1. electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting March 24, 2016 1

2. 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 o Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded o 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. o Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute All Panelists 2

3. 3 Agenda TopicPresenterTimeframe Welcome Announcements Lynette Elliott10 mins eLTSS Plan Alignment and Data Set Harmonization Overview Becky Angeles50 mins

4. Announcements Health 2.0 Technology for Healthy Communities Pilot – What: Technology for Healthy Communities is a digital health pilot program sponsored by the Robert Wood Johnson Foundation that facilitates technology adoption at the community level by tackling the most pressing local health issues. The inaugural program connects health technology innovators with four underserved communities across the U.S. with the goals of improving health outcomes and building sustainable partnerships. – Participating States: CA, FL, SC, TX – For more Information: http://www.communityhealthtech.org/http://www.communityhealthtech.org/ – To apply (deadline May 17, 2016): https://health2con- paxfp.formstack.com/forms/technologyforhealthycommunitieshttps://health2con- paxfp.formstack.com/forms/technologyforhealthycommunities 4

5. Announcements, cont’d... State Medicaid Director Letter on HITECH Administrative Matching Funds Updated – What: CMS is expanding the interpretation of the scope of State expenditures eligible for the 90 percent HITECH match, given the greater importance of coordination of care across providers and transitions of care in Meaningful Use modified Stage 2 and Stage 3 – Subject to CMS prior approval, States may thus be able to claim 90 percent HITECH match for expenditures related to connecting Eligible Providers to other Medicaid providers, including community-based Medicaid providers. – For more Information: http://www.medicaid.gov/federal- policy-guidance/downloads/SMD16003.pdfhttp://www.medicaid.gov/federal- policy-guidance/downloads/SMD16003.pdf 5

6. Announcements, cont’d… ONC Introduces the ONC Tech Lab – What: ONC Tech Lab is an organizing structure to help focus on what can be contributed to improve existing standards and build consensus around those that best serve specific interoperability needs, as recently outlined in the 2016 Interoperability Standards Advisory. Consists of four components: Standards Coordination, Testing and Utilities, Pilots and Innovation with the goal of seeing standards in use that have been rigorously tested and consistently implemented. – For more information: https://www.healthit.gov/buzz- blog/interoperability/our-next-chapter-for-standards-and- technology-introducing-the-onc-tech-lab/https://www.healthit.gov/buzz- blog/interoperability/our-next-chapter-for-standards-and- technology-introducing-the-onc-tech-lab/ – To access the ONC Tech Lab: https://www.healthit.gov/techlab/https://www.healthit.gov/techlab/ 6

7. Announcements, cont’d… ONC Introduces the Interoperability Proving Ground – What: The IPG is an open, community platform to share, learn, and be inspired by interoperability projects taking place across the nation. It provides a simple way to share a succinct set of basics about projects (e.g., title, description, hyperlink to your project website) and “tag” it with any standards or keywords that may be associated with it (e.g., C-CDA, FHIR, PDMP, ADT). The data shared populates the main IPG home page so anyone can easily filter and search across the entire interoperability project database or view interoperability projects nationwide on an interactive map. – For more information: https://www.healthit.gov/buzz- blog/interoperability/interoperability-proving-ground/https://www.healthit.gov/buzz- blog/interoperability/interoperability-proving-ground/ – To access the IPG: https://www.healthit.gov/techlab/ipg/https://www.healthit.gov/techlab/ipg/ 7

8. Announcements, cont’d… CMS Accountable Health Communities Model Call for Grant Funding Applications – What: Over a five-year period, CMS will implement and test a three-track Accountable Health Communities Model (Track 1 Awareness, Track 2 Assistance and Track 3 Alignment) based on promising service delivery approaches. Each track features interventions of varying intensity that link beneficiaries with community services. CMS will award, through a competitive process, renewable one-year cooperative agreements to successful applicants (award recipients). – When: Application deadline March 31, 2016 – To submit Letter of Intent (due by Feb. 8, 2016): http://innovationgov.force.com/ahc http://innovationgov.force.com/ahc – To apply (must include LOI confirmation number): http://www.grants.gov/view-opportunity.html?oppId=280812 http://www.grants.gov/view-opportunity.html?oppId=280812 – For more information: https://innovation.cms.gov/initiatives/ahcmhttps://innovation.cms.gov/initiatives/ahcm 8

