1. electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting February 25, 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 Evelyn Gallego10 mins eLTSS Plan Analysis Walk-Through and Discussion Grant Kovich Katiya Shell 30 mins

4. Announcements 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/ 4

5. 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/ 5

6. Announcements, cont’d... ONC Releases Corrections and Clarifications to 2015 Edition Final Rule – What: ONC issued a Federal Register notice to provide corrections (e.g., corrects cross-references and citation omissions) and clarifications for the final rule entitled “2015 Edition Health Information Technology (Health IT) Certification Criteria, 2015 Edition Base Electronic Health Record (EHR) Definition, and ONC Health IT Certification Program Modifications.” These corrections and clarifications will eliminate confusion and ambiguity, permitting stakeholders to better understand, implement, and comply with the final rule. – When: The final rule and notice were effective January 14, 2016 – Review the Federal Register Notice: https://www.gpo.gov/fdsys/pkg/FR-2015-12-11/pdf/2015-31255.pdf https://www.gpo.gov/fdsys/pkg/FR-2015-12-11/pdf/2015-31255.pdf 6

7. 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 7

8. 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 8

9. Announcements, cont’d... State Health IT Policy Levers Compendium Released – What: The State Health IT Policy Levers Compendium provides information on how other states are using waivers, Medicaid Health Home State Plan Amendments and other state-level policy levers to advance health IT and interoperability goals. – Developed by HHS and ONC in coordination with states; this tool is intended to support state efforts of advancing interoperability and can also be used in service of delivery system reform providing better care, smarter spending, and healthier people. – Download the Compendium: https://www.healthit.gov/policy- researchers-implementers/health-it-legislation-and- regulations/state-hit-policy-levers-compendiumhttps://www.healthit.gov/policy- researchers-implementers/health-it-legislation-and- regulations/state-hit-policy-levers-compendium 9

10. Announcements, cont’d... CMS Updates its 2016 Quality Strategy – What: CMS has published an updated version of its 2014 Quality Strategy with a focus on applying the Administration’s strategy around person-centered care. This document guides the various components of CMS, including Medicaid, Medicare and the Center for Consumer Information and Insurance Oversight, as they work together toward the common goal of health system transformation. – Review the 2016 Quality Strategy: https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality- Strategy.html https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/QualityInitiativesGenInfo/CMS-Quality- Strategy.html 10

11. 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 11

12. 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 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 12 Initiative Kick Off: 11/06/14 Phase 1: Pre-Discovery Phase 2: Use Case Development & Functional Requirements Phase 3: Pilot Guide Development Q4 ‘16

13. 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. 13

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15. Comprehensive Service Plan Inputs and Core Components 15 Core Components of a Comprehensive Service Plan  Service provider types (cf. HCBS Taxonomy)  Service provider name (s) and other identifier(s)  Unit of Service/Support (e.g., visit, X minutes, X hours, etc.) per Provider  Frequency of service (e.g., # times per week, month, etc.) per Provider  Beneficiary preferences for service delivery (e.g., day(s) of week, time of day, tasks to be performed, etc.) per provider  Contact Information for back-up(s) for critical service(s) and how back-up plan will be triggered  Service Planning & Coordination (e.g. service budget, money management, cost estimate, etc.) Core Components of a Comprehensive Service Plan  Service provider types (cf. HCBS Taxonomy)  Service provider name (s) and other identifier(s)  Unit of Service/Support (e.g., visit, X minutes, X hours, etc.) per Provider  Frequency of service (e.g., # times per week, month, etc.) per Provider  Beneficiary preferences for service delivery (e.g., day(s) of week, time of day, tasks to be performed, etc.) per provider  Contact Information for back-up(s) for critical service(s) and how back-up plan will be triggered  Service Planning & Coordination (e.g. service budget, money management, cost estimate, etc.) Inputs of a Comprehensive Service Plan  Beneficiary Demographics (e.g. Name, Date of Birth, Address, Medicaid ID Number, etc.)  Goals & Strengths (e.g. Complete X activity by X date)  Risks (e.g. concerns, barriers, that may impact the likelihood of the beneficiary achieving plan goals)  Additional Person Centered Items Inputs of a Comprehensive Service Plan  Beneficiary Demographics (e.g. Name, Date of Birth, Address, Medicaid ID Number, etc.)  Goals & Strengths (e.g. Complete X activity by X date)  Risks (e.g. concerns, barriers, that may impact the likelihood of the beneficiary achieving plan goals)  Additional Person Centered Items Plan Inputs often come from other sources (usually an Assessment) Not generated at the plan level Background information about the beneficiary Crucial inputs that determine beneficiary services and supports Plan Core Components are unique to a Service Plan and feed off of the Plan Inputs Generated at the plan level Provide key information describing the services and supports the beneficiary will ultimately receive Funding and contact information for services

16. Plan Analysis and Cross Walk Let’s review a submitted plan – Maryland example Analyze of the inputs to the plan (input, assessment, plan, etc.) The analysis crosswalk 16

17. Analysis of Plan Input… 17 Pulled From Intake Form

18. Analysis of Plan Input… 18 Enter at Plan Level

19. Analysis of Plan Input… 19 Pulled from Assessment Enter at Plan Level (B ENEFICIARY P REFERENCE ) Enter at Plan Level (S ERVICE P LANNING AND C OORDINATION )

20. Analysis of Plan Input… 20 Pulled from Assessment (S ERVICE P LANNING AND C OORDINATION )

21. Next Steps If you are interested in piloting for round 2, please express your interest using the Pilot Interest Survey form: – http://wiki.siframework.org/electronic+Long+Term+Services+and+Supports+Pilot+Interest+Survey http://wiki.siframework.org/electronic+Long+Term+Services+and+Supports+Pilot+Interest+Survey 21 DateRTM Meeting TopicParties of InterestTip for Preparation February 11, 2016 Update the Plan Section a.Beneficiary/Advocate b.eLTSS Plan Facilitator/Steward KY, MN, All vendors Review or attempt to fill out this out section of the RTM February 18, 2016 Review/Questions regarding RTM, updated RTM worksheet and data elements All members Confirm selected subdomains Begin identifying questions you want to ask based on sub domains February 25, 2016 Review/Questions regarding RTM, updated RTM worksheet and data elements All members Confirm selected subdomains Begin identifying questions you want to ask based on sub domains MarchReview eLTSS Plans to align plan-specific components and data elements All members Submit your eLTSS Plan if you have not already done so AprilPilot Completion ActivitiesAll members Provide feedback and findings on pilot

22. FACA Meetings (Federal Advisory Committees) Upcoming FACA Meetings Precision Medicine Task Force – February 26, 2016 Joint API Task Force – March 8 Joint Interoperability Experience Task Force – March 8 Joint HIT Committee Virtual Meeting – March 10 Precision Medicine Task Force – March 16 Joint API Task Force – March 22 Joint Interoperability Experience Task Force – March 23 Precision Medicine Task Force – March 30 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@accenture.com)angelique.j.cortez@accenture.com 23