ATTM 014.pdf

Delivery of Automated Systems for Healthcare (DASH) Program

Phase Summary Checklists

ATTM 014

V.9.0

Table of Contents

1. INTRODUCTION

2. PHASE GATES

2.1. INITIATE-PLANNING PHASE GATE

2.2. REQUIREMENTS PHASE GATE

2.3. DESIGN PHASE GATE

2.4. DEVELOPMENT PHASE GATE

2.5. USER ACCEPTANCE TEST PHASE GATE

2.6. DEPLOYMENT PHASE GATE

2.7. CLOSE PHASE GATE

2.8. OPERATIONS PHASE GATE

2.9. TRAINING PHASE GATE

2.10. CONVERSION PHASE GATE

2.11. FEDERAL CERTIFICATION OPERATIONAL READINESS REVIEW PHASE GATE

2.12. FEDERAL CERTIFICATION REVIEW PHASE GATE

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1. Introduction The South Carolina Department of Health and Human Services (SCDHHS) defines a Phase Gate as a methodology of entrance and exit criteria for each project’s milestones. The following summaries are included as part of the Phase Summary Checklists and the deliverables are included as part of the Consolidated Deliverables Management List (CDML); both are applicable to SCDHHS Vendors for system implementation projects. The entrance and exit criteria listed herein are the expected minimum list for SCDHHS Vendor contracts.

The Delivery of Automated Systems for Healthcare (DASH) program is responsible for the successful planning and implementation of the various modular Medicaid components that together comprise the enterprise Medicaid Management Information System (MMIS). DASH has established project management standards, plans, and controls to be used as a framework for management of these projects.

The DASH Program has defined standard phase gates to manage key SDLC decision points for each project. Each phase gate includes entrance and exit criteria that specify the resources, actions, and deliverables necessary to complete the SDLC phase. The project schedule must address the major milestones for each phase gate. The DASH Program works with each Vendor to complete, manage, and administer the entrance and exit criteria throughout the SDLC.

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2. Phase Gates

2.1. Initiate-Planning Phase Gate

Initiate-Planning Phase Gate Summary

Goal Verify that processes/resources/schedule are in place for SDLC start Inputs SCDHHS Inputs

• DASH Project Plans & Processes

• SCDHHS Organization Chart

• Approved Implementation Advanced Planning Document (IAPD)

• Request for Proposal (RFP)

• RFP Amendments

• Record of Negotiation (RON)

• Contract Award

• Project SharePoint Site Vendor Inputs

• Vendor RFP Response

• Constraints/Assumptions

• Vendor Organization Charts

• Proposed Project Schedule

Outputs • Baselined Project Schedule

• Approved DASH/Project PM Plans/Amendments

• Initial Risk/Issues lists

• Updated Project Org Chart

• Stakeholder List

• Requirements Repository Setup

Entrance Criteria 1. Award Vendor contract

2. Identify key SCDHHS and Vendor project staff (Decision Makers)

3. Establish Project SharePoint site with initial users/security

4. Copy Project PM Plans and processes to Project SharePoint site as PDFs

5. Copy Project templates to Project SharePoint site

6. Load Vendor proposal and supporting documentation to Project

SharePoint site

7. Onboard vendor resources needed for project start

(Agency, DASH, and Project-Team onboarding)

8. Capture Vendor input to Initiate-Planning Phase Gate Checklist

Exit Criteria

1. Conduct Project Kickoff

2. Capture Vendor/DASH/SCDHHS resources identified and documented in

Stakeholder Contacts in Project SharePoint site (project org chart)

3. Confirm Vendor Key Personnel

4. Provide Project SharePoint site access for team resources

5. Train Project team on Risk, Issue, Decision and Action Item processes

6. Baseline schedule in accordance with DASH Schedule Management Plan

(PGM.PLAN.0007 - Schedule Management Plan)

7. Initiate Risk/Issue and Project Status meetings, identify initial Risks/Issues

8. Assess environment and data requirements with SCDHHS technical staff

(MES-Core) Concurrent Phase • N/A SCDHHS Role • Oversee Program/Project Management

