Pillar · Governance

Governance frameworks built from scratch — at state Medicaid scale, and at agency scale.

Most consultants do project work or governance work. I've done both, and the difference matters: governance frameworks I've stood up — at the state Medicaid level for NYS DOH, and at the agency level for SANDAG and ODJFS — are structures other teams have to live inside afterwards. That's the discipline that separates a framework from a slide deck.

Playbook

The artifacts behind the governance work.

Preview pages from working tools used in real engagements. These are what an inherited governance framework actually looks like — structured, defensible, audit-ready.

Case studies

Three engagements where governance was the work.

NYS DOH Medicaid Enterprise System — Governance Framework

IDR / KPMG · New York State Department of Health · 2024–present
$1B+
Enterprise scale
Context
A multi-year Medicaid Enterprise System modernization across the largest state Medicaid program in the country, with federal HHS compliance obligations under 45 CFR.
Challenge
No defensible governance framework spanned the full scope: Business Policy, Program & Project Management, Vendor Management, and Enterprise / Business / Data / Security Architecture domains.
Approach
Three-tier body framework (executive, domain councils, working layer), explicit COBIT 2019 alignment, intake and prioritization governance, defined decision authority per body, vendor oversight integrated into the structure.
Outcome
Comprehensive governance framework delivered and approved by client leadership — complete with three-tier body structure, COBIT 2019 alignment, intake and prioritization governance, and decision-authority schema. Operationalization underway at client pace under their ownership.
What you'd inherit
A working three-tier governance body framework, with decision-authority schema and COBIT alignment, adaptable to any regulated enterprise IT environment.

SANDAG — Enterprise IT PMO Governance

San Diego Association of Governments · Dec 2018 – Nov 2020
14
Business areas in scope
Context
A regional planning agency entering a multi-year digital transformation cycle with no centralized PMO and inconsistent project intake.
Challenge
Build enterprise IT PMO governance from scratch — intake, prioritization, project lifecycle, executive reporting — while simultaneously seeding the actual transformation project pipeline.
Approach
Stood up the PMO governance structure with documented decision authority, established the intake-to-prioritization workflow, and produced documented project artifacts (timelines, deliverables, resource plans, budget estimates) for the multi-year pipeline.
Outcome
Operational PMO governance structure seeding a documented multi-year project pipeline; agency executive leadership equipped to make portfolio-level investment decisions on consistent evidence.
What you'd inherit
A PMO governance model proven at agency scale — including the intake-to-prioritization workflow that's typically the missing piece in greenfield PMO standups.

ODJFS — Enterprise Architecture Governance

Ohio Department of Job and Family Services · State agency engagement
5
Federal compliance domains
Context
EA Section Chief role inside a large state HHS agency administering CRIS-E and adjacent federally-funded systems under 45 CFR oversight.
Challenge
Inside-the-agency governance work — not consulting from outside — requiring EA governance defensible under federal compliance review across Child Support, TANF, SNAP, and Medicaid program lines.
Approach
EA governance model integrated with federal compliance frameworks (MITA, TOGAF), with documented policy alignment, technical standards governance, and federal-state coordination mechanisms.
Outcome
EA governance defensible under federal compliance review; technical standards aligned across program lines without losing the federal funding flow.
What you'd inherit
An EA governance model proven inside a regulated agency context — including the federal-state coordination patterns that outside consultants rarely capture correctly.
Discuss governance

Have a governance gap to fill?

If you're standing up a PMO, building a defensible enterprise IT governance framework, or shoring up vendor and policy oversight, let's discuss what would actually work in your environment.

Email rjames@s1techconsulting.com
Engagement models See how I structure work