Electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting April 2, 2015 DRAFT: Not for distribution.

electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting
April 2, 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
Topic Presenter Timeframe Welcome Announcements eLTSS Roadmap Lynette Elliott / Evelyn Gallego 10 mins Use Case Working Session: Actors & Roles In and Out of Scope Becky Angeles / eLTSS Community 45 mins Homework / Next Steps Becky Angeles 5 mins Concert Series Presentation: Person-Centered Planning Tools Mary Lou Bourne 30 mins

Announcements ONC issued the Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0 The draft Roadmap is a proposal to deliver better care and result in healthier people through the safe and secure exchange and use of electronic health information. Includes Person-Centered Planning and eLTSS initiative Several areas of alignment with eLTSS (see next slide)

eLTSS Alignment to Nationwide Interoperability Roadmap
Roadmap Section Roadmap Category C. Individuals are empowered to be active managers of their health C1. Cultural change for individuals including demanding and using their electronic information C2. Providers and technology developers supporting individual empowerment C3. Privacy and Security for Individuals C4. Education and digital health literacy for Individuals D. Care providers partner with individuals to deliver high value care D2. Providers embrace a culture of interoperability and work with vendors and other supporting entities to improve interoperability D7. Transparency of value and engagement of patients, families, and caregivers G. Consistent representation of permission to collect, share, and use identifiable health information G4. Technical standards for basic choice I. Stakeholder assurance that Health IT is interoperable I2. Certification Programs J. Consistent Data Formats and Semantics J3. Develop and pilot new standards for priorities DRAFT: Not for distribution

Interoperability Roadmap, cont’d…
More detailed alignment slides are available on the wiki: ment%20to%20Interoperability%20Roadmap_ pptx/ /eLTSS%20alignment%20to%20Int eroperability%20Roadmap_ pptx Submit comments before 5pm ET April 3, 2015 here: implementers/interoperability-roadmap-public- comments

Announcements (continued)
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 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 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

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. . 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 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 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.)

HIMSS Interoperability Showcase is being held April 12-16, in Chicago, IL Live interactive demonstration where health IT solution providers collaborate to maximize the collective impact of their technologies Highlight seamless health information exchange in multiple care settings More information: er=27978

New Funding Announcement
Advance Interoperable Health Information Technology Services to Support Health Information Exchange Funding Opportunity Announcement Letters of Intent Due: March 2, 2015; Application Deadline: April 6, 2015 Leverages investments and lessons learned from HITECH State HIE Program to accelerate widespread adoption and use of HIE infrastructure Grantees MUST select at least one eligible care provider and at least two non-eligible care providers for their target populations:

Announcement – Community Leads
Andrey Ostrovsky – Care at Hand Nancy Thaler - NASDDDS Terry O’Malley – Partners HealthCare System Individuals who demonstrate a strong interest and subject matter expertise Leadership and Advisory Role (Volunteer) Assist Project Team with development and review of materials

Concert Series Presentations
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? DRAFT: Not for distribution

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: 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 ) and Lynette Elliott A pre-planning meeting will be scheduled prior to any public demonstration DRAFT: Not for distribution

Upcoming Concert Series Presentations
April 2nd: Person-Centered Planning Tools April 9th: PeerPlace April 16th: MyDirectives.com / A|D Vault, Inc. April 23rd: Care at Hand April 30th: State of Colorado May 7th: Inofile / Kno2 May 14th: State of Minnesota DRAFT: Not for distribution

eLTSS Initiative Roadmap
Q3 ‘14 Q4 ‘14 Q1 ‘15 Q2 ‘15 Q3 ‘15 Q4 ‘15 Q4 ‘17 Initiative Kick Off: 11/06/14 Pre-Planning Call for Participation Conduct Environmental Scan Success Criteria Stakeholder Engagement Phase 4: Pilots & Testing Pilot site readiness Implementation of solution Test User Stories and Scenarios Monitor Progress & Outcomes Utilize Requirements Traceability Matrix Phase 2: Use Case Development & Functional Requirements Develop, review, and finalize the Use Case and Functional Requirements Launch initiative Review and Finalize Charter Review initial Candidate Standards Finalize Candidate Standards Standards Gap Analysis Technical & Standards Design Develop Requirements Traceability Matrix Develop Implementation Guide Phase 5: Evaluation Evaluate outcomes against Success Metrics and Criteria Update Implementation Guidance Phase 1: Pre-Discovery Phase 3: Standards & Harmonization Timelines for Consideration: Two Pilot Phases, SDO Ballot Cycles DRAFT: Not for distribution

