PL 005 - updated.pdf

MMRP Operations and

Maintenance Manual

Version 4.0

Last Revised: 6/16/2021

Prepared by:

South Carolina Department of Health and Human Services (SCDHHS)

Member Management Replacement Program (MMRP)

MMRP O&M Manual V4.0

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Table of Contents

1.0 Introduction

1.1 Document Review Plans

1.2 Document Location

1.3 Background

1.4 Scope

1.5 Project Repository

1.6 Referenced Documents

1.7 Acronyms/Glossary

1.8 MMRP O&M Acronyms/Glossary

2.0 Governance

2.1 SCDHHS MMRP Organizational Structure

2.1.1 SCDHHS MMRP O&M Organizational Structure

2.2 Roles & Responsibilities

2.3 Authority

3.0 System Overview

3.1 Data Management

3.2 Database Design

3.3 Security Certificates

3.4 Maintenance Windows and Frequency

3.4.1 Standing Windows

3.4.2 Emergency Maintenance

3.4.3 Special Considerations

4.0 Business Environment

4.1 User community (Internal/external)

4.2 Peak Processing Time

4.3 Hours of Operation

4.3.1 System Availability

4.3.2 Shifts for SCDHHS Internal Users

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4.3.3 Hours of Operations for the E&E Systems Helpdesk

4.4 Impact from System Failures

4.5 Reporting requirements

4.6 System Performance Review

5.0 Incident Management

6.0 MMRP O&M Enhancement SDLC

7.0 Enhancement Management

7.1 Requirements Analysis & Design

7.1.1 Routine Maintenance

7.1.2 Non-Business Case Work Requests

7.1.3 Business Case Process

7.1.3.1 Business Case Components

7.1.3.2 Business Case Process Models

7.1.3.2.1 Business Case Process Flow and Narrative

7.1.3.3 Business Case Review

7.1.3.3.2 Internal BC Review Meeting

7.1.3.3.3 Business Case Workbook

7.1.3.3.4 Cúram Priorities Prod Support Leadership Meeting

7.1.4 BC Prioritization

7.1.5 Technical Design Documentation, ADD updates, and/or solution abstract

8.0 Development

8.1 Design and Development Standards

8.1.1 Code Review

8.2 JUnit Testing

9.0 Quality Management

9.1 Perform Quality Assurance

9.2 Perform Quality Control

9.2.1 O&M Contractor Testing Team Expectations

9.2.2 UAT Approach and Methodology

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9.2.3 Defect Management

9.2.3.1 Test Cases and Defects

9.2.3.2 Bug Details

9.2.3.3 Severity versus Priority

9.2.3.4 Resolution

9.2.4 Jira Testing Labels and Fields

9.2.5 Test Environments

9.2.6 Testing Plans

9.2.7 Requirements Traceability

9.2.8 Load and Performance Testing

9.2.9 Tools for Quality Management

9.3 Browser Upgrade Testing

10.0 Release Management

10.1 High Level Code Release Process

10.2 Release Planning

10.2.1 DDI Release Planning

10.2.2 O&M Release Planning

10.2.3 Release Coordination

10.2.3.1 Pre-Implementation Meeting

10.2.4 Release Communication

10.3 Release Schedule

10.4 Release Monitoring

10.5 Release Documentation

10.5.1 Release Packages/Products

10.5.2 Release Versioning/Naming/Numbering Standards

10.5.2.1 Numbering/Versioning

10.5.2.2 System Prefix Standards

10.5.3 Release Notes

10.6 Release Authorization

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10.7 Implementation

10.7.1 Pre-Release Meeting

10.7.2 Implementation Schedule

10.7.3 Release Deployment

10.7.4 Release Close-out

10.8 Smoke Testing

10.8.1 Smoke Testing Steps

10.8.2 Post Smoke Testing Clean-up

10.8.3 Smoke Testing Process Model and Narrative

10.9 Tools

11.0 Demand & Capacity Management

12.0 Application Development to Application Maintenance (ADAM)

12.1 Communication and Knowledge Transfer Related to Upcoming Changes

12.1.1 Technical Knowledge Transfer

12.1.2 Knowledge Transfer to MMRP O&M Team and Stakeholders

12.2 ADAM Tools, Templates and Forms

12.2.1 Pre-Implementation Checklist

12.2.2 ADAM Checklist

12.2.3 Other ADAM Tools

13.0 Configuration Management

14.0 Staff Management

14.1 Vacancy Management

14.2 Onboarding

15.0 Change Management

15.1 Change to Approved Business Case

15.1.1Change to Approved Business Case Process Flow and Narrative

15.2 Change to Design Only

15.2.1 Change to Design Only Process Flow and Narrative

15.3 CR Status Updates

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15.4 O&M Change Request Form

