California's Health and Human Services Agency: Efforts in Advancing toward Integration and Interoperability

Policy & Practice, June 2014 | Go to article overview

California's Health and Human Services Agency: Efforts in Advancing toward Integration and Interoperability


Adam Dondro is assistant director at the California Department of Social Services and leads the department's efforts to integrate health and human service programs across program and department boundaries to provide the best overall experience for their clients. The horizontal integration unit focuses on providing a vision of integration for the department and seeking out opportunities to integrate systems, processes, and improve the way services are provided to California's needy populations.

Ashley Billings, APHSA's Public Policy intern, interviewed Adam Dondro for Policy & Practice about California's efforts toward integration and interoperability.

Overview of Integration Efforts

P&P: How would you describe your integration effort as it relates to vision and direction setting?

Adam Dondro: The state of California first considered interoperability within an enterprise architectural view. This view focuses on an IT perspective of integration that aimed to result in more success, while cutting the cost of service delivery. In our effort toward integration, the state continues to look for integration opportunities and connections across and within the agency that can help us advance toward this goal of integration. In regard to integration, California is creating a template that allows an easier, expedited approach to data sharing between agencies. Key to this effort is the development of vision and direction setting across those lines of business. The development of a governance structure at the agency level is critical to facilitate these efforts. California's current plan is predominantly technology focused; however, it is expected to grow to have a programmatic view as well. At the department level, the Department of Social Services is learning to address cultural changes while leveraging other systems to accomplish an effective integrated system.

P&P: What is the agency structure that supports integration?

AD: In April 2013, the Department of Social Services of the California Health and Human Services Agency (CHHS) created the office of Horizontal Integration to support integration and the establishment of the government structure allocated through the State Systems Interoperability and Integration (S2I2) grant. CHHS received this grant, awarded by the U.S. Department of Health and Human Services' Administration for Children and Families, to enhance state efforts toward interoperability and integration for eligibility and enrollment, case management, and other related functions. Accomplishing an interoperable system will aid in streamlining administration tasks within health and human services.

P&P: What programs are included in the integration effort?

AD: Medicaid and CalFresh, the state Supplemental Nutrition Assistance Program (SNAP), are two of the main programs included in California's integration efforts. Temporary Assistance for Needy Families (TANF), child services, as well as court and education systems, are some of the additional programs that the state is attempting to involve in our integration efforts.

P&P: What technology is needed to support the integration?

AD: The state is focusing on service-oriented architecture capable of communicating between several systems. This architecture would provide the necessary technology components to support integration.

P&P: What is the breadth and depth of integration efforts within your agency?

AD: California is taking a firm approach toward integration. For example, if policies and practices are (relatively) similar across lines of business, then combine them. The S2I2 grant also provided the initial groundwork for interoperability and integration in California. It raised awareness to build a strategy and roadmap for integration. California is also implementing a Governance structure to facilitate this change, has established an office of Horizontal Integration in April 2013 that is located within our Department of Social Services, and is working on developing common data-sharing agreements between the previously identified programs (Medicaid, SNAP, and TANF). …

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