Electronic Visit Verification
& Client Care
Session – T16
32nd
Presented at:
Annual Governor’s Conference on Aging and Disability
By: Elton A. Arrindell
Illinois Department on Aging
Division Planning, Research & Development
Thursday, December 12, 2013
Electronic Visit Verification (EVV)
IT’S THE LAW!
Presentation Overview
All CCP In-Home Service Providers
and Home Service Program Personal
Assistants (PA’s) must comply!
 Statutory Provision
 Purpose, Rationale & Opportunities
 IL Department on Aging (IDoA) and Human Services (DHS) EVV Models
 Permissible EVV Technology for CCP
 CCP Network Compliance by Key Indicators
 Next Steps
 Q&A’s by IDoA, DHS and EVV Providers
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EVV Statutory Provision
IT’S THE LAW!
In-home service units must be delivered
using an auditable EVV system to record
sign-in & sign-out of homecare aide visits
Public Act 097-0689
signed on June 14, 2012
a.k.a. Save
Medicaid Access and Resources Together (SMART) Act,
Sec. 5-5f., sub-part (g) provides the following:
“For the Home Services Program operated by the Department of Human
Services and the Community Care Program operated by the Department on
Aging, the Department of Human Services, in cooperation with the
Department on Aging, shall implement an electronic service verification based
on global positioning systems (GPS) or other cost-effective technology.”
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Purpose, Rationale & Opportunities
 Service delivery assurance to vulnerable older adults and persons with disabilities
 Accountability at the point-of-service and overall management
 Budgetary / Efficiency Cost Savings
 Improved billing, payroll and related administrative efficiencies at multiple levels
 Fraud mitigation and prevention
 Improved reporting and data collection
 Timely documentation of service tasks to help inform client care and health outcomes
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FY14 Community Care Program Budget
($ in millions)
The budget reflects $25 million in EVV Efficiency Cost Savings
of approximately 5% in In-Home Service (INH) Units for 9 months
$32.2
3%
$60.8
6%
CCP Current Year
Services
CCP - Capitated
Coordinated Care
$882.8
91%
Case Management
The FY14 Enacted budget includes $975.8 million in General Revenue funds for Community Care Program Services.
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State of Illinois
Electronic Visit Verification Models
Department on Aging
Department of Human Services
EVV Model: Standards Based
Flexible EVV System
EVV Model: Single Payer-Single System
Mandated EVV for PA’s and select
Homemaker Agencies*
Effective Date: July 1, 2013
Effective Date: January 1, 2014
Target Group: All Community Care
Program In-Home Service
Providers and Managed Care
Organizations
Payer: Each Individual Provider
Agency for all costs
Target Group: All Home Service Program
Personal Assistants and In-Home Service
Agencies & Managed Care Organizations
Payer: DHS for the PA’s;
DHS to reconcile INH providers ongoing use
and recoup usage costs
* INH providers with a pre-existing system can opt to retain their EVV system
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CCP Permissible EVV Technology
Does one size fit all?
For CCP, all EVV solutions to document and monitor homecare aides (HCAs) visits must be supplied by and paid
for by the in-home service provider agency. Client cell-phone is not permitted for reliability and security purposes.
Companies currently providing EVV services
to CCP In-Home Service Providers
SANDATA
AMPERSAND INTERNATIONAL
ACCESSIBLE SOLUTIONS
PHONE WORKS
EPAY Systems, Inc.
CARE MONITORING 2000
AUGUST SYSTEMS
CAREWATCH
GENERATIONS
VISIT CARE
CARETIME
ICASP
ARIEL PARTNERS
HOME TRAK, INC
ADP
CARE ANYWARE
DIAL N DOCUMENT
ANKOTA, INC
CellTrak
McKESSON HOMECARE
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CCP Electronic Visit Verification
&/or Related Important Policy Actions & Timeframes
EVV Standards Released to the Aging Network
FY13 / April 1, 2013
7-Minute Rounding (Policy Instruction Memorandum)
April 1, 2013
CCP Service Authorization Guidelines
April 2, 2013
Compliance Procedures Policy (PIM)
June 28, 2013
CCP Electronic Visit Verification Effective Date
Client and HCA Notification Letters LEP translated client letters are available)
FY14 / July 1, 2013
July 5, 2013
Emerg. Rulemaking 1st Notice published (amends Sec. 240-1530; Adds 240-1531)
July 19, 2013
INH Compliance Notification first filling with IDoA
July 31, 2013
INH Compliance Notification 2nd Filing with IDoA
September 30, 2013
DHS / IDoA Joint Letter to providers servicing both agencies
October 18, 2013
Client Verification PIM (Capturing Service Tasks & eService Calendar allowance)
October 29, 2013
Rulemaking 2nd Notice Published
Prevention of Contract Action Notification Letter
October 4, 2013
December 9, 2013
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Community Care Program
EVV Compliance Status by Key Indicators – As of Dec. 6, 2013
Count Percent
Legal Entities
Compliant
Lacking Updated Compliance Forms(s)/Not Compliant
107
57
50
100%
53%
47%
Contract Agreements
Compliant
Lacking Updated Compliance Forms(s)/Not Compliant
244
146
98
100%
60%
40%
Service Units/Hours (based on FY13 Data)
Compliant
Lacking Updated Compliance Forms(s)/Not Compliant
40.1 million
34.9 million
5.2 million
100%
87%
13%
Caseload (based on FY13 Data)
Compliant
Lacking Updated Compliance Forms(s)/Not Compliant
99,600
87,000
12,600
100%
87%
13%
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EVV Technology
Reported in Use or to be Used
(Many CCP In-Home Service Providers use 2 or more)
50.0%
45%
45.0%
40.0%
35.0%
30.0%
25.0%
24.0%
24.0%
20.0%
15.0%
10.0%
5.8%
5.0%
1.0%
0.0%
Mobile Phone/GPS
Telephony
Tablet
Fixed Visit Verification
Other
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IDoA’s Next Steps
 Issuance of non-compliance notices
Updated IL-402-1152 EVV Compliance Form per INH agreement must be received by IDOA by 12/27/31
 Suspension of Intake for non-compliance WILL begin January 1, 2014
 Field monitoring and added contract action for non-compliance
 Ongoing monitoring by providers of their HCAs; reducing sign-in/out exceptions, and
addressing other implementation issues (e.g., training, internal policy development, etc).
 Tracking EVV data and developing reporting requirements / Best Practices
 Accountability reporting to the General Assembly pursuant to P.A. 98-0008
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Questions & Answers
Providers seeking EVV policies & procedures
and related information, please visit:
Community Care Program
https://www.egov.aging.state.il.us/egov/root/ccpis_INFOProviderOnly.asp
or call the Senior HelpLine at: 1-800-252-8966 or 1-888-206-1327 (TTY)
Home Service Program
http://www.dhs.state.il.us/page.aspx?item=66961
Thank You!
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