1. electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting May 28, 2015 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). o 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 2

3. 3 Agenda TopicPresenterTimeframe Welcome Announcements eLTSS Roadmap Lynette Elliott15 mins eLTSS Plan Content SWG DebriefGrant Kovich5 mins eLTSS Use Case End-to-End Review Comment Discussion Becky Angeles30 mins eLTSS Use Case Consensus Voting OverviewBecky Angeles10 mins

4. Announcements Upcoming Hearing on Advanced Health Models Please join ONC on June 2, 2015 for a hearing conducted by the Advanced Health Models and Meaningful Use Workgroup. Invited panelists will describe how their integrated, holistic model can produce optimal health and healthcare for individuals and communities across the health continuum and will highlight the key health IT elements required to support their model. The hearing will further understanding on the opportunities, challenges, and policies needed for successfully scaling and sustaining the IT infrastructure required to promote advanced health models across communities. When: Tuesday, June 2, 2015, 9:00am-5:00pm ET Where: Crystal City Marriott at Reagan National 1999 Jefferson Davis Hwy Arlington, VA 22202 Web Conference information and materials: http://www.healthit.gov/facas/calendar/2015/06/02/policy-advanced-health- models-and-meaningful-use-workgroup-public-hearing 4

5. Announcements Health Datapalooza 2015 Health Datapalooza is the only event where leaders across industries unite to discuss the future of open health data. Health Datapalooza 2015 will be focused on dialogue key to advancing the availability and responsible use of open health data. As we explore the policies, standards, practices and collaborations that will enable data sharing across the health system, we take an important step towards a patient-centered health system, powered by data. The expert panel includes representatives from Humana, The Dartmouth Institute, White House Office of Science and Technology Policy, and Centers for Medicare and Medicaid Services (CMS). When: May 31 – June 3, 2015 Where: Marriott Wardman Park 2600 Woodley Road NW Washington, D.C. 20008 Detailed Agenda: http://healthdatapalooza.org/detailed-agenda/ http://healthdatapalooza.org/detailed-agenda/ Registration: http://healthdatapalooza.org/registration-3/ http://healthdatapalooza.org/registration-3/ 5

6. Announcements Funding Opportunity: States encouraged to enhance access to long term services and supports through No Wrong Door Systems Eligible applicants must be from one of the 25 states which received a 2014 Transforming State LTSS Access Programs and Functions into A No Wrong Door System for All Populations and All Payers grant. Applicants must be a state entity and only one application can be submitted per state. The Office of the Governor must designate the state entity to be involved in the development and implementation of its NWD System. View Grant Opportunity: http://www.grants.gov/web/grants/view-opportunity.html?oppId=276621 http://acl.gov/Funding_Opportunities/Announcements/Index.aspx Conference Call for Potential Applicants: May 27, 2015, at 2:00 pm ET Call: 888-282-1672 Passcode: 3363664 Webinar Link: https://optum.webex.com/optum/j.php?MTID=m3ce54d749f5a3de764704b75de321bc3 https://optum.webex.com/optum/j.php?MTID=m3ce54d749f5a3de764704b75de321bc3 Letter of Intent Due: June 14, 2015 Deadline for Application Submission: July 27, 2015, at 11:59 pm ET 6

7. Announcements (continued) 2015 Long Term Post Acute Care (LTPAC) & HIT Summit – What: The LTPAC HIT Summit is the premiere health IT conference for individuals within and working with the LTPAC industry for over 10 years. As the key conference of HIT leaders, policy makers, providers, vendors and professionals, the Summit continues to advance initiatives facing the long term, post acute care industry and priorities from the latest Roadmap for Health IT in LTPAC. – When: June 21-23, 8am-5pm ET – Where: Baltimore, MD in the Baltimore Hilton – To register: http://www.ahima.org/events/2015june-ltpac http://www.ahima.org/events/2015june-ltpac 7

