NEW MEXICO HEALTH INSURANCE
EXCHANGE INFORMATION TECHNOLOGY
(NMHIX) PROJECT
P R OJ EC T CHA R TER FOR C ER T IFIC A TION
EXECUTIVE SPONSORS –
DANIEL DERKSEN, MD, HSD OFFICE OF HEALTH CARE REFORM DIRECTOR
CHARISSA SAAVEDRA, HSD DEPUTY CABINET SECRETARY
EXECUTIVE BUSINESS OWNER – LISA REID, HSD OFFICE OF HEALTH CARE
REFORM DEPUTY DIRECTOR
EXECUTIVE TECHNOLOGY OWNER – REDDYKUTHURU, HSD/ITD ACTING CHIEF
INFORMATION OFFICER
ITD PROJECT MANAGER –KATHY MARTINEZ
PROJECT MANAGER – MARY WHITE
ORIGINAL PLAN DATE: 1/10/2012
REVISION DATE:
REVISION:
TABLE OF CONTENTS
TABLE OF CONTENTS............................................................................................................................................... I
1. PROJECT BACKGROUND ..................................................................................................................................... 1
1.1 EXECUTIVE SUMMARY -RATIONALE FOR THE PROJECT ....................................................................................1
1.2 SUMMARY OF THE FOUNDATION PLANNING AND DOCUMENTATION FOR THE PROJECT .....................................1
1.3 PROJECT CERTIFICATION REQUIREMENTS ...........................................................................................................3
2.0 JUSTIFICATION, OBJECTIVES AND IMPACTS...................................................................................................... 3
2.1 AGENCY JUSTIFICATION ......................................................................................................................................3
2.2 BUSINESS OBJECTIVES .........................................................................................................................................4
2.3 TECHNICAL OBJECTIVES ......................................................................................................................................4
2.4 IMPACT ON ORGANIZATION .................................................................................................................................5
2.5 TRANSITION TO OPERATIONS ...............................................................................................................................6
3.0 PROJECT SCOPE OF WORK................................................................................................................................ 8
3.1 DELIVERABLES ....................................................................................................................................................8
3.1.1 Project Deliverables .....................................................................................................................................8
3.1.2 Product Deliverables .................................................................................................................................10
3.2 SUCCESS AND QUALITY METRICS ......................................................................................................................11
4.0 SCHEDULE ESTIMATE ..................................................................................................................................... 12
5.0 BUDGET ESTIMATE ......................................................................................................................................... 12
5.1 FUNDING SOURCE(S)..........................................................................................................................................13
6.0 PROJECT AUTHORITY AND ORGANIZATIONAL STRUCTURE ............................................................................ 14
6.1 STAKEHOLDERS ...........................................................................................................................................15
6.2 PROJECT GOVERNANCE PLAN ..................................................................................................................16
6.3 PROJECT MANAGER .....................................................................................................................................18
6.3.1 PROJECT MANAGER CONTACT INFORMATION .........................................................................................18
6.4 PROJECT TEAM ROLES AND RESPONSIBILITIES ...................................................................................19
6.5 PROJECT MANAGEMENT METHODOLOGY ..........................................................................................................22
7.0 CONSTRAINTS ................................................................................................................................................ 22
8.0 DEPENDENCIES............................................................................................................................................... 23
9.0 ASSUMPTIONS ............................................................................................................................................... 24
10.0 SIGNIFICANT RISKS AND MITIGATION STRATEGY ......................................................................................... 25
11.0 COMMUNICATION PLAN FOR EXECUTIVE REPORTING ................................................................................. 26
12.0 INDEPENDENT VERIFICATION AND VALIDATION - IV&V ............................................................................... 26
13.0 PROJECT CHARTER AGENCY APPROVAL SIGNATURES................................................................................... 27
14.0 PROJECT CHARTER CERTIFICATION APPROVAL SIGNATURE ......................................................................... 28
i
Revision History
REVISION NUMBER
DATE
COMMENT
1.0
January 10, 2011
Original DoIT PMO Document
2.0
3.0
4.0
ii
PROJECT CHARTER HIX PROJECT
1. PROJECT BACKGROUND
1.1 EXECUTIVE SUMMARY -RATIONALE FOR THE PROJECT
The Project Goal is to implement a Health Insurance Exchange System. HSD will procure a
software solution that connects to the ISD2R (ASPEN) and MMIS systems for eligibility and
enrollment, fiscal transactions, “No Wrong Door” and shop and compare functions.
The Affordable Care Act (ACA) allows states to develop Health Insurance Exchanges to help
