electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting November 5, 2015 DRAFT: Not for distribution

Meeting Etiquette Remember: If you are not speaking, please keep your phone on mute Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded Another reason to keep your phone on mute when not speaking Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know. Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). Please DO NOT use the Q&A—only the presenter sees Q&A, not necessarily the person facilitating the discussion From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute  All Panelists

Agenda Welcome Announcements eLTSS Roadmap Evelyn Gallego 10 mins Topic Presenter Timeframe Welcome Announcements eLTSS Roadmap Evelyn Gallego 10 mins eLTSS Pilot Plan Presentations KY Office of Administrative & Technology Services (Sheena Batts) MD Department of Health & Mental Hygiene (Kale Sweeney) CT Department of Social Services Division of Health Services (Minakshi Tikoo) CO Department of Health Care Policy & Financing (Kelly Wilson) 80 mins

Announcements NATE and the California Association of Health Information Exchanges (CAHIE) Call for Participation: New National Forum for Provider Trust Community What: NATE and the California Association of Health Information Exchanges (CAHIE) recently announced that CAHIE is assuming administration of the NATE Provider-to-Provider Trust Bundle for Direct messaging among providers. We are now looking for participants to serve on a new national forum to help establish a voluntary governance process to manage and govern the new national trust community. When: Interested parties should respond as soon as possible For information: http://www.ca-hie.org/news/call-for-participants- national-forum

Announcements, cont’d… Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap version 1.0 What: This draft interoperability roadmap lays out a clear path to catalyze the collaboration of stakeholders who are going to build and use the health IT infrastructure. These documents include all the public comments that were submitted during the public comment period. Roadmap Website: https://www.healthit.gov/policy-researchers- implementers/interoperability Rules: https://www.federalregister.gov/articles/2015/10/16/2015-25595/medicare- and-medicaid-programs-electronic-health-record-incentive-program----stage- 3-and https://www.federalregister.gov/articles/2015/10/16/2015-25597/2015- edition-health-information-technology-certification-criteria-2015-edition- base-electronic

Announcements, cont’d… Common Clinical Data Set Renamed the “Common MU Data Set.” This does not impact 2014 Edition certification. Includes key health data that should be accessible and available for exchange. Data must conform with specified vocabulary standards and code sets, as applicable. 2015-2017 Send, receive, find and use priority data domains to improve health and health quality ONC Interoperability Roadmap Goal Patient name Lab tests Sex Lab values/results Date of birth Vital signs (changed from proposed rule) Race Procedures Ethnicity Care team members Preferred language Immunizations Problems Unique device identifiers for implantable devices Smoking Status Assessment and plan of treatment Medications Goals Medication allergies Health concerns Red = New data added to data set Blue = New standards for data

Announcements, cont’d… mHealth Summit What: The 2015 mHealth Summit explores what is new in mobile, telehealth and connected health—from the impact on healthcare delivery, clinical care and patient/consumer engagement to new technologies, research, investment activities, policy and shifts in the business environment. When: November 8 –11, 2015 Where: Gaylord National Resort and Convention Center ~ Washington, D.C. To register: http://www.mhealthsummit.org/registration

Announcements, cont’d… National Call for Applications Opens: Community Health Peer Learning Program What: In July 2015 the Office of the National Coordinator for Health Information Technology (ONC) has awarded AcademyHealth $2.2 million to lead the Community Health Peer Learning Program (CHP). Throughout this two-year program, AcademyHealth will work in partnership with ONC to establish a national peer learning collaborative for 15 competitively-awarded communities to address specified population health management challenges through increased sharing and use of data. When: Application Due Date November 10, 2015 ~ Anticipated Award Date January 8, 2016 For more information: http://www.academyhealth.org/Programs/ProgramsDetail.cfm?ItemNumber= 16918&navItemNumber=17093 To apply: http://www.academyhealth.org/Programs/content.cfm?ItemNumber=17238

