comply with numerous regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and Social Security Administration (SSA) requirements. Enterprise Architecture is critical for understanding the goals of the department, how these goals are realized by business processes and how these business processes can be better served through technology. Aligning with the Medicaid Information Technology Architecture (MITA) framework and the Affordable Care Act (ACA) will be used as the department’s guiding enterprise approach to achieve these goals.

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3.0 DHCS IT Mission 2012-2015 The DHCS IT Mission describes our business: We enhance the overall DHCS delivery effectiveness to each constituent group we serve through the use of business and technology innovation, collaboration and business outcome focus -- consistently exceeding constituent and business partner expectations.

We strive to enhance, not just enable delivery. Given the constraints in the State and the considerable needs of our constituents, we need to assist our business partners by enhancing existing IT solutions, and planned delivery of IT services, in order to fulfill our mission.

We will dedicate resources to continually look for innovative ways to apply business and technology constructs to deliver superior constituent-perceived value.

We will also dedicate resources to proactively collaborate with our business partners to mine new ideas to improve the constituent’s overall experience.

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4.0 DHCS IT Capabilities

In order for us to deliver services to our business partners and constituents, we need to have and/or develop specific capabilities within our organization to respond to the external business environment and in particular address the implications for IT. Table 4.1 links the implications for IT, the required capabilities and our IT Strategic Goals (note: each of the elements in the table is explained in greater detail—Capabilities in Section 4 and Goals in Section 5). Table 4.1

Implications for IT Core Capabilities IT Strategic Goals

IT is a strategic investment

Multisourcing: The planned optimal use of internal and external resources.

Methodical approach to optimal utilization of internal and external resources to deliver optimized solutions.

Constituent-focused solutions

Constituent experience management

Systemic and Holistic Understanding of the Constituent and their interaction with DHCS services

Coordinated approach to information management

Enterprise Information Management (“EIM”)

Functional EIM which identifies key data to operate the business (and business outcomes) and predictive analytics to influence Constituent behavior

Robust, focused innovation

Business technology and innovation (skunk works)

Innovation adoption

Mature innovation methodology to identify, test and incorporate radical innovations to improve delivery

Flexible delivery organization

Workforce Development: Focus development of “versatilists” (staff who are SME’s in 2 or more areas), as well as leveraging multi-generational workforce.

Mature workforce development and retention program, which incentivizes staff to broaden scope, identifies critical areas for development (based on Multisourcing and technology skill lifecycle)

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Core Capabilities:

Multisourcing:

In order to meet the challenge to reduce the cost per capita of care, we need to ensure we are spending the optimal amount to deliver the specific capability and present our constituents with the appropriate level of care.

Multisourcing determines the optimal blend of internal and external delivery capabilities, based on the current organizational capabilities, and current and projected constituent needs.

A roadmap is need to identify new and/or enhanced capabilities driven by Constituent Engagement Management assessment, new technology introduction assessment and fiscal constraints or boundaries.

Constituent Engagement Management (“CEM”):

Differentiation through innovation alone is fleeting. Constituents are leaning more toward experience and service. Therefore, we need to continually assess the efficacy of the customer experience management and attract constituents to use, and benefit from, the overall DHCS service. While this capability may sound like a ―retail channel‖ approach, it is a critical element in developing a ―consumer friendly, streamlined process for offering Californians affordable healthcare…‖

Within the confines of the CEM capability is the critical element of collaboration with our business partners to mine for opportunities to deliver enhanced features and benefits to the constituents.

Ultimately, the combination of collaboration and CEM will enable DHCS to anticipate constituent needs and develop features and benefits the constituents didn’t know they wanted but find indispensable.

Enterprise Information Management (“EIM”):

EIM is a discipline used to turn information into assets for an organization. EIM focuses on the problems of handling different types of data; i.e., the ability to analyze it properly, which is the way information is put to use and therefore turn it into an enterprise asset. Data types include such things as video streams, images, audio, and social networks.

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EIM will provide focus on what information is important initially to understand a business outcome, and eventually to influence or control the business outcome or constituent behavior.

By utilizing information as an asset, we may lower the per capita cost of care by focusing on a few key pieces of information that can influence the constituents’ behavior and incentivize them to engage in more preventative care services.

Business and Technology Innovation (Skunk Works)

This capability focuses on continuously surveying the external environment. This includes innovative business and technology approaches in other industries and sectors, as well as our own sector. The focus is to investigate and evaluate a select group of innovative processes and technologies for their applicability to enhance DHCS delivery.