individuals and small businesses purchase health insurance. New Mexico seeks to modernize the
state’s health insurance market based on the fundamental principles of real consumer choice,
competition, shared responsibility and value to create the New Mexico Health Insurance
Exchange (NMHIX).
Significant IT gaps were identified in the state’s current eligibility, enrollment and fiscal
transactions systems. The current HSD Medicaid and assistance programs use an Integrated
Serviced Delivery IT eligibility system (ISD2). The system is in the implementation phase of
replacement with ISD2R (ASPEN). To prevent expensive duplication and reworking of the
NMHIX eligibility system, it must be included in the ISD2R planning and implementation work
plans. The Medicaid enrollment and fiscal transaction IT system, the Medicaid Management
Information System (MMIS) used for enrollment and fiscal transactions, is undergoing
competitive procurement for MMIS upgrade and operations. To ensure seamless interfaces,
ISD2R and MMIS IT systems must be integrated with the NMHIX IT eligibility, enrollment and
financial transactions systems.
The NMHIX IT platform will provide functionality to: facilitate plan selection for an individual
eligible to enroll in a Qualified Health Plan(QHP), provide consumers a single, streamlined on
line application consistent with federal requirements (screening, enrollment forms, verifications,
notices); report to the IRS and enrollees each year regarding the enrollee’s NMHIX coverage.
The NMHIX will include a Small Business Health Options Program (SHOP) Exchange.
NMHIX will develop a detailed plan for SHOP implementation and evaluate the small group
market. The SHOP Exchange will create an efficient process to meet the needs of small
employers.
1.2 SUMMARY OF THE FOUNDATION PLANNING AND DOCUMENTATION FOR THE PROJECT
In November 2011 New Mexico received Notice of Award for a Level I Health Insurance
Exchange Establishment Grant to establish the New Mexico Health Insurance Exchange
(NMHIX).
The applicant organization is the New Mexico Human Services Department (HSD) - the cabinet
agency responsible for Medicaid, Information Technology Division (ITD), Office of Health Care
Reform (OHCR), Income Support, Child Support Enforcement, Behavioral Health,
Supplemental Nutrition Assistance Program (SNAP), Low Income Energy Assistance Program
(LIHEAP), the HSD’s Information Technology Division, and other health and social services
programs.
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PROJECT CHARTER HIX PROJECT
Of New Mexico’s population of two million, Medicaid covers 550,000; Medicare covers
300,000 and 430,000 are uninsured. Of the uninsured, an estimated 175,000 will become eligible
for Medicaid and up to 250,000 for NMHIX between 2014 and 2020. It is estimated that as
many as 135,000 of the uninsured will enroll in 2014 (80,000 through the expansion of
Medicaid, and 55,000 through the NMHIX).
Funding will allow the state to develop and establish the NMHIX over the next 12 months and
meet the timelines for certification and operation by 2014. The objectives for the NMHIX Level
I establishment grant are to:
 Refine the NMHIX vision and objectives to comply with laws and regulations.
 Amend state law as necessary to comply with federal law.
 Secure staff and consultant resources for NMHIX planning, development,
implementation, operations, and stakeholder engagement.
 Develop and implement a multi-year NMHIX business and operational plan, including
the activities, timelines, and benchmarks, including the IT infrastructure and functionality
necessary to fully operate in 2014.
 Develop systems and program capacity in each core area to achieve NMHIX federal
certification by January 2013.
 Submit a Level II Exchange grant application in March, 2012
 Begin NMHIX operations in 2014.
 Determine funding mechanisms to be self-sustaining by 2015.
NMHIX is tailored to meet the diverse needs of New Mexicans, be high quality and costefficient, and self-sustaining without raising taxes. NMHIX complements and expands the
commercial insurance market, streamlines government bureaucracy and regulation, and
facilitates private sector solutions.
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PROJECT CHARTER HIX PROJECT
1.3 PROJECT CERTIFICATION REQUIREMENTS
The project meets the Department of Information Technology (DoIT) certification requirements
in dollar size and impact to multiple agencies. Included in this is the requirement to provide
monthly project reporting to DoIT, Independent Verification and Validation (IV&V) risk
assessment reporting, project management guidance and leadership to the project.
2.0 JUSTIFICATION, OBJECTIVES AND IMPACTS
2.1 AGENCY JUSTIFICATION
PAGE 3
NUMBER
DESCRIPTION
JUSTIFICATION ONE
Developing the NMHIX IT system will insure more New
Mexicans by fostering competiveness, encouraging
efficiency, and creating individual and small employer
private health insurance choices.
JUSTIFICATION TWO
States can set up their own exchanges, or have the Federal
government do it - to meet the Patient Protection and
Affordable Care Act (ACA) Health Insurance Exchange
requirement the State of New Mexico will establish HIX for
individuals and small businesses to purchase insurance.
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PROJECT CHARTER HIX PROJECT
2.2 BUSINESS OBJECTIVES
NUMBER
Business Objective #1
Business Objective #2
DESCRIPTION
Coordinate seamlessly between the New Mexico Health Insurance
Exchange (“Exchange” or “NMHIX”), the Integrated Services
Delivery Replacement (“ISD2R”), also known as the Automated
System Program Eligibility Network (“ASPEN”), eligibility system
for Medicaid and other state Human Services Department (“HSD”)
programs, and the Medicaid Management Information System
(“MMIS”)
To meet the deadlines associated with Health Care Reform requirements set
forth in ACA.
Business Objective #3
Allow individuals eligible for Medicaid to have brokers, navigators,
presumptive eligibility workers, providers and others as designated
by the individual to complete and submit an application on their
behalf
Business Objective #4
To facilitate plan selection for an individual eligible to enroll in a Qualified