16.0 Risk and Issue Management

16.1 Entering Risks

16.2 Entering Issues

16.3 Writing a Risk/Issue Description

16.4 Risk Management Meetings

16.5 Risk and Issue Monitoring

16.6 Risk Management Process and Narrative

17.0 Contractor Management

18.0 Cost Management

18.1 Cost Monitoring and Control

19.0 Communication Management

19.1 Communication Roles and Responsibilities

19.2 Escalation

19.3 Emergency Communication

19.4 MMRP Project Meetings

19.4.1 Meeting Protocols

19.4.1.1 Meeting Invitations

19.4.1.2 Meeting Agendas

19.4.1.3 Meeting Minutes

19.4.1.4 Action Items

19.4.1.5 Meeting Guidelines

19.4.1.6 Meeting Roles and Responsibilities

19.5 MMRP Communications Tools and Documentations

19.6 Stakeholder Engagement Plan

19.6.1 Organizational Change Management

19.7 Document Management

19.7.1 Terminology and Acronyms

19.7.2 Document Formatting Guidelines

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19.7.2.1 Title Page

19.7.2.2 Table of Contents Page

19.7.2.3 Referencing Documents

19.7.2.4 Document Control

19.7.2.5 Miscellaneous Formatting

19.7.3 File Naming Conventions

19.7.4 Document Version Numbers and Watermarks

19.7.5 Changes to Baseline or Approved Documents

19.7.6 Templates

19.7.7 Document Storage/Working Papers

19.8 Deliverables Management

20.0 Security

21.0 System Monitoring

21.1 Server and Network Monitoring

21.2 Application Monitoring

21.3 Database Monitoring

21.4 Logging and Analysis

22.0 Batch Operations and Escalations

22.1 Production Support Calendar

22.2 Scheduled Batches

22.3 Manually Executed Batches

22.4 Reporting

22.5 Escalation

23.0 System Maintenance

23.1 Red Hat Spacewalk Server

23.2 Security Patching

23.3 Server Maintenance

23.3.1 Log Auditing and Monitoring

24.0 Appendix

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Appendix A: MMRP Daily Scrum Status Update Spreadsheet

Appendix B: Disaster Recovery Procedures

Appendix C: Severity Level Definitions

Appendix D: Contact List

Appendix E: Cúram Version Elements

Appendix F: Review Status Schedule

Appendix G: Production Job Criticality Level Descriptions

25.0 Document Control

25.1 Document Control/Revision History

25.2 Review History

25.3 Approvals

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List of Tables

Table 1: Related Documents/References

Table 2: O&M Acronyms & Glossary

Table 3: O&M Primary Points of Contact

Table 4: Business User Groups

Table 5: Business Case Process Flow Narrative

Table 6: Defect Severities

Table 7: Defect Priorities

Table 8: Jira Testing Labels and Fields

Table 9: Implementation Activity Timeline

Table 10: Production Smoke Test Process Flow Narrative

Table 11: ADAM Knowledge Transfer to O&M Team & Stakeholders

Table 12: Change to Approved BC Process Flow Narrative

Table 13: Change to Design Only Process Flow Narrative

Table 14: Risk/Issues Responsibilities

Table 15: How to Write a Risk /Issue Description

Table 16: Risk/Issue Monitoring Tasks

Table 17: Risk Management Process Flow Narration

Table 18: Escalation Priorities

Table 19: Meeting Roles and Responsibilities

Table 20: Communications Tools and Documents

Table 21: Scenario 1 – Initial Draft

Table 22: Scenario 2 – Draft to Draft

Table 23: Scenario 3 – Draft to Initial Approved Version

Table 24: Scenario 4 – Approved to Revised Draft

Table 25: Scenario 5 - Revised Draft to Approved

Table 26: Watermark Versioning

Table 27: Approvers for MMRP Document

Table 28: Deliverable Review Standard Timeline

Table 29: Severity Level Definitions

Table 30: Contact List

Table 31: Cúram Version Elements

Table 32: Review Status Schedule

Table 33: Production Job Criticality Level Descriptions

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List of Figures

Figure 1: MMRP Organizational Chart

Figure 2: MMRP O&M Organizational Chart

Figure 3: O&M MMRP SDLC

Figure 4: O&M Enhancement Management

Figure 5: Business Case Process Flow

Figure 7: Routine Internal BC Review Deliverable Timeline

Figure 8: Routine Cúram Priorities Prod Support Leadership Deliverable Timeline

Figure 9: TDD/ADD Standard Review Timeline

Figure 10: High Level Code Release Process

Figure 11: Sample Release Version Numbering

Figure 12: Release Notes Timeline

Figure 13: Example of “Smoke Test Data” List

Figure 14: Production Smoke Test Process

Figure 15: Change to Approved BC Process Flow

Figure 16: Change to Design Only Process Flow

Figure 17: O&M Change Request Form

Figure 18: Contractor Management Roles and Responsibilities

Figure 19: Cost Management Roles and Responsibilities

Figure 20: Meeting Invitation Example

Figure 21: Meeting Notes Template Example

Figure 22: Drop down View in MMRP SharePoint

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1.0 Introduction

The Member Management Replacement Program (MMRP) Operations and Maintenance (O&M)

Manual documents the resources, tools, processes and procedures needed to provide operations and maintenance support for the MMRP systems. These resources and processes are established to support releases into the production environment while maintaining a system that effectively supports business operations.

IBM is the vendor contracted to provide technical O&M services for in scope applications/systems and will be referred to as the O&M Contractor throughout the document.

Clemson University (CU) is the vendor responsible for hosting the MMRP environments and will be referred to as the MMRP Hosting and Infrastructure Contractor throughout the document. In addition to CU, there are other 3rd party vendors involved in the O&M processes, such as print vendors, call centers, etc. (See Appendix D for contact information.)

All the roles and titles mentioned in the MMRP O&M Manual will be referring to SCDHHS

(MMRP) roles and titles unless otherwise indicated. MMRP is used to reference the team

(people) and Member Management Replacement System (MMRS) to reference the systems used by the MMRP Team throughout the document.

The original versions of the figures included in this document will be stored in the Operations and Maintenance library on the MMRP SharePoint site as an “Approved” Operations Supporting

Document.

