PL 011.pdf

MMRP Project Management Plan

Version 12.0

Last Revised: 11/4/2020

Prepared by:

South Carolina Department of Health and Human Services (SCDHHS)

Member Management Replacement Program (MMRP)

PL 011

MMRP Project Management Plan V12.0

11/4/2020 Page 2 of 150

Table of Contents

1.0 Executive Summary

2.0 Introduction

2.1 Document Review Plans

2.2 Document Location

2.3 Purpose of Document

2.4 Background

2.5 Project Assumptions and Constraints

2.5.1 Assumptions

2.5.2 Constraints

2.6 Project Approach

2.7 Project Repository

2.8 Related Documents/References

2.9 Definitions and Acronyms

3.0 Governance

3.1 SCDHHS MMRP Organizational Structure

3.2 Key Stakeholders

3.3 Authority

3.4 Roles and Responsibility Matrix

4.0 Scope Management

4.1. Project Scope Statement

4.1.1 In Scope

4.1.2 Out of Scope

4.1.3 Deliverable Expectations

4.1.4 Scope Verification

4.1.5 Scope Monitoring and Controlling

4.1.6 Scope Roles and Responsibilities

5.0 Schedule Management

5.1 Schedule Development

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5.2 Schedule Management

5.3 Project Schedule Changes

5.4 Internal Weekly State Task Update Process

6.0 Cost Management

6.1 Cost Monitoring and Control

7.0 Communication Management

7.1 Communication Roles and Responsibilities

7.2 Escalation

7.3 Emergency Communication

7.4 MMRP Project Meetings

7.4.1 Meeting Protocols

7.4.1.1 Meeting Invitations

7.4.1.2 Meeting Agendas

7.4.1.3 Meeting Minutes

7.4.1.4 Action Items

7.4.1.5 Meeting Guidelines

7.4.1.6 Meeting Roles and Responsibilities

7.4.1.7 Project Meetings Categories

7.5 MMRP Communications Tools and Documentations

7.6 Stakeholder Engagement Plan

7.6.1 Organizational Change Management

7.7 Document Management

7.7.1 Terminology and Acronyms

7.7.2 Document Formatting Guidelines

7.7.2.1 Title Page

7.7.2.2 Table of Contents Page

7.7.2.3 Referencing Documents

7.7.2.4 Document Control

7.7.2.5 Miscellaneous Formatting

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7.7.3 File Naming Conventions

