MEMORANDUM OF AGREEMENT
BETWEEN THE DIVISION OF PUBLIC HEALTH
THE DIVISION OF INFORMATION RESOURCE MANAGEMENT
THE DIVISION OF ENVIRONMENTAL HEALTH
THE NORTH CAROLINA ASSOCIATION OF LOCAL HEALTH DIRECTORS

This Memorandum of Agreement (MOA) is established among the Division of Public Health (DPH) within the Department of Health and Human Services (DHHS), the Division of Information Resource Management (DIRM) within DHHS, the Division of Environmental Health (DEH) within the Department of Environment and Natural Resources (DENR), and the North Carolina Association of Local Health Directors (NCALHD) for the purpose of developing an enterprise vision for the public health enterprise and an automation implementation plan to realize that vision. Both local and State hardware, software and other resource needs are to be addressed as part of this vision. The plan would involve all listed groups as full partners. Efforts conducted under this MOA must conform to both State Information Resource Management Council (IRMC) and Health Insurance Portability & Accountability Act (HIPAA) standards and procedures. This MOA replaces the previously approved HSMS-SC Charter adopted July 15, 1999 by the NCALHD.

The efforts to be conducted under this MOA and its future revisions are divided into the following four (4) phases. A best attempt has been made to estimate time frames for completion of each phase based on current knowledge. However, circumstances may prevail that causes need to adjust these elapsed time frames. All parties shall be informed of these changes and shall approve of the need for these changes.

Phase I: AssessmentConcept Exploration.

During this phase all stakeholders (as identified by the co-chairs of the steering committee defined below) will develop a vision for the public health enterprise of the future. This vision will address the changing nature of local and state responsibilities, as well as the benefits that state of the art automation can bring to enabling that new vision. A high-level description of architecture supporting the vision will be developed. This phase is estimated to take approximately 3 to 4 weeks elapsed time. It will be led by an expert in business visioning approved by the Steering Committee (see below) and will consist primarily of facilitated sessions involving senior members of the stakeholder community. on or about December 1, 2000.

Phase II: Understanding.

In this phase, the stakeholders will document the processes and information required to realize the new vision. The gap between the current and future processes, information and supporting automation will be examined in order to identify specific targets of opportunity (quick hits) and larger, foundation projects required to initiate implementation of the vision as quickly as possible. These potential projects will be prioritized, funding secured and initial projects approved. This will result in an "Action Plan for the Public Health Enterprise" (hereinafter "plan") to be approved by the Steering Committee. This plan shall include specific details for approval and sign-off of project deliverables including who has authority and at what points in time, including interim and final approvals. This plan shall also address local planning and resource issues including hardware and implementation requirements. This phase is estimated to take approximately four (4) months.

Phase III: Initiate.

As shown in Appendix I below, this phase initiates implementation of the action plan developed in Phase II. Those quick hit and foundation projects classified as having the greatest urgency will be put on a fast track. This phase will consist of multiple projects resolved into smaller modules for rapid, iterative delivery. This phase is estimated to take six (6) to twelve (12) months.

Phase IV:II Accelerate.

When the first group of projects is nearing completion, the stakeholders will refine the public health enterprise vision and associated automation requirements. Based on then current priorities, the plan will be updated and a new round of quick hits and foundation projects begun. This is Phase IV. The same rapid fire, iterative delivery method adopted for Phase III will be followed. From this point forward, the public health enterprise should establish a regularly planned refinement to the enterprise vision and to the associated action plan.

This MOA as signed and dated on page 7 below covers only phases I and II above. This MOA will be revised during Phase II after the development of an agreed upon plan for Phase III.

Roles and Responsibilities:

1. Steering Committee

   1. Purpose and Scope.

   A Steering Committee shall be established (hereafter referred to as "the committee") to provide guidance on all issues pursuant to the efforts carried out under this MOA. This committee will serve as the executive-level committee responsible for providing oversight to the Project Director and the Project Advisory Committee (see Figure 1). The committee will serve as a forum to set direction, share information, prioritize deliverables and resolve resource issues, including those resources required at both the local and State levels for implementation of these deliverables.