As appropriate throughout the O&M Manual, hyperlinks will be used to assist in locating referenced sites or documentation. The hyperlinks will link directly to the site/documentation or the library or folder where the documentation is stored. (Note: Some links will require permission be granted before the user is able to access the document.)

1.1 Document Review Plans

This plan will be reviewed and updated:

• Following a regularly scheduled review, at a minimum every 12 months, and

• As changes or updates occur to correct or enhance information content.

1.2 Document Location

The approved MMRP O&M Manual will be located in the Operations and Maintenance library of the MMRP SharePoint site as an “Approved” MMRP Operations Document.

https://schhs.sharepoint.com/sites/1211207/Operations%20and%20Maintenance/Forms/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Operations%20and%20Maintenance/Forms/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Operations%20and%20Maintenance/Forms/AllItems.aspx

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The MMRP will follow a 7-year retention plan for all MMRP documents (Meeting Minutes, BRDs, CDMLs, audit records, inspection reports, etc.). MMRP documents will be stored on the

MMRP SharePoint site. These retentions and dispositions apply regardless of physical format

(paper, electronic storage, digital imaging, etc.). Informational or duplicate copies are not governed by this regulation and may be destroyed when no longer needed for reference.

MMRP will follow the state agency policy for destroying records.

MMS will follow at least a 10-year retention period for MMS Production data. The retention period will begin after the implementation, creation, or date of last use (will vary based on the type of data).

1.3 Background

SCDHHS is a cabinet agency of the South Carolina Governor’s Office. SCDHHS serves as the single state agency designated to administer the South Carolina Medicaid program.

Healthy Connections, the South Carolina Medicaid Program, is South Carolina’s grant-in-aid program by which the federal and state governments share the cost of providing medical care for eligible people. Title XIX of the Social Security Act, signed into law on July 30, 1965, authorized the Medicaid program; South Carolina (SC) began participation in Medicaid in July

1968. SCDHHS also administers the State Children’s Health Insurance Program (CHIP) under

Title XXI of the Social Security Act.

Approximately 1.2 million individuals receive SC Medicaid benefits.

SCDHHS submitted an Implementation Advance Planning Document (IAPD) in June 2011 to request Federal Financial Participation (FFP) for project expenditures related to replacing the

State’s Medicaid Eligibility Determination System (MEDS) and the reengineering of the member management processes with supporting technology. The Centers for Medicare and Medicaid

Services (CMS) approved the IAPD effective September 1, 2011.

SCDHHS procured the MMRP technology framework from IBM/Cúram in December 2012. Most of the development team was provided by CU with assistance from IBM/Cúram and oversight by SCDHHS. Utilizing Cúram’s Universal Access and Health Care Reform (HCR) products, SCDHHS implemented an online Medicaid application in October 2013 and began operations with the functionality for determining eligibility and enrollment into the Modified Adjusted Gross

Income (MAGI)-based coverage groups in November 2014. Since that time changes have added to or enhanced the system functionality and improved user experience.

In March 2016, SCDHHS implemented the functionality to send to IRS Form 1095-B notices to

Medicaid beneficiaries and transmit the information to the IRS.

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On December 1, 2016, SCDHHS transitioned to IBM Watson Health as the System Integrator (SI) of the Cúram HCR System. As Cúram HCR SI, IBM Watson Health is responsible for Design, Development and Implementation (DDI) on the remaining HCR work packages and all

Operations and Maintenance (O&M) of the Cúram HCR solution as well as in-scope systems, applications, and tasks as defined by the contract between IBM and SCDHHS. On May 22, 2018, IBM Watson Health was awarded the contract for SI for the MMRP Cúram Global Income

Support (CGIS). The CGIS project focuses on the Non-MAGI based Medicaid application solutions.

IBM Watson Health was procured as the SI of the Cúram Global Income Support (CGIS) module.

The CGIS project kickoff was June 6, 2018. As the Cúram CGIS SI, IBM Watson Health is responsible for DDI work packages. The purpose of the CGIS project is to develop, configure, test, and implement the CGIS module and associated data interfaces into the current SCDHHS information technology. CGIS module implementation of the Cúram CGIS module will allow

SCDHHS to conduct eligibility determinations and program enrollment for Non-MAGI Medicaid applicants, as well as comprehensive verification and reporting of Non-MAGI Medicaid applicants’ and members’ assets. The CGIS Release 1, Release 2, and auto-conversion releases were successfully implemented into Cúram. CGIS DDI work is ongoing until the completion of the “warranty period”.

The following table captures the major releases and enhancements to functionality implemented into Cúram.

Release Date Functionality

2.7.1 March 2017 Manual Eligibility, which allowed Caseworkers to override Cúram determinations, and Person Composite Services (PCS). PCS, while not a Cúram functionality, was linked through Cúram to help caseworkers validate and verify client information.

2.8.1 June 2017 Caseworkers to easily search for and update Authorized Representatives (AR) information and follow the improved method for processing reported changes via change of circumstances (CoC).

3.0.0 August 2017 Cúram upgrade was implemented that included new functionality and system enhancements. Caseworkers could add/change Address Evidence, verify Outstanding Evidence, and access Eligibility Viewer all for multiple household members at the same time. Caseworkers could also enter Absence Evidence for beneficiary’s temporarily living outside of the state

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3.1.0 March 2018 Caseworkers were introduced to new time-saving enhancements. Notice Redesign improved timely communications regarding eligibility determinations; Verified Lawful Presences (VLP) automated the process for verifying citizenship; Application Ingest reduced the number of applications that had to be entered manually; Periodic Auto Renewal (PAR) reduced unnecessary backlog; Eligibility Determinations Details (EDD) ensured accurate information was reflected in MMIS, and 2nd Application Handling reduced the likelihood of duplicate evidences being on an integrated case.