Announcements, cont’d.. Aging 2.0’s AgeTech Expo – Charting the Course: Innovations in Aging What: The Aging2.0 AgeTech Expo brings together aging services providers and tech companies for cross-sector innovation insights and collaboration opportunities. The 2-day conference and technology exposition features innovation tours and workshops, inspiring keynotes, practical education panels, technology exhibits and the live “Pitch-for-Pilots (P4P)” session. When: November 19-20, 2015 Where: Hyatt Regency Hotel ~ San Francisco, CA For more information: http://www.aging2.com/expo/ To register: http://www.aging2.com/expo/#registration

Announcements, cont’d… CMS needs your comments on discharge planning proposed rule on patient preferences What: The proposed rule emphasizes the importance of the patient’s goals and preferences during the discharge planning process. CMS advises that in planning transitions providers should consult with Aging and Disability Resource Centers, Area Agencies on Aging, and Centers for Independent Living, or SAMHSA’s treatment locator. These improvements should ensure that patients and their caregivers can work with organizations that provide community supports and help promote their personal goals upon discharge from the hospital or post-acute care setting. When: CMS will accept comments until January 4, 2016 Submit comments: http://www.regulations.gov Proposed Rule – Revisions to Discharge Planning Requirements (CMS-3317-P): https://www.federalregister.gov/articles/2015/11/03/2015-27840/medicare-and- medicaid-programs-revisions-to-requirements-for-discharge-planning-for-hospitals CMS Press Release: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press- releases/2015-Press-releases-items/2015-10-29.html

eLTSS Initiative Timeline Phase 1 Pilots & Testing … Pilot Guide Development Use Case & Functional Requirements Pre-Discovery DEC 14 JUN JAN FEB MAY JUL AUG SEP OCT NOV Kick Off 11/06/14 Evaluation... Content Work Stream eLTSS All-Hands Work Group Use Case 1. eLTSS Use Case eLTSS Plan Content SWG eLTSS Plan Domains & Data Elements Candidate Standards & Technologies Three-tiered implementation Approach Functional Requirements Matrix MAR APR DEC 15 JAN 16 Pilot Execution

Goals for the eLTSS Initiative Identify key assessment domains and associated data elements to include in an electronic Long-term Services & Supports (eLTSS) plan Create a structured, longitudinal, person-centered eLTSS plan that can be exchanged electronically across and between community-based information systems, clinical care systems and personal health record systems. DRAFT: Not for distribution

eLTSS Artifacts Final published Project Charter: http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+Charter eLTSS Glossary: http://wiki.siframework.org/eLTSS+Glossary The eLTSS Glossary is a working document containing eLTSS-relevant terms, abbreviations and definitions as defined by stakeholders Final published Use Case: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case Pilot Artifacts Pilot Starter Kit: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Pilots#Pilot Starter Kit The Pilot Starter Kit includes the Pilot Guide (consisting of a ReadMe overview, Functional Requirements Matrix/FRM and Tiered Approach), the Requirements Traceability Matrix (RTM), and Pilot Plan Templates Pilot Resource Materials: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Pilots#Pilot Resource Materials Pilot Resource Materials include overview documentation, design process documentation, and the Domain Harmonization Matrix DRAFT: Not for distribution

eLTSS Pilot Plan Presentations DRAFT: Not for distribution

KY Office of Administrative & Technology Services Pilot Plan Presenters – Contact Information KY Office of Administrative & Technology Services Sheena Batts ~ sheena.batts@ky.gov MD Department of Health & Mental Hygiene Kale Sweeney ~ kale.sweeney@maryland.gov CT Department of Social Services Division of Health Services Minakshi Tikoo ~ minakshi.tikoo@uconn.edu CO Department of Health Care Policy & Financing Kelly Wilson ~ kelly.wilson@state.co.us