   2. Steering Committee Functions.
      • Establish goals and approve budgets and timelines.
      • Review, approve, and monitor the project plans.
      • Define stakeholders and select project participants.
      • Review and approve project deliverables.
      • Make recommendations to the North Carolina Association of Local Health Directors Executive Committee, the Department of Health and Human Services and the Department of Environment and Natural Resources.
      • Facilitate the exchange and sharing of information regarding the public health enterprise vision and associated action plan with all North Carolina Local Health Departments, Alliances, Developmental Evaluation Centers, and other State and Federal Organizations.
2. Membership.
   • Co-Chairs. NCALHD President, the State Health Director and the Deputy Secretary DHHS will serve as Co-Chairs.
   • Members. The Co-Chairs shall appoint or dismiss committee members, except that the NCALHD President shall appoint all NCALHD and local health department members. The committee shall be comprised of ten voting members. In addition to the Co-Chairs, voting members shall include: DPH Director, DIRM Director, representative of DEH, representative of NCALHD Technology Committee and three representatives of local health departments. Additional voting members may be added upon approval of all members of the committee.
   • Decision Authority. The committee shall strive to reach consensus on all issues. If consensus cannot be reached, decisions shall be reached through majority vote and the following voting rules shall apply. Voting privileges shall be extended to committee members only and cannot be designated to alternates. All votes require a quorum of six or more members and shall be appropriately documented in meeting minutes.
   • Ex-officio Members. Each Co-chair shall appoint or dismiss ex-officio members as required to serve the needs of the committee.
   1. Chair Responsibilities
      • Call and chair committee meetings.
      • Seek and represent consensus on issues relating to the public health enterprise vision and associated action plan to local, state and other stakeholders.
      • Establish working groups, as required, to support efforts carried out under this MOA.
      • Review and approve committee agenda submitted by the Project Director in consultation with the Project Advisory Committee.
   2. Member Responsibilities.
      • Advise the co-chairs on issues relating to efforts carried out under this MOA.
      • Facilitate implementation of committee decisions.
      • Provide representation to working groups as required.
   3. Operation.
      • The co-chairs shall establish a regular meeting schedule.
      • The committee shall maintain records of decisions and assigned actions.
      • Decisions are made by majority vote of the committee.

Deliverables:

1. Summaries of the Steering Committee meetings will be prepared by the Project Director, reviewed by committee members, approved by the Co-Chairs and distributed to members and relevant stakeholders.
2. A Project Advisory Committee shall be formed. Members shall include members and ex-officio members of the former HSMS Steering Committee.

The following organization chart provides a high-level depiction of committee management and reporting relationships:

--Insert Figure 1. Management and Reporting Relationships.--

 

1. North Carolina Association of Local Health Directors (NCALHD)
   • NCALHD shall provide the following:
   • Co-Chair for the committee.
   • Other representation on the committee (as appropriate).
   • Funds to support efforts defined under this MOA (as appropriate).
   • Coordination among local health departments, contracted care providers and others acting as stakeholders in efforts defined under this MOA.
   • Interim approval of deliverables produced by efforts defined under this MOA.
   • Medicaid maximization funds allocated by the NCALHD on 11/20/97. Authorization for use of these funds is to be made by the NCALHD.
2. Local Health Departments
   • Local Health Departments shall provide the following:
   • Staff for work groups and other forms of participation in efforts defined under this MOA
   • Funds to support efforts defined under this MOA (as appropriate).
   • Interim approval of deliverables produced by efforts defined under this MOA.
3. Department of Health and Human Services
   • DHHS shall provide the following:
   • Two (2) co-chairs for the committee.
   • Funds to support efforts defined under this MOA (as appropriate).
   • Retain Medicaid maximization funding in a protected interest bearing trust fund designated for public health.
4. Division of Public Health
   • DPH shall provide the following:
   • Representation on the committee.
   • Staff for work groups and other forms of participation in efforts defined under this MOA.
   • Interim approval of deliverables produced by efforts defined under this MOA.
   • Funds will be matched with the NCALHD as required to complete Phases I and II of this MOA.
5. Division of Information Resource Management
   • DIRM shall provide the following:
   • Representation on the committee.
   • Sign-off on the Project Director and other appropriate staff selected for efforts defined under this MOA.
   • Sign-off on work plans and project timelines.
   • Interim sign-off on deliverables produced by efforts defined under this MOA.
   • Staff for work groups and other forms of participation in efforts defined under this MOA.
   • Sign-off on architecture and technical design related to efforts defined under this MOA.
   • Coordination of presentations to IRMC and other state bodies whose approval is required for efforts defined under this MOA.
6. Other Divisions of DHHS
   • Other divisions may be designated as participants in efforts defined under this MOA. Such divisions shall provide the following:
   • Representation on the committee (as appropriate).
   • Staff for work groups and other forms of participation in efforts defined under this MOA.
   • Interim approval of deliverables produced by efforts defined under this MOA.
7. Division of Environmental Health
   • DEH shall provide the following:
   • Representation on the committee.
   • Staff for work groups and other forms of participation in efforts defined under this MOA.
   • Interim approval of deliverables produced by efforts defined under this MOA.

Modification

This MOA will require modification during Phase II to encompass efforts defined by the "Action Plan for the Public Health Enterprise". The pParties to this Agreement concur that the MOA will be periodically reviewed and updated to reflect the necessary framework for effective and efficient implementation of that plan.

This Memorandum of AgreementUnderstanding is effective this ____ day of ____________, 2000.

Thomas Bridges, Director, Henderson County Health Department
President, North Carolina Association of Local Health Directors

Dr. A. Dennis McBride, MD, MPH
State Health Director / Acting Director, Division of Public Health

Jim Edgerton
Deputy Secretary, Dept. of Health and Human Services

William S. Bill Cox
Director, Division of Information Resource Management

Linda C. Sewall
Director, Division of Environmental Health