Electronic Visit Verification & Client Care Session T16
Electronic Visit Verification & Client Care Session T16 32 nd Presented at: Annual Governors 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) Presentation Overview ITS THE LAW! All CCP In-Home Service Providers and Home Service Program Personal Assistants (PAs) 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&As by IDoA, DHS and EVV Providers 2 EVV Statutory Provision ITS 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. 3 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 4 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 ; 3.30% $60.8 ; 6.23% CCP Current Year Services CCP - Capitated Coordinated Care $882.8 ; 90.47% Case Management
The FY14 Enacted budget includes $975.8 million in General Revenue funds for Community Care Program Services. 5 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 PAs 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 PAs; 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 6 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 EPAY Systems, Inc. CARE MONITORING 2000 ARIEL PARTNERS HOME TRAK, INC AMPERSAND INTERNATIONAL
AUGUST SYSTEMS CAREWATCH ADP CARE ANYWARE ACCESSIBLE SOLUTIONS GENERATIONS VISIT CARE DIAL N DOCUMENT ANKOTA, INC PHONE WORKS CARETIME ICASP CellTrak McKESSON HOMECARE 7 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 8 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% 9 EVV Technology Reported in Use or to be Used (Many CCP In-Home Service Providers use 2 or more) 50.0% 45.2% 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 10 IDoAs 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 11 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! 12
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