Health Plan (QHP), provide consumers a single, streamlined on line
application consistent with federal requirements.
Business Objective #5
To allow citizens to access services through a common portal via the
internet, for online application completion, multiple program eligibility
determination, and ACA requirement verification.
Business Objective #6
To automate Federal, State, and internal reporting.
2.3 TECHNICAL OBJECTIVES
NUMBER
DESCRIPTION
Technical Objective #1
Coordinate seamlessly between the New Mexico Health Insurance
Exchange (“Exchange” or “NMHIX”), the Integrated Services
Delivery Replacement (“ISD2R”), also known as the Automated
System Program Eligibility Network (“ASPEN”), eligibility system
for Medicaid and other state Human Services Department (“HSD”)
programs, and the Medicaid Management Information System
(“MMIS”).To implement a modern technology that meets HSD business
needs, is flexible to changing requirements, and is easily maintainable.
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PROJECT CHARTER HIX PROJECT
NUMBER
DESCRIPTION
Technical Objective #2
To create a single solution built on an n-tier architecture that complies
with industry approved SOA standards.
The exchange designs must take into account the CMS/CCIIO
technical and architecture standards and principles.
Technical Objective #3
To use HIPAA transaction standards.
Technical Objective #4
To create a seamless eligibility and enrollment process with Medicaid and
other State Health Subsidy Programs.
Technical Objective #5
To implement a modern technology that meets HSD business needs, is
flexible to changing requirements, and is easily maintainable
Technical Objective #6
To Integrate components of the Enroll UX 2014 design.
2.4 IMPACT ON ORGANIZATION
The impacts on the organization are areas that need to be addressed by the project through its
planning process. They may not be internal project risks, but they can impact the success of the
project’s implementation.
AREA
DESCRIPTION
END USER
Learning a completely new approach to the collection of data,
eligibility determination and incorporation of navigators, brokers, and
staff at provider locations.
BUSINESS PROCESSES
IT OPERATIONS AND
STAFFING
BUSINESS
OPERATIONS/EXCHANGE
FUNCTIONS
PAGE 5
Analyze federal statute, rules and requirements and recommend
necessary state legislative changes for NMHIX activities,
processes, and structures to conform; identify the operational
systems and IT systems needed to successfully implement
NMHIX in compliance with state and federal requirements.
How this item is addressed will be dependent upon solution
selected through RFP process.
1. Maintaining normal business operations while still supplying the
HIX IT Project with the qualified staff necessary to ensure the
success of the project.
2. Analyzing federal requirements and recommending necessary
state legislative changes that may be required for NMHIX
activities, processes, and structures; identify the operational
systems and IT systems needed to successfully implement
NMHIX in compliance with state and federal statute, rules and
1/5/2011
PROJECT CHARTER HIX PROJECT
AREA
DESCRIPTION
requirements.
3. Maintaining business continuity during development, UAT and
the deployment of the HIX IT system.
HEALTH PLAN
CERTIFICATION/RECERTI
FICATION/DECERTIFICATI
ON
Establish standards, processes, and criteria for qualifying,
certifying, recertifying and decertifying health plans. DOI,
NMHIX and OHCR will collaborate to develop QHP
certification standards and market rules.
2.5 TRANSITION TO OPERATIONS
BUSINESS TRANSITION TO OPERATIONS
AREA
DESCRIPTION
BUDGET
TRANSITION
The New Mexico Health Insurance Alliance (NMHIA) will develop
detailed financial management and oversight procedures for strong
internal monitoring of all NMHIX operations and expenditures.
OHCR and NMHIX will obtain financial consulting expertise from
qualified accountants to develop oversight procedures and
monitoring policies.
PRELIMINARY
OPERATIONS
LOCATION AND
STAFFING PLANS
Resolution of this item is dependent upon the solution selected through the
RFP process.
BUSINESS
CONTINUITY
Resolution of this item is dependent upon the solution selected through the
RFP process.
MAINTENANCE
STRATEGY
Resolution of this item is dependent upon the solution selected through the
RFP process.
RECORD RETENTION
The project will comply with state record retention requirements.
TECHNICAL TRANSITION TO OPERATIONS
AREA
DESCRIPTION
BUDGET
All renewals for maintenance and support of hardware and software will
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PROJECT CHARTER HIX PROJECT
need to be included in the base budget, which will be submitted the year
prior to transition to maintenance & operations. The budget for these items
will be dependent upon the solution selected through RFP process.
PRELIMINARY
OPERATIONS
LOCATION AND
STAFFING PLANS
The preliminary operations locations and staffing plans are dependent upon
the solution selected through RFP process.
DATA SECURITY,
BUSINESS
CONTINUITY
HSD-ITD’s Security Officer will ensure that all current data security steps
are followed. The Security Officer will also assure all new security related
policies or mandates are applied to the system in a timely manner.
MAINTENANCE
STRATEGY
Resolution of this item will be dependent upon the solution selected
through the RFP process.
INTEROPERABILITY
Resolution of this item will be dependent upon the solution selected
through the RFP process, as well as standards set forth by Federal and State
oversight agencies.
DOIT
CONSOLIDATION
STRATEGY
Resolution of this item will be dependent upon the solution selected
through RFP process.
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PROJECT CHARTER HIX PROJECT
3.0 PROJECT SCOPE OF WORK
The HSD is implementing a New Mexico Health Insurance Exchange Information Technology
System that connects to ISD2R (ASPEN), MMIS systems for eligibility and enrollment, fiscal
transactions, “NO Wrong Door” and shop and compare functions.
The project’s scope of work includes meeting Health Care Reform requirements as set forth by the
Federal government. The NMHIX IT system shall meet the ACA implementation requirement date
