Techwire posed six questions by email to DHCS leadership Thursday after the report came out. Department spokesperson Anthony Cava on Friday responded to each. Here are those questions and answers:
The Auditor’s report states: “DHCS lacks an adequate governance structure for managing the development of (California Medicaid Management Information Systems) CA-MMIS modules as part of its broader Medi-Cal modernization effort.” Does DHCS leadership agree with this observation? What, if anything, is being discussed or done to address the governance issue?
DHCS replied: “DHCS is in transition from CA-MMIS Modernization to Medi-Cal Enterprise System (MES) Modernization. During this transition, the existing CA-MMIS Modernization projects have continued to be governed at a project level. At this time, only the Federal Draw and Reporting project is in an execution phase, so broader governance has not been critical. A governance structure for managing across all MES Modernization modules/products will be a key aspect of the development of the MES Modernization approach.”
The Auditor’s report states: “A year has passed since DHCS first reported the shift to MES modernization in its October 2019 legislative briefing, yet it continues to lack a detailed plan.” Is work underway on that planned shift from modular to enterprise?
DHCS replied: “There is no shift away from a modular approach since MES Modernization will continue to be modular. The shift from CA-MMIS Modernization to MES Modernization is a critical change in order to take an enterprise approach for the building of the technology supporting the entire Medi-Cal program, not just the medical fee-for-service (FFS) portion of the program. This evolution is key due in part to the important changes that have occurred in recent years that transitioned Medi-Cal from FFS to a primarily managed care delivery system. Work on this shift is a priority for DHCS, but subject to available/additional resources.”
The report states: “According to DHCS’ chief information officer, DHCS intends to develop a high-level approach document and map the modernization of CA-MMIS subsystems and it is working toward securing funding for this effort. However, he indicated that it is unlikely that it will complete this work before November 2021. We believe that DHCS needs to prioritize the mapping of CA-MMIS subsystems to future modules to provide transparency into its modernization efforts.” Does DHCS agree that such a reprioritization is necessary, and does it plan to do so? Has the November 2021 target date changed?
DHCS replied: “DHCS will work to map existing business applications/functions to a future set of MES modules/products as part of its MES Modernization strategy. MES Modernization governance will ultimately prioritize these modules/products. Work on this effort is a priority for DHCS, but subject to available/additional resources.”
The report states: “Failure to appropriately manage the integration effort significantly raises the risk of system failure, which might result in delayed or unpaid claims and system outages. We previously reported that the work of systems integration is highly specialized and is not a role with which the CA-MMIS division has direct experience, a concern which CDT echoed in its July 2020 report.” Has DHCS sought, or is it seeking, the systems integration expertise that CDT says is lacking?
The department responded: “DHCS will work to incorporate system integration expertise as part of its MES Modernization strategy.”
The Auditor’s report discusses Portfolio Management as one of three recommended elements, the others being Project Management and Program Management. Does DHCS intend to pursue this third level, as the Auditor recommends?
The department’s response: “DHCS intends to incorporate Product Portfolio Management as part of its MES Modernization approach.”
The Auditor recommends legislation requiring the California Department of Technology (CDT) to implement processes for overseeing agencies’ modular modernization efforts. Does DHCS agree with the need for this legislation?
DHCS responded: “CDT oversight of state information technology is generally required under existing law.”
