The Big Bang Burn: How States are Leveraging Modular, Component -Based Approaches to HHS ModernizationKPMG

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The Big Bang BurnPhoenix Convention Center- Room 101AB

September 19, 2016

3© 2016 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. Printed in the U.S.A. All rights reserved. NDPPS 558793

Agenda Welcome and overview (KPMG)

Summary of Government Business Council Report: Life After the Big Bang: Exploring Modular, Agile Paths Toward

Health and Human Services Modernization

Panel Discussion (State Representatives)

Questions and Answers (Audience)

4© 2016 KPMG LLP, a Delaware limited liability partnership and the U.S. member firm of the KPMG network of independent member firms affiliated with KPMG International Cooperative (“KPMG International”), a Swiss entity. Printed in the U.S.A. All rights reserved. NDPPS 558793

IntroductionsPaul Hencoski

US Lead Partner, KPMG Health and Human Services

Alisha Griffin

Director, California Department of Social Services

Rina Li

Research Analyst, Government Business Council

Scott Rogillio

Director of Application Development and Maintenance, Texas Department of Family and Protective Services

David Hansell

Managing Director & Lead, KPMG Center of Excellence for Health and Human Services

Janel Simpson

Deputy Commissioner, Connecticut Department of Social Services

Life After the Big BangExploring Modular, Agile Paths Toward Health and Human Services Modernization

Government Business Council• Research and analysis division of Government Executive

Media Group• Conduct 40-50 research reports and studies annually on

issues facing federal, state, and local government agencies

Research Methodology• From July 7, 2016 to August 11, 2016, GBC conducted 30- to- 45-minute

interviews with HHS systems modernization experts• Interview topics include organizations’ modernization initiatives, procurement

methodologies, systems development processes, etc.• Total of 17 experts representing a range of federal, state, local, academic,

and non-profit organizations and job functions participated

A Changing Landscape• Recent federal initiatives have generated growing

interest in HHS systems modernization• 2010 Affordable Care Act (ACA)

– Streamlined eligibility and enrollment processes– A-87 Cost Allocation Waiver

• Comprehensive Child Welfare Information System (CCWIS)

• U.S. Digital Service (USDS), 18F, and other digital services groups

HHS Systems: Overview• Siloed development of HHS processes/administrative systems• Priorities:

– Integration and interoperability– Mobility– User-centricity

• Caseworker side: designing intuitive processes that allow for greater mobility, automation, information sharing, etc.

• Client side: creating an integrated customer experience

Everyone is trying to enhance customer service, and it’s become such a fuzzy, meaningless concept. It’s more about creating an experience for the customer where the confusion of all the different agencies and their individuals decisions and verification methods are seen not as 15 different siloed processes, but as a common experience.”

– Greg Kunz, Deputy Administrator of ID Dept. of Health and Welfare (IDHW)

Revisiting the “Big Bang” Theory• Traditional monolithic model of procurement/development:

1. Identification of requirements2. Procurement3. Design and development4. Testing5. Implementation and deployment of a single system6. Maintenance and operations

Big Bang: Disadvantages• Complex, expensive, multi-year process: often leaves projects over budget

and behind schedule• Vague, disparate specifications can result in a half-baked, bloated RFP

If you’re undergoing design, development, and implementation phases that last three or four years, by the time you flip the switch on a system, some of the underlying technology and policy it was built around will already be outdated. The system is obsolete the moment it is delivered.”

– Fernando Muñiz, Deputy Commissioner of CT Dept. of Children and Families (DCF)

Going Agile and Modular• Breaking large projects down into smaller modules/phases• Agile development principles:

– Iterative development, rapid sprint cycles, constant adjustments– Continuous delivery/enhancement of services

• Agile procurement: some states (e.g., CA) are experimenting with multiple contracts for separate modules (vs. a single large RFP)

I do think smaller, faster turnaround of functionality that’s user-centric and aimed at good data will snowball in its positive effect: win after win after win, rather than the traditional monster product with mixed feedback.”

– Marc Slager, IT Director of FL Dept. of Children and Families (DCF)

Case Study: Transforming Child Welfare in Texas• TX Dept. of Family and Protective Services (DFPS) is modernizing its child

welfare system according to modular principles– Projects are separately procured/build incrementally upon core functionality– TX provides funding biennially — DFPS needs to demonstrate progress in order to

continue receiving funding

• Challenges:– Maintaining overall vision– Communicating the “art of the possible”– End-user training and support

Project Management & Governance• Agile/modular requires more robust project management & governance• Separate phases/rollouts need to cohere into a single functional system• Establish an overarching vision for what the final system is intended to

achieve• “Problem-first mentality”• Facilitate close collaboration among IT, business, and policy groups

If you’re in governance, you can’t be at arm’s length from any technology development area: you have to own it. Governance needs to be transparent, regular, and all-inclusive — and you need to commit to it.”

– Alisha Griffin, Director of CA Dept. of Child Support Services (DCSS)

Case Study: Utah Dept. of Workforce Services• Taking advantage of A-87 cost allocation waiver to promote integration• Coordination of policy, business, and IT groups throughout a project’s

lifecycle• Goal: continually update an existing system• “We’ve started not just providing citizens with the services they’re eligible for,

but connecting them with resources that will enable them to move beyond needing those benefits in the first place” – Kevin Burt, Assistant Director of DWS

End-User Feedback• Encourage end-user input on both existing and beta systems/processes• Seek targeted feedback — bring ideas to end-users, obtain specific

suggestions on potential improvements/issues– “If you’d asked people what they wanted in a music player before MP3s

were invented, they would have requested a phonograph with a longer extension cord.” – Greg Kunz, IDHW Deputy Administrator

• Challenge: recruiting busy end-users to aid in the development process

Case Study: California Dept. of Social Services• Agile approach to modernizing CA child welfare system

– Collaborating with Code for America, etc.

• Agile development pre-qualified (ADPQ) vendor pool• Embedding end-users into ADPQ and development processes• Concern: private sector best practices may not be as effective in the public

sector

Change Management• Formulate cohesive strategy for managing/communicating the change effort• Provide support, monitoring, training, etc. to ensure acclimation to the new

framework• “You might have a great information system, but that doesn’t mean your

people know or even care how to use it.” – Marc Slager, FL DCF IT Director

Government-Vendor Relationships• Organizations select the most qualified vendor for each module• Shorter delivery cycles allow states/localities to retain key vendor personnel

for the duration of the project• Concern: government procurement landscape may not be well-aligned with

modular principles• Communicate overall mission priorities/goals to vendors

Takeaways• Moving forward, organizations should appreciate the challenges associated

with…– Procurement– Project management & governance– Incorporating end-user feedback– Change management– Government-vendor relationships

• …in transitioning to a modular, agile approach.

It’s unacceptable to remain ten years behind the technology curve — not when there are children and families on the line. We can’t lose sight of that. They’re the whole reason we’re doing this.”

– Marc Slager, FL DCF IT Director

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Post Session Housekeeping

• RATE this session in the conference app• To download the conference app search for APHSA Events

• VISIT the vendors in the Exhibit Hall during Breakfast and the Networking Breaks to learn more about the solutions presented throughout the day.

• DONATE to Childhelp – the ISM Technology for a Cause campaign to raise $10,000 to help stop child abuse in Arizona and across the country.

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See you again soon

THANKS FORCOMING