9. Announcements, cont’d… HL7 C-CDA Rendering Tool Challenge call for participation – What: The ONC and HL7 challenge the community to develop a viewer that enables clinicians to more efficiently review clinically relevant patient data from C-CDA documents. Cash prizes for winning submissions: 1 st Place Prize $15,000, 2 nd Place Prize $5,000. – When: Submission deadline is May 31, 2016 – To review the rules: http://www.hl7.org/events/toolingchallenge.cfm#rules http://www.hl7.org/events/toolingchallenge.cfm#rules – To submit: http://www.hl7.org/events/toolingchallenge.cfmhttp://www.hl7.org/events/toolingchallenge.cfm 9

10. Announcements, cont’d... Call for Participation: Help HL7 Help You Reduce C-CDA Implementation Inconsistencies – What: HL7 invites C-CDA users to complete a survey that will help clarify the inconsistencies and pain points encountered when sending and/or receiving CCDs, Discharge Summaries and/or Referral Notes. Collection of data on these three document types will continue for several months. Results will be shared via webinar once results are compiled. Respondents should have direct experience sending and/or receiving the document types noted above. – When: Survey available until March 2016 – Survey link: https://www.surveymonkey.com/r/C- CDA21Contenthttps://www.surveymonkey.com/r/C- CDA21Content 10

11. Timelines for Consideration: Two Pilot Phases, SDO Ballot Cycles eLTSS Initiative Roadmap Q3 ‘14Q4 ‘14Q1 ‘15 Q2 ‘15 Q3 ‘15Q4 ‘15Q4 ‘17 Phase 4: Pilots & Testing Pilot site readiness Implementation of solution Test User Stories and Scenarios Monitor Progress & Outcomes Utilize Requirements Traceability Matrix Phase 5: Evaluation Evaluate outcomes against Success Metrics and Criteria Develop, review, and finalize the Use Case and Functional Requirements Pre-Planning Call for Participation Conduct Environmental Scan Success Criteria Stakeholder Engagement Finalize Candidate Standards Standards Gap Analysis Technical & Standards Design Develop Requirements Traceability Matrix Launch initiative Review and Finalize Charter Review initial Candidate Standards 11 Initiative Kick Off: 11/06/14 Phase 1: Pre-Discovery Phase 2: Use Case Development & Functional Requirements Phase 3: Pilot Guide Development Q4 ‘16

12. Reminder: Join the eLTSS Initiative To join the electronic Long Term Services and Supports (eLTSS) Initiative, go here: http://wiki.siframework.org/eLTSS+Join+the+Initiative. http://wiki.siframework.org/eLTSS+Join+the+Initiative Registered Members are included on all initiative communications, updates and announcements. – You may join as an Interested Party or a Committed Member. (More information about these options on the Join page.) Thank you! Your commitment and participation are critical to the success of the eLTSS initiative. 12

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14. LTSS Plan Alignment/Harmonization Process 1.TEFT Grantees and Non-TEFT pilots submit sample LTSS plan elements and values 2.Pilot Harmonization Team populates LTSS plan elements and values into crosswalk analysis spreadsheet and identifies: a.Similar content across plans b.Which elements are core to the plan? c.Which elements are drawn from an Intake or Assessment? 3.All hands community call work group sessions will require: a.Engagement and feedback from each pilot and their plan experts b.Consensus on common core elements c.Harmonization of the element name, format and values 4.Create a harmonized set of LTSS Plan elements, format and values 14

15. LTSS Plan Alignment/Harmonization Timeline 15 March 2016April 2016May 2016June 2016July 2016August 2016 Harmonized LTSS Plan LTSS Plan Submission Harmonization Team Populates Crosswalk Harmonization Phase (need LTSS Plan Data Experts)