Tentative Presentation Schedule DATE ORGANIZATION TEFT/NON Point of Contact 10/15/2015 Janie Appleseed Non TEFT Lisa Nelson 10/22/2015 National Disability Institute Mary Lynn Revoir FEi Systems Chirag Bhatt Kno2 Dane Meuler ADvault Scott Brown 10/29/2015 MN Department of Human Services TEFT Tom Gossett GA Department of Community Health Bonnie Young Care at Hand Andrey Ostrovsky Meals on Wheels Allison Thompson 11/05/2015 KY Office of Administrative & Technology Services Sheena Batts MD Department of Health & Mental Hygiene Kale Sweeney CT Department of Social Services Division of Health Services Minakshi Tikoo CO Department of Health Care Policy & Financing Kelly Wilson 11/12/2015

Maryland Department of Health and Mental Hygiene Thursday, November 5, 2015 DRAFT: Not for distribution

Agenda Introduction Goal of Pilot Tier Piloting Activity to Pilot Role of DHMH in the pilot Standards and Technologies Under Consideration Logistics Ecosystem Defining Success Resources/References

Introduction: Pilot Team Name Role Email Kale Sweeney Co-Project Lead kale.sweeney@maryland.gov David Wertheimer david.wertheimer@maryland.gov Whitney Moyer Chief, ISAS Division whitney.moyer@maryland.gov Lorraine Nawara Deputy Director, Community Integration Programs (Long Term Care) lorraine.nawara@maryland.gov Christin Whitaker Chief, COA Division (Long Term Care) christin.whitaker@maryland.gov

Introduction: Organization Maryland Department of Health and Mental Hygiene (DHMH), aka Maryland Medicaid We are the state Medicaid agency for the State of Maryland and one of the main payers for Maryland beneficiaries The state plan for Maryland Medicaid includes providing Long Term Supports and Services for Maryland beneficiaries Maryland launched its electronic LTSS system (LTSSMaryland) using funds from the Balancing Incentive Program (BIP). LTSS currently includes the beneficiary groups of Community Options Waiver, Money Follows the Person, Community First Choice (State Plan), Community Personal Assistance Services (State Plan),  Increased Community Services, and Brain Injury, with Community Pathways (DD Waiver) and Medical Day Care planned for the future. We also have the In-home Supports Assurance System (ISAS) to ensure that service providers are in the beneficiaries homes caring for them when they say they are.

Pilot Introduction: Business Drivers Long Term Care (CFC, CO Waiver Programs, Brain Injury Waiver) Business use case: A platform where service plan information can be stored and service providers can be tracked. Use case is provider-based.

Goal of the Pilot User Story 2

The current workflow is all user-initiated Pilot Workflow The current workflow is all user-initiated The desired workflow is that we want to have the users to View their plan Trigger specific events where a supports planner would be able to assist them in the modification of their plan

Which Tier are you piloting? Round 1: Tier 1 Round 2: Tier 2

What are you intending to pilot? Pick which one(s) apply Access, View, Review Plan Have you identified a Service provider with which to work, if so who? In Progress Do you know if they have an electronic system? To Be Determined Do you know which sub-domains from the FR document will you pilot: Work, Community, Choice & Decision Making, Relationships, Self-Direction, Demographics, Person-Centered Profile, Medication, ADLs/IADLs, Safety, Behavioral Needs, Restrictions, Service, Financial/Payer Information, Service Information, Family Information, Community Connections, Access & Support Delivery, Information & Planning, and Health Note: We are currently vetting/going through a process for identifying a Service provider with which to work.

What role do you play in the pilot? Beneficiary System LTSS/Case Management Information LTSS/Service Provider System Payer Please describe the role you intend to play in the pilot: Identify population Give access to plan Monitoring compliance, user behavior, user feedback

Standards Under Consideration: Tier 1 Non Electronic – paper documents Tier 2 Electronic – .pdf or export files such as CCDs Tier 3 (future phase) Secure exchange methods (HIE)

Pilot Logistics: Timeline – (April 2016 is end date for round one pilots) Kick off: November 2015 Identify Partners/Providers/Beneficiary Pilot Population – December 2015 Complete Partner Data Use/Sharing Agreements – January 2016 Develop methods for producing and sharing eLTSS data – February 2016 Exchange eLTSS data via paper, fax, or other secure method – Early to Mid March 2016 Receive Pilot Population Feedback – Mid to Late March 2016 Complete Pilot: April 2016 Challenges: Beneficiary access to technology Beneficiary education and training Setting baselines to monitor performance standards and improvement Building incentives for beneficiary participation, both for pilot and beyond Assessing business needs and modification of workflow within DHMH