for full operation of January 1, 2014.
The NMHIX Project is in the process of a Request for Proposal for procuring professional services to
implement a NMHIX IT system. This procurement will result in a single source award to a
Contractor who shall be wholly responsible for performance of the Contract whether or not
Subcontractors are used.
The system shall satisfy HIX requirements. The Federal timelines for states to establish their own
Exchanges are ambitious. The current timelines are unlikely to be met by the majority of states. The
system shall pass the Federal mandated review by the Center for Medicare & Medicaid Services
(CMS) to assess readiness by January 1, 2013, and be fully operational by January 1, 2014. The
system shall be prepared to begin enrolling qualified individuals into the Exchange by October 1,
2013. While these are the current timelines, it is likely that they will be delayed so that states can
have adequate time to do their Exchanges.
3.1 DELIVERABLES
3.1.1 PROJECT DELIVERABLES
This initial list of project deliverables are those called for by the IT Certification Process and
Project Oversight memorandum, but does not exhaust the project deliverable documents.
Project Charter
The Project Charter for Certification sets the overall scope for the
project, the governance structure, and when signed is considered
permission to proceed with the project. The Project Charter for
Certification is used to provide the Project Certification
Committee with adequate knowledge of the project and planning
to certify the initiation phase of the project.
Certification Form
The Request for Certification and Release of Funds form for the
Planning Phase is being requested 1/18/2012.
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PROJECT CHARTER HIX PROJECT
Project Management Plan
IV&V Contract & Reports
RFP
Risk Assessment and Management
The Project Management Plan (PMP) is a formal document
approved by the executive sponsor and the Department and
developed in the plan phase used to manage project execution,
control, and project close. The primary uses of the project plan
are to document planning assumptions and decisions, facilitate
communication among stakeholders, and documents approved
scope, cost and schedule baselines. A project plan includes other
plans for issue escalation, change control, communications,
deliverable review and acceptance, staff acquisition, and risk
management.
Independent Verification and Validation (IV&V) means the
process of evaluating a project to determine compliance with
specified requirements and the process of determining whether
the products of a given development phase fulfill the
requirements established during the previous stage, both of which
are performed by an organization independent of the lead agency.
Independent verification and validation assessment reporting.
The Department requires all projects subject to oversight to
engage an independent verification and validation contractor
unless waived by the Department.
Request for Proposal (RFP) is the mechanism to obtain
competitive proposals from qualified organizations for the
design, development, and implementation of a HIX/IT System.
The DoIT Initial PROJECT RISK ASSESSMENT template
which is meant to fulfill the following requirement:
“Prepare a written risk assessment report at the inception of a
project and at end of each product development lifecycle phase or
more frequently for large high-risk projects. Each risk assessment
shall be included as a project activity in project schedule.”
Project Oversight Process memorandum.
Project Schedule
A tool used to indicate the planned dates, dependencies, and
assigned resources for performing activities and for meeting
milestones. The default standard is Microsoft Project.
Monthly Project Status Reports to
DoIT
Project status reports. For all projects that require Department
oversight, the lead Agency project manager shall submit an
agency approved project status report on a monthly basis to the
Department.
Project Closeout Report
This is the Template used to request that the project be officially
closed. Note that project closure is the last phase of the
certification process.
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PROJECT CHARTER HIX PROJECT
3.1.2 PRODUCT DELIVERABLES
DELIVERABLE
DESCRIPTION
Requirements Documents
A detailed business function requirements document will be developed by
the Integration Vendor during the planning phase, and will include input
from all levels of stakeholders.
Design Documents
Among the design-level activities are:
 Design of the Solution Architecture for the project
 Development of the Logical model (e.g. Entity Relation Diagram or
Object Model) for the project
 Development of the Physical Data Model for the project
 Data Dictionary
 Systems Architecture Requirements
 The design deliverables include a High-Level Design document as well as
a Detailed-Level Design document.
o A Preliminary Design Review (PDR) will be conducted
after the High-Level Design Document is delivered.
o A Critical Design Review (CDR) will be conducted after
the Detailed Design Review is completed.
Systems Specifications
Software Requirements Specification (SRS) will address the following high
level list of requirements and questions:
 Define the functions of the system
 Define the Hardware and Software Functional Partitioning
 Define the Performance Specification
 Define the Hardware and Software Performance Partitioning
 Define the User Interface
 Functionality - What is the software supposed to do?
 External interfaces - How does the software interact with people, the
system’s hardware, other hardware, and other software?
 Performance - What is the speed, availability, response time, recovery
time of various software functions, etc.?
 Attributes - What are the portability, correctness, maintainability,
security, etc. considerations?
 Design constraints imposed on an implementation - Are there any
required standards in effect, implementation language, policies for
database integrity, resource limits, operating environment(s) etc?
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PROJECT CHARTER HIX PROJECT
DELIVERABLE
Systems Architecture
DESCRIPTION