7.7.4 Document Version Numbers and Watermarks

7.7.5 Changes to Baseline or Approved Documents

7.7.6 Templates

7.7.7 Document Storage/Working Papers

7.7.8 MMRP Deviations from the PMO

7.8 Deliverables Management

8.0 MMRP Software Development Life Cycle (SDLC)

9.0 Requirements and Design Management

9.1 Business Requirement Documentation

9.2 Functional Design Specification Documentation

9.3 Technical Design Specification Documentation

9.4 Open Items

9.5 Methodology for Percentage Complete Reporting

10.0 Development

10.1 Design and Development Standards

10.1.1 Code Review

10.2 Unit/JUnit Testing

11.0 Quality Management

11.1 Perform Quality Assurance

11.2 Perform Quality Control

11.2.1 SI Testing Team Expectations

11.2.2 UAT Approach and Methodology

11.2.3 Defect Management

11.2.3.1 Test Cases and Defects

11.2.3.2 Bug Details

11.2.3.3 Severity versus Priority

11.2.3.4 Resolution

11.2.4 Test Environments

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11.2.5 Testing Plans

11.2.6 Requirements Traceability

11.2.7 Load and Performance Testing

11.2.8 Tools for Quality Management

12.0 Change Management

12.1 DDI Requirement Changes

12.1.1 Project Documentation Updates Based on Approved CR

12.2 DDI Non-Requirements Based Change Request Process

12.3 DDI CR Status Updates

12.4 PMR Process

12.5 RFE Process

12.6 Escalation Process for Cúram Software PMRs/RFEs

13.0 Risk and Issue Management

13.1 Entering Risks

13.2 Entering Issues

13.3 Writing a Risk/Issue Description

13.4 Risk Management Meetings

13.5 Risk and Issue Monitoring

14.0 Staff Management

14.1 Vacancy Management

14.2 Onboarding

15.0 Contractor Management

16.0 Configuration Management

17.0 Implementation and Transition Plan

18.0 Security

19.0 Appendix

20.0 Document Control

20.1 Document Control/Revision History

20.2 Review History

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20.3 Approvals

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List of Tables

Table 1: Related Documents/References

Table 2: Key SCDHHS Stakeholder List

Table 3: Escalation Priorities

Table 4: Meeting Roles and Responsibilities

Table 5: Communications Tools and Documents

Table 6: Scenario 1 – Initial Draft

Table 7: Scenario 2 – Draft to Draft

Table 8: Scenario 3 – Draft to Initial Approved Version

Table 9: Scenario 4 – Approved to Revised Draft

Table 10: Scenario 5 - Revised Draft to Approved

Table 11: Watermark Versioning

Table 12: MMRP Deviates from the PMO

Table 13: Approvers for MMRP Document

Table 14: Deliverable Review Standard Timeline

Table 15: Business Analysis Requirements Documentation Process Flow Narrative

Table 16: FDS Documentation Process Flow Narrative

Table 17: TDS Documentation Process Flow Narrative

Table 18: BRD Milestones for Weekly Updates

Table 19: Defect Severities

Table 20: Defect Priorities

Table 21: Defect Resolutions

Table 22: MMRP Requirements Change Request Process Narrative

Table 23: PMR Process Flow Narration

Table 24: PMR Sub-Process Flow Narration

Table 25: RFE Process Flow Narrative

Table 26: PMR/RFE Escalation Process Flow Narrative

Table 27: Risk/Issues Responsibilities

Table 28: How to Write a Risk /Issue Description

Table 29: Risk/Issue Monitoring Tasks

List of Figures

Figure 1: MMRP Organizational Chart

Figure 2: SCDHHS and IBM Points of Contact Matrix

Figure 3: OSD Governance Triangle Diagram

Figure 4: Scope Management Roles and Responsibilities

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Figure 5: Schedule Management Roles and Responsibilities

Figure 6: Cost Management Roles and Responsibilities

Figure 7: Communication Workflow

Figure 8: Communication Activity Managers

Figure 9: Meeting Invitation Example

Figure 10: Meeting Notes Template Example

Figure 11: Drop down View in MMRP SharePoint

Figure 12: MMRP SDLC

Figure 13: Business Analysts Requirements Documentation Process

Figure 14: FDS Documentation Process

Figure 15: TDS Documentation Process

Figure 16: MMRP Requirement Change Request Process

Figure 17: Project Documentation Updates for Approved CR

Figure 18: MMRP Non-Requirement Based Change Request Process

Figure 19: PMR Process Flow

Figure 20: PMR Sub Process Flow

Figure 21: RFE Process

Figure 22: PMR/RFE Escalation Process

Figure 23: Risk Management Process Flow

Figure 24: Contractor Management Roles and Responsibilities

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1.0 Executive Summary

The goals of the Member Management Replacement Program (MMRP) are to improve the citizen experience, redesign business processes, and deliver enhanced services. The South

Carolina Department of Health and Human Services (SCDHHS) intends to accomplish these goals by investing in newer technology and re-engineering its eligibility processes through replacing the State’s Medicaid Eligibility Determination System (MEDS) and implementing a modern approach to member management in South Carolina. The overall objectives of the

MMRP are described in the project charter:

• Customer Experience – Improve the customer experience for both members and providers. Members will have easier access to services, while providers will benefit from having improved eligibility verification through a reduction in eligibility gaps. The system is designed to perform data exchange in real-time, which allows a customer-service oriented experience that is on par with contemporary web-enabled user interfaces.

Eligibility determinations, in particular, will leverage data provided at the State and

Federal level for the purpose of documentation and verification of potential beneficiary data related to eligibility.

• Performance – The Department’s eligibility, enrollment, and member management processes will be performance focused. The MMRP will implement functionality to promote efficient processes. Key performance measures will be identified, and Medicaid

Information Technology Architecture (MITA) aligned for measuring the success of the processes with high level business metrics being monitored by Department executive leadership and detailed measures being monitored by supervisory staff. Major areas of performance to be measured include timeliness, speed, accuracy (including program integrity), and quality.

• Maturity – Increase in MITA process maturity by re-engineering processes to ensure standardization and repeatability.

• Technology – To the greatest extent, align with the architectural requirements identified in the enhanced eligibility funding final rule [MITS-11-01-v1.0 and State

Medicaid Director Letter 16-009]:

• Modularity

• MITA

• Industry Standards

• Leverage

• Business Results

• Reporting

• Interoperability

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• Critical Success Factors

• Health Benefit Exchange (HBE) Integration – Develop a solution that leverages a connection with the Federally Facilitated Marketplace (FFM) to enable a near real-time eligibility determination process for those beneficiaries referred from the FFM based on

Modified Adjusted Gross Income (MAGI) methodology determination and/or assessment. For those applicants who are not found eligible for Medicaid programs, but may qualify for the Advance Premium Tax Credit (APTC) or participation in a Qualified

Health Plan (QHP) offered via the FFM, the solution will refer their electronic record to the FFM.