Pilot Ecosystem Current or Potential Partners/Providers: DHMH Long term care staff, supports planners, agency providers, beneficiaries and their guardians/caretakers What electronic systems/what vendor(s) do they use to support their work: Maryland LTSS/ISAS What electronic systems/what vendor(s) do you use to support your work:

How do you define success? Tier 1 Whether or not we can get beneficiary/participant buy-in User behavior and engagement with their supports planners should be higher Beneficiary Survey (before and after pilot)? Tier 2 System-level metrics User behavior within client profile and/or service plan

Helpful References Maryland Medical Assistance Programs: https://mmcp.dhmh.maryland.gov/SitePages/Home.aspx Maryland Money Follows the Person (MFP): https://mmcp.dhmh.maryland.gov/longtermcare/SitePages/Maryland%20Money%20Follows%20the%20Person.aspx Maryland Home and Community-Based Services (HCBS): https://mmcp.dhmh.maryland.gov/waiverprograms/SitePages/Home.aspx

Next Steps Schedule your Pilot Plan Presentation Next available date: Nov 12th Please schedule your presentation by emailing jamie.parker@esacinc.com or any member of the support team and we will schedule you If you are interested in piloting, please express your interest using the Pilot Interest Survey form: http://wiki.siframework.org/electronic+Long+Term+Services+and+Supports+Pilot+Interest+Survey

eLTSS Pilot Starter Kit Useful Links eLTSS Pilot Starter Kit http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+Pilots#Pilot Starter Kit eLTSS Glossary: http://wiki.siframework.org/eLTSS+Glossary eLTSS Reference Materials http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+References

Connecticut TEFT November 5, 2015 DRAFT: Not for distribution

Agenda Introduction Goal of Pilot Tier Piloting Activity to Pilot Role of Connecticut in the pilot Standards and Technologies Under Consideration Logistics Ecosystem Defining Success Resources/References

Introduction: Pilot Team Name Role Email Dawn Lambert DSS Project Director Dawn.lambert@ct.gov Minakshi Tikoo Project Director Minakshi.Tikoo@uconn.edu Rachel Rusnak Research Assistant Rachel.Rusnak@uconn.edu Giuseppe Macri Giuseppe.Macri@uconn.edu Ben Abrahamsson Benjamin.Abrahamsson@uconn.edu Paul Ford DSS liaison with UCONN Paul.Ford@ct.gov Dr. Minakshi Tikoo is Connecticut’s Health IT Coordinator, who heads the eLTSS and PHR component of the TEFT grant. As Health IT Coordinator, Dr. Tikoo works to promote synergy amongst the Health IT projects across the state. The team is also comprised of consumers & advocates. Outreach and education to our consumers is of utmost importance to us. In order for innovative technology to be adopted and meaningfully used, consumer input must be included as part of the process.

Introduction: Organization Who we are? We are CT TEFT, focusing on empowering consumers through the use of Health IT. We are comprised of staff from the CT Department of Social Services & the University of Connecticut. What we currently do? The team goes out into the community to gather input from consumers & advocates on how HealthIT solutions can best serve consumers. The team has developed educational materials, and will offer PHR training to users. How are we involved in services and support? The team engages consumers& advocates in interactive dialogues, allowing them to express their views on Health IT while providing feedback on the project. We analyze consumer & advocate responses in order to better understand their concerns. How do we currently carry out eLTSS activities? Connecticut does not have an eLTSS system or HIE. Rather, the state still uses paper processes for a majority of LTSS communications. This data is typically shared by fax.

Pilot Introduction: Business Drivers Business Drivers for CT: Empower consumers via information sharing Improve consumer health through Health IT Streamline workflows Business Use Case: CT will pilot the ability to create & share an eLTSS Plan. CT will also evaluate the utility of the established domains & subdomains. The CT team will pilot a version of User Story 2, “Sharing a Person-Centered eLTSS Plan”. A Business Use Case is in development to reflect CT specific process related to the Community First Choice program.