System and Acceptance
Testing



Operations Requirements
The System Architecture will be SOA, which will be services that are
loosely coupled.
SOA services also run in "safe" wrappers such as Java or .NET, which
manage memory allocation and reclamation, allow ad-hoc and late
binding, and provide some degree of indeterminate data typing and will
provide optimal degree of fault-tolerance, backward compatibility,
forward compatibility, extensibility, reliability, maintainability,
availability, serviceability, and usability.
The Systems Architecture document will be produced in the design
phase.
System and Acceptance Testing includes the infrastructure needed for the
testing, how the testing will be carried out, number of end users from
each agency, format for the testing and defining acceptable test results.
The System and Acceptance Testing Plan will identify the method for
defining the necessary Use Cases, the method for development of the test
scripts, and the coordination of test execution with the users.
Both the Systems and User Acceptance Planning documents will be
produced during the design phase.
Operations Requirements include capacity planning for the systems
networking and hardware needs, the number of staff and types of skill sets
needed to maintain the system.
3.2 SUCCESS AND QUALITY METRICS
Metrics are key to understanding the ability of the project to meet the end goals of the Executive
Sponsor and the Business Owner, as well as the ability of the project team to stay within
schedule and budget.
NUMBER
DESCRIPTION
QUALITY METRIC 1
Meet ACA requirements deadlines.
QUALITY METRIC 2
QUALITY METRIC 3
QUALITY METRIC 4
QUALITY METRIC 5
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PROJECT CHARTER HIX PROJECT
4.0 SCHEDULE ESTIMATE
HIX RFP Schedule 12.27.11.pptx
HIX
Project Schedule
Procurement
Develop / Test
Pilot
Statewide
4th Qtr
5/1/2012
2/01/2012
Release RFP
•
•
•
•
Procurement
30 Days on Street
15 Days to Review
15 Days Demo
30 Days
Contracting
1/1/2014
HIX Open
Enrollment
•
•
•
•
•
•
•
Release RFP
Vendor Start
Develop and Test (12 mths)
Pilot HIX Application
Roll Out HIX
Enroll into HIX
HIX Statewide
2/1/2012
6/1/2012
9/1/2012 – 10/1/2013
4th Qtr 2013
4th Qtr 2013
10/1/13
1/1/2014
5.0 BUDGET ESTIMATE
Within the Project Charter, budgets for the project can only be estimated. Original budgets
requested in appropriations or within agency budgets are probably not the numbers being worked
with at project time. Funding sources are asked for to help evaluate the realism of project
objectives against funding, and the allocation of budget estimates against project deliverables.
The budget presented below is an estimated project budget and will be revised after responses
have been received from the Request for Proposal.
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PROJECT CHARTER HIX PROJECT
NMHIX Project Budget Details
Expense Summary
SFY12
State Staff
Travel, Misc
Contracts:
PMO
IV&V Services
Contract Staff
Integrator Contract
Sub Total Contracts
Total Budget
SFY13
92,132
SFY14
131,132
136,000
131,132
-
Total
354,396
136,000
270,785
649,884
379,331
1,300,000
250,000
600,000
350,000
1,200,000
83,335
200,004
116,661
400,000
11,975,000
8,584,604
20,559,604
604,120
13,424,888
9,430,596
23,459,604
832,252
13,556,020
9,561,728
23,950,000
5.1 FUNDING SOURCE(S)
Grant
Expiration
Date:
Level I Establishment
Grant
11/28/2012
PAGE 13
Appropriated:
11/29/2011
Extension Status:
Will Revert 11/28/2012
1/5/2011
PROJECT CHARTER HIX PROJECT
6.0 PROJECT AUTHORITY AND ORGANIZATIONAL
STRUCTURE
HIX Project Management Office
Executive
Steering
Committee
Executive Sponsors
ISD2R/ASPEN Charissa Saavedra, Dep. Dir. HSD
NM HIX Dan Derksen MD, Dir. OHCR
Executive
Owner
ITD / CIO
Reddy Kuthuru
TBD
Executive
Owner
Lisa Reid, Dep. Dir. OHCR
Strategic
Tactical
PMO Leadership Team
ITD
Owner
Project
Manager
TBD
TBD
HSD
Senior
Project
Executive
TBD
PMO Core Team
Network
Lead
Application
Lead
OCHR
PGM &
Policy
MAD
Policy
Project
Management
Business
Technical
Support
Vendor
Budget &
Contracts
- State Staff
- PMO Contract Staff
- Integration Vendor
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1.2011
1/5/2011
PROJECT CHARTER HIX PROJECT
6.1 STAKEHOLDERS
Stakeholders should be a mix of agency management and end users who are impacted positively
or negatively by the project.
Executive Sponsors:
ISD2R - Charissa Saavedra, HSD Cabinet Deputy Secretary; NMHIX Dan Derksen MD, Dir. OHCR
Executive Steering Committee:
Name
Title
Stake in Project
Charissa Saavedra
Deputy Cabinet Secretary, HSD
Executive Sponsor
Dan Derksen
OCHR
Executive Sponsor
Prabhakar Reddy
ITD Acting Chief Information Officer
Executive Owner
Technology
Lisa Reid
OHCR Deputy Director
Executive Owner
Business
Ted Roth
Director, Income Support Division, HSD
HSD
Sidonie Squier
HSD Cabinet Secretary
HSD
Julie Weinberg
Director, Medical Assistance Division
HSD
PMO Leadership Team:
Title/Role
Stake in Project
Kathy Martinez
IT Project Manager, HSD
Project Manager
Mary White
Project Manager, DewPoint
PMO
Subject Matter Advisors:
Title/Role
Stake in Project
Priscilla Caverly
OHCR
SME, Native
Americans
Lisa Reid
Deputy Director, OHCR
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1/5/2011
PROJECT CHARTER HIX PROJECT
Jonni Lu Pool
Management Analyst, OHCR
Mike Nunez
Director, NM Health Insurance Alliance
Designated HIX
John Franchini
Superintendent of Insurance
SME, Insurance
Regulation
Mark Pitcock
Deputy Director, Medical Assistance
Division
SME, Medicaid
Deborah Armstrong
Director, New Mexico Medical Insurance
Pool
SME, Insurance
Providers
Stakeholder Group Representatives
SME, Insurance
Providers, Health
Providers,
Consumers
TBD
6.2 PROJECT GOVERNANCE PLAN
Office of Health Care Reform (OHCR) oversees planning and establishment project activities,
measures progress and success, provides leadership, coordinates public and private partnerships,
and implements work plans. OHCR will meet monthly to review draft project deliverables and
approve final deliverables. The New Mexico Health Insurance Alliance (NMHIA) board,
through a contractual agreement, will be responsible for carrying out NMHIX action plans.
NMHIA will meet regularly and formally report on its progress to meet project objectives. HSD
will provide project oversight, especially related to the development of the IT infrastructure,
coordinating Medicaid and other state program integration with NMHIX. The Project Director
will provide executive leadership for the project.
This will be initiated with the formalization of the Issue Resolution, Change Management and
Work Approval Processes along with the HIX PMO governance structure and reporting. In
addition to Project Control Processes, key business and technical activities will commence.
Communication plans and approach will be finalized involving all stakeholders both within and
outside of state government.
The PMO team will utilize standard industry project methodologies, approach and governance
from the project inception. Clear goals and deliverables will be communicated. A master project
plan and schedule will be created for all tasks and deliverables. Every task will have a single
owner and be tracked against effort and completion. Schedules will be reviewed on a weekly
basis to facilitate timely delivery.
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PROJECT CHARTER HIX PROJECT
HIX Project Governance Model
Executive Sponsors
ISD2R/ASPEN and NM HIX
Executive Steering
Committee
State Purchasing
Division
PMO Leadership
Team
Federal Partners
DoIT
Project Oversight
Project Mgt
IV & V Contractor
PMO Core Team
Business
PAGE 17
Technology
Vendor
Contracts
Budget
1/5/2011
PROJECT CHARTER HIX PROJECT
6.3 PROJECT MANAGER
6.3.1 PROJECT MANAGER CONTACT INFORMATION
NAME
ORGANIZATION
Dan Derksen
OHCR
505-827-7750
Dan.Derksen@state.nm.us
Reddy Kuthuru
ITD Acting CIO
505-476-3964
Prabhakar.Reddy@state.nm.us
Kathy Martinez
ITD Project Management Staff
505-476-3978
Kathy.Martinez1@state.nm.us
Mary White
TEKSystems
505-980-7329
Mary.White1@state.nm.us
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PHONE #(S)
EMAIL
1/5/2011
PROJECT CHARTER HIX PROJECT
6.4 PROJECT TEAM ROLES AND RESPONSIBILITIES
Roles and Responsibilities are subject to change based on on-going project needs.
Role
Responsibilities
Executive Sponsor