• Cost – Reduce ongoing administrative costs through innovative technology and re-engineered business processes.

• Privacy and Security – Ensure continued compliance with privacy and security laws.

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2.0 Introduction

The MMRP Project Management Plan (PMP) outlines any specific tasks, strategies, and process flows that are unique to the MMRP projects and which are not covered under the PMO

Enterprise plans. The project team is comprised of members from three distinct organizations:

the SCDHHS, Clemson University (CU), and IBM/Cúram. SCDHHS is the single State-agency responsible for administering Medicaid in South Carolina and oversees the project management and functional requirements of the solution. CU is responsible for hosting the MMRP environments as well as Mainframe system changes and testing required to support the MMRP deliverables. IBM/Cúram is the vendor providing the Commercial off the Shelf (COTS) framework for the solution and is the System Integrator (SI) for the MMRP Health Care Reform

(HCR) and Cúram Global Income Support (CGIS) project, as well as the vendor for Operations and Maintenance.

All the roles and titles mentioned in the MMRP PMP will be referring to a SCDHHS (MMRP) role and title unless otherwise indicated.

The original versions of the figures included in this document will be stored in the Project

Management Planning Documents library with a Document Type of “PMP Supporting

Documents” on the MMRP SharePoint site. Active documentation, such as organizational charts, roles, and responsibility spreadsheets, etc. will be stored in the Project Management

Planning Documents library with a Document Type of “MMRP Project Document” with an

“Active” status.

The remainder of this document will define, in detail, the unique nature of the Software

Development Life Cycle (SDLC) as defined and implemented for the MMRP projects.

As appropriate throughout the MMRP PMP, 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.)

2.1 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.

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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2.2 Document Location

The approved MMRP PMP will be located in the Project Management Planning Documents library with a Document Type of “MMRP Project Document” on the MMRP SharePoint site.

The MMRP will follow a 7-year retention plan for all project documents (Meeting Minutes, BRDs, CDMLs, etc.). MMRP documents will be stored on the MMRP SharePoint site or tools

(such as SharePHI, Jira, Confluence, etc.). 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.

2.3 Purpose of Document

The purpose of this document is to establish the baseline Project Management Plan for the

MMRP. MMRP follows the project management standards and governance activities that are established by the Project Management Office (PMO) for the following Project Management plans:

• Risk Management

• Issue Management

• Scope Management

• Change Management

• Cost Management

• Schedule Management

• Quality Management

• Communication Management

• Contractor Management

• Document Management

• Requirements Management

• Staff Management

Each of these plans are maintained by the PMO and are located on SCDHHS Project

Management-as-a-Service: PMaaS SharePoint site.

Documentation related to the resources, tools, processes and procedures needed to provide operations and maintenance support for the MMRP systems is located in the MMRP Operations and Maintenance (O&M) Manual.

https://schhs.sharepoint.com/sites/1211207/Project%20Management%20Planning%20Documents/Forms/Project%20Management%20by%20Doc%20Type.aspx https://schhs.sharepoint.com/pmo/SitePages/PMaaS.aspx https://schhs.sharepoint.com/:b:/r/sites/1211207/Operations%20and%20Maintenance/SCDHHS%20MMRP%20Operations%20and%20Maintenance%20Manual%20V3.0.pdf?csf=1&web=1&e=qZLg7C https://schhs.sharepoint.com/:b:/r/sites/1211207/Operations%20and%20Maintenance/SCDHHS%20MMRP%20Operations%20and%20Maintenance%20Manual%20V3.0.pdf?csf=1&web=1&e=qZLg7C

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2.4 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 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 South Carolina 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 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.

SCDHHS began receiving Account Transfer (AT) applications via a service that transfers an applicant’s application and all verification data via the Federal Data Services Hub (FDSH) in

February 2014. SCDHHS stood up an interim solution for the State-to-FDSH process and transmitted the first round of applications to the FDSH in May 2014. In November 2014, SCDHHS implemented the FDSH-to-State AT 2.3.2 processing and in December 2014 implemented the State-to-FDSH 2.3.2 process. SCDHHS implemented the functionality to send responses concerning dispositions of applications received via FDSH in May 2015. In July 2016, SCDHHS implemented FDSH-to-State and State-to-FDSH AT BSD 2.4. SCDHHS is currently using

FDSH services such as Social Security Administration (SSA) Composite, Remote Identity Proofing

(RIDP), and Verify Current Income. SCDHHS will continue to add/improve services via the FDSH and will continue efforts to optimize the AT process as needed.