Which Tier are you piloting? CT will pilot Tier I: Basic, Non-Electronic Information Exchange Objectives: Develop tangible, high-level Use Case of mutual interest and value between participating partners (applicable to Tier I technology and objectives) Identify gaps in what data elements captured, and what data elements are available using workflow analysis Identify data elements, for future use, which can be shared as a report from a system using existing content standards, in an effort to validate data elements within Tier I. Exchange eLTSS data in a paper format. Assess the value of engaging the beneficiary in developing and sharing their LTSS data electronically in the future. Engage front-line staff throughout the entire change management process, including process redesign and improvement Draft and submit a report documenting the risks, challenges, findings, recommendations and outcomes of the Tier I piloting process

User Story 2 Connecticut intends to pilot User Story 2: Sharing a person-centered eLTSS plan. Paper eLTSS plans will be transmitted between actors.

Pilot Workflow Current State: Pilot Workflow: Person (or designee) creates the plan. The plan is submitted to the access agency, who then submits the plan to DSS. No established process for the plan to be shared with the person post approval. Pilot Workflow: Person (or designee) creates the plan, and shares to the plan access agency, who then submits the plan to DSS. The plan is rerouted to the person, who can also share it with all relevant parties. Recipients can communicate back to the person (or designee) regarding the plan. Person Access Agency DSS Person DSS PCP Visiting Nurse Advocate Physical Therapist Access Agency

What are you intending to pilot CT TEFT will pilot: Plan Creation Transfer/Sharing of the Plan Validity of Domains & Subdomains

CT eLTSS Data Element Crosswalk

What role do you play in the pilot CT TEFT team will act as educators, advocates and researchers during the pilot. The team will advocate for consumer access to their health data. A major component of the grant is to enable consumer access in order to empower them. The team will research the best practices for eLTSS plan implementation to encourage stakeholder participation in the process. The team expects to go into the community and gain input on how an eLTSS plan should look and be used.

Standards Under Consideration: Tier 1 Paper transfer Secure Direct Messaging

Pilot Logistics: Timeline: Establish Pilot Plan: October & November 2015 Identification of Partners: November & December 2015 Launch Pilot: January & February 2016 Completion of Pilots: April 2016 Challenges: Time Constraints Time to organize and conduct outreach Data definitions: Did not leverage existing standards Fluidity of definitions

Minakshi Tikoo - PHR - MFP Pilot Ecosystem Minakshi Tikoo - PHR - MFP 10/09/2015

Pilot Ecosystem Cont. CT TEFT will pilot the eLTSS Plan with the Community First Choice population For Round 1 piloting, CT TEFT will utilize Tier 1: Basic, Non-Electronic Information Exchange Potential Outcomes/Value Add: Validate target eLTSS Use Cases Develop options to be executed in future tiers Assesses impact on workflow improvements and process redesign for participating providers Establish a transport framework that is scalable Assists in identification of TEFT Pilot Evaluation metrics Identify standards that can be leveraged to create eLTSS output, in various forms, from multiple and disparate LTSS MIS systems Engage CB-LTSS stakeholders (providers, beneficiaries, advocates, accountable entities and payers) in more valuable ways Promote user friendly electronic information Provide knowledge and guidance to assist in quality improvement for subsequent tiers

How do you define success The overarching success metric will be significant uptake and use of an eLTSS plan & information sharing. Potential ways to capture this data include: Surveying stakeholders Significant increase in communication between consumers and providers Town Hall style meetings with interactive discussion The goal of CT TEFT’s eLTSS pilot is to empower consumers through Health IT in order to improve health outcomes.