Document approval (sign-off).
Ensure the success of the project.
Ultimate decision maker.
Federal Partners


Review & approve APD Documents.
Review & approve contracts & RFPs >$5 million.
NM Department of
Information
Technology



IT Project Oversite.
Chair PCC meetings.
Review & approve all contracts associated with the HIX Project.
Executive Steering
Committee (ESC)

Responsible for the project's feasibility, strategy, business plan and
achievement of outcomes.
Executive Owner – 
Technical



Executive Owner Business




HSD Senior Project 
Executive



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Direct involvement and oversight of all technical aspects of the
project.
Notify ESC when serious risks arise.
Responsible for all technical activities and resources involved in the
HIX project.
Responsible to the PMO for working within the agency to coordinate
any technical strategies / requirements, setting priorities, identifying
resources and agency communications.
Direct involvement and oversight of all business aspects of the project
Notify ESC when serious risks arise.
Responsible for all business activities and resources involved in the
HIX project.
Responsible to the PMO for working within HSD to coordinate any
business strategies / requirements, setting priorities, identifying
resources and agency communications.
Involvement and oversight of all business aspects of the project.
Focal point for all HSD activities and resources involved in the HIX
project.
Identify, analyze, mitigate and control risks of the business
development of the replacement system.
Responsible to the PMO for working within the agency to coordinate
any business strategies, requirements, setting priorities, identifying
resources and agency stakeholder communication.
1/5/2011
PROJECT CHARTER HIX PROJECT
Role
Responsibilities
Project Manager