In March 2016, SCDHHS implemented the functionality to send 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 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. On May 22, 2018, IBM Watson Health was awarded the contract for SI for the MMRP CGIS. The CGIS project focuses on the Non-MAGI based Medicaid application solutions.

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

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

11/4/2020 Page 15 of 150 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 implemente4d, 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 for the HCR R3 Certification Review.

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

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 determination and program enrollment for Non-MAGI Medicaid applicants, as well as comprehensive verification and reporting of Non-MAGI Medicaid applicants’ and members’ assets.

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2.5 Project Assumptions and Constraints

2.5.1 Assumptions

The following assumptions were made in the course of creating this project plan:

• Projects under MMRP will have adequate resources to complete objectives.

• MMRP assumes that SCDHHS leadership will continue to find it desirable to phase out the existing MEDS legacy platform.

• Projects under MMRP assume that an Enterprise Service Bus (ESB) implemented as part of this project will be scalable and able to integrate with adjacent architectures in the future from CMS or other State and Federal Agencies.

• Projects under MMRP assume that IBM/Cúram will continue to support and offer consulting advice regarding their COTS framework.

• Projects under MMRP assume that additional configuration of state verification interfaces will be required to allow the COTS framework to achieve complete verification interface integration for all known verification types.

• MMRP assumes that any system changes as a result of Federal or State legislative action will go through the Change Management process.

2.5.2 Constraints

The following constraints were identified in the course of creating this project plan:

• Communications for MMRP system(s) must take place over the existing SCDHHS and broader South Carolina networking infrastructure.

• Any upgrades to the Medicaid Management Information System (MMIS) by SCDHHS will take place independently of this project plan; MMRP system(s) must be capable of providing all input to the existing MMIS that the current MEDS does to ensure ongoing operations.

2.6 Project Approach

The method of project management to be used for MMRP projects is based on the SCDHHS

PMO standards. SCDHHS created the PMO to ensure project management standards and governance activities are established and conducted at the enterprise level. Enterprise level governance also includes oversight and review of supplier (vendor/contract) management requirements (e.g., external vendors, inter-governmental agencies [IGAs], etc.). The PMO provides process, program and portfolio, release, testing, quality management, and Information

Technology Infrastructure Library (ITIL) governance-related services. To ensure successful delivery of agency projects from initiation to closure, SCDHHS follows the approach, 11/4/2020 Page 17 of 150 methodology and governance guidelines outlined in each component of the PMO’s PMP. In addition, the PMO provides policy review, change management framework assistance, and oversight for Information Technology (IT) and non-IT initiatives.

Details specific to MMRP projects, including deviations from the PMO standards and guidance, are addressed in this document and are approved by the PMO Director and MMRP Program

Director.

2.7 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 Project Schedule for HCR will be located in the MMS HCR Project Web App (PWA) SharePoint site at https://schhs.sharepoint.com/sites/pwa/MMRS%20IBM%20HCR%20DDI/default.aspx?e=1:ccbf 72d14ed4467f8e6f0881b19fa435

User stories, Business Cases, and Test Cases are stored in Jira at https://devtools.scdhhs.gov/jira and http://cuihhsiutl10.clemson.edu/secure/RapidBoard.jspa?rapidView=1026&projectKey=CGIS&v iew=detail.

The DDI and O&M technical teams use Confluence to collaborate and share information. It can be located at https://devtools.scdhhs.gov/confluence/dashboard.action?updatesSelectedTab=popular (HCR) https://cuihhsiutl12.clemson.edu:8443/display/CGIS/Interfaces+Flows (CGIS)

2.8 Related Documents/References

The following documents and sites are important to this project 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 PMP.

Site/Document Name Version Date last updated

Link

Member Management Project Charter

20130328 Click here to access Project Charter

SCDHHS Project Management-as-a-Service (PMaaS)

Click here to access the PMaaS site https://devtools.scdhhs.gov/confluence/display/ProdSupp/Curam+-+ESB+Server+Environments?e=1:ccbf72d14ed4467f8e6f0881b19fa435 https://devtools.scdhhs.gov/confluence/display/ProdSupp/Curam+-+ESB+Server+Environments?e=1:ccbf72d14ed4467f8e6f0881b19fa435 https://team.scdhhs.gov/pmo/ProjectRepository/1211207/Templates/Forms/AllItems.aspx https://team.scdhhs.gov/pmo/ProjectRepository/1211207/Change%20Request%20Documents/Forms/AllItems.aspx?updatesSelectedTab=popular https://schhs.sharepoint.com/:b:/r/sites/1211207/Project%20Management%20Planning%20Documents/Member%20Management%20Project%20Charter.pdf?csf=1&web=1&e=ip8tfl https://team.scdhhs.gov/pmo/ProjectRepository/1211207/Change%20Request%20Documents/Forms/AllItems.aspx