3.2.0 April 2018 Cúram Workflow automated the procedures for processing applications, CoC, and annual case reviews. Automatic processes for ELE Auto-Enrollment of children between ages of 1 and 19, SC State Retirement System for eligible state retirement beneficiaries, and DSS Foster Care for transferring Foster Care information from DSS to Cúram were also part of the release.

4.0.0 October 2018 Cúram upgrade featured a new look and feel of the system, as well as several functionality enhancements. Caseworkers were able to follow the CoC Script to Add a Person to an existing Insurance Affordability Case, as well as create a new address and end-date an old address for all household members at the same time through the Change of Address functionality.

Individual Disposition allowed for some household members to be approved for benefits while others were deferred.

4.2.0 March 2019 Caseworkers able utilize Advanced Evidence Sharing (AES) and manage incoming evidence and authorize 2nd applications.

Enhancements to Annual Review, Eligibility Determinations, and Intake were applied.

4.2.10 January 2020 As part of the release a Healthy Connections Community Engagement Initiative link was added to the Citizen Portal.

4.2.14 June 2020 Manual eligibility was updated to allow issuance of the COVID- 19 Limited Benefits.

4.2.15 July 2020 A patch that added a link to the FM3404 COVID-19 Limited benefit application PDF to the Citizen Portal.

4.2.16 August 2020 Updates to SCDEW interface were implemented, closure notice text, rules for notice generation, and a page in the application script for COVID-related policy changes.

4.2.17 October 2020 Implemented the initial phase of the Electronic Notices functionality, rapidly implemented to meet CMS expectation from the HCR R3 Certification Review.

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5.0.0 November 2020 CGIS Release 1 was implemented and introduced COVID-19 Limited benefits Online Application on the Citizen Portal.

5.0.2 February 2021 FPL changes for 2021 effective as 3/1/2021 and updated tax dependent filing thresholds were implemented. Person Composite Service was implemented to include configuration changes to grant access privileges to two new user roles.

5.0.3 March 2021 Ty2020 changes for transmitting 1095-B Forms to the IRS.

5.1.0 March 2021 CGIS Release 2 included address validation enhancements, the manual conversion wizard, TMA, and several interfaces.

5.2.0 April 2021 Implemented auto conversion for Non-MAGI payment categories 54 and 86 cases remaining in MEDS along with a SDX prospect record data fix.

Note: MMRP continues enhancing and resolving O&M issues in Cúram via O&M Releases.

1.4 Scope

The scope of this plan is to provide an overall framework for operations and maintenance at the program level by covering all MMRP deliverables when they transition to the O&M phase.

This document describes:

• MMRP Governance

• System Overview

• Business Environment

• Incident Management

• Issue Resolution

• Enhancement Management

• System Testing

• Release Management

• Demand Capacity Management

• Application Development to Application Maintenance (ADAM)

• Configuration Management

• Staff Management

• Change Management

• Risk & Issue Management

• Contractor Management

• Cost Management

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• Communication Management

• Security

• System Monitoring

• Batch Operations and Escalation

• System Maintenance

1.5 Project Repository

SCDHHS has established a SharePoint site that will serve as the project repository for MMRP project documentation. The project repository is located at https://schhs.sharepoint.com/sites/1211207/SitePages/Home.aspx

Risks, Issues, Decisions and the DDI Project Schedules for the MMRP are located in the following SharePoint sites.

SharePoint site Name /

Library

Link

Member Management

Replacement System (MMRS)

HCR Project Web App (PWA)

SharePoint site https://schhs.sharepoint.com/sites/pwa/MMRS%20IBM%20HCR%

20DDI/ (HCR)

Member Management

Replacement System (MMRS)

CGIS Project Web App (PWA)

SharePoint site https://schhs.sharepoint.com/sites/pwa/MMRS%20CGIS%20(Cúra m%20Global%20Income%20Support)/Lists/Risks/AllItems.aspx

O&M Risk Register https://schhs.sharepoint.com/sites/1211207/Lists/OM%20Risk%2

0Register/active.aspx

CEW Risk Register Risks - All Items (sharepoint.com)

(CGIS)User stories, Business Cases, Test Cases, and defects are stored in Jira.

Jira Instance Project/Users Support Team

Clemson Instance (Dev Tools) HCR, O&M (PROD) Clemson https://schhs.sharepoint.com/sites/1211207/SitePages/Home.aspx https://schhs.sharepoint.com/sites/pwa/MMRS%20IBM%20HCR%20DDI https://schhs.sharepoint.com/sites/pwa/MMRS%20IBM%20HCR%20DDI https://schhs.sharepoint.com/sites/pwa/MMRS%20CGIS%20(Curam%20Global%20Income%20Support)/Lists/Risks/AllItems.aspx https://schhs.sharepoint.com/sites/pwa/MMRS%20CGIS%20(Curam%20Global%20Income%20Support)/Lists/Risks/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Lists/OM%20Risk%20Register/active.aspx https://schhs.sharepoint.com/sites/1211207/Lists/OM%20Risk%20Register/active.aspx https://schhs.sharepoint.com/sites/pwa/Community%20Engagement%20Waiver/Lists/Risks/AllItems.aspx https://devtools.scdhhs.gov/jira%20(Clemson%20instance)

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SCDHHS – PMO Instance CGIS, CoreOps SCDHHS Enterprise

Applications

The DDI and O&M technical teams use Confluence to collaborate and share information. The

Confluence pages are located at https://devtools.scdhhs.gov/confluence/ and https://cuihhsiutl12.clemson.edu:8443/index.action#all-updates.