8. Announcements HHS, CMS and ONC announced the release of the following on March 20, 2015: – Stage 3 Notice of Proposed Rulemaking (NPRM) for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Program Stage 3 Notice of Proposed Rulemaking (NPRM) for the Medicare and Medicaid Electronic Health Records (EHRs) Incentive Program specifies new criteria that EPs, EHs, and CAHs must meet to qualify for Medicaid EHR incentive payments proposes criteria that providers must meet to avoid Medicare payment adjustments based on program performance beginning in payment year 2018 – 2015 Edition Health IT Certification Criteria 2015 Edition Health IT Certification Criteria aligns with the path toward interoperability identified in ONC's draft shared Nationwide Interoperability Roadmap builds on past editions of adopted health IT certification criteria, includes new/updated IT functionality and provisions that support the EHR Incentive Programs care improvement, cost reduction, and patient safety across the health system – Comment period ends May 29, 2015 8

9. Announcements (continued) PUBLIC COMMENTS: You may submit comments, identified by RIN 0991-AB93, by any of the following methods (please do not submit duplicate comments). Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. Federal eRulemaking Portal: Follow the instructions for submitting comments. Attachments should be in Microsoft Word, Microsoft Excel, or Adobe PDF; however, we prefer Microsoft Word. http://www.regulations.gov.http://www.regulations.gov Regular, Express, or Overnight Mail: Department of Health and Human Services, Office of the National Coordinator for Health Information Technology, Attention: 2015 Edition Health IT Certification Criteria Proposed Rule, Hubert H. Humphrey Building, Suite 729D, 200 Independence Ave, S.W., Washington, D.C. 20201. Please submit one original and two copies. Hand Delivery or Courier: Office of the National Coordinator for Health Information Technology, Attention: 2015 Edition Health IT Certification Criteria Proposed Rule, Hubert H. Humphrey Building, Suite 729D, 200 Independence Ave, S.W., Washington, D.C. 20201. Please submit one original and two copies. (Because access to the interior of the Hubert H. Humphrey Building is not readily available to persons without federal government identification, commenters are encouraged to leave their comments in the mail drop slots located in the main lobby of the building.) 9

10. Concert Series Presentations 10 Organizations are invited to present on an existing project or initiative that is related to the eLTSS scope of work and/or will help inform the eLTSS target outcomes and deliverables These projects do not have to be technically-focused Criteria for consideration: Has solution, whether it is technical or process driven, been implemented in a one or more of the eLTSS settings: home and community-based setting or clinical setting? Does solution incorporate existing or emerging standards and/or other relevant guidance?

11. Concert Series Presentations: Logistics Presentations will be scheduled as part of the weekly eLTSS Community Meetings and will occur the last 30 mins of the call Duration: 15-20 mins webinar (or demo); 5-10 mins Q&A eLTSS Workgroup activities will always take precedence over concert series presentations If you have an interest in participating, please contact Evelyn Gallego (evelyn.gallego@siframework.org ) and Lynette Elliott (lynette.elliott@esacinc.com)evelyn.gallego@siframework.orglynette.elliott@esacinc.com A pre-planning meeting will be scheduled prior to any public demonstration 11

12. Upcoming Concert Series Presentations 12 June 4 th : (available) June 11 th : (available) June 18 th : MyDirectives.com (A|D Vault) June 25 th : Right Care Now

13. Timelines for Consideration: Two Pilot Phases, SDO Ballot Cycles eLTSS Initiative Roadmap Q3 ‘14Q4 ‘14Q1 ‘15Q2 ‘15Q3 ‘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 Update Implementation Guidance 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 Develop Implementation Guide Launch initiative Review and Finalize Charter Review initial Candidate Standards 13 Initiative Kick Off: 11/06/14 Phase 1: Pre-Discovery Phase 2: Use Case Development & Functional Requirements Phase 3: Standards & Harmonization

14. 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. 14

15. eLTSS Use Case Development: Domain Identification 15

16. eLTSS Plan Content SWG: Domain Identification Progress The Plan Content SWG is in the final stages of baseline domain mapping: – States with Baseline Domain Mapping: Connecticut Maryland Minnesota – States to Complete Baseline Domain Mapping: Colorado Georgia Kentucky – Domains will be harmonized across each of the TEFT states and against the eLTSS Domains (based on NCI). Updated Domain Harmonization Matrix will be presented at the next SWG Meeting Next Steps: Draft domain evaluation criteria, validate domain and sub-domain definitions, and begin gap mitigation 16