• Oversee project schedule and schedule metrics

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Initiate-Planning Phase Gate Summary

• Provide Organizational Change Management (OCM) oversight

Vendor Role • Plan and conduct Project Kickoff

• Create/manage/maintain schedule

• Adopt DASH Project Management Plans

Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Visio

• MS Office Products

Data Requirements • N/A Contract Deliverables • D-001 – Vendor Staff Management Plan

• D-002 – Quality Assurance Management Plan

• D-003 – Configuration Management Plan

• D-004 – Development Methodology Document

Considerations • Organizational Change Management (OCM)

• Vendor-specific SDLC tools

2.2. Requirements Phase Gate

Requirements Phase Gate Summary

Goal Develop and approve a comprehensive listing of project requirements Inputs • Request for Proposal (RFP)

• Record of Negotiation (RON)

• Contract Requirement documents

• Federal/CMS Requirements and Outcome documents

• Validated As-Is business process documentation

• DASH Requirements Management Plan (RMP)

• DASH Change Management (CM) Plan

• Oversight from DASH Change Control Board

• SCDHHS DevOps Project Requirement Repository

Outputs • Approved Project Requirements Management Plan (RMP)

• Approved Project Configuration Management Plan

• Approved and Baselined Project DevOps requirements

• Project Joint Review Committee (JRC) in place

• JRC Meeting schedule defined and communicated to JRC distribution list

• Requirement-related risks and issues captured per approved process

• Agreed upon requirement status reporting and metrics

Entrance Criteria 1. Confirm requirement attributes and finalize DevOps as Source of Truth

2. Confirm requirements traceability model and expected downstream SDLC artifacts

3. Confirm approval of Project Requirements Management Plan (RMP)

4. Confirm approval of Project Configuration Management Plan (CMP)

5. Confirm accurate capture of Source requirements (RFP, RFP

Amendments, RON, Contract, and CMS documents)

6. Document Joint Application Development (JAD) process and communicate JAD topics, participants, and schedule

7. Confirm project stakeholder access to DevOps and any Vendor requirement repository Exit Criteria 1. Confirm all Source requirements have been reviewed or decomposed per

RMP process during JAD sessions

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Requirements Phase Gate Summary

2. Confirm JAD Notes and Participants documented per JAD process

3. Validate DevOps contains comprehensive listing of Project Functional and

Non-Functional requirements

4. Capture and resolve relevant Action Items

5. Obtain JRC requirement approval

6. Baseline requirements per Project Schedule

Concurrent Phase • N/A SCDHHS Role • Oversee requirement development and management activities

• Ensure appropriate SCDHHS stakeholders/information are available for

JAD

• Participate in JAD to provide SCDHHS input and make decisions as needed

• Provide JRC mechanism to approve and maintain requirements

• Approve Requirement Specification Documents (RSDs)

• Manage updates to business processes and State and Federal policy

Vendor Role • Collaborate with SCDHHS to document Source requirements

• Plan, facilitate, and manage JAD sessions

• Collaborate with SCDHHS to decompose high-level requirements in JAD

• Identify and propose resolutions for application requirement gaps

• Reconcile any Vendor-specific requirements repository with DevOps

• Build and maintain traceability to downstream SDLC activities

• Support RTM generation

Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Visio

• MS Office Products

Data Requirements • As needed for Technical/Interface requirements Contract Deliverables • N/A Considerations • Bi-directional traceability for all requirement types

• Security requirements, Office of Cybersecurity (OCS)

• Operations requirements

• Training requirements

• Training for DevOps/Vendor tools

• Include Test, Training, Federal Certification, and Organizational Change

Management (OCM) team members in requirement sessions/review

2.3. Design Phase Gate

Design Phase Gate Summary Goal Confirm readiness for Vendor to commence Design phase activities Inputs • Project schedule