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

Project Charter and eLTSS Glossary
FINAL Published Project Charter located here: eLTSS Glossary posted here: 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 DRAFT: Not for distribution

eLTSS Plan vs. eLTSS Record
The S&I eLTSS leads and the eLTSS community defined the scope of this Initiative to the LTSS Plan because: The concept of a “LTSS record” is: not defined and not specified in HIT standards Would require work to define (time and money) While potentially useful, even once defined, may not immediately result in something (information) that is exchangeable The concept of “LTSS plan” is: narrower (than a record) more easy to define (than the concept of a record) more aligned w/ CMS requirements for a “person centered service plan” more easy to link to available HIT standards

Proposed Use Case Development Timeline
Wk. Target Date (2015) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following Tuesday by 8 P.M. Eastern 1-5 1/22-2/19 Use Case Kick-Off & UC Process Overview Use Case Value Framing Discussions Review and Answer Value Framing Questions on wiki 6 2/26 Review: Consolidated UC Value Framing Introduce: Context Diagram & User Stories Review: Context Diagram & User Stories 7 3/12 Finalize: Context Diagram & User Stories Review: User Stories 8 3/19 Review: User Stories Comments Review: User Stories, Glossary 9 3/26 Introduce: Actors & Roles Review: User Stories, Actors & Roles 10 4/2 Finalize: Actors & Roles Introduce: In/Out of Scope Review: In/Out of Scope 11 4/9 Finalize: In/Out of Scope Introduce: Assumptions & Pre/Post Conditions Review: Assumptions & Pre/Post Conditions 4/16 Finalize: Assumptions & Pre/Post Conditions Introduce: Activity Diagram & Base Flow Review: Activity Diagram & Base Flow 12 4/23 Finalize: Activity Diagram & Base Flow Introduce: Functional Requirements & Sequence Diagram Review: Functional Requirements & Sequence Diagram 13 4/30 Finalize: Functional Requirements & Sequence Diagram Introduce: Data Requirements Review: Data Requirements 14 5/7 15 5/14 Finalize: Finalize Data Requirements Introduce: Risks & Issues Review: Risks & Issues 16 5/21 Finalize: Risks and Issues Begin End-to-End Review End-to-End Review by community 17 5/28 End-to-End Comments Review & disposition End-to-End Review ends 18 6/4 Finalize End-to-End Review Comments & Begin Consensus Begin casting consensus vote 19 6/11 Consensus Vote* Conclude consensus voting

We Need YOU! In order to stick to our timeline and to ensure that the artifacts we develop fit the need of our stakeholders (you), we need your feedback, comments and participation Each week, please review the use case content and provide comments via the wiki at: Thank you for providing input for our eLTSS Use Case Framing Questions (via the wiki, live discussions or ). We have consolidated the responses and posted the document on the eLTSS wiki at: This document and YOUR responses will be used as input for various sections of the eLTSS Use Case Artifact

Use Case Development Working Session:
Actors and Roles In / Out of Scope DRAFT: Not for distribution

User Story Actors & Roles
Actors are a person or organization (e.g., Beneficiary, Service Provider, Payer, etc.) in the creation/sharing/exchange of the eLTSS Plan requirements for each scenario Actor must use a System (e.g., LTSS, PHR, EHR, etc.) to participate in the creation/sharing/exchange of the eLTSS Plan System or System Actor has Roles (e.g., send, receive, update, display, etc.) in relation to the creation/sharing/exchange of the eLTSS Plan

Scope Further defines the scope of the Use Case itself and NOT the scope of the Initiative If there are multiple Use Cases within the same Initiative, this section can be used to explain how the scope of this Use Case relates to the others. Diagrams and other supplemental data / examples help provide context and clarify the basis for the Use Case

Scope Subsections Background In Scope Out of Scope
describes the relevance of the Use Case in relation to what gaps currently exist within the healthcare industry. Includes all policy and/or regulatory issues/dependencies that may impact the Use Case In Scope indicates what is in scope for the Use Case. For example, the type of transactions, the information/data to be exchanged, and specific aspects that need to be in place to enable the information to be sent, received and understood the same at both ends of the transmission. Out of Scope indicates what is out of scope for the Use Case. These points may highlight dependencies on the feasibility, implementability, and usability that result in limitations of the Use Case. At a high level, whatever is not declared “In Scope” is by definition, “Out of Scope”. Note: Items that are out of scope for the Use Case, Functional Requirements and Standards Harmonization activities can be still be part of a Pilot. Communities of Interest