17. eLTSS Plan Content SWG Information Sign up for the eLTSS Plan Content SWG on the Wiki – http://wiki.siframework.org/eLTSS+Plan+Content+SWG http://wiki.siframework.org/eLTSS+Plan+Content+SWG – Joining the eLTSS Plan Content SWG ensures that you are included on workgroup communications and announcements. Next eLTSS Plan Content SWG Meeting – Tuesdays (weekly) from 11:00am – 12:00pm Eastern – http://wiki.siframework.org/eLTSS+Plan+Content+SWG http://wiki.siframework.org/eLTSS+Plan+Content+SWG Thank you! Your commitment and participation are critical to our success. 17

18. Project Charter and eLTSS Glossary FINAL Published Project Charter located here: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter eLTSS Glossary posted here: http://wiki.siframework.org/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 – We are looking for your feedback and comments Discussion Thread available Submit any change requests via the Change Request Form located on the wiki – Reminder: the Glossary is a living document and content may change as the initiative progresses 18

19. Wk. Target Date (2015) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following Tuesday by 8 P.M. Eastern 1-51/22-2/19 Use Case Kick-Off & UC Process Overview Use Case Value Framing Discussions Review and Answer Value Framing Questions on wiki 62/26 Review: Consolidated UC Value Framing Introduce: Context Diagram & User Stories Review: Context Diagram & User Stories 73/12Finalize: Context Diagram & User StoriesReview: User Stories 83/19Review: User Stories CommentsReview: User Stories, Glossary 93/26 Review: User Stories Introduce: Actors & Roles Review: User Stories, Actors & Roles 104/2 Finalize: Actors & Roles Introduce: In/Out of Scope Review: In/Out of Scope 114/9 Finalize: In/Out of Scope Introduce: Assumptions & Pre/Post Conditions Review: Assumptions & Pre/Post Conditions 124/16 Finalize: Scope, Assumptions & Pre/Post Conditions Introduce: Activity Diagram & Base Flow Review: Activity Diagram & Base Flow 134/23 Finalize: Activity Diagram & Base Flow Introduce: Functional Requirements & Sequence Diagram Review: Functional Requirements & Sequence Diagram 144/30 Finalize: Functional Requirements & Sequence Diagram Introduce: Data Requirements Review: Data Requirements 155/7 Finalize: User Stories Introduce: Risks, Issues & Obstacles Review: Risks, Issues & Obstacles 165/14Dataset Requirements – eLTSS Plan Content SWGReview: Refer to SWG Homework 175/21Begin End-to-End ReviewEnd-to-End Review by community (Ends 5/28 at 8pm ET) 185/28End-to-End Comments Review & disposition 196/4Finalize End-to-End Review Comments & Begin ConsensusCast Consensus Vote 206/11Consensus Vote* Proposed Use Case Development Timeline 19

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21. Use Case End-to-End Review & Consensus Timeline DateItem 5/21Open End-to-End Review 5/28Review End-to-End Comments (Close End-to-End Review at 8pm ET) 5/29-6/3End-to-End Review Comment Dispositions 6/4Open Consensus Voting 6/11Close Consensus Voting at 8:00pm ET 6/12-17Consolidate Votes and Address “No” Votes 6/18Review Final Comment Dispositions and Complete all Outstanding Votes Verbally 6/19Publish Consensus Voting Results 21

22. eLTSS Use Case End-to-End Review The eLTSS Plan Use Case is ready for End-to- End RevieweLTSS Plan Use Case This is your final chance to review and provide modifications prior to Consensus Voting Please review the Use Case and provide comments: – Via the Wiki Comment FormWiki Comment Form – Via email to becky.angeles@esacinc.combecky.angeles@esacinc.com Comment Period Closes Thursday, May 28 th at 8pm ET 22

23. Comments Received Thank you to those who submitted comments via the wiki or email We are reviewing all comments internally and will be providing dispositions to submitters by no later than Wednesday, June 3 rd We will look at the comments submitted via the wiki today A final version of the Use Case will be posted on the wiki by COB June 3 rd in preparation for Consensus Voting 23