1.6 Referenced Documents

The following documents and sites are important to MMRP O&M processes and provide additional information for review. If a link is provided in the table below, a version and date will be provided only when the specific version impacts content within the MMRP O&M Manual.

Site/Document Name Version Date last updated

Link

MMRP Project Management Plan

V120 6/20/19 The latest approved version will be located in the Project Management Planning Documents library (Document Type = MMRP Project Document with an “Approved” status)

MMRP Concepts of Operations

V.0 7/25/2013 Click here to access the latest CONOPS

MMRP O&M Incident Management Process

V3.0 8/21/19 The latest approved version will be located in the Operations and Maintenance library (Document Type = MMRP Operations Document with an “Approved” status)

MMRP System Design Document

V8.0 02/03/21 The latest approved version will be located in the Project Management Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

MMRP Configuration Management Plan

V14.0 02/09/21 The latest approved version will be located in the Project Management Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

MMRP Database Design Document

V3.0 2/15/19 The latest approved version will be located in the Project Management Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

MMRP Data Management Plan

V2.0 2/14/19 The latest approved version will be located in the Project Management http://cuihhsiutl10.clemson.edu/secure/RapidBoard.jspa?rapidView=1026&projectKey=CGIS&view=detail https://devtools.scdhhs.gov/confluence/ https://cuihhsiutl12.clemson.edu:8443/index.action#all-updates https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?id=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents%2FMember%20Management%20Conops%2Epdf&parent=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents https://schhs.sharepoint.com/sites/1211207/Operations%20and%20Maintenance/Forms/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Operations%20and%20Maintenance/Forms/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx

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Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

MMRP Data Dictionary Summary

V7.0 1/20 The latest approved version will be located in the Project Management Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

MMRP Physical Data Model V3.0 6/20/19 The latest approved version will be located in the Project Management Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

MMRP Logical Data Model 3.0 6/20/19 The latest approved version will be located in the Project Management Planning Documents library (Document Type = CDML Deliverable with an “Approved” status)

Table 1: Related Documents/References

1.7 Acronyms/Glossary

Click here to view the MMRP Acronyms and Glossary list.

1.8 MMRP O&M Acronyms/Glossary

Term Definition ADAM Application Development to Application Maintenance

Analysis Backlog The Analysis Backlog contains the Business Cases that have not yet been approved.

ARB Architecture Review Board for MMRP

CIO Chief Information Officer

BC Business Case

CISO Chief Information Security Officer

CR Change Request

CU Clemson University

Cúram Off-the-shelf application that provides case management and application functionality to SCDHHS. Allows eligibility workers to process eligibility for those who applied and allows citizens to apply online for new Medicaid coverage.

DBA Database Administrators

DEV Development

DR Disaster Recovery is the process, policies, and procedures related to preparing for recovery or continuation of technology infrastructure that are vital to an organization after a natural or human-induced disaster.

EEMS Eligibility, Enrollment and Member Services https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Lists/MMRP%20Acronyms%20%20Glossary/AllItems.aspx

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HCIS Healthcare Infrastructure Services (Clemson)

IAR Impact Analysis Report

Icinga An open source computer system and network monitoring application.

Ingest The process of ingesting an application into Cúram and OnBase.

Jira A proprietary issue tracking product, developed by Atlassian, used for bug tracking, issue (story) tracking, project management as well as release management; used specifically for development ticketing and tracking, SDLC tracking and production release management and tracking.

MEVS Medicaid Eligibility Verification System is an electronic system used to verify Medicaid eligibility.

MITS Medicaid IT Services (Clemson)

MCO Managed Care Organizations

OEM Oracle Enterprise Manager

OS Operating Systems

PCA Protocol Conversion Application

PCS The Person Composite Service is used to validate and verify client information from multiple sources including:

• Social Security Administration (SSA): SSN Verification, Citizenship:

Quarters of Coverage, SSA Income/Benefit Amount

• South Carolina Department of Employment and Workforce (SCDEW):

Wage Payments, Unemployment Compensation Payments

• SCDHHS MEDS: Eligibility History

• Equifax: Income

PROD Production

Production (PROD) Backlog

Business Cases are added to the PROD Backlog once they have been approved and then prioritized by EEMS Leadership.

RPO Recovery Project Objective

RTO Recovery Time Objective

SCDHHS

Enterprise ARB

Enterprise level Architectural Review Board

SOA Services Oriented Architecture

Splunk A software used for searching, monitoring, and analyzing machine-generated big data, via a web-style interface.

SSL Secure Sockets Layer

TRR Test Readiness Report

Automic UC4 A web-based application which lets you schedule and submit jobs as well as view and print output.

Zabbix A mature and effortless enterprise-class open source monitoring solution for network monitoring and application of millions of metrics.

Table 2: O&M Acronyms & Glossary

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2.0 Governance

The MMRP and MMRP projects follow SCDHHS PMO’s Governance guidelines and Contractors are responsible for adhering to the program governance structure established by the SCDHHS

OIM.

2.1 SCDHHS MMRP Organizational Structure

The MMRP is part of the Office of Operations and Information Management (OIM). The MMRP

O&M Manager reports to the MMRP Program Director/Deputy Director of the Office of

Systems Development. The MMRP Program Director reports to the Deputy Director of OSD. The

Deputy Director of OSD reports to the SCDHHS Director and is responsible for the management and oversight of the OIM and the MMRP. Project and Contract Management is supported by the Governance and Continuous Improvement and Financial and Contract Management Office.

