Electronic Visit Verification (EVV) Phase I
Electronic visit verification (EVV) is an electronic-based system that collects information through a secure website, a mobile application (“app”) or a telephone. Federal law, Subsection l of Section 1903 of the Social Security Act (42 U.S.C. 1396b) , requires all states to implement EVV for Medicaid-funded personal care services by January 2020 and home health care services by January 2023. States can select and implement their own EVV design. However, the EVV system must verify: type of service performed; individual receiving the service; date of the service; location of service delivery; individual providing the services and time the service begins and ends.
Which programs will be impacted by EVV in California?
EVV will impact all personal care services and home health care services provided under the state plan and various waivers. In California personal care services are delivered to eligible aged, blind and disabled individuals through multiple programs managed by California Department of Social Services (CDSS) and Department of Health Care Services (DHCS).
Most publicly-funded personal care services are managed by CDSS through the following four programs collectively known as the In-Home Supportive Services (IHSS) Program:
- Personal Care Services Program (PCSP)
- IHSS Plus Option (IPO)
- Community First Choice Option (CFCO)
- IHSS Residual (IHSS-R)
DHCS and its designees (Departments of Aging, Developmental Services and Public Health) are responsible for providing oversight of personal care services provided under Medicaid Home and Community-Based Service (HCBS) programs. Impacted HCBS programs include:
- Home and Community-Based Alternatives (HCBA) Waiver
- In-Home Operation (IHO)
- Pediatric Palliative Care Waiver (PPCW)
- HIV/AIDS Waiver
- HCBS Waiver for Californians with Developmental Disabilities
- 1915(i) State Plan Amendment for Californians with Developmental Disabilities
- Multipurpose Senior Services Program (MSSP)
California is implementing EVV in two phases:
- Phase I is focused on the IHSS and Waiver Personal Care Services (WPCS) programs that currently use the Case Management Payrolling & Information Systems (CMIPS) and Electronic Timesheet and Telephonic Timesheet Systems.
- California plans to implement Phase I EVV over the course of the next two years or so and will seek a good faith exemption request to delay full implementation until January 1, 2021.
- Phase II is focused on identifying either an existing system(s) or a new system to implement EVV for non-CMIPS and agency personal care services, and self-directed and agency home health services. For more information, please visit the DHCS EVV Phase II website.
California is committed to the full involvement of recipients, providers and other stakeholders in the planning and implementation of EVV. Over the past year, California has carefully considered feedback from the stakeholder community, best practices and the State’s capacity to implement EVV for over one million IHSS and WPCS recipients and providers in a consumer-directed environment.
The State has convened four statewide stakeholder meetings focused on Phase I with between 200-250 participants, including recipients, providers, advocacy groups, labor unions, counties, the Legislature and the Administration. The state will continue to engage stakeholders during the development of the EVV prototype and statewide EVV implementation plan for IHSS and WPCS, as well as the phased statewide rollout.
Please visit the EVV Phase I Stakeholder Meetings webpage for information on both upcoming and previous meetings.
EVV Phase I is guided by the following principles:
- California’s approach to EVV will be consistent with federal law.
- EVV will be developed through a collaborative stakeholder process.
- EVV will be developed in a manner that respects recipients and providers, does not alter their Olmstead protections and is minimally burdensome.
- EVV will not change the number of service hours, nor how or where services are delivered.
- Use of geo-tracking or global positioning system capabilities (GPS) will not be required.
- Existing electronic and telephonic timesheet systems will be leveraged for EVV.
- Providers, recipients and other stakeholders will be trained on the use of the EVV system.
Proposed Solution and Development Timeline
The EVV solution for the Self-Directed Model for IHSS and WPCS is to leverage and enhance the existing Electronic Timesheet System (ETS), now referred to as the Electronic Services Portal (ESP), and the Telephonic Timesheet System (TTS). This approach can be accomplished with current vendors, which minimizes development and implementation costs. Providers and recipients will be able to access the EVV system through an online ESP web portal that can be used on any device with internet access or via telephone (landline or mobile). In the future, a mobile phone application will also be considered.
Many providers and recipients are already familiar with these easy-to-use systems, so the impact of EVV requirements will be minimal. This approach also allows providers to access other system features such as enrolling into direct deposit, claiming sick leave and travel time and online tracking of timesheet processing.
EVV will not change the amount of service hours, nor how or where IHSS and WPCS are provided. However, at some point, EVV will fully replace the current paper timesheet for IHSS and WPCS providers.
The EVV web portal and telephonic systems will be developed on separate but parallel tracks as follows:
||EVV Web Portal
||Telephone Timesheet System
|Develop workable EVV web portal prototype.
Round 1 for EVV Web Portal
Conduct demonstrations of prototype for stakeholder input.
December 2018 – February 2019
Modify prototype based on feedback.
Begin development of basic script.
-Round 2 for EVV Web Portal
-Round 1 for Telephone Timesheet System
|Conduct demonstrations of prototype for stakeholder input.
||Conduct stakeholder meetings to solicit feedback on scripts.
Modify prototype based on feedback.
Modify script based on feedback.