Scope DRAFT Today we will look at the draft scope section content (via a word document) Document is uploaded and text is provided on the Use Case Wiki: Please review and comment on the Scope section for homework Use the Comment Form provided on the wiki or comments to

Next Steps and Homework
DRAFT: Not for distribution

Next Steps HOMEWORK – Due by COB Tuesday, April 7th: NEXT WEEK:
Actors and Roles Scope Utilize Comment Form at feedback / comments to or NEXT WEEK: Finalize User Stories, Actors / Roles, Scope Introduce Assumptions, Pre/Post Conditions Concert Series Presentation: Peer Place Join the eLTSS Initiative: Included on the eLTSS distribution list Committed Members can vote on artifacts

Concert Series Presentation: Person-Centered Planning Tools
DRAFT: Not for distribution

Support Development Associates ©
The Imagine Project Ohio’s Effort to Create an Electronic, Interactive Platform to Support Person Center Practices April 2, 2015 Debra Albert, Project Owner Mary Lou Bourne, Consultant Support Development Associates ©

For Today: Brief overview of person centered planning and practice Highlights of the Ohio Project- what they did and how Results- screen shots of Ohio’s IMAGINE System Lessons Learned Questions Support Development Associates ©

IMAGINE Overview: High Level Goal/Purpose: Design a set of process work flows to establish the foundation of a person centered DD system Establish an IT platform capable of supporting the work flows designed– which will create fidelity to the person centered planning processes Imagine is an Ohio effort drive from the bottom up by 18 small rural counties, their families, consumers, providers, service coordinators with full support of county leadership and a consultant. – This is a community effort Increasing individual/guardian & control in the planning & implementation Increasing participation in the individuals life by those the individual chooses Making the plan an organic rather than static process; Standardizing processes to create efficiencies; Increasing transparency so everyone is aware of costs and services; Provides a holistic picture by connecting to other applications (13) with a long term vision to incorporate EHR. Security (HIPPA, PHI) Training Support Development Associates ©

A Brief Comparison of Care Plans and Person Centered Plans
Traditional Care Planning Person Centered Planning Focus on person’s life; supports so that preferences and values are realized in daily life Desired outcomes exceed goals, and are identified by the person and family Planning process is lead by the person and their closest family; at minimum they actively participate in development It evolves over time and changes/updated as the person’s preferences and needs change Aim is to achieve a balance between personal preferences and health/safety/social rules. Focus on treatment for a medical diagnosis Goals for treatment identified by professionals, not the person’s own goals in life Developed without the person involved. Typically completed in one session; Changed in response to treatment Support Development Associates ©

Person Centered Planning: one way to describe it
… is grounded in demonstrating respect for the dignity of all involved…seek to discover, understand and clearly describe the unique characteristics of the person, so that the person: Has positive control over the life he/she desires and finds satisfying; Is recognized and valued for their contributions to their communities (past, current and potential); and Is supported in a web of relationships, both natural and paid, within the desired community/neighborhood Support Development Associates ©

Key Elements of Person Centered Planning
Circumstances and relationships matter Sequence matters (talk about preferences and values FIRST) Building on gifts & talents & natural support is different from fixing what is wrong & believing professional support is best The degree of effort invested in planning is equal to the degree of support requested It addresses both/and – does not fall into either/or (lifestyle OR health and well being ) Friends and families and those who love us and know us best are equally as important as professional care givers in the plan development process Building on Gifts and Talents and natural support ---- good example of this is Kate Louric’s approach to Chronic Disease Self Management moving to self empowerment for identifying goals – not being judged by others whether or not their goals are good enough – woman who had diabetes and severe obesity – going from 8 candy bars to 2 per day --- gave her status and control something that is very important to most all of us. Support Development Associates ©

Key Steps in the Development of IMAGINE:
Working with the USERS – local management entities, case managers, individuals with disabilities, families, state agency staff, Process and IT consultants: Clarified the core elements of person centered practice Requested stakeholder views on existing practices: “What is the value of the current system?” Analyzed the existing business processes Designed the desired business processes and data elements Designed the technology as an iterative process Piloted the new processes, including training on both business process and IT system. Gathered lessons learned Support Development Associates ©

