County Director. Chief Information Officer. County Director

Transcription

1 County Name: Kern Enclosure 3 Exhibit 1 Face Sheet For Technological Needs Project Proposal Project Name: Network Infrastructure Modernization - Project 1 This Technological Needs Project Proposal is consistent with and supportive of the vision, values, mission, goals, objectives, and proposed actions of the Mental Health Services Act (MHSA) Capital Facilities and Technological Needs Component Proposal. We are planning to, or have a strategy to modernize and transform clinical and administrative systems to improve quality of care, operational efficiency, and cost effectiveness. Our Roadmap for moving toward an Integrated Information Systems Infrastructure, as described in our Technological Needs Assessment, has been completed. This Project Proposal also supports the Roadmap. We recognize the need for increasing client and family empowerment by providing tools for secure client and family access to health information within a wide variety of public and private settings. The Proposal addresses these goals. This proposed Project has been developed with contributions from stakeholders, the public and our contract service providers, in accordance with California Code of Regulations (CCR), Title 9, Sections 3300, 3310 and 3315(b). The draft proposal was circulated for 30 days to stakeholders for review and comment. All input has been considered, with adjustments made as appropriate. Mental Health Services Act funds proposed in this Project are compliant with CCR Section 3410, non-supplant. All documents in the attached Proposal are true and correct. County Director Name: Phone: Name: Phone: James A. Waterman, PhD (661) jwaterman@co.kern.ca.us M. Daniel Walters (661) dwalters@co.kern.ca.us Signature: Date: Chief Information Officer Signature: Date: Name: Phone: County Director Signature: Date: Page 1 of 1 Enclosure 3, Exhibit 1 - Face Sheet October 30, 2008

2 Enclosure 3 Exhibit 3 Technological Needs Project Proposal Description County Name: Kern Date: Apr 15, 2009 Project Name: Network Infrastructure Modernization - Project 1 Check at Least One Box from Each Group that Describes this MHSA Technological Needs Project New System. Extend the Number of Users of an Existing System. Extend the Functionality of an Existing System. Supports Goal of Modernization / Transformation. Support Goal of Client and Family Empowerment. Indicate the Type of MHSA Technological Needs Project > Electronic Health Record (EHR) System Projects (Check All that Apply) Infrastructure, Security, Privacy. Practice Management. Clinical Data Management. Computerized Provider Order Entry. Full Electronic Health Record (EHR) with Interoperability Components (Example: Standard Data Exchanges with Other Counties, Contract Providers, Labs, Pharmacies). > Client and Family Empowerment Projects Client/Family Access to Computing Resources Projects. Personal Health Record (PHR) System Projects Online Information Resource Projects (Expansion / Leveraging Information-SharingServices) > Other Technological Needs Projects that Support MHSA Operations Telemedicine and Other Rural / Underserved Service Access Methods. Pilot Projects to Monitor New Programs and Service Outcome Improvement. Data Warehousing Projects / Decision Support. Imaging / Paper Conversion Projects. Other. Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 1 of 9 October 30, 2008

3 Indicate the Technological Needs Project Implementation Approach Custom Application Name of Consultant or Vendor (if applicable): Commercial Off-The -Shelf (COTS) System Name of Vendor: Product Installation Name of Consultant or Vendor (if applicable): This project will require the installation of products from several vendors. The primary vendors will be Nortel for switching and routing hardware and AT&T for network services. Software Installation Name of Vendor: Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 2 of 9 October 30, 2008

4 Project Description and Evaluation Criteria (Detailed Instructions) Small County? Complete Each Section Listed Below. Yes No Small counties (under 200,000 in population) have the Option of submitting a Reduced Project Proposal; however, they must describe how these criteria will be addressed during the implementation of the Project. A completed Technological Needs Assessment is required in addition to the Technological Needs Project Proposal. Technological Needs Project Proposals that are for planning or preparation of technology are not required to include hardware, software, interagency, training, or security considerations. These items are indicated with an *. Project Management Overview (Medium-to-High Risk Projects) Counties must provide a Project Management Overview based on the risk of the proposed Project. The Project must be assessed for Risk Level using the worksheet in Appendix A. For Projects with Medium to High Risk, the County shall provide information in the following Project management areas. Independent Project Oversight Integration Management Scope Management Time Management Cost Management Quality Management Human Resource Management (Consultants, Vendors, In-House Staff) Communications Management Procurement Management Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 3 of 9 October 30, 2008

