Electronic Visit Verification - PowerPoint Presentation

Electronic Visit Verification & Client Care Session – T16Presented at:32nd Annual Governor’s Conference on Aging and DisabilityBy: Elton A. ArrindellIllinois Department on AgingDivision Planning, Research & DevelopmentThursday, December 12, 2013

2 Presentation Overview 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 IT’S THE LAW! All CCP In-Home Service Providers and Home Service Program Personal Assistants (PA’s) must comply! Electronic Visit Verification (EVV)

3 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 .” 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 EVV Statutory Provision

4 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 outcomesPurpose, Rationale & Opportunities

5FY14 Community Care Program Budget($ in millions) The FY14 Enacted budget includes $975.8 million in General Revenue funds for Community Care Program Services. The budget reflects $25 million in EVV Efficiency Cost Savings of approximately 5% in In-Home Service (INH) Units for 9 months

6 Department on Aging EVV Model: Standards Based Flexible EVV System Effective Date: July 1, 2013 Target Group: All Community Care Program In-Home Service Providers and Managed Care Organizations Payer : Each Individual Provider Agency for all costs Department of Human Services EVV Model: Single Payer-Single System Mandated EVV for PA’s and select Homemaker Agencies * Effective Date : January 1, 2014 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 State of Illinois Electronic Visit Verification Models

7 Companies currently providing EVV services to CCP In-Home Service Providers SANDATA AMPERSAND INTERNATIONAL ACCESSIBLE SOLUTIONS PHONE WORKS EPAY Systems, Inc. AUGUST SYSTEMS GENERATIONS CARETIME CARE MONITORING 2000 CAREWATCH VISIT CARE ICASP ARIEL PARTNERS ADP DIAL N DOCUMENT CellTrak HOME TRAK, INC CARE ANYWARE ANKOTA, INC McKESSON HOMECARE 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.

8CCP 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 FY14 / July 1, 2013       Client and HCA Notification Letters LEP translated client letters are available) 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 agenciesOctober 18, 2013 Client Verification PIM (Capturing Service Tasks & eService Calendar allowance)October 29, 2013    Rulemaking 2nd Notice PublishedOctober 4, 2013    Prevention of Contract Action Notification Letter December 9, 2013 

9Community Care Program EVV Compliance Status by Key Indicators – As of Dec. 6, 2013 CountPercent Legal Entities 107 100% Compliant 57 53% Lacking Updated Compliance Forms(s)/Not Compliant 50 47%             Contract Agreements 244 100% Compliant 146 60% Lacking Updated Compliance Forms(s)/Not Compliant 98 40%             Service Units/Hours (based on FY13 Data) 40.1 million 100% Compliant 34.9 million 87% Lacking Updated Compliance Forms(s)/Not Compliant 5.2 million 13%             Caseload (based on FY13 Data) 99,600 100% Compliant 87,000 87% Lacking Updated Compliance Forms(s)/Not Compliant 12,600 13%

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11 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. 98-0008IDoA’s Next Steps

12Questions & AnswersProviders seeking EVV policies & procedures and related information, please visit:Community Care Programhttps://www.egov.aging.state.il.us/egov/root/ccpis_INFOProviderOnly.aspor call the Senior HelpLine at: 1-800-252-8966 or 1-888-206-1327 (TTY) Home Service Programhttp://www.dhs.state.il.us/page.aspx?item=66961 Thank You!