Step 1: The Core Concept: What’s Important TO and What’s Important FOR
What is IMPORTANT TO a person includes what results in feeling satisfied, comforted, fulfilled, or happy. Relationships (People to be with) Status and control (valued role) Rituals & routines (cultural and personal) Financial Resources Rhythm or pace of life Things to do and places to go (something to look forward to) Things to have What is important to you also reveals your values, your own principles, these tend to guide your life decisions and to some degree, influence your satisfaction and contentment Support Development Associates ©

Within the context of those domains, Important FOR is addressed
What others see as necessary to help the person: Be valued (social rules, laws) Be a contributing member of their community (citizenship) Establish Financial stability Address issues of health Prevention of illness Treatment of illness/medical conditions Promotion of wellness (diet, exercise, sobriety) And issues of safety Environment Well being (physical and emotional) Free from fear (threats, abuse) These are typically requirements IMPOSED by external forces– other people, society expectations, etc. Paying bills, following the law, etc. They may not matter at all TO the person, but most people agree to follow them Support Development Associates ©

Step 1 Cont: Established Guiding Principles
Quality of Life: individually defined, important TO and important FOR in balance Language: dignified and respectful, easily understood Culture of Strengths and Abilities: emphasize natural relationships and build capability Collaborative: all focus on values and culture desired Results Based: focus on the outcome for the person Practical: managed within resources available and maximize resources of the person Support Development Associates ©

Step 2: Ask Stakeholders for their Thoughts on the Existing Processes
Feedback from focus groups (individuals who receive our services, parents, guardians, Local Administrators, Case Managers) Two questions, four areas: What is the current value you receive? What is the value you desire? ISP; Monitoring; Assessment; Collaboration Results: Process is overwhelming– to complicated, invasive Intimidating– professional “speak” Waiting Lists Multiple assessments– repetitive, unnecessary, irrelevant Focus is on what individual cannot do Support Development Associates ©

What our customers want:
Consistent and accurate methodology Welcoming and supportive system, not intimidating Balance hope with false hope Families feel listened to and respected Technological support so that information is accurate and accessible Less jargon Respectful language Focus on abilities Shorter ISP No redundancy Processes that are simple, efficient, and timely Support Development Associates ©

Step 3: Analyze Existing Business Processes
Workgroups Formed: Intake and Eligibility Assessment Monitoring of services Service Plan Development Finance and Waiting List Existing Procedures and Regulations Identified Compared differences across counties, and impact on families and providers 5 work groups, what they started with and what they ended up with. They looked at each process more welcoming and how to make this more welcoming. Very inclusive work group. They did not have individuals in the workgroup. But did have family members and a single service provider on each. DODD was represented as well as SSA and County Tasked with identify the current as is- what are the rules, regulations, and practices now? Develop a process map as is; then focus on the process and the document, and create requirements and expectations. Data Elements preliminarily identified. Support Development Associates ©

Step 4: Design The Desired Business Process and data elements
Workgroups created process maps Identified key data elements involved Identified what must change in the existing Rules, Regulations and standards Renamed key business processes Intake & Eligibility (Introduction & Eligibility) Assessment (Discovery) Monitoring (Listening & Learning) Service Planning (Support Planning) Finances & Waiting List (Resource Management) Established Centers for Excellence- iterative design Introductino and Eligibility Key Changes: I & E Guide Use 1 eligibility assessment for both county board and waiver eligibility Follow up with individual/family to rate satisfaction Focus on “How can we help you now?” Discovery Ability focused, not deficit based Focus on existing supports System only goes where it’s invited Determine desired outcomes Conversational, not a test No annual meeting; update information as necessary Listening and Learning Everyone is involved, not just Service & Support Administrator (SSA) Continuous process, not an event Person Centered, focus will differ for each person Share information through technology Support Planning Collaborative process that includes those who know the individual the best Only address areas that were requested Build on strengths and existing supports Area on IS for individual and family to post new information Shift focus from compliance based to individual based Layout – think Facebook for the 1st page Positive, photos, visual information Resource Management Focus 1st on supports needed, not funding Promote natural supports and community County Boards share functions Make use of technology Community based SSAs Support Development Associates ©

Step 6: Designed the Technology Through Iterative Model
Virtual cues to SSAs for updates Mobile App desired – not in first round Access for individual, family, and providers Increased opportunity for feedback DODD IT Department and McGladrey teamed together to develop IT solution for IMAGINE Development began January 2013 Couple years to get up and going. Microsoft platform for this. Support Development Associates ©