Helpful References Name Phone Email Minakshi Tikoo 860-679-5559 Minakshi.Tikoo@uconn.edu Rachel Rusnak 860-679-7317 Rachel.Rusnak@uconn.edu Giuseppe Macri 860-679-7314 Giuseppe.Macri@uconn.edu Ben Abrahamsson 860-679-2643 Benjamin.Abrahamsson@uconn.edu CT Health IT Website: http://www.ct.gov/dss/cwp/view.asp?a=3922&q=562672 CT TEFT Website: http://www.ct.gov/dss/cwp/view.asp?a=3922&q=562672 PHR outreach presentation: http://www.ct.gov/dss/lib/dss/hit/phrltc.pdf CT Health IT Resources: http://www.ct.gov/dss/cwp/view.asp?a=3922&q=563576

State of Colorado Health Care Policy and Financing Colorado TEFT Team November 5, 2015 DRAFT: Not for distribution

Agenda Introduction Goal of Pilot Tier Piloting Activity to Pilot Role of Colorado TEFT Team in the pilot Standards and Technologies Under Consideration Logistics Ecosystem Defining Success Resources/References

Introduction: Colorado TEFT eLTSS Pilot Team

Introduction: Colorado TEFT Team Who we are: CO Department of Health Care Policy and Financing, TEFT Grantee CORHIO - Colorado Regional Health Information Organization QHN – Quality Health Network What we do: HCPF administers Medicaid, Child Health Plan Plus, and other health care programs for Coloradans who qualify. CORHIO – HIE on the front range connecting hospitals, labs, physicians, emergency services, behavioral health, skilled nursing, home health, hospice and QHN – HIE on the western slope - first HIE in Colorado Collaborative: Colorado TEFT Team includes members of the HCPF LTSS department, internal IT Interchange staff, quality and health improvement unit and the Governor’s Office of Health IT Two state HIE’s, Quality Health Network and CORHIO Focus Group members in five communities across the state of Colorado

Pilot Introduction: Business Drivers Comprehensive assessment and re-assessment of clients Person-centered services provided to clients Business Use Case: Create and test new means of sharing LTSS data electronically with clients and our current LTSS Service providers and stakeholders Identify new and efficient ways of exchanging information Include both clinical and non-clinical data

Goal of the Pilot Colorado will be using: User Story 1 for our Pilot in Round One: LTSS Eligibility, eLTSS Plan Creation and Approval

User Story 2 User Story 2: Sharing a Person-Centered eLTSS Plan Tier 2 – Pilot in Round 2

Pilot Workflow Single Entry Point: Case managers have approximately 100 clients in their caseload Annual assessments per case mangers average 8-10 in-home each month Each assessments can take up to three hours Assessments are currently conducting by taking notes on paper - with an ink pen  All assessments must be entered and submitted within 10 days of conducting the assessment into the BUS (Business Utilization System) Intake Case managers conduct between 20-30 assessments per month and follow same workflow process. The BUS is the living document for clients’ assessments and service plans. If clients meet functional eligibility through the assessment, case managers need to check financial eligibility. This process differs among agencies. Currently information gathered for clients include ADLs, IADLs and service plans.

Which Tier are you piloting in Round 1? The Colorado TEFT Team will be using a three tiered approach with each tier building on the previous tier with advancing technology. We will be piloting Tier 1 - Basic non-Electronic Information Exchange in Round One – targeting workflow redesign and testing to facilitate future electronic information sharing Objectives: Share what eLTSS data elements are currently in use Ex. SEP enters all information online onto the BUS (Benefits Utilization System at HCPF). PAR (Prior Authorization Requests) Client face sheets and the Professional Medical Page all on paper Identify gaps in data elements Evaluate if any subdomains overlap Develop tangible Use Case piloting options of mutual value between participating providers and clients The eLTSS data will be shared as a file compatible with existing standards (ie. C-CDA) Assess the value of engaging the client in developing and sharing their eLTSS plan

Which Tier are you piloting in Round 2? We will be piloting Tier 2 – in Round 2 – Secure, Electronic Data Exchange Tier 2 will build on the objectives in Tier 1 and incorporate electronic information exchanges with readily available services, transport standards, and content standards. Tier 2 will target use of the data, reports, and files defined in Tier 1 and exchanging them with participating providers by means of established secure exchange standards. Objectives: Use the data/reports/files from Tier 1 and exchange with participating providers using established secure exchange standards Investigate additional methods available to participating providers to utilize established e-Health secure exchange methods