24. Consensus on the Use Case On June 4th, eLTSS Committed Members will be asked to cast a vote on the “eLTSS Plan Use Case” – Yes A Yes vote does not necessarily mean that the deliverable is the ideal one from the perspective of the Initiative Member, but that it is better to move forward than to block the deliverable – Yes with comments If a Consensus Process attracts significant comments (through Yes with comment votes), it is expected that the comments be addressed in a future revision of the deliverable. – Formal Objection- with comments indicating a path to address the objection in a way that meets the known concerns of other members of the Community of Interest. "Formal Objection" vote without such comments will be considered Abstain votes. A Formal Objection means that the objector cannot proceed with the project unless the objections are met. It is acceptable and expected to use a Formal Objection in a first consensus round to communicate a point of view or process issue that has not been addressed in the drafting of the initial deliverable. Should a Consensus Process attract even one "Formal Objection" vote with comments from an Initiative Member, the deliverable must be revised to address the "Formal Objection" vote (unless an exceptional process is declared). – Abstain (decline to vote) 24 Note: Each Organization, no matter the number of Committed Members only receives 1 Vote. If there are multiple committed members from your organization please verify your collective vote with them

25. Submitting Your Vote http://wiki.siframework.org/electronic+Lo ng- Term+Services+and+Supports+%28eLTSS% 29+Consensus 1.Review the eLTSS Plan Use Case: – Final document will be available 6/3/2015 2.Complete the Voting Form: – NOTE: You must be a Committed Member to Vote Yes Yes with comments. Formal Objection Abstain (decline to vote) 3.Submit your Vote 4.A message is displayed verifying your vote was recorded 25 2 2 3 3 4 4 1 1

26. Viewing Your Vote 5. You can view and track your Vote (located directly below the Voting Form) Note: you may need to refresh your browser a few times to see your vote 26 Note: All Consensus Votes are due June 11 th by 8:00 pm ET 5 5

27. Become a Committed Member Only Committed Members are allowed to VOTE on the Use Case If you are signed up as an Other Interested Party, you are not able to vote. However, you can change your status to Committed Member (so you can vote) here: – http://wiki.siframework.org/eLTSS+Join+the+Initia tive http://wiki.siframework.org/eLTSS+Join+the+Initia tive Please contact Becky Angeles (becky.angeles@esacinc.com) if you would like to confirm your submission, change your status, or if you have any other membership/wiki concerns.becky.angeles@esacinc.com 27

28. eLTSS All-Hands Next Steps Complete an end-to-end review of the Use Case and provide comments/feedback by Thursday, May 28 th at 8pm ET Join us next Thursday, June 4 th to review the final Use Case and kick off Consensus Voting We are looking for technical experts that have solutions for the next phase of our eLTSS work. Please spread the word to those you think could help us and have them join our Thursday All-Hands meetings. 28

29. eLTSS Initiative: Project Team Leads ONC Leads – Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov)elizabeth.palenahall@hhs.gov – Patricia Greim (Patricia.Greim@hhs.gov)Patricia.Greim@hhs.gov CMS Lead – Kerry Lida (Kerry.Lida@cms.hhs.gov)Kerry.Lida@cms.hhs.gov Federal Lead – Jennie Harvell (jennie.harvell@hhs.gov)jennie.harvell@hhs.gov Community Leads – Andrey Ostrovsky (andrey@careathand.com)andrey@careathand.com – Nancy Thaler (nthaler@nasddds.org)nthaler@nasddds.org – Terry O’Malley (tomalley@mgh.harvard.edu)tomalley@mgh.harvard.edu Initiative Coordinator – Evelyn Gallego-Haag (evelyn.gallego@siframework.org)evelyn.gallego@siframework.org Project Management & Pilots Lead – 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 eLTSS Plan Content SWG Lead – Grant Kovich (grant.kovich@accenture.com)grant.kovich@accenture.com Standards Development Support – Angelique Cortez (angelique.j.cortez@accenture.com)angelique.j.cortez@accenture.com Harmonization – Atanu Sen (atanu.sen@accenture.com)atanu.sen@accenture.com 29