• Designated SCDHHS and Vendor Design stakeholders

• Approved State and Federal requirements

• Approved DASH Design Templates

• D-003 Configuration Management Plan

Outputs • Completed CDML design documents

• D-010 - Release Management Plan

• D-024 - Data Conversion Plan

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Design Phase Gate Summary

• Design phase submission of D-005 - Requirements Traceability

Matrix (RTM) Entrance Criteria 1. Confirm SCDHHS and Vendor Design stakeholders

2. Communicate Design schedule as defined in project schedule; Must include cycles for design review and approvals

3. Confirm JAD sessions for requirement validation have commenced

4. Approve D-006 - Functional Design Specification (FDS) template

5. Approve D-007 - Technical Design Specification (TDS) template

6. Approve D-008 - Interface Control Document (ICD) template

7. Approve D-009 - Data Analytics Specification (DAS) template

Exit Criteria 1. Approve completed D-006 - Functional Design Specification (FDS)

2. Approve completed D-007 - Technical Design Specification (TDS)

3. Approve completed D-008 - Interface Control Document (ICD)

4. Approve completed D-009 - Data Analytics Specification (DAS)

5. Approve completed D-010 - Release Management Plan

6. Approve completed D-024 - Data Conversion Plan

7. Approve Design phase submission of D-005 - Requirements Traceability

Matrix (RTM) Concurrent Phase • Requirements, Conversion SCDHHS Role • Provide Project Management and Organizational Change Management

(OCM) oversight

• Collaborate with Vendor during design sessions

• Promote SCDHHS stakeholder engagement and ownership

• Review and approve design deliverables and RTM

• Document updated business processes and critical business impacts Vendor Role • Develop design templates

• Develop completed designs

• Provide design updates per review comments or document defects

• Submit Design phase RTM

• Manage design documents according to D-003 Configuration

Management Plan Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Office Products

Data Requirements • As applicable Contract Deliverables • D-005 - Requirements Traceability Matrix (RTM)

• D-006 - Functional Design Specification (FDS)

• D-007 - Technical Design Specification (TDS)

• D-008 - Interface Control Document

• D-009 - Data Analytics Specification

• D-010 - Release Management Plan

Considerations • Include Test, Training, Federal Certification, and OCM team members in design sessions/review

• Document defects may be identified for approved design documents by the Test team

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2.4. Development Phase Gate

Development Phase Gate Summary Goal Confirm readiness for Vendor to commence Development phase activities Inputs • Project schedule

• Designated SCDHHS and Vendor Development stakeholders

• D-003 - Configuration Management Plan

• D-004 - Development Methodology Document

• CDML design documents traced to approved requirements

Outputs • Completed configuration/Unit tested components

• Development releases

• Application demonstrations/walkthroughs

• Finalized component list to support Test phase submission of D-005 -

Requirements Traceability Matrix (RTM) Entrance Criteria 1. Confirm SCDHHS and Vendor Development stakeholders

2. Communicate Development schedule as defined in project schedule;

Must define release schedule and include cycles for technical review/demonstrations

3. Confirm development tools and process are fully addressed by D-003 - Configuration Management Plan

4. Confirm code development, standards, and management process adheres to D-004 - Development Methodology Document

5. Compile draft list of application components Exit Criteria 1. Complete planned development release(s)

2. Complete planned development demonstration(s)

3. Confirm Unit test and technical component validations are complete

4. Confirm Unit test defects are resolved

5. Approve finalized list of application components

Concurrent Phase • Design Phase SCDHHS Role • Provide Project Management oversight

• Collaborate with Vendor to address technical issues

• Promote SCDHHS stakeholder engagement and ownership

• Coordinate with Office of Cybersecurity (OCS)

• Evaluate Vendor demonstrations for organizational change impacts

Vendor Role • Manage and deliver application software components/releases

• Provide software component list

• Lead application demonstrations

• Manage and report development status/risks

• Comply with OCS security requirements and protocols

Tools • Vendor-defined development tool suite

• SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Office Products

Data Requirements • As needed upon request for agency, conversion, or partner-provided data

Contract Deliverables • N/A

Considerations • Include Test, Training, Federal Certification, and Organizational Change Management (OCM) team members in application demonstrations