What are you intending to pilot Pick which one(s) apply Tier I - Create Plan Tier II– Send and Receive Plan Update Plan Tier III – Send and Receive Plan Have you identified a Service provider with which to work, if so who? We have identified two Focus Group Communities: Northern Colorado – Weld County and Larimer County Southern Colorado – Colorado Springs area Do you know if they have an electronic system? Northern Colorado Focus group members do not utilize an electronic system Southern Colorado Focus Group providers are connected to CORHIO and one provider is in implementation with Care At Hand Do you know which sub-domains from the FR document will you pilot: The sub-domains will be discussed with both communities for their input and agreement

What role do you play in the pilot Colorado TEFT Team Our role will be to work with the two Focus Group Communities to: Identify and recruit providers in the LTSS continuum Train/educate providers on the pilot and objectives Inventory existing Provider technology Assess readiness of Provider to work with eLTSS data Map data elements in plan to the eLTSS dataset Share data elements among partners Develop Use cases of mutual interest Document and implement changes to provider workflow Test secure exchange of data

Standards Under Consideration: Tier 1 E.g. Non Electronic – Paper to an on-line submission into the BUS (Benefits Utilization System) E.g. Electronic – exchange eLTSS data as a report object Tier 2 E.g. CCDA Use the data/reports/files from Tier I and exchange with participating providers using established secure exchange standards Option: FEi and Care At Hand Tier 3: E.g. CCDA (content and transport), OAUTH (security), FHIR etc.

Pilot Logistics: Timeline Kick off: November 2015 –On-site meetings at both communities Identification of Provider staff and clients- December 2016 Completion of Provider Data Use/Sharing Agreements – January 2016 On-site meetings with the vendor technology and readiness – January 2016 Develop methods to produce eLTSS data appropriate for sharing – February 2016 Exchange eLTSS data via paper, fax or other secure method – March 2016 Completion of Pilots: April 2016 Challenges: Identification of common data elements across providers

Case Managers and EBD clients Pilot Ecosystem Partners: Two Northern County Department of Human Services/SEP working with EBD Waiver clients Case Managers and EBD clients Southern Colorado – Regional Care Collaborative Organization, Community Center Boards, combination of EBD and SLS ID/DD clients Systems: HCPF systems include MMIS, BUS, BIDM, PAR (financial eligibility determination), as well as the new care assessment redesign tool .

How do you define success Support from the two Focus Group Communities to assist in TEFT/Evaluation and validates eLTSS Use Cases Engages the eLTSS Focus Group members and clients in new ways Pioneer methods of creating eLTSS output, in various forms, from multiple LTSS Health IT Systems to increase access Gap analysis with domains completed Impact workflow by reducing time in processing paper notes into electronic exchanges Establishes transport framework that will be built upon in Tier 2 and Tier 3

For more information: Helpful References Colorado Department of Health Care Policy and Financing https://www.colorado.gov/hcpf Colorado Regional Health Information Organization HIE www.corhio.org Quality Health Network HIE www.qualityhealthnetwork.org

Comments/Discussion Questions? Comments?

eLTSS Initiative: Project Team Leads ONC Leadership Mera Choi (mera.choi@hhs.gov) Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov) CMS Leadership Kerry Lida (Kerry.Lida@cms.hhs.gov) Community Leadership Mary Sowers (msowers@nasddds.org) Terry O’Malley (tomalley@mgh.harvard.edu) Initiative Coordinator Evelyn Gallego-Haag (evelyn.gallego@siframework.org) Project Management Lynette Elliott (lynette.elliott@esacinc.com) Use Case & Functional Requirements Development Becky Angeles (becky.angeles@esacinc.com) Pilot Guide Development Grant Kovich (grant.kovich@accenture.com) Pilots Management Jamie Parker (jamie.parker@esacinc.com) Standards and Technologies Identification Angelique Cortez (angelique.j.cortez@accenture.com)