A Contract Administrator from the Financial and Contract Management Office is assigned to each contract to address and approve contractual matters. Detailed MMRP Organizational

Charts can be found in the Project Management Planning Documents (PMP supporting document with an “Active” status) library on the MMRP SharePoint site.

https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx

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Figure 1: MMRP Organizational Chart

2.1.1 SCDHHS MMRP O&M Organizational Structure

The SCDHHS MMRP O&M team consists of the following units: Production Support Interface

Support, Business Analysis, and Eligibility and Enrollment Systems Helpdesk.

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Figure 2: MMRP O&M Organizational Chart

2.2 Roles & Responsibilities

The MMRP O&M is responsible for the operation and provision of Cúram and all its supporting systems. The MMRP provides services including Information Technology (IT) infrastructure, business analysis, application development, and technical support. The MMRP Roles and

Responsibilities matrix is maintained in the MMRP SharePoint site.

The Primary Points of Contact (POC) for MMRP O&M are listed below.

Role/Position Person Responsibility

MMRP Program Director/

Deputy Director of OSD

Rhonda Morrison Responsible for directing all aspects of the

MMRP to include DDI and O&M activities, and all the Eligibility and Enrollment applications.

Operations & Maintenance

Manager

Chris Cranford Manages, monitors and directs all tasks associated with the O&M activities associated with the MMRP.

https://schhs.sharepoint.com/:x:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7BDA5120A5-9F65-4E11-A623-5AC6A72F6ACB%7D&file=MMRP%20Roles%20and%20Responsibilities.xlsx&action=default&mobileredirect=true https://schhs.sharepoint.com/:x:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7BDA5120A5-9F65-4E11-A623-5AC6A72F6ACB%7D&file=MMRP%20Roles%20and%20Responsibilities.xlsx&action=default&mobileredirect=true

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Role/Position Person Responsibility

Product Support Manager Sharon King Manages the team responsible for coordinating and monitoring production support activities (including release management) for the replacement eligibility system. Works with the O&M Manager to develop and execute strategies for addressing escalated system/operations issues in a timely manner. Manages user access/security roles and maintains the organizational structure within the system. Coordinates with business, technical and other MMRP staff to document process flows, implementation plans and checklists. Coordinates with the System

Integrator’s Delivery and Release Managers to document, manage and ensure successful production deployments/releases.

Business Analyst Manager DerShaun Blanding Manages a team responsible for researching eligibility determination system related issues, testing production defects and validating resolutions to production issues. Leads the team in troubleshooting issues, documenting solutions/mitigations, requirements and needed development solutions. Responsible for communicating with production support staff, Testing Team and system developers as needed to provide feedback on identified system issues.

Eligibility and Enrollment

(E&E) Systems Helpdesk

Manager

Matt Warren Manages a team responsible for researching and resolving eligibility determination system related issues, as well supporting OnBase, PathOS, and MEDS issues. Responsible for ensuring all helpdesk tickets are addressed timely and the quality assurance process is executed. Responsible for establishing, updating, and enforcing standard operating procedures within the Helpdesk.

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Technical SME Sudheer Arimbra Assists in ensuring that all technical aspects of the O&M project are addressed, and the project is implemented in a technically sound manner; responsible for review of all technical and solution designs for O&M.

Technical Lead Renjan Bhasi Assists in ensuring that all technical aspects of the DDI and O&M project are addressed, and the project is implemented in a technically sound manner; responsible for review of all technical and solution designs for O&M.

Servers as a technical SME for MMRP.

Testing Manager Richa Gupta Responsible for development and execution of test plans, resource allocation, User

Acceptance Testing (UAT) status reporting and communication related to impact and risk analysis of issues/defects. Manages all of the

Testing Team and assigns the Testing Lead for each release. Reports metrics for testing cycles and ensures all testing processes are followed. Adheres to the schedule and escalates anticipated late delivery of tasks to the DDI or O&M Manager. Provides consultation to the Testing Leads regarding environment and batch requests. Responsible for reviewing and approving test plans.

O&M Contractor QA

Manager

Sudie Johnson Manages the Contractor testing, ensures all testing processes are followed, and coordinates testing activities with the help of the O&M Contractor Release Manager.

O&M Contractor Manager Jeff Leyh Manages day to day operations to ensure the

O&M standards of the contract are met in an efficient manner.

O&M Contractor Release

Manager/Project Manager

Sudie Johnson Manages and coordinates the planning, scheduling and build activities for the MMRP environments.

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Director of Health Care

Infrastructure, Clemson

University

Matt Garrett Oversees the team responsible for the MMRP

Hosting and Infrastructure environment; also responsible for team responsible for MEDS and MMIS hardware, including servers and the mainframe.

Executive Director, Medicaid IT Services, Clemson University

Tom Taylor Provides Executive Oversight reporting to the

Clemson University CIO for all of the SCDHHS contracts, including the MMRP.

Table 3: O&M Primary Points of Contact

2.3 Authority

Listed below are the governing bodies responsible for defining strategic goals and objectives and making decisions concerning critical risks, issues and escalated items for MMRP.

IT Change Advisory Board (CAB) mission is to govern and control the configuration and evolution of the SCDHHS enterprise systems by using a collaboration effort with technology and business stakeholders. The IT CAB establishes an environment that fosters a shared vison and promotes open communication.