• Involve SCDHHS technical staff to confirm appropriate oversight

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2.5. User Acceptance Test Phase Gate

User Acceptance Test Phase Gate Summary

Goal Confirm readiness for SCDHHS to commence User Acceptance Test for full scope of application

Inputs • SCDHHS UAT Plan

• D-021 - User Acceptance Test (UAT) Support Plan

• Project schedule

• State and Federal requirements

• Design documents

• Use cases

• UAT test cases

• Active defects from prior test phases

• Trained UAT Participants

• Fully coded and available application and interfaces connectivity

• Test data (including master/reference, transactional, converted) and test files

• User credentials/profiles

• Network and server configuration and parameters

• System performance benchmarks for online and batch transactions

Outputs • Completed UAT test cases

• UAT defects

• SCDHHS UAT Summary Report

• D-005 - Requirements Traceability Matrix (RTM)

Entrance Criteria 1. Approve E2E Summary Report; Validate coverage and traceability

2. Conduct UAT Test Strategy meeting with test stakeholders

3. Communicate test schedule as defined in project schedule; Must include periodic planned releases for defect corrections

4. Confirm release management process is approved; Release Notes format and frequency is mutually agreed upon

5. Communicate approved configuration management process for project documentation changes

6. Communicate approved defect management process; Confirm no open

Severity 1 or 2 defects unless approved by SCDHHS; Remaining defects have mutually agreed upon target resolution dates

7. Configure DevOps and any supporting testing tools including access permissions for UAT stakeholders

8. Confirm DevOps UAT test cases are ready; Validate full coverage for approved requirements and designs/components

9. Confirm UAT environment is ready, including any supporting applications, configuration, interface connectivity, and batch

10 Conduct a successful UAT Smoke Test

11. Confirm test data is ready including test files/interface data in accordance with defined security procedures; Reference data/tables are populated and required converted data is available

12. Confirm UAT participant training is complete

13. Validate testing user credentials/profiles are ready

14. Confirm third parties are prepared to exchange UAT files/extracts

15. Confirm UAT support resources are available; Help desk is staffed and operational

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User Acceptance Test Phase Gate Summary

1. Execute planned UAT test cases; Results are available in testing tool

2. Document UAT pass rate

3. Confirm no open Severity 1 or 2 defects unless approved by SCDHHS;

Remaining defects have mutually agreed upon target resolution dates

4. Confirm workarounds are documented for Severity 3 and 4 defects and are accepted by Business Owners

5. Complete documentation updates or capture as UAT defects

6. Confirm training materials, e-Learning modules, and online help are complete and approved

7. Publish UAT Test Summary Report

Concurrent Phase • N/A SCDHHS Role • Plan, execute, and manage UAT

• Develop UAT test cases

• Train UAT participants on SCDHHS UAT process and tools

• Facilitate UAT defect triage

• Assess overall UAT results as input to Go/No Go decision

Vendor Role • Support UAT planning and execution

• Provide application training for SCDHHS UAT participants

• Provide UAT test data including converted data and interface data as specified by SCDHHS

• Support batch and interface processing to mirror Production

• Troubleshoot and resolve UAT defects

• Perform regression testing for UAT defects in lower test environments including Unit, SIT, E2E, and PRF; Update applicable system documentation

Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Office Products

• Batch/API Test Tools

• Performance Test Tools

• Security Test Tools

• Automated Test Tools

• Accessibility Test Tools

Data Requirements • Agreed-upon volume of UAT data Contract Deliverables • D-021 - User Acceptance Test (UAT) Support Plan

• D-005 - Requirements Traceability Matrix (RTM) Considerations • Include Training, Federal Certification, and Organizational Change

Management (OCM) team members in UAT defect triage

• Escalate Federal Certification-related defects for triage and impact analysis

• Coordinate with Federal Certification effort/activities as needed

• Coordinate with OCM on status and communication with stakeholders as needed

2.6. Deployment Phase Gate

Deployment Phase Gate Summary

Goal Verify the approach, processes, and required activities to execute the installation, deployment, and transition of the solution to Production