A ―skunk works” project is one typically developed by a small and loosely structured group of people who research and develop a project primarily for the sake of radical innovation (Source: Wikipedia). The goal is to seek radical innovation, to make substantive differences in the way DHCS serves our constituents. The success of a skunk works capability is also dependent on the level of collaboration with our business partners. We fully anticipate working with our internal business partners to mine for issues, challenges and ideas which need radical innovation.

Innovation Adoption

This capability is where we (IT and our business partners) decide where to apply some of the radical ideas developed from the ―skunk works‖ to a particular business area. We will examine the ―fit‖ based on several factors—including organizational acceptance, risk, projected benefit (internal and constituent-focused) etc.

Utilizing the combination of the ―skunk works‖ and methodical adoption, we could greatly increase the efficacy of the constituents’ engagement of DHCS services from unique channels or platforms.

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Workforce Development

The needs of a flexible workforce necessitate a multifaceted development capability. The concept of the ―versatilist ‖ is where a given staff member can be a skill leader in 2 or 3 areas, not just a Subject Matter Expert (―SME‖) in a single area. This provides for flexibility in handling the ―demand‖ placed on IT, but it also serves as a risk mitigator against single person critical skill set in the organization.

This capability also leverages the strengths of each generation of our multi-generational workforce.

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5.0 DHCS IT Goals and Objectives Our IT Strategic Goals provide us with an end state to focus our efforts. We provide detail into the description and rationale for each of our goals along with key objectives which need to be achieved in order to attain our desired end state. Goal #1: Methodical approach to optimal utilization of internal and external resources to deliver solutions The methodical approach to optimal utilization of internal and external resources is based on several factors; e.g., cost, skill set, risk (implementation and political) etc. The optimization of resources is generally a ―structural‖ decision, since the Multisourcing approach advises a rigorous examination of the skills which are critical to keep internally, and those that are more commoditized and not visible to the Constituent.

Objective #1: Assess the gap between the current internal skill set and the required skills to support the business partner/Constituent projected needs.

Objective #2: Compare external resources skills, price/performance point and risks vs. internal costs (cost to close the skills gap), price/performance and risk.

Objective #3: Determine initial utilization of internal and external resources and develop a roadmap for transition and implementation.

Objective #4: Periodically review utilization mix, based on staff and external resource changes in skills, price/performance points, risk and new skills required by internal business partners and constituents.

Goal #2: Systemic and Holistic Understanding of the Constituent and their interaction with DHCS for solution development This is a comprehensive program to classify the Constituent Groups and/or Classes and determine the primary attributes that drive their consumption of the DHCS service(s). Solutions are developed based on understanding the information which influences Constituent behavior and ultimately drives the desired business outcome (note: This goal can only be achieved through collaboration with our internal business partners, who understand the Constituent Groups, their needs, and what is the desired business outcome):

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Objective #1: Classify the Constituent groups and their attributes.

Objective #2: Determine the common and unique attributes and how they drive architecture.

Objective #3: Design and Pilot sample solution – including correlations with the theoretical (assumed) and actual

Objective #4: Establish a learning and updating methodology to include new insights and lessons learned to accelerate the learning curve.

Goal #3: Functional EIM which identifies key data to operate the business (and business outcomes) and predictive analytics to influence Constituent behavior This a mature end state where the key data is well understood and its effects on business enterprises correlated. It includes the identification and update of key data, the assignment of data stewards (to keep the key data secure ) and a significant capability of conducting hypothesis-driven analysis to establish causal relationships between business outcomes and the ―leading indicators‖ of the key data for the purposes of predictive analytics.

Goal #4: Mature innovation methodology to identify, test and incorporate radical innovations to enhance DHCS delivery This is the establishment of a functioning ―skunk works,‖ which continuously scans the external environment for business and technology innovations to examine for incorporation at DHCS. The innovation adoption component is critical, since adopting too many radical ideas may lead to chaos, not improvement in overall DHCS delivery. Hence, there is a need for a pragmatic application of adoption to any specific area or program.

Objective #1: Establish the scope, goals and expected outcomes of the skunk works –including exclusion of certain types of technologies etc.

Objective #2: Establish a consistent methodology to select, prioritize and adopt radical innovations developed by the skunk works to specific areas or programs.

Objective #3: Pilot and evaluate a radical innovation for a small program (to mitigate initial risk), evaluate its progress relative to the initial theoretical limits.