5 For Low-Risk Projects, as determined by the Worksheet in Appendix A, the above Project Management Reporting is Not Required. Instead, the County shall provide a Project Management Overview that describes the steps from concept to completion in sufficient detail to assure the DMH Technological Needs Project evaluators that the proposed solution can be successfully accomplished. For some Technological Needs Projects, the overview may be developed in conjunction with the vendor and may be provided after vendor selection. Please reference the paragraph "Nature of the Project" below for an overview of the project goals. This will provide the background information necessary to put the project planning into context. Implementation of this plan is contingent on implementation of Phase I of the County's strategic plan, scheduled for summer of This will provide high bandwidth communications between key locations in the County. Once that is complete, this MHSA project will commence with the installation of equipment to connect existing links to two of our primary facilities by using the new High-speed links installed by the County. Step 2 of this project will require the finalization of a cost/benefit analysis already in process to determine the most effective communications method between the remaining nine locations. Thus far, the analysis is indicating that carrier technology called Multi-Protocol Label Switching (MPLS) will be the most cost effective. The primary alternative to MPLS being considered is the installation of Microwave links between locations. The cost/benefit analysis requires performing site surveys to determine the viability of that technology. Once the most effective technology has been identified for each site, the project will proceed with the installation of equipment beginning with the sites with the highest concentration of users. In addition to modernization of communications infrastructure between the Department's primary facilities, this project will also address the infrastructure required for our Tele-Medicine project. The final step in this project will be the installation of high-speed links between those locations utilizing the Tele-Medicine equipment. Based on the remote locations of these facilities, it is likely that the MPLS technology will be utilized. Attachment 1 to Exhibit 3 for Project 1 contains the details of the locations involved, the current expectation of the bandwidth that will be required for each location and pricing estimates based on current information from the cost/benefit analysis. Project Cost Technological Needs Projects will be reviewed in terms of their cost justification. The appropriate use of resources and the sustainability of the system on an ongoing basis should be highlighted. Costs should be forecasted on a Quarterly basis for the life of the Project. Costs on a Yearly and Total basis will also be required for input on Exhibit 3 - Budget Summary. 08/09 09/10 10/11 Future Total Personnel $85,000 $25,000 $75,000 $185,000 Hardware $73,000 $73,000 Software $0 3rd Party $42,400 $42,400 Recurring $100,000 $100,000 $300,000 $500,000 Total $300,400 $125,000 $375,000 $800,400 Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 4 of 9 October 30, 2008

6 Nature of the Project Extent to which the Project is Critical to the Accomplishment of the County, MHSA, and DMH Goals and Objectives. This project is being coordinated with the County's overall Infrastructure Strategic Plan. In that plan, redundant high-speed connections are being installed between the most critical hubs in the county. See Attachments 2 and 3, Exhibit 3, Project 1 for an overview of the County plan. This plan, as it applies to the Mental Health Department, will provide high speed links between the County Hospital complex (Kern Medical Center or KMC) and the Primary County Hub (the "Downtown Campus" on the attachments). There are existing high-speed links between the Downtown Campus and Mental Health's primary location and between the KMC Campus and another of the Department's primary outpatient clinic locations (1111 Sagebrush). This project is focused on increasing the bandwidth and providing current technology equipment for the other nine primary Mental Health facilities. In addition, this project will also address the infrastructure required for our Tele-Medicine project. Tele-Medicine was implemented using MHSA CSS One-time funds. Equipment was installed in 25 locations, the communications protocol selected at that time was ISDN dial-up technology. It was felt that this would be the most costeffective and flexible method of interconnecting the Tele-Medicine equipment. However, as the Department began using this equipment, the limitations of this technology came into play. Moreover, in many cases the tele-medicine equipment is located at the same facilities being addressed by this project. Therefore, this project will include upgrades to each of the tele-medicine facilities to provide more reliable and more flexible communications. Attachment 1 to Exhibit 3 for Project 1 contains the details of the locations involved, there is a column on this spreadsheet specific to sites with tele-medicine requirements. Degree of Centralization or Decentralization Required for this Activity. The purpose of this project is to provide effective decentralization of centralized applications, primarily access to the Electronic Health Record. The Tele-Medicine component of the project promotes decentralization of clinical services (primarily Doctors) by allowing services to be provided at remote locations without either the service provider or the client being required to travel to obtain these services. Data Communication Requirements associated with the Activity. This project is focused on Data Communications, specific requirements are indicated throughout this Exhibit. Characteristics of the Data to be Collected and Processed (i.e., source, volume, volatility, distribution, and security or confidentiality). Degree to which the Technology can be Integrated with Other Parts of a System in achieving the Integrated Information Systems Infrastructure. The technology being proposed is completely compatible both with current technology already in place and both the Department's and the County's strategic plans. Completion of this project is a major step in the implementation of an Integrated Information Systems Infrastructure. Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 5 of 9 October 30, 2008