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Deployment Phase Gate Summary Inputs • Deployment checklist template

• Initial list of deployment roles and responsibilities

• Agency policy or Medicaid State Plan updates

• Activities identified for configuration, data preparation, software release, administration, support, training, and turnover plan

• UAT defects

• Mock conversions

• Certification considerations

Outputs • D-027 - Final Data Conversion Report

• Completed Deployment Checklist

• Completed contingency/rollback plan

Entrance Criteria 1. Create draft deployment checklist

2. Identify deployment resources and stakeholders

3. Approved business processes, procedures, and policies

4. Approved configuration management plan for Production

5. Approved release management plan for Production

6. Approved system administration manual

7. Approved D-012 – System Administration Document

8. Approved D-013 – User Manual

9. Approved D-023 - Help Desk Plan

10. Approved D-030 – Training Delivery

11. Approved D-029 – Training Materials

12. Approved D-030 – Training Delivery (may run concurrent if phased deployment)

13. Mock conversion results

14. Communicate deployment activities as defined in project schedule

15. Communicate with federal certification representative target go-live date

1. Confirm completed deployment checklist

2. Contingency/rollback plan

3. Review deployment summary report

4. Review approved D-027 - Final Data Conversion Report

5. Communicate deployment status to stakeholders

6. Publish updated Agency policy as needed

7. Capture lessons learned during Deployment Phase

Concurrent Phase • Training Phase

• Conversion Phase

• Federal Certification Phase

SCDHHS Role • Plan and manage deployment

• Determine Go/No-Go decision

• Manage Organizational Change Management (OCM) readiness and business impacts

• Coordinate policy updates

Vendor Role • Prepare and successfully deploy the solution

• Complete deployment checklist

Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Visio

• MS Office Products

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Deployment Phase Gate Summary Data Requirements • N/A Contract Deliverables • D-011 - Deployment Plan

• D-023 - Help Desk Plan Considerations • OCM project activities, including Readiness Checklists and Resolution

Plan

2.7. Close Phase Gate

Close Phase Gate Summary

Goal Conduct review at the end of the project to ensure the required work has been completed and approved prior to project closure

Inputs • Project Plan

• Issue Log

• Risk Log

• Action Items

• Project Status Report

• Schedule

• Completed Final Federal Certification Review (CR)

Outputs • Closed Issue Log

• Closed Risk Log

• Closed Action Items

• Closed Project Plan

• Final Project Closure Report

• Final Schedule

Entrance Criteria 1. Complete all project phases and deliverables per Project Plan

2. Review and document ALL management plans for Lessons Learned

3. Draft inventory of all pertinent systems and environments

4. Review schedule activities

5. Federal Certification activity complete

1. Close or transfer all Issues, Risks, Action Items, and Business Readiness Tasks

2. Generate final Project Closure Report

3. Finalize ALL management plans

4. Obtain approval from the Program Sponsor

5. Conduct administrative closure on project contracts

6. Conduct formal communication / recognition of the completion of project

7. Archive project documents

Concurrent Phase • N/A SCDHHS Role • Manage, review, approve, and/or authorize project closure

• Manage Organizational Change Management (OCM) readiness Vendor Role • Support project closure activities Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Visio

• MS Office Products

Data Requirements • N/A Contract Deliverables • N/A Considerations • N/A

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2.8. Operations Phase Gate

Operations Phase Gate Summary

Goal Review the maintenance and operations of the deployed solution, including help desk support and ongoing enhancements, including role and responsibilities

Inputs • D-023-Help Desk Plan

• Updated business processes, procedures and policies

Outputs • D-022 - Operations and Maintenance (O&M) Plan

• D-031 - Turnover Plan

Entrance Criteria 1. Review help desk plan definitions for level of roles and responsibilities

2. Review incident tracking process

3. Review response procedures for SLA reporting

4. Review status reporting process

5. Review on-going training needs for Vendor and SCDHHS support staff

1. Document the description of each support function, resource, and role mapped to each support team (Vendor and SCDHHS) and Help Desk