IBM & SCDHHS MMRP Leaders Meeting is the official project governance meeting. The agenda for the meeting includes IBM's HCR Update [includes high level DDI, O&M, Organizational

Change Management (OCM) and Governance and Continuous Improvement updates and risks], the Schedule Health dashboard from the PK monthly report (to be presented when published), the PM’s schedule status dashboard, a review of approved Change Requests (CRs), IBM HCR SLA review (when published), testing metrics, and Release coordination activities. The IBM &

SCDHHS MMRP Leaders Meeting participants include managers from DDI, O&M and IBM, as well as, the Eligibility Operations Program Manager, Eligibility, Enrollment and Member Services

(EEMS) Policy & Process Director, and PK.

MMRP Change Advisory Board (CAB) is responsible for reviewing DDI CRs and determining if the CR will be submitted for further consideration by the SCDHHS OIM Steering Committee and/or the MMRP Eligibility Executive Oversight Committee (EEOC). The MMRP CAB is made up of 1) MMRP Program Director/Deputy CIO, 2), Assistant Deputy Director of Governance and

Continuous Improvement, and 3) Eligibility Operations Program Manager.

SCDHHS OIM Steering Committee is responsible for providing strategic oversight at the enterprise level and directing operating principles to SCDHHS OIM Contractors. The OIM

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Steering Committee is responsible for approving Enterprise level CRs. The core members of the

OIM Steering Committee include the CIO, Deputy CIOs, Chief Information Security Officer

(CISO), Assistant Deputy Director of Governance and Continuous Improvement, Contracts

Management Director, Medicaid Enterprise System (MES) Program Director, IT Services

Program Director, Replacement Medicaid Management Information System (RMMIS) Program

Director and MMRP Program Director.

MMRP Eligibility Executive Oversight Committee (EEOC) is responsible for creating an integrated governance structure that makes decisions related to MMRP budget, scope and schedule. The EEOC is composed of voting and advisory members who have strategic and/or tactical responsibilities for designing, developing and implementing functionality to replace the existing MEDS. The EEOC works toward meeting the goals of the MMRP to improve the citizen experience, redesign business processes, and deliver enhanced services. The EEOC is responsible for reviewing, approving, and prioritizing MMRP CRs. The voting members are 1)

MMRP Program Director, 2) MMRP DDI Manager, 3) Deputy Director of EEMS, 4) Eligibility

Operations Program Manager, and 5) Deputy Director of Health Programs.

MMRP Management Team consists of managers from the DDI and O&M areas. This team is responsible for managing the day to day activities of the projects and ongoing operations.

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3.0 System Overview

The System Design Document (SDD) describes the technical design supporting the SCDHHS implementation of the MMRP. The SDD is located in the Project Management Planning

Documents library (“CDML Deliverable” Document Type with an “Approved” status) on the

MMRP SharePoint site.

The MMS is a web-based system providing a portal for consumers, community-based counselors, state workers and agents. It helps users determine an individual’s eligibility for

Medicaid, facilitates enrollment in Managed Care Organizations (MCOs), and interfaces with the Federally-Facilitated Marketplace (FFM) and the Centers for Medicare and Medicaid

Services (CMS).

Currently, Medicaid eligibility data is processed through a reconciliation process which intakes files sent by both Cúram and MEDS and reconciles them into one current eligibility data file sent to the MMIS to facilitate downstream Managed Care enrollment and claims operations.

The SDD documents and tracks the necessary information required to effectively define architecture and system design of the MMRP.

3.1 Data Management

The MMRP Data Management Plan provides an overview of functions, terminology and best practices that are needed to manage enterprise information across the MMRP.

The MMRP Data Dictionary Summary explains the web-based Data Dictionary available for the

MMRP application. The Data Dictionary enables team members to quickly and easily understand the data elements and values that make up the SC Cúram implementation.

Deployed as a web-based application, the MMRP Data Dictionary makes it easy to explore related data elements and data dependencies. The MMRP Logical Data Model provides visual representation of the interaction of entities within the MMRP database while a complete listing of database tables used by MMRP can be found in the MMRP Physical Data Model.

Note: All Approved CDML Deliverables are located in the Project Management Planning

Documents library (“CDML Deliverable” Document Type with an “Approved” status) on the

MMRP SharePoint site.

3.2 Database Design

The MMRP Database Design Document explains the database design pertaining to MMRP.

https://schhs.sharepoint.com/:w:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7BCB1C11FC-A26B-48F5-B945-DBE44706AC35%7D&file=SCDHHS%20IBM%20MMRP%20SYSTEM%20DESIGN%20DOCUMENT.docx&action=default&mobileredirect=true https://team.scdhhs.gov/pmo/ProjectRepository/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?GroupString=%3B%23MMRP%20Project%20Document%3B%23Revised%20Draft%3B%23&IsGroupRender=TRUE https://team.scdhhs.gov/pmo/ProjectRepository/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?GroupString=%3B%23MMRP%20Project%20Document%3B%23Revised%20Draft%3B%23&IsGroupRender=TRUE https://schhs.sharepoint.com/:w:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7BB4606C77-4523-428A-A805-E85F63DF0AF4%7D&file=SCDHHS%20IBM%20MMRP%20DATA%20MANAGEMENT%20PLAN.docx&action=default&mobileredirect=true https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?id=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents%2FSCDHHS%20IBM%20MMRP%20DATA%20DICTIONARY%20SUMMARY%2Epdf&parent=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents http://cuimemdutl02.clemson.edu/MITS/index.html https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?id=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents%2FSCDHHS%5FIBM%5FMMRP%5FLOGICAL%5FDATA%5FMODEL%2Epdf&parent=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?id=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents%2FSCDHHS%5FIBM%5FMMRP%5FPHYSICAL%5FDATA%5FMODEL%2Epdf&parent=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx?id=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents%2FSCDHHS%5FIBM%5FMMRP%5FDATABASE%5FDESIGN%5FDOCUMENT%2Epdf&parent=%2Fsites%2F1211207%2FProject%20Management%20Planning%20Documents

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The centerpiece of the MMRP is IBM’s Cúram software, which contains a built-in data model.