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MMRP Operations & Maintenance Manual

V3.0 20200221 The latest approved version will be located in the Operations and Maintenance library (as an Approved “MMRP Operations Document” )

Table 1: Related Documents/References

2.9 Definitions and Acronyms

The following table includes all definitions of specialized terms that will be used throughout the document. Click here to view the entire MMRP Acronyms and Glossary list.

Term Definition

AD Approach Documents are used to document and align requirements between HCR and CGIS.

ADAM Application Development to Application Maintenance

ADD Architectural Description Document (combination of the TDS, FDS and

ICD)

APDU Advance Planning Document Update

APTC Advance Premium Tax Credit

ARB Architecture Review Board for MMRP

CAB Change Advisory Board

CAP Corrective Action Plan

CGIS Cúram Global Income Support

CIO Chief Information Officer

CISO Chief Information Security Officer

CIT Component Integration Testing

Contract Administration Plan

Documentation providing guidance to SCDHHS staff of the approach and practices of contract management and administration to be employed in the execution of the contract.

Contract Monitoring Plan

Documentation of services that will be monitored and the contract of compliance requirements set for the contractor.

COTS Commercial off the Shelf

CR Change Request

DDI Design, Development, and Implementation

DS Documentation Specialist

EEMS Eligibility Enrollment and Member Services

EEOC Eligibility Executive Oversight Committee

EOC Executive Oversight Committee

ES Enterprise Services

FDS Functional Design Specification

FDSH Federal Data Services Hub 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/Lists/MMRP%20Acronyms%20%20Glossary/AllItems.aspx https://schhs.sharepoint.com/sites/1211207/Lists/MMRP%20Acronyms%20%20Glossary/AllItems.aspx

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FFP Federal Financial Participation

FFY Federal Fiscal Year

HBE Health Benefit Exchange

HCIS Healthcare Information Services

HCR Health Care Reform

IAPD Implementation Advance Planning Document

IGA Inter-governmental agencies

ISO Clemson’s Infrastructure Service and Operations; also, SCDHHS’ Information Systems Operations

IT Information Technology

ITIL Information Technology Infrastructure Library

IV&V Independent Verification and Validation

LOE Level of Effort

LMS Learning Management System

MEELC Medicaid Eligibility & Enrollment Life Cycle

MEET Medicaid Eligibility & Enrollment Toolkit

MES Medicaid Enterprise System

MITA Medicaid Information Technology Architecture

O&M Operations and Maintenance

OCM Organizational Change Management

OIA Office of Information Assurance

OIM Operations and Information Management

PWA Project Web App

QA Quality Assurance

QHP Qualified Health Plan

Requirements Elaboration Session

Sessions to ensure all staff have a clear understanding of the requirements and business needs related to the work package.

RFP Request for Proposal

RMMIS Replacement Medicaid Management Information System

RTM Requirements Traceability Matrix

SCDHHS Enterprise

ARB

Enterprise level Architectural Review Board

SDLC Software Development Life Cycle

SFY State Fiscal Year

SI System Integrator

SIT System Integration Testing

SLA Service Level Agreement

SME Subject Matter Expert (policy)

SPI Schedule Performance Index The ratio of the budgeted cost of work performed to the budgeted cost of work scheduled.

TRR Test Readiness Report

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UAT User Acceptance Testing

WBS Work Breakdown Structure

WBT Web-based Training

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3.0 Governance

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

Office of Systems Development (OSD).

Due to the size, complexity, and risk associated with MMRP, CMS has mandated that the State employ an Independent Verification & Validation (IV&V) team to provide feedback directly to

CMS and State executive leadership on the progress, risks, and issues associated with the projects. IV&V exercises oversight but does not exercise control over the project.

3.1 SCDHHS MMRP Organizational Structure

The MMRP is part of the (OSD). The MMRP Program Director reports to the Deputy Director of

Systems Development. The Deputy Director of Systems Development reports to the SCDHHS

Director and is responsible for the management and oversight of the OSD and the MMRP.

Project and Contract Management is supported by the PMO 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.