2. Establish Change Management process

3. Confirm Configuration Management process

4. Define Service Level Agreement reporting

5. Establish O&M Status Reporting criteria

6. Approve D-022 - Operations and Maintenance (O&M) Plan

7. Approve D-031 - Turnover Plan

8. Execution of O&M by vendor

Concurrent Phase • Close Phase

• Federal Certification Phase

SCDHHS Role • Coordinate O&M activities for final plan

• Provide Organizational Change Management (OCM) oversight

Vendor Role • Provide staff and activities for Help Desk and ongoing support

• Submit status reporting per O&M schedule

Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Visio

• MS Office Products

Data Requirements • N/A Contract Deliverables • D-022 Operations and Maintenance (O&M) Plan Considerations • Helpdesk Software

• Ongoing OCM training on business process changes for Agency staff

2.9. Training Phase Gate

Training Phase Gate Summary

Goal Successfully train testers and end users in the functionality of the implemented system

Inputs • Request for Proposal (RFP)

• Record of Negotiation (RON)

• Contract Amendments, Contract Requirement documents

• DASH Training Plan

• Project Requirements

• Design Documents

Outputs • Training Learning Management System (LMS) Setup

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Training Phase Gate Summary

• Training Participant List

• Training Reports

• Training Environments

Entrance Criteria 1. Communicate training timeframes defined in approved Project Schedule

1. Develop Training Schedule

2. Develop Vendor Training Plan

3. Develop Course Outlines (after approved design documents)

4. Develop Training Materials (after approved design documents)

5. Identify Training Audiences and Roles

6. Trace Training Materials to Design Docs or Components (DevOps)

7. Order equipment for any in person training – (laptops, Wi-Fi, etc.)

8. Set up Training Environments (including data, training IDs/credentials, etc.) (after SIT)

9. Setup LMS for training registrations and surveys

10. Identify and setup up training facilities for any in person training - (central or regional locations); if virtual training, set up webinars

11. Communicate training registration instructions to participants prior to each phase (UAT and Deployment)

12. Conduct UAT training and provide training reports

13. Conduct Deployment training and provide training reports

Concurrent Phase • Development Phase

• User Acceptance Test Phase

SCDHHS Role • Oversee training tasks

• Manage Organizational Change Management (OCM) training and coaching Vendor Role • Conduct training tasks Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Visio

• MS Office Products

• LMS

• Training Environments

Data Requirements • Constructed Data Contract Deliverables • D-028 – Vendor Training Plan

• D-029 – Training Materials

• D-030 – Training Delivery

Considerations • OCM project activities, including Training and Coaching Plan

• Training Outreach

• Security

2.10. Conversion Phase Gate

Conversion Phase Gate Summary

Goal Identify data requiring conversion and validate this converted data is correct and complete

Inputs • Project Schedule

• Conversion stakeholders identified

• Project Requirements

• Design Documents

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Conversion Phase Gate Summary

• Identified Data Sources

Outputs • Conversion Plan o Conversion Roles and Responsibilities o Conversion Tools and Environments o Conversion Processes and Procedures o Conversion Configuration Management Process o Conversion Backup and Restore Processes o Conversion Recovery/Backout Processes o Conversion Testing (Mock Conversions) o Conversion Status Reporting o Conversion Deployment Support

• Data mapping rules o Source/Target Metadata (Data Dictionary) o Rules for Source to Target Mapping o Mapping related reporting