7 Hardware Considerations * (As Applicable) Compatibility with Existing Hardware, Including Telecommunications Equipment. The technology being proposed is completely compatible with current technology already in place and both the Department's and the County's strategic plans. Completion of this project is a major step in the implementation of an Integrated Information Systems Infrastructure. Physical Space Requirements Necessary for Proper Operation of the Equipment. Generally speaking, each of the locations targeted for hardware upgrades currently utilize wiring closets and/or server rooms that have adequate space and environmental controls to support this project. Hardware Maintenance. Hardware maintenance is purchased from the original hardware manufacturer and/or reseller on an ongoing basis. Existing Capacity, Immediate Required Capacity and Future Capacity. See attachment 1, Exhibit 3, Project 1 for details of existing capacity and the proposed upgrades. Backup Processing Capability. Software Considerations * (As Applicable) Compatibility of Computer Languages with Existing and Planned Activities. Maintenance of the Proposed Software (e.g., vendor-supplied). Availability of Complete Documentation of Software Capabilities. Availability of Necessary Security Features as defined in DMH Standards noted in Appendix B. Ability of the Software to meet Current Technology Standards or be Modified to meet them in the future. Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 6 of 9 October 30, 2008

8 Interagency Considerations* (As Applicable) Describe the County s interfaces with contract service providers and state and local agencies. Consideration must be given to compatibility of communications and sharing of data. The information technology needs of contract service providers must be considered in the local planning process. As can be seen in Attachment 1, Exhibit 3, Project 1, the three primary Mental Health Contract Providers are included in the plan. Network improvements have already been implemented at the remote sites managed by these providers. There remain two sites with sub-par carrier service that need to be updated. Additionally, 12 of the tele-medicine packages are installed at contract provider locations and will be included in the communications upgrades. The technology used for tele-medicine is compliant with national standards for tele-video as well as the California Tele-Health Network (CTN). Training and Implementation * (As Applicable) Describe the current status of workflow and the proposed process for assessment, implementation and training of new technology being considered. Security Strategy * (As Applicable) Describe the County's policies and procedures related to Privacy and Security for the Project as they may differ from general Privacy and Security processes. Protecting Data Security and Privacy. Operational Recovery Planning. Business Continuity Planning. Emergency Response Planning. Health Information Portability and Accountability Act (HIPAA) Compliance. State and Federal Laws and Regulations. Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 7 of 9 October 30, 2008

9 Project Sponsor(s) Commitments [Small Counties May Elect to not Complete this Section] Sponsor(s) Name(s) and Title(s) Identify the Project Sponsor Name and Title. If multiple Sponsors, identify each separately. James A. Waterman, PhD Dr. Tai Yoo, M.D. Dan Walters Director Joint Chairman of Psychiatry Program Director, UCLA - Kern Psychiatry Residency Program Clinical Professor and Vice Chairman, Department of Psychiatry and Biobehavioral Sciences David Geffen School of Medicine at UCLA Technology Services Manager Commitment Describe each Sponsor's commitment to the success of the Project, identifying resource and management commitment. Dr. Waterman has continuously promoted consistent use of the EHR. He is well aware that down-time and slow response are barriers to effective use of this critical tool. As such, he is committed to the same goal of providing sufficient bandwidth to each user to allow them to utilize the EHR with minimal interruptions and at a transaction speed allowing smooth clinical operation. Dr. Waterman is also aware of the contributions to quality services made by the Tele-psychiatry project. Additionally, as the Department Director, he is also intimately familiar with the fiscal challenges facing the Department. He believes that the Telepsychiatry network can solve both challenges by providing services that both meet the needs of our clients and are cost effective. Dr. Yoo was the original driving force behind the implementation of Tele-psychiatry functionality in Kern County. He is well aware of the challenges of maintaining an excellent Medical Staff and of the value of the Doctors currently on his staff. He is constantly striving for ways of improving the quality and availability of medical services to our clients. He has recognized that technology can provide a basis for providing those services at locations throughout the County. He is totally committed to making the improvements in technology included in the project to further enhance the remote services that his staff can provide. Mr. Walters has been responsible for Kern s EHR project since its inception. As such, he has directly experienced the challenges associated with insufficient communications capabilities. He is committed to modernizing the Infrastructure to the point that it is invisible to the end users. The expectation is that sufficient bandwidth will be provided to each user to allow them to utilize the EHR with minimal interruptions and at a transaction speed allowing smooth clinical operation. Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 8 of 9 October 30, 2008