The Database Design Document will introduce the system’s context and basic design approach, including dependencies on other systems. This document also identifies how MMRP databases interface with other databases and contains diagrams of all databases in each of the MMRP

Development and Production environments.

3.3 Security Certificates

NOTE: The security privacy considerations for Secure Sockets Layers (SSL) certifications are covered under the SCDHHS official System Security Plan (SSP).

Security certificates protecting Cúram systems must be regularly renewed and installed to ensure proper operation of all systems. In addition, Federal Data Service Hub (FDSH) certificates and keystores must be regularly updated to ensure successful communication with CMS.

Certificates for SCDHHS systems (*.scdhhs.gov) are purchased and maintained by the SCDHHS

Information Technology Services (ITS). Server installation and configuration is completed by the

Hosting & Infrastructure Contractor. Keystores are updated and provided to CMS by the O&M

Contractor Team. See SCDHHS Security Certificates for expiration dates. The O&M Contractor

Team is responsible for the tracking of the certification and ensures that the renewals/updates occur.

Key production level certificates for MMRS include:

Production:

• Citizen Portal - apply.scdhhs.gov

• Worker Portal - access.scdhhs.gov

• Application Ingest - appingest.scdhhs.gov

• Data Services Hub - fdsh.scdhhs.gov (requires CMS coordination)

• IRS AIR – air.scdhhs.gov

• PCS Application – pcs.scdhhs.gov

Non-Production

• IRS Test Air – airtest.scdhhs.gov

• Test Data Services Hub – dshtest.scdhhs.gov

• Staging - *staging.scdhhs.gov

• Prod Support - *prodsupport.scdhhs.gov

• Training - *training.scdhhs.gov https://schhs.sharepoint.com/:w:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7B9FDBAE94-E419-49DC-911C-495E034791C9%7D&file=SCDHHS%20Security%20Certificates.docx&action=default&mobileredirect=true

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3.4 Maintenance Windows and Frequency

By default, Production Systems are available and operational 24/7/365. Planned outages messages and details will be posted to scdhhs.gov.

3.4.1 Standing Windows

Cúram and supporting systems have Service Level Agreement (SLA) defined maintenance windows every Sunday, Tuesday, and Thursday from 10 pm to 2 am. However, to minimize impact to business operations, SCDHHS requests that maintenance efforts are performed on

Thursdays whenever possible. The dates that the system will not be available must be posted to max.gov by the Production Support Manager or designee.

It is the practice of the O&M Teams (SCDHHS and Contractor) to align maintenance activities as follows:

• First Thursday o Operating Systems (OS) Patching o Security Patching

• Second Thursday o Database Maintenance o Filesystem Maintenance

• Third Thursday o O&M Application Release o O&M Release

• Fourth Thursday o DDI Application Release

Note: The O&M Management Team can adjust these activities as needed.

3.4.2 Emergency Maintenance

In the event that emergency maintenance must be performed on the MMRP Systems (see

Application List), it is the responsibility of the O&M Contractor Manager to coordinate with the

Production Support Manager. Emergency maintenance may occur any day of the week and would follow the Incident Management Process (located in the Operations and Maintenance library as an “Approved” MMRP Operations Document).

https://schhs.sharepoint.com/:w:/r/sites/1211207/_layouts/15/Doc.aspx?sourcedoc=%7B7F63FC35-B508-40DA-8E8B-164769193825%7D&file=PlannedOutageMessageFormats.docx&action=default&mobileredirect=true https://schhs.sharepoint.com/sites/1211207/Lists/Application%20List/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Operations%20and%20Maintenance/Forms/AllItems.aspx?RootFolder=%2Fsites%2F1211207%2FOperations%20and%20Maintenance

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3.4.3 Special Considerations

There are multiple times during the calendar year where the impact of maintenance activities on previously scheduled activities should be taken into account prior to scheduling maintenance on Cúram systems. These periods include (but are not limited to):

• FFM Open Enrollment (November – December 15)

• CMS PDM Batch Runs (Scheduled by CMS in February then every 3-6 months)

• IRS 1095 Transmit Windows (Initials January 31 – March 31 are filed and approved by

IRS unless a deadline extension is needed. Corrections are quarterly – February, May, August and November.)

• Potential impacts on other SCDHHS systems’ activities/implementations

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4.0 Business Environment

4.1 User community (Internal/external)

Cúram has a cadre of dedicated users. Some are direct users of the system, such as Eligibility

Staff, while others are influenced by the system, such as Providers. These user groups are listed in the table below.

User Group Description Citizen Portal

Interaction Worker Portal

Interaction

Eligibility Staff

Eligibility staff are the most abundant of the direct users. These are the users who spend the most time in the current eligibility system. They enter and update member information, review interface data and/or complete eligibility decisions.

X

Eligibility Supervisors

Supervisors oversee the decisions made by…