• Conversion validation scripts

• Conversion test reports

• Data cleanup reports/repository

Entrance Criteria 1. Project requirements approved

2. Project design in progress

3. Conversion data sources identified

1. Approved Conversion Plan

2. Approved Data Mapping Rules

3. Executed Data Validation Scripts and Reports

4. Completed Data Cleanup

5. Completed Data Conversion

6. Post-Deployment data cleanup completed

Concurrent Phase • Design Phase

• Development Phase

• User Acceptance Test Phase

SCDHHS Role • Assist with definition of source data for conversion

• Participate in data conversion cleanup

• Facilitate availability of data for conversion

• Verify converted data

Vendor Role • Create Conversion Plan

• Generate Mapping Rules

• Execute conversion testing

• Provide conversion validation, quality, readiness and cleanup reports

Tools • SCDHHS Project SharePoint site

• SCDHHS DevOps

• MS Project

• MS Office Products

Data Requirements • Secure databases/locations for extracted data

• Security controls on application instances containing converted data

Contract Deliverables • D-024 – Data Conversion Plan

• D-025 – Data Conversion Mapping Rules

• D-026 – Data Conversion Validation Scripts and Test Results Report

• D-027 – Final Data Conversion Report

Considerations • Data Mapping approval prior to End-To-End Testing

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Conversion Phase Gate Summary

• Conversion may extend past deployment if post-conversion data cleanup is identified

2.11. Federal Certification Operational Readiness Review Phase Gate Federal Certification Operational Readiness Review Phase Gate Summary

Goal Ensure the certification of each qualifying Medicaid modernization system Inputs • Center for Medicaid and Medicare Systems (CMS) and state-specific

Outcomes and Performance Measures

• Implementation Advanced Planning Document (IAPD)

• Request for Proposal (RFP), and responses from selected vendor(s)

• Record of Negotiation (RON)

• Contract documents

• DASH Federal Certification Plan

Outputs • Approved Operational (Key Performance Indicator - KPI reporting) Template

• Approved Outcomes Intake Form, with sample evidence

• Approved Conditions for Enhanced Funding Intake Form and evidence

• Approved Evidence Packets for Operational Readiness Review (ORR)

• Approved other required artifacts (defined by module)

• Approved Design Development and Implementation (DDI) Test Plan, Test

Cases and Test Results (may be test data)

• Approved samples of each KPI report

• Approved Independent Security Audit Report

• Approved ORR event presentation materials

• Approved SCDHHS responses to CMS Request Listing (pre-review questions)

• Approved SCDHHS responses to any post-review Action Items from CMS

Entrance Criteria 1. Initiate Design Development and Implementation (DDI) project

2. Onboard Vendor DDI Project Teams

1. Onboard SCDHHS and Vendor Project Teams to Federal Certification project

2. Prepare and submit all required Federal evidence

3. Prepare SCDHHS and Vendor staff to present at Operational Readiness

Review (ORR) event

4. Respond to CMS Request Listing (pre-review questions)

5. Present evidence to CMS at ORR event

6. Facilitate CMS post-ORR briefing with SCDHHS

7. Prepare and submit responses to any post-ORR Action Items to CMS

8. Receive SCDHHS Go-live Decision

Concurrent Phase • Initiate Planning Phase

• Requirements Phase

• Design Phase

• Development Phase

• User Acceptance Test Phase

SCDHHS Role • Prepare, review, and approve all artifacts required for certification

• Create, review, and approve the evidence

• Prepare participants to present during the ORR

• Respond to CMS Request List (pre-review questions)

• Present evidence at the ORR

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Federal Certification Operational Readiness Review Phase Gate Summary

• Follow-up on post-ORR CMS Action Items

• Prepare, review, and approve Third Party System Security Audit Report

• Provide Organizational Change Management (OCM) oversight and reporting Vendor Role • Assist SCDHHS in developing certification evidence

• Prepare participants to present during the ORR

• Respond to CMS Request List (pre-review questions)

• Present evidence at the ORR

• Follow-up on post-ORR CMS Action Items

• Review and approve Third Party System Security Audit Report

Tools • SCDHHS Project SharePoint site

• MS Office Products

• CMS Box platform

Data Requirements • N/A Contract Deliverables • N/A Considerations • ORR activities start in the Project Planning (pre-DDI) Phase, continue throughout the DDI Project Phase, and end at System Go-live

• The ORR is followed by the Final Certification Review (CR), which is discussed in the Federal Certification CR Phase Gate document

• The System Security Audit (a KPI report) will be submitted annually for both SMC and OBC-based projects o The first System Security Audit is created by an independent, third-party security auditor. It is submitted as evidence in support of the ORR activity.