10 Approvals/Contacts Please include separate signoff sheet with the Names, Titles, Phone, , Signatures, and Dates for: Individual(s) responsible for preparation of this Exhibit, such as the Project Lead or Project Sponsor(s). Signatures Prepared By Name: M. Daniel Walters Title: Technology Services Manager Signature: Date: Phone: (661) Address: Name: James A. Waterman, PhD Title: Director Signature: Date: Phone: (661) Address: Enclosure 3, Exhibit 3 - Technological Needs Project Proposal Description Page 9 of 9 October 30, 2008

11 Category Estimated Cost of Project Project Manager Experience Like Projects Completed in a "key Elements of Project Type Application Service Provider COTS* Installation Appendix A - Project Risk Assessment Factor Rating Score Over $5 million 6 Over $3 million 4 Over $500,000 2 Under $500,00 1 None 3 staff" role One 2 1 Two or More 1 Team Experience Like Projects Completed by at least 75% key staff 1 Hardware Software *Commercial Off-The-Shelf Software New Install Update/Upgrade Infrastructure Custom Development- Number of Users Architecture None 3 One 2 Two or More 1 Local Desktop/Server 1 Distributed/Enterprise Server 3 Local Desktop/Server 1 Distributed/Enterprise Server 2 Local Network/Cabling 1 Distributed Network 2 Data Center/Network Operations 3 Center 5 "Off-the-Shelf" 1 Modified COTS 3 Over 1,000 5 Over Over 20 2 Under 20 1 Browser/thin client based 1 Two-Tier (client/server) 2 Multi-Tier (client & web, database, 3 application, ect. Servers) Total Score: Total Score Project Risk Rating High Medium 8-15 Low Project: Network Infrastructure Modernization - Project 1 Appendix A - Project Risk Assessment March 5, 2008

12 Location City Approx User Count Current Bandwidth Proposed Bandwidth Total Network Infrastructure Upgrade Proposed Technology Monthly Cost Installation Cost Equipment Cost Total nonrecurring KCMH Sites 3300 Truxtun Data Bakersfield MB 150 MB Microwave, T1, T3 $25,000 $25,000 Central hub of Network 2151 College Bakersfield MB 300 MB * Microwave $2,500 $2,500 See Note 1, County Infrastructure Plan 1721 Westwind Bakersfield MB 3 MB T1x2 $360 $1,800 $2,500 $4, Sillect Ave (SA) Bakersfield MB 1.6 MB * T1 $0 $0 No Change 2621 Oswell Bakersfield MB 4 MB T1x3 $540 $3,600 $3,500 $7, L Street Bakersfield MB 55 MB * Microwave/fiber $0 $0 No Change 7900 Niles Bakersfield MB 3 MB T1x2 $360 $1,800 $2,500 $4, E. Belle Terrace Bakersfield MB 3 MB T1x2 $360 $1,800 $2,500 $4, Columbus Bakersfield MB 3 MB T1x2 $360 $1,800 $2,500 $4, N. Chester Bakersfield MB 5 MB T1x3 $540 $3,600 $3,500 $7, F. Street Wasco MB 3 MB T1x2 $360 $1,800 $2,500 $4, th St Taft MB 10 MB * Microwave $0 $0 Increase number of available channels Notes 5121 Stockdale HWY Bakersfield MB 5 MB T1x3 $540 $3,600 $3,500 $7, S. Union Bakersfield MB 1.6 MB * T1 $180 $0 $ Columbus Bakersfield MB 10 MB * Fiber to KMC Campus, M/W to Hub $3,000 $3, Industrial Farm Rd Lerdo 1.6 MB 2 MB T1 $180 $0 $0 See Note 1, County Infrastructure Plan Note 1: County Infrastructure Plan Install 300 MB MW from County Data Center to County Hospital. Fiber connections to two MH Locations co-located with hospital clinics 778 Contractors College Community Services (Dependent on connection speed at each location) 113 F Street Techachapi 512 KB T1 $400 $1,800 $1,500 $3,300 Tehachapi Regional Office Tehachapi 512 KB T1 $400 $1,800 $1,500 $3, th St Wasco 512 KB T1 $400 $1,800 $1,500 $3, Nugget Ave Lake Isabella 512 KB T1 $400 $1,800 $1,500 $3, N. Norma Street Sutie 133 Ridgecrest 512 KB T1 $400 $1,800 $1,500 $3, Hwy 14, Suite F Mojave 512 KB T1 $400 $1,800 $1,500 $3,300 Clinica Sierra Vista Bakersfield 1.6 MB 1400 S. Union Bakersfield 512 KB T1 $180 $1,800 $1,500 $3, Burgandy Ave Lamont 512 KB T1 $400 $1,800 $1,500 $3, High Street Suite B & C Delano 512 KB T1 $400 $1,800 $1,500 $3, Mt Pinos Way Frazier Park 768 KM T1 $400 $1,800 $1,500 $3,300 Child Guidance Center Bakersfield 1.6 MB 1318 High Street Delano 512 KB T1 $400 $1,800 $1,500 $3,300 Crestwood Bakersfield 512 KB T1 $180 $1,800 $1,500 $3,300 Good Samariton Bakersfield 512 KB T1 $180 $1,800 $1,500 $3,300 Provided Secure Routers that connect to County WAN via Connected contractor's WAN to County WAN via T1 and Secure Router Connected contractor's WAN to County WAN via T1 and Secure Router Annual Recurring: $99,840 $8,320 $43,200 $73,000 $116,200 Attachment 1, Exhibit 3, Project 1