Key Factors in Technology
Decided on MS Dynamics CRM foundation out of box functionality addressed usability and privacy issues Ease of customization Time to market Able to interact with legacy data stores Two platforms- one internal for administration of the system, one Web Based, externally facing accessed by people who receive support and service providers Person enters their demographic, preference and additional information; pictures can be uploaded Work Flow alerts; notifications; storage; dashboards on performance metrics; Security; approval; service authorization; configured Support Development Associates ©

Step 6: Pilot Roll Out Process and Fundamental Person Centered Trainings Local process coaches to support the roll out Centers of Excellence A means to collect and analyze data throughout the pilot Venue to implement system changes (as proven necessary by the pilot) and support agile design 8 Key Life Areas – and individually articulated goals Outcomes for each person, with associated services Collaboration among multiple agencies is expanding rapidly PCT: Coaches, Trainers They are testing out a new support plan now and discovery. Doughnut tool that identifies what is responsibility is and what isn't. Bob Sattler, Mary Lou, Micheal Smull. Support Development Associates ©

Person Centered Plan Components
Imagine Components -Multiple Portals: Case Management; Individuals; DODD; -Accessible from the Front Page Person Centered Plan Components Supporting Components -Discovery (what is important to/for and risk ) -Outcomes Identified -Planning –Develops Support Considerations -Action Plan -Resource Management Local Medicaid Community Resources -Agreement occurs -Notification -Learning Log -Alerts (Need for immediate attention) -Documents (Categorized) Confidential Non Confidential -Pictures Support Development Associates ©

Key Components of Discovery and Planning
Eight Areas of Life: Relationships Day to Day Life Home and Housing Finances Health and Wellness Communication and Learning Getting Around Employment For each section “opened” we discover: What’s important To/ what’s important For? What support is needed? What’s the risk? How is it addressed? Are there outcomes in this area? Support Development Associates ©

Imagine Front Page – Health Related Information
Essential Health -- Diagnosis information used for DD eligibility and current active diagnosis -- Allergies and allergy protocol for interaction -- Adaptive devices e.g. chair, walker, etc -- Special diet e.g. drinks with low sugar content -- Health related e.g. take vitals 2x/day -- Do not resuscitate -- Medications including medication assessment and list of medications

Lessons Learned: “…one guy I’ve known for years…. We discovered how into art he is. How did I not know that before? This process is life changing.” SSA Support Development Associates ©

Lessons Learned: Project Assessment in July 2014
People’s lives are changing Collaborative, multi-stakeholder involvement: necessary for success, takes longer than expected Guiding Principles: key factor in decision making during design; inevitable differences in decisions resolved by grounding in principles Involve IT in business process discussions: must understand the business process details and end user needs; paper review was not enough Agile design: no expectation of perfection in the first versions; people who are quality managers struggle with this Collaboration and stakeholder involvement requires frequent and clear communication – delays and decisions must be clearly communicated; media and promotion is important, and so are facts, status updates, and changes. Support Development Associates ©

For More Information: Debra Albert, Interface between IT and Program folks, Trainer & Implementer, Ohio Department of Developmental Disabilities (614) , Mary Lou Bourne, Business Process Development, Person Centered Foundations, Support Development Associates (SDA) Youtube Channel: Imagine

eLTSS Initiative: Project Team Leads
ONC Leads Elizabeth Palena-Hall Patricia Greim CMS Lead Kerry Lida Federal Lead Jennie Harvell Initiative Coordinator Evelyn Gallego-Haag Project Management & Pilots Lead Lynette Elliott Use Case & Functional Requirements Development Becky Angeles Standards Development Support Angelique Cortez Harmonization Atanu Sen

Background Slides DRAFT: Not for distribution

Use Case Outline Tailored for each Initiative
1.0 Preface and Introduction** 2.0 Initiative Overview 2.1 Initiative Challenge Statement** 3.0 Use Case Scope 3.1 Background** 3.2 In Scope 3.3 Out of Scope 3.4 Communities of Interest** 4.0 Value Statement** 5.0 Use Case Assumptions 6.0 Pre-Conditions 7.0 Post Conditions 8.0 Actors and Roles 9.0 Use Case Diagram 10.0 Scenario: Generic Provider Workflow 10.1 User Story 1, 2, x, … 10.2 Activity Diagram Base Flow Alternate Flow 10.3 Functional Requirements Information Interchange Requirements System Requirements 10.4 Sequence Diagram 11.0 Risks, Issues and Obstacles 12.0 Dataset Requirements Appendices Related Use Cases Previous Work Efforts References ** Leverage content from Project Charter

Electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting April 2, 2015 DRAFT: Not for distribution.

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