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Goal #5: Mature Workforce Development and Retention Program This goal represents a multifaceted approach to the workforce. Initially, the program will identify critical skills required (in conjunction with the Multisourcing effort) and determine approaches to fill these gaps. These gaps can be addressed by a combination of the development of the ―Versatilist‖, a staff member who gains proficiency in 2 or 3 areas, as opposed to being a SME in one, or leveraging the specific strengths of the multigenerational workforce. The goal also will have a design to retain staff through incentives, such as challenging career opportunities, training, education, etc.

Objective #1: Identify the critical skill gaps in the organization (working with the Multisourcing assessment)

Objective #2: Develop alternatives to close the critical skill gaps (in conjunction with the multisource), to include training, etc.

Objective #3: Pilot and test 2-3 incentive programs to observe and learn how the teams respond to the ideas.

Objective #4: Correct initial program, observe continual progress and modify as needed to achieve the desired outcome.

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6.0 Risks and Mitigation Strategies This plan contains an aggressive strategy for DHCS ITSD to deliver state of the art IT solutions to support DHCS’ mission, with a number of risks included. However, we believe the ―risk‖ of ―doing nothing‖ will far exceed the risk and costs of the material detailed in this plan. The first risk in this strategy document is aggressive in both scope and breadth. There is a risk of trying to change too quickly where the ―organization drag‖ will become a major factor and slow down progress on all fronts. This risk is mitigated by the fact our strategic goals can be executed somewhat independently of each other. This was by design, so that we could maximize the progress in each area, without appreciably affecting the other. We also address overall risk by requiring that each strategic goal’s objective(s) has at least one place where we ―pilot‖ or test a new construct before rolling it into a production environment. The second risk we see is the development of a Multisourcing capability within DHCS IT. We address this risk in two ways. The first is through doing an objective market survey, which is public, and will show the price/performance compared to internal resources. In some cases it may show internal resources are not as competitive as some of the external resources. In some cases the internal functions; e.g. disk storage, server maintenance, etc., might need to be given to an external provider to free up internal resources for more important, constituent-facing assignments. The second way is to provide great career opportunities, to challenge themselves and their skills to improve. The third risk we see is developing a comprehensive view of the Constituents’ likes and needs. This is out of the norm for us to do. Our plan to mitigate this is to develop Constituency attributes slowly, challenging them as we progress and ―piloting‖ them to learn and improve from our initial efforts. Again, the piloting concept mitigates the risk by controlling the population effected. The fourth risk we see is in developing an Enterprise Information Management (―EIM‖) construct to identify and manage key data and information elements of the business. We will mitigate the risk here by setting a more conservative time frame of 18-24 months to incorporate this discipline enterprise wide. In addition, we will pilot an area to ensure we learn from the initial experiment before we apply it to the overall enterprise.

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The fifth risk is in developing the innovation methodology and the life-cycle it will span. This risk will be mitigated though the two-stage process we are implementing. The skunk works phase surveys, instigates and determines the fit of an innovation program to DHCS. Our safeguard in this process is the 2nd stage of innovation where we will apply pragmatic rules AND pilot to mitigate the risk from too early or large of an adoption before it is ready.

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Appendix A: FY 2011-2012 Key Accomplishments

• Supported Governor's executive order - Integrated iPhone and Android based smartphones into the inventory and reduced department cell phone usage cost by 50%

• Developed Policies for "Bring Your Own Device"

• Deployed Wi-Fi services for employees and visitors to access intranet and internet via mobile devices

Mobility

• Integrated cloud-based enterprise project and portfolio management tools, and enterprise test tools

• Completion of DHCS and CDPH CGEN migration

• Ongoing server consolidation and virtualization efforts

• Transitioned from tape backup to disk-to-disk backup

• Upgraded staff desktop and IT service desk softwares

Infrastructure

Optimization

• Completed CA-MMIS takeover

• Supported CBAS implementation, PERM audit, LIHP transition and Pharmacy rebate projects

• Updated and replaced systems to achieve compliance with HIPAA 5010 transaction standard (Short-Doyle 5010 and managed care capitation systems)

• Implemented enterprise data warehousing and and analytics solutions for MIS/DSS

Mission Critical

System

Development

• Partnered on RFP planning, vendor selection and procurement activities

• Operational and ongoing maintenance support

• Supported HBEX and MRMIB for advance planning on federal approval and funding

Health Benefit

Exchange

(HBEX)

• Implemented improved IT security controls

• Conducted infrastructure security assessments and updated security policies and requirements

• Developed enterprise security plans

• Implemented improved disaster recovery capabilities

Security

• Implemented DHCS Federated IT governance model

• Completed phase I of the DMH reorganization including assimilation of approximately 160 staff and IT systems

• Phase I ADP transition

Organizational

Transitions

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Appendix B: Supporting DHCS Objectives

DHCS IT GOALS

#1 #2 #3 #4 #5

To the People We Serve,

1. Improve the consumer experience so individuals can easily access high quality health care when they need it, where they need it, at all stages of life.