13 Current Situation Single Points of Failure Servers Communication Lines Low Speed Link Network Downtown Campus Public Health Servers Network KMC Campus

14 Phase 1 Add High Speed Links and Second Connection Redundant Communication Lines Servers Redundant Servers Network Network Downtown Campus Communications Center Departmental Servers KMC Campus

15 Phase 2 Add High Speed Links and Storage to Rest of Sites Redundant Servers Network Storage SAN SAN Redundant Servers Network Storage Downtown Campus Communications Center Public Services Fire Sheriff Departmental Servers SAN Mental Health Human Services KMC Campus

16 Phase 3 Add Backup Links from a Different Carrier Redundant Servers Network Storage SAN SAN Redundant Servers Network Storage Downtown Campus Different Carrier Communications Center Public Services Fire Departmental Servers Mental Health Sheriff SAN Human Services KMC Campus

17 Technical Overview Includes High Speed Microwave and Different Carriers Downtown Campus Comm Center No Line of Sight KMC Campus 2 High Speed Microwave links 8 T1 lines from Existing County Microwave System 2 High Speed Microwave links 100Mbps Fiber Connection

18 Technical Overview Includes High Speed Microwave and Different Carriers Downtown Campus Comm Center No Line of Sight KMC Campus Missing Link 8 T1 lines from Existing County Microwave System 2 High Speed Microwave links Fiber Carrier 100Mbps Fiber Connections 2 High Speed Microwave links

19 County Name: Kern Enclosure 3 Exhibit 4 Budget Summary For Technological Needs Project Proposal Project Name: Network Infrastructure Modernization - Project 1 (1) (List Dollars in Thousands) (2) (3) (4) (5) (6) Category 08/09 09/10 10/11 Future Years Total One-time Costs ( ) Personnel Estimated Annual Ongoing Costs* Total Staff (Salaries and Benefits) Hardware From Exhibit 2 Total Hardware Software From Exhibit 2 Total Software Contract Services (list services to be provided) Communications Carrier Total Contract Services Administrative Overhead Other Expenses (Describe) Total Costs (A) Total Offsetting Revenues (B) ** MHSA Funding Requirements (A-B) * Annual Costs are the ongoing costs required to maintain the technology infrastructure after the one-time implementation. ** For Projects providing services to Multiple-Program Clients (e.g., Mental Health and Alcohol and Drug Program clients), Attach a Description of Estimated Benefits and Project Costs allocated to Each Program. Project Proposal, Enclosure 3, Exhibit 4 - Budget Summary Page 1 of 2 10/29/2008

20 Notes: Project Proposal, Enclosure 3, Exhibit 4 - Budget Summary Page 2 of 2 10/29/2008