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Figure 1: MMRP Organizational Chart

3.2 Key Stakeholders

The roles and responsibilities of the Key SCDHHS Stakeholders for the MMRP are listed below.

These are the stakeholders with whom the Contractor(s) may interface during the course of the

MMRP projects.

Role/Position Person Responsibility

SCDHHS Director Joshua Baker Cabinet-level official appointed by the

Governor and serves as the State Medicaid

Director.

Program Sponsor / Chief

Information Officer

David H. Ulmer Responsible for the design, development, release and maintenance of all technology systems and services for SCDHHS to include an

IT modernization plan that delivers agile, secure, integrated and responsive solutions to

SCDHHS and its stakeholders. Responsible for providing strategic direction, resources and executive support for MMRP.

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Role/Position Person Responsibility

Deputy Director of Systems

Development

Rhonda Morrison Responsible for developing, operating, and incrementally improving a catalog of

Information Technology Service Management

(ITSM) and software development lifecycle

(SDLC) services supporting system integration

(SI); solution design, development, and implementation (DDI); and system operations and maintenance (O&M) activities. Leads a small team of OSD technology and operations leaders charged with executing the transformation strategy articulated and the federal Centers for Medicare and Medicaid

Services (CMS). Working together, transformation leadership team members shall conduct all functional planning, operations management, project oversight, progress monitoring, risk management, and issue remediation activities necessary to ensure a smooth transition to the Medicaid-as-a-Service model.

Chief Operating Officer /

Deputy Director of the

Office of Medicaid

Operations

Michael Jones Responsible for the daily operations for the

Medicaid enterprise and the redesign and management of all repeatable processes to optimize efficiency and effectiveness. He will also consolidate all operational functions into a single operational unit and act as the universal business owner to generate high-quality requirements and project definitions for execution by OIM.

MMRP Program Director Rhonda Morrison Responsible for directing all aspects of the

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

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MMRP Project Manager Paul Leo Is responsible for ensuring project management practices are followed to include: scope management, schedule management, cost management, risk mitigation and management, communications management, resource planning and management, quality management, and enterprise integration.

Design, Development, and

Implementation Manager

Timothy Cozine Manages, monitors, and directs all tasks associated with DDI activities associated with the MMRP; responsible for implementing new system functionality and for product management, change management, user acceptance testing, and vendor management.

Operations & Maintenance

Manager

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

Technical Lead Renjan Bhasi Responsible for ensuring that all technical aspects of the project are addressed, and the project is implemented in a technically sound manner; responsible for review of all technical and solution designs; responsible for communicating technology issues, risks, and how the technology solution will accomplish the business needs to the MMRP team.

Product Manager (Interim) Abhishek Sahu Responsible for ensuring that new/enhanced system functionality meets the business needs and that the agency/program priorities are pursued. Manages the business analysts and documentation specialists responsible for gathering and documenting requirements, rules and processes, and communicating business needs to the technical staff.

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User Acceptance Testing

Technical Manager

Hugh McIntosh Responsible for completing the assigned testing team tasks (test case creation, review, execution). Reviews the O&M and DDI requirements (business and functional) and reports on the quality of test cases in Jira and defects compared to standards for documents.

Testing Manager Richa Gupta Responsible for development and execution of test plans, resource allocation, UAT status reporting and communication related to impact and risk analysis of issues/defects.

Manages all of the testing team and assigns the test 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. Responsible for the day-to-day management of DDI project activities, as approved by the DDI Manager. Assists the DDI

Manager and Product Manager in creating and executing procedures that ensure all systems, products, and services meet agency standards and end user requirements.

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Production 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.

O&M 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

Team, Testing Team, and system developers as needed to provide feedback on identified system issues.

Eligibility & Enrollment

Systems Helpdesk Manager

Matt Warren Manages a team responsible for researching and resolving eligibility determination system related 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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Process & Artifact

Development Manager

Erin Coleman Directs and manages the establishment of process architecture for all phases of the SDLC for major DDI projects at SCDHHS, including

MMRP.

Medicaid Enterprise System

(MES) Program Director

David Keels Reports to the Deputy Director for Systems

Development. Responsible for establishing and implementing Enterprise Architecture standards and governance.

Eligibility and Enrollment

Applications Management

Manager

Peter Schlies Reports to the Deputy Director for Systems

Development. Responsible for establishing and maintaining the Eligibility and Enrollment applications.

Enterprise Services (ES)

Technical Architect

Gerhard Ungerer Reports to the Deputy Director for Systems

Development Responsible for establishing

Enterprise Architecture standards.