Senior Project
Manager



Program and Policy 
Advisors

Single point of contact coordinating all activities and personnel
within the PMO, reporting to the Executive Sponsor and ESC.
Manage the overall executive relationship and facilitate all HIX
strategies, issues and decisions at the executive level while
simultaneously driving operational focus and accountability within
the PMO and delivery organizations.
Oversee all aspects of the delivery of the project and ensure all
activities are performed according to plans and scope.

Responsible for all program and policy decisions, documentation and
clarification.
Identifies resources required to define program and policy
requirements and participate in application design sessions.
Create test scenarios to validate policy functionality in the new
system.
Provide final approval to ensure system adherence with policy.
Budget Advisor


Contribute to efforts for defining key project terms.
Contribute to the creation of all budget documents and tracking.
System/Network
Lead


Responsible to the PMO for all aspects of the technical infrastructure.
Focal point to identify resources for technical requirements and
design sessions (infrastructure), technical assessments, and technical
documentation.
Work closely with the system integrator for development and
implementation of the new infrastructure.


Technical
Application Lead



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Work closely with the PMO project manager to coordinate all project
activities required by the State staff for business or technical related
activities.
Create detailed project plans and schedules with clear milestones and
deliverables.
Integrate all project plans and schedules (vendor and HSD) to create
the overall master schedule.
Responsible to work with all leads to accurately status and report on
their progress.
Responsible to the PMO for all aspects of the legacy applications.
Focal point to identify resources for technical requirements and
design sessions (application), technical assessments, technical
documentation, interfaces, data conversion and legacy system
changes.
Work closely with the system integrator for development and
implementation of the new application.
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PROJECT CHARTER HIX PROJECT
Role
Responsibilities
System Integrator
Project Manager




System Integrator
Project
Manager/Scheduler



Technical Analyst




Business Analyst


Communication
Lead



User Acceptance
Testing Lead



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Have overall responsibility, authority and control of all aspects of the
system integrator team.
Responsible to the PMO and Senior Project Manager throughout the
duration of the contract.
Provide system integrator leads for key project functional areas, such
as: design, development, testing, training, conversion and site support
Work closely with PMO sub teams and business leads.
Works closely with the PMO Project Manager/Schedulers.
Responsible to create and maintain a project plan for all activities
associated with the design, development, testing, training, conversion
and deployment of the HIX system.
Provide detailed schedules for the system integrator’s activities and
weekly reporting, to include metrics and status.
Work with the Technical Leads to facilitate the development and
review of technical requirements for the HIX RFP.
Coordinate activities with the system integrator’s technical lead.
Develop, facilitate and maintain key processes required by the PMO
for managing scope and schedule.
Support the creation of all PMO technical reporting and work with
the ITD legacy staff to assess legacy data integrity and plans for data
cleanup.
Support the Senior Business Architect in defining requirements and
provide leadership to the business sub-teams during the business
design sessions.
Provide focus and support related to understanding and rationalizing
field office processes.
Responsible to work with the PMO Senior Project Manager and Field
Lead in creating the overall communication approach and plan for all
stakeholders.
Help define the media, format and schedule for each stakeholder
identified
Facilitates the execution of communication protocols within the
agency and field.
Instrumental in supporting the validation of policy and business
functionality in the new application.
Facilitates the creation of test scenarios and the defect tracking
process.
Works closely with the ISD Business Lead, Policy and Field Leads to
identify, coordinate and manage the State UAT staff under direction
of the Senior Business Architect.
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PROJECT CHARTER HIX PROJECT
Role
Responsibilities
Correspondence
Lead





Contract Manager




Responsible to identify and rationalize all the existing correspondence
currently generated from the legacy systems.
Works with the system integrator to define the correspondence
requirements and business processes of the new system.
Facilitates any legal approvals required.
Coordinates testing and review during UAT.
Works with the Communication Lead to communicate changes to
clients and other stakeholders.
Focal point for managing any contract issues, changes or approvals
and steering them through the state’s procurement processes.
Facilitate the approvals of PMO / System Integrator contract
deliverables with the appropriate State staff.
Responsible for maintaining a database or spreadsheet with contract
due dates, submission dates, revisions and approvals.
Facilitate the collection of budget data from ISD, ITD and the
vendors to create a complete financial perspective and forecast for the
HIX project.
6.5 PROJECT MANAGEMENT METHODOLOGY
The HIX Project Team will follow the DoIT certification gates of: Initiation, Planning,
Implementation, and Closeout as the overarching framework. The HIX Project will follow the
Project Management Institutes, Project Management Body of Knowledge (PMBOK). The
PMBOK’s knowledge areas of Scope, Time, Cost, and Resources will be heavily utilized for
guidance.
For all software and systems implementations the Software/System Development Life Cycle
(SDLC) of Planning, Requirements, Design, Development, Test, UAT, Training,
Implementation, Migration (Go Live), and Transition to Maintenance and Operations will be
used. The Integrator will be allowed to choose the method that they feel works best for the
project.
7.0 CONSTRAINTS
NUMBER
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DESCRIPTION
1.
Project success depends on adequate funding.
2.
Project success depends upon Executive Leadership involvement and timely decision
making.
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PROJECT CHARTER HIX PROJECT
NUMBER
DESCRIPTION
3.
Inconsistent or inadequate state project staffing could lead to increased project costs,
schedule delays or project failure.
4.
Unknown, yet to be proposed and finalized ACA rules and requirements could lead to
increased project costs and/or schedule delays.
5.
Project success depends on communication. Failure to communicate can lead to poor
decision making, increased project costs, schedule delays or project failure.
8.0 DEPENDENCIES
Types include the following and should be associated with each dependency listed.