16. LTSS Plan Elements – By the Numbers (DRAFT) State# of ElementsRows of Elements + Values Colorado (In progress)24109 Connecticut5873 Georgia (In progress)4449 Kentucky146887 Maryland106256 Minnesota (includes elements reused in multiple sections) 3141027 16

17. Element / Value Harmonization Example 1 – Service Status 17 Plan ComponentMinnesotaKentucky Element NameStatusService Status FormatDropdown?? ValuesPending Approved External Authorization Prior Authorization ??

18. Element / Value Harmonization Example 2 – Service Delivery Location (not at residence) 18 Plan ComponentKentuckyMaryland Element NameService Delivery LocationAddress Type (in the Address to Receive Services section) FormatDropdown ValuesCommunity Outpatient Facility Residential Site Provider Site Employment Site ??

19. Element / Value Harmonization Example 3 – Service Plan Type 19 Plan Component ColoradoGeorgiaKentuckyMarylandMinnesota Element NameService Plan TypeCare Plan TypeCategory of PlanPlan of Service TypeN/A FormatRadio ButtonsListRadio ButtonsDropdownRadio Buttons Values6 Month Review CCT Certification Extension Continued Stay Review Deinstitutionalization (DI) Employment Site Initial/EnrollmentInitial Reverse Deinstitutionalization Revision Unscheduled Review Recertification Provisional Annual New Reassessment 30 Day CCP Review

20. Element / Value Harmonization Example 4 – Program 20 Plan ComponentMinnesotaMarylandKentucky Element NameProgramProgram TypeProgram [Program] FormatText BoxDrop Down Values ABI-LTC ABI-Acute Model II HCB MPW SCL CPAS CO BI CFC ICS

21. Next Steps 21 DateActivityParties of Interest Tip for Preparation MarchSubmission of LTSS plan by March 31st All members Send LTSS plans Element Format Element Values March to Mid-April Pilot team will review LTSS Plans to align plan- specific components and data elements All members Submit your LTSS Plan if you have not already done so Mid-April to August Group HarmonizationAll members Be very familiar with plan and data Bring plan experts to the meeting

22. FACA Meetings (Federal Advisory Committees) Upcoming FACA Meetings Precision Medicine Task Force – March 30 Interoperability Experience Task Force – April 6 API Task Force – April 12 Precision Medicine Task Force – April 13 Joint HIT Committee Meeting – April 19 Interoperability Experience Task Force – April 20 API Task Force – April 21 Precision Medicine Task Force – April 21 API Task Force – April 26 Public attendance is encouraged https://www.healthit.gov/facas/calendar/2016/1 22

23. eLTSS Initiative: Project Team Leads ONC Leadership – Mera Choi (mera.choi@hhs.gov)mera.choi@hhs.gov – Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov)elizabeth.palenahall@hhs.gov CMS Leadership – Kerry Lida (Kerry.Lida@cms.hhs.gov)Kerry.Lida@cms.hhs.gov Community Leadership – Mary Sowers (msowers@nasddds.org)msowers@nasddds.org – Terry O’Malley (tomalley@mgh.harvard.edu)tomalley@mgh.harvard.edu Initiative Coordinator – Evelyn Gallego-Haag (evelyn.gallego@emiadvisors.net)evelyn.gallego@emiadvisors.net Project Management – Lynette Elliott (lynette.elliott@esacinc.com)lynette.elliott@esacinc.com Use Case & Functional Requirements Development – Becky Angeles (becky.angeles@esacinc.com)becky.angeles@esacinc.com Pilot Guide Development – Grant Kovich (grant.kovich@accenture.com)grant.kovich@accenture.com Pilots Management – Jamie Parker (jamie.parker@esacinc.com)jamie.parker@esacinc.com Standards and Technologies Identification – Angelique Cortez (Angelique.j.cortez@accenturefederal.com)Angelique.j.cortez@accenturefederal.com 23