Chief Information Security

Officer (CISO)

Thomas Scott Reports to the CIO. Responsible for ensuring the confidentiality, availability, and integrity of

SCDHHS data, in all forms, in a manner that poses the least impact on business operations while complying with all applicable governance regulations.

TBD Karla Buru Reports to the CIO. Responsibilities include ensuring project management standards and oversight activities are in place at the program level. In addition, the PMO also provides policy reviews and manages changes for IT and non-IT initiatives.

Contract Administrator Gerry Williams-

Cohen

The SCDHHS-designated Contract

Administrator shall be responsible for all administrative contractual matters. The

Agency Contract Administrator or authorized designee(s), shall establish and oversee

Contract Management functions, including ongoing monitoring and enforcement of

Contractor compliance with performance standards.

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Table 2: Key SCDHHS Stakeholder List

The SCDHHS and IBM Points of Contact Matrix provides the name, role, email and phone number for SCDHHS and IBM MMRP HCR project leadership.

Figure 2: SCDHHS and IBM Points of Contact Matrix

3.3 Authority

The figure below represents the OSD Governance strategy. Decisions that do not impact the project budget, scope or schedule will be made at the project level. Initial investment, contract, and enhancement decisions, as well as decisions related to changes impacting budget, scope and/or schedule will be made by the appropriate Executive Oversight Committee (EOC) when impacting the related program area only and by the OSD Steering Committee when impacting the enterprise.

SCDHHS Team Member SCDHHS Email Address SCDHHS Phone Number IBM Team Member IBM Email Address IBM Phone Number Rhonda Morrison

Deputy Director of Systems

Development morrison@scdhhs.gov 803-898-0430

Ryan Doherty

Delivery Executive Ryan.J.Doherty@ibm.com 202-870-7343

Rhonda Morrison

MMRP Program Director morrison@scdhhs.gov 803-898-0430

Larry Reed

Program Manager lreed@us.ibm.com 904-910-6539

Nicole Michelle Threet

Eligibility Operations Program

Manager mitcheln@scdhhs.gov 803-898-2689

Kathleen Elmore

Training Lead kelmore@us.ibm.com 480-208-1796

Chris Cranford

MMRP O&M Manager Chris.Cranford@scdhhs.gov 803-898-3407

Jeff Leyh

O&M Manager jeff.leyh@us.ibm.com 803-413-8359

Renjan Bhasi

MMRP Technical Lead Renjan.Bhasi@scdhhs.gov 856-996-5451

Dev Muthakana

O&M Solution Architect dev.muthakana@us.ibm.com 571-246-2593

Timothy Cozine

MMRP DDI Manager COZINE@scdhhs.gov 803-898-4577 Courtney Stevens

DDI Manager casteven@us.ibm.com 810-965-5379

Erin Coleman

MMRP Process & Artifact Manager Lindsay.Coleman@scdhhs.gov 803-898-8083

Laura L. Glenn

PMO Manager laura.l.glenn@us.ibm.com 224-535-1254

Renjan Bhasi

MMRP Technical Lead Renjan.Bhasi@scdhhs.gov 856-996-5451

Dev Muthakana

DDI Solution Architect dev.muthakana@us.ibm.com 571-246-2593

Vacant

Director of Information Security

Trevor Young

DS&P Lead ttyoung@us.ibm.com 720-381-8923

Paul Leo

MMRP Project Manager Paul.Leo@scdhhs.gov 803-898-0072

Laura L. Glenn

PMO Manager laura.l.glenn@us.ibm.com 224-535-1254

Abhishek Sahu

Interim Product Manager Abhishek.Sahu@scdhhs.gov 803-898-0331

Tiffany Ortega

BA Lead Tiffany.Ortega1@ibm.com 864-316-5582

Richa Gupta

Testing Manager Richa.Gupta@scdhhs.gov 803-898-0310

Brian Grieves

QA Lead brian.grieves@ibm.com 813-751-4198

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Figure 3: OSD Governance Triangle Diagram

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

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, OCM and PMO updates and risks), the Schedule Health dashboard from the IV&V 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, EEMS Policy & Process Director, and IV&V.

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, 2) PMO Director, and 3) Eligibility Operations Program

Manager.

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

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

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

(CISO), PMO Director, Contracts Management Director, MES Program Director, IT Services

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

Director, and MMRP Program Director.

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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 towards 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 Change Requests. The voting members are 1) MMRP Program Director/Deputy Director of OSD 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 project.

3.4 Roles and Responsibility Matrix

It is important to understand the roles and responsibilities of all MMRP Team Members and key stakeholders. The MMRP Roles and Responsibilities matrix is maintained in the MMRP

SharePoint site.