M -Mandatory dependencies are inherent to the work being done.
D- Discretionary dependencies are defined by the project management team. This may also encompass
particular approaches because a specific sequence of activities is preferred, but not mandatory in the project
life cycle.
E-External dependencies involve a relationship between project activities and non-project activities such
as purchasing/procurement
NUMBER DESCRIPTION
TYPE
M,D,E
1.
Dependent on the ability to recruit business personnel positions to ensure
continuity of service during the life of the project.
M
2.
Dependent on development of a full business team.
M
3.
Dependent on the Executive Steering Committee (ESC) for timely decisions on
issues escalated to these groups.
M,E
4.
Dependent on continued funding to project completion.
M,E
5.
Dependent on clarification of HCR requirements from CMS and State HCR
panel.
M,E
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1/5/2011
PROJECT CHARTER HIX PROJECT
9.0 ASSUMPTIONS
NUMBER
PAGE 24
DESCRIPTION
1.
DoIT will approve state expenditures.
2.
Subject matter experts will be ready and available on schedule.
3.
Departments and State oversight agencies recognize the importance of the HIX
project.
4.
The selected contractors have experience designing and implementing enterprise
eligibility requirements and SHOP.
5.
Requirement changes during the project may incur additional costs.
1/5/2011
PROJECT CHARTER HIX PROJECT
10.0 SIGNIFICANT RISKS AND MITIGATION STRATEGY
Early identification and management of risk is critical in maintaining project schedules and
budget. Risks identified as early as possible in the project lifecycle will be more effectively
avoided or minimized. Project risks will be identified, assigned owners and due dates for
mitigation, assessed for impact and mitigation contingencies, and tracked until satisfactorily
mitigated. Risks will be reviewed and assessed at major project phases. Any risks that are
beyond the decision-making authority of the PMO will be escalated to the Executive Steering
Committee for appropriate action. The PMO will compile and maintain risk documentation
according to DoIT standard templates. All mitigation resolution will be documented for audit and
historical purposes.
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1/5/2011
PROJECT CHARTER HIX PROJECT
11.0 COMMUNICATION PLAN FOR EXECUTIVE REPORTING
Communication between project stakeholders is key to the success of the project. The purpose
of this communication is to provide:
 Awareness:
o Communication is shared in a timely matter.
o Provide a structured way the project stakeholders receive information.
 Content:
o Advocate a transparent, honest, and multi-faceted approach to communication.
o Create a venue where all stakeholders can constructively debate ideas.
 Communication Flow:
o Coordinate communication with milestones, activities, and events.
o Keep all stakeholders informed while continuing to move the project forward.
 Effectiveness:
o Allow for the continuous oversight of all processes.
o Allow for effective change in management.
To streamline the project, the following matrix outlines the communication expectations of
project stakeholders:
To be developed.
12.0 INDEPENDENT VERIFICATION AND VALIDATION - IV&V
New Mexico will utilize the services of an independent verification and validation (IV&V)
contractor as a third party quality assurance consultant. The IV&V contractor will monitor the
project’s progress towards achieving stated objectives and required deliverables. The IV&V
contractor will report to the Office of Health Care Reform Leadership Team and the Executive
Director of the Office of Health Care Reform. The IV&V contractor will provide progress
reports to the Executive Director and the Leadership Team. The State plans to procure IV&V
services after the RFP has been issued.
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1/5/2011
PROJECT CHARTER HIX PROJECT
13.0 PROJECT CHARTER AGENCY APPROVAL SIGNATURES
SIGNATURE
DATE
EXECUTIVE SPONSOR
ISD2R - CHARISSA
SAAVEDRA
EXECUTIVE SPONSOR
NMHIX - DAN DERKSEN
EXECUTIVE OWNER
ITD/CIO
REDDY KUTHURU
HSD/ITD PROJECT
MANAGER
KATHY MARTINEZ
PROJECT MANAGER
MARY WHITE
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1/5/2011
PROJECT CHARTER HIX PROJECT
14.0 PROJECT CHARTER CERTIFICATION APPROVAL
SIGNATURE
SIGNATURE
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DATE
1/5/2011