Successfully Navigating Child Welfare Information System Modernization

The Comprehensive Child Welfare Information System (CCWIS) rules (81 FR 35449) went into effect on August 1, 2016. States had until July 31, 2018 to declare the intent to create a CCWIS. As of August 1, 2018, 46 States, the District of Columbia, and Puerto Rico have declared to become a CCWIS.

As stated in the regulations, it is not required to move to a CCWIS, but the overwhelming majority of States are doing so.

I believe successful navigation to the CCWIS requires consideration of Policy, Process, and Technology. Let me elaborate.

Policy

CCWIS regulations allow flexibility. On one end, the new CCWIS may be a system that maintains all the functionality needed to operate a Title IV-E program. At the other end, the CCWIS may be a data repository that collects and exchanges data captured in other systems. Or States may choose something in between. A new CCWIS starts as a policy discussion at the State level. Right-sizing your CCWIS is the first step in a successfully implementation.

Process

Agile and modular are the new focus in public sector procurements and implementations. Agile procurements seek to reduce the time to begin work by techniques such as pre-certified vendor pools and micro-procurements that allow for a simplified procurement process.

Modular procurements seek to reduce risk to the State by avoiding monolithic, high stakes procurements that result in vendor lock-in due to the amount of money involved. Too many times a single vendor has a multi-million-dollar project that grows 3X because the State is locked into one vendor. The State is forced to come up with more money or watch the project fail. Modular procurements break up the money at stake, so any given vendor’s failure doesn’t sacrifice the whole project.

Modular procurements have been seen in the area of implementation roles, such as PMO, Architecture, Security, DDI, and M&O. They can also be structured to match functional modules, such as intake, provider management, financials, etc.

During the Design, Development, and Implementation (DDI) phase of a CCWIS, agile development has become a preferred methodology. Agile has the benefit of enabling the end user to see the working product long before User Acceptance, and avoid expensive rework that delays go live. The important consideration for agile is to have a clear understanding of the trade-off between time and change: more change means more time.

Some key considerations for adopting an agile implementation approach include:

  • Agile doesn’t mean arbitrary: know what you are going to develop and only change items that are in scope
  • Structure your requirements and design: SME time is valuable and you should really understand what you are to build before you start
  • Try it early: “Conference Room” pilots let you see how all the functionality fits – or doesn’t

Technology

The technology direction for CCWIS is part of a recent growing trend in Health and Human Services, a trend that has been in play in the commercial world for some time. Frameworks such as Medicaid Information Technology Architecture (MITA) and National Human Services Interoperability Architecture (NHSIA) have been prioritizing business needs as paramount and encourage re-use where possible. Modular, even granular functionality is preferred to enable incremental changes, whether policy or legal change, or just because there is a new technology that could benefit a process.

When planning a CCWIS, take the opportunity to think through your enterprise approach to Health and Human Services systems. Consider adopting a common reference architecture to be used across all HHS systems. Understand what is optimal to support your business process before you decide on technology or software to avoid having your software define your solution.

The future of technology, including HHS technology, is modular, loosely coupled services. Decompose your business functionality to see how you could support a modular development and procurement to minimize risk and maximize future flexibility. For example, you can break a large process of intake into multiple processes, one of which is checking for the existence of a person. This process can be further broken down into discrete services to check identity, address, etc. All of these granular processes are potentially usable as fine grained services instead of embedded in a monolithic application. Leverage micro services to enable a MITA view of functionality and allow for fine-grained change.

At the foundation, it is about data. Enable data federation through Master Data technologies, such as Master Citizen Indexes and Master Data Indexes. Plan for multiple, modular databases and create an Operational Data Store to aggregate the data into usable formats.

Batch is the foundation of many legacy systems. Design it out wherever possible. Processes that aggregate data and run at scheduled times create backlogs by nature. Real-time systems can be enabled by AI-empowered structured decision making. Advanced child welfare information system should help their users and the citizens they serve.

Conclusion

CCWIS offers an opportunity for States to define their policy and make the right solution choices that ensure better outcomes. It’s not difficult but does require careful planning and consideration.

Author Details

Richard Brady
Richard Brady

Rick leads the Government Healthcare practice at Infosys for the US and Canada. He has 20+ years experience in healthcare and public sector.

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