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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4.0 Scope Management

4.1. Project Scope Statement

MMRP follows the PMO Scope Management plan.

At a high level, the scope of the MMRP is to implement a system that provides all functionality required to process eligibility and enrollment for all Medicaid members (both MAGI and Non-

MAGI). The system should support functions such as workflow and task management, notifications to the clients, document management, business rules management, and associated business processes required to launch and continuously operate an efficient and effective eligibility and enrollment system.

The MMRP HCR Project focuses on the MAGI based Medicaid application solutions. IBM serves as the SI for HCR and is responsible for the DDI and O&M MAGI based Medicaid solutions and related systems/applications.

The MMRP Cúram Global Income Support (CGIS) Project focuses on the Non-MAGI based

Medicaid application solutions. On May 22, 2018, IBM was awarded the contract to implement the CGIS module and associated data interfaces. IBM serves as the SI for CGIS and is responsible for the DDI and O&M Non-MAGI based Medicaid solutions and related systems/applications per the HCR contract.

In September 2019, SCDHHS amended the HCR contract with IBM to include DDI activities for

Community Engagement Waiver (CEW). In anticipation of CMS’s approval of the CEW Standards

Terms and Conditions (STC), SCDHHS had established a July 1, 2021 implementation date for the

Phase 1 of the CEW MVP. Phase 2 dates are currently targeted for January 1, 2022.

Phase 1 includes application script changes and generic notice changes and went live on July 1, 2020. Phase 2 of the CEW waiver will be the implementation of both waivers including the

CEW, the targeted adult groups, and all notice changes SCDHHS will need to implement. The dates for the CEW implementation shifted because resources that were allocated to work on

CEW were reallocated to focus on the State’s response to the COVID 19 global pandemic.

4.1.1 In Scope

The Member Management Project Charter includes the initial scope for MMRP. Proposed changes to scope will follow the Change Management process. The HCR Project Roadmap reflects the items that were in scope for HCR. The CGIS Request for Proposal (RFP) outlines the scope for CGIS and a CGIS Project Roadmap reflects the items currently in scope for CGIS. A

CEW Project Roadmap will be created during the CEW project initiation. Requirements for items https://schhs.sharepoint.com/:b:/r/sites/1211207/Project%20Management%20Planning%20Documents/Member%20Management%20Project%20Charter.pdf?csf=1&web=1&e=ip8tfl https://schhs.sharepoint.com/:x:/r/sites/1211207/Project%20Management%20Planning%20Documents/HCR%20Project%20Roadmap.xlsx?d=w2b406845ae514c4291bf90a730810f11&csf=1&web=1&e=2iar5Q https://schhs.sharepoint.com/:x:/r/sites/1211207/Project%20Management%20Planning%20Documents/CGIS%20Project%20Roadmap.xlsx?d=w1cbee5a1e5484386999296659d4ac17a&csf=1&web=1&e=hPbmuU

11/4/2020 Page 32 of 150 that are within scope are detailed in the Business Requirement Document (BRD) and/or

Functional Design Specification (FDS) located under the appropriate Track Name in the Business

Requirements and Design Documents, CGIS Business Requirements and Design Documents, or the Community Engagement Waiver BRDs library on the MMRP SharePoint site.

Note: The FDS is part of the ADD for the CGIS and CEW projects.

4.1.2 Out of Scope

Items not listed as in scope, are considered out of scope. Functionality known to be out of scope includes:

• The integration of health plan selection into the replacement eligibility system.

• Integration of Cúram with the member call center technology to link telephone calls to member data.

4.1.3 Deliverable Expectations

The HCR Project Roadmap and CGIS Project Roadmap lists the functionality tracks that are expected to be implemented. For details related to the tracking of MMRP deliverables, refer to the Deliverable Management section of the MMRP PMP. (The MMRP HCR and CGIS Project Roadmaps are located in the Project Management Planning Documents library as an “Active” MMRP Project Document).

4.1.4 Scope Verification

The HCR Project Roadmap and CGIS Project Roadmap will reflect the functionality that is in scope for the DDI projects. The MMRP Program Director, DDI Manager, and Product Manager will monitor the Project Roadmap and project schedule to ensure the team is assigned and working only on in scope tasks. (The CEW Project Roadmap will be added at project initiation.)

Contractors will be monitored for scope compliance using a detailed, mutually agreed upon and officially baselined Work Breakdown Structure (WBS). The WBS will become the official detailed Project Plan. CRs will not be approved if they are out of scope and thereby will not become part of the project plan.

4.1.5 Scope Monitoring and Controlling

The MMRP…