• CMS will require the re-certification of each system on an annual basis

2.12. Federal Certification Review Phase Gate

Federal Certification Review Phase Gate Summary

Goal Ensure the certification of each qualifying Medicaid modernization system Inputs • Operational Readiness Review (ORR) evidence artifacts

• SCDHHS responses to any ORR Action Items

• SCDHHS Go-live decision notification (post-ORR)

• Center for Medicare and Medicaid Services (CMS) ORR approval letter

Outputs • Approved Operational (Key Performance Indicator – KPI) Reports

• Approved System Acceptance Letter

• Approved Certification Review Request Letter

• Approved updated Outcomes Intake Form with evidence from production

• Approved updated Conditions for Enhanced Funding Intake Form and evidence

• Approved KPI Reports (with 6-months of live data)

• Approved other required artifacts (defined by module)

• Approved Operations Testing Defects and Planned Remediations reports

• Approved Certification Review (CR) event Presentation Materials

• Approved SCDHHS responses to CMS Request Listing (pre-review questions)

• Approved SCDHHS responses to any post-review Action Items from CMS

• CMS Certification Decision Award Notification

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Federal Certification Review Phase Gate Summary Entrance Criteria 1. Run system in production for at least six months (Operations phase)

2. Create six months of KPI reports from production data

1. Prepare and submit six months of Operational (KPI) Reports to CMS

2. Prepare and submit System Acceptance Letter to CMS

3. Prepare and submit Certification Request Letter to CMS

4. Prepare and submit updated Outcomes Intake Form to CMS

5. Prepare and submit updated Conditions for Enhanced Funding Intake form to CMS

6. Prepare and submit other Required Artifacts to CMS

7. Prepare and submit Certification Review (CR) event Presentation

Materials to CMS

8. Respond to CMS Request Listing (pre-CR questions to SCDHHS)

9. Prepare SCDHHS and Vendor staff to present at the CR event

10. Present evidence to CMS at CR event

11. Facilitate CMS post-CR briefing with SCDHHS

12. Prepare and submit responses to any post-CR CMS Action Items

13. Receive CMS Certification Award Notification

14. Close out DASH FedCert System Certification Project

Concurrent Phase • Operations Phase SCDHHS Role • Prepare, review, and approve all artifacts required for certification

• Create, review, and approve the evidence

• Prepare participants to present during the CR

• Respond to CMS Request List (pre-review questions)

• Present evidence at the CR

• Follow-up on post-CR CMS Action Items

Vendor Role • Assist SCDHHS in developing certification evidence

• Prepare participants to present during the CR

• Respond to CMS Request List (pre-review questions)

• Present evidence at the CR

• Follow-up on post-CR CMS Action Items

• Prepare, review, and approve Third Party System Security Audit Report

Tools • SCDHHS Project FedCert SharePoint work area

• MS Office Products

• CMS Box platform

Data Requirements • N/A Contract Deliverables • N/A Considerations • The CR phase starts at Go Live and continues through the receipt of the

CMS Certification Award Decision notification (approximately 3-4 months after the end of the CR event)

• For modules certified under Streamlined Modular Certification (SMC), KPI reports must be produced annually at a minimum, or on a more frequent schedule to be determined by SCDHHS

• For modules certified under Outcomes Based Certification (OBC), KPI reports must be produced monthly and delivered to CMS quarterly.

Currently the only module using OBC is Electronic Visit Verification (EVV) systems

• The System Security Audit (a KPI report) will be submitted annually for both SMC and OBC-based projects o The first System Security Audit is created by an independent, third-party security auditor

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Federal Certification Review Phase Gate Summary o System Security Audit is submitted in support of the ORR

• CR certification activities will occur in parallel with the early Operations Phase of the system

• The CR is preceded by ORR, which is discussed in the Operational Readiness Review Phase Gate document

• CMS will require the re-certification of each system on an annual basis