X X

2. Treat the ―whole person‖ by coordinating and integrating medical, mental health, long-term care, and substance use treatment services.

X X

3. Improve and maintain health and well-being through effective prevention and intervention.

X X

4. Develop effective, efficient and sustainable health care delivery systems.

X X X X

To the Public,

5. Ensure there is a viable health care safety net for people when they need it.

X X X X

6. Maintain effective, open communication and engagement with the public, our partners, and other stakeholders.

X X X

7. Hold ourselves and our providers, plans, and partners accountable for performance.

X X X

8. Be prudent, responsible fiscal stewards of public resources.

X X

To our Employees,

9. Focus on collaboration, teamwork, and effective decision-making.

X X X X

10. Recognize and show appreciation for dedication, innovation, and excellence.

X

X

11. Foster a healthy, positive, and respectful work environment.

X

12. Provide opportunities for professional learning and growth.

X

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Appendix C: Alignment with State IT Goals

DHCS IT Goals

#1 #2 #3 #4 #5

1. Accessible and Mobile Government x X x

2. Leadership and Collaboration Yield Results X x x

3. Efficient, Consolidated and Reliable Infrastructure and Services

x

4. Information is an Asset x X

5. Capable Information Technology Workforce x

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Appendix D: Year 2012- 2013 Priorities and Projects

• Drive the Mobile Workforce strategy forward by implementing desktop virtualization and mobile device management solutions to enable virtual desktop interface on personal computers and mobile devices

Mobility

• Continue to emphasize agency-wide infrastructure consolidation and virtualization efforts

• Roll out new department website

• Enhance the capabilities of enterprise security threat management tools

• Transition DHCS to the Consolidated Email System

Infrastructure

Optimization

• Continue providing design, development and implementation support for the CA-MMIS

• Develop an IAPD for a MEDS Modernization project

• Begin efforts to upgrade MEDS batch Interfaces to real-time to support eligibility and enrollment

• Initiate a project to streamline and enhance the provider enrollment process for DHCS programs

• Replace the current Paid Claims and Encounter System

Mission Critical

System

Development

• Continue to partner on CalHEERS design, development and initiation effort

• Finalize the IAA to support the infrastructure for the 350 HBEX state and contract staff

• Continue development of the Health Exchange and Medi-Cal Interface (HEMI)

Health Benefit

Exchange

(HBEX)/Covered California

• Provide IT support for departments / programs transitioning to CHHS (e.g. the Office of the Patient Advocate)

• Transition DMH non-Medi-Cal program, remaining ADP programs, and select CDPH programs to DHCS

• Transition the Healthy Families Program to Medi-Cal

Organization

Transitions

• Develop the Enterprise Architecture Plan for DHCS

• Provide Annual ITSD Performance Review to Director and Executive staff

• Enhance security risk and compliance management

• Improve security incident monitoring and prevention

Enterprise Architecture and

Security

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Appendix E: Acronyms ACA Affordable Care Act

ADP Alcohol and Drug Programs

ALM Application Lifecycle Management

CALHEERS California Healthcare Eligibility, Enrollment and Retention System

CA-MMIS California Medicaid Management Information System

CBAS Community Based Adult Services

CDPH California Department of Public Health

CGEN California Government Enterprise Network

CHHS California Health and Human Services

CMS Centers for Medicare and Medicaid Services

COTS Commercial Off The Shelf

DD&I Design, Development and Implementation

DHCS Department of Health Care Services

DMH Department of Mental Health

DSS Decision Support Systems

HBEX Health Benefit Exchange

HEMI Health Exchange and Medi-Cal Interface

HIE/HIT Health Information Exchange / Health Information Technology

HIPAA Health Information Portability and Accountability Act

IAA Intra Agency Agreements

IAPD Implementation Advance Planning Document

ITSD Technology Services Division

LIHP Low Income Health Program

MEDS Medi-Cal Eligibility Data System

MIS/DSS Management Information System/Decision Support System

MITA Medicaid Information Technology Architecture

MMIS Medicaid Management Information System

MRMIB Managed Risk Medical Insurance Board

PERM Payment Error Rate Measurement

RFP Request for Proposal