The Washington DC House of Representatives successfully passed H.R. 6042 that would delay by one year the implementation of Electronic Visit Verification. Electronic Visit Verification (EVV) is a tracking system that requires electronic verification of when a person receives Medicaid funded personal care or home health services. The bill that has passed the House extends the deadline to January 1, 2020 for implementing EVV for personal care services. A Senate vote on the bill is expected in July
Nicole Jorwic, Director of Rights Policy at The Arc of the United States, calls the delay of EVV a ‘civil rights issue.’ She says the delay is important because it will give stakeholders the opportunity to work out the challenges of privacy protection.
Why is The Arc of the United States in favor of delaying the EVV implementation?
“The Arc’s perspective on the EVV issue from the very beginning has always been a civil rights issue. That has been the focus of all of our advocacy and our outreach. It’s a civil rights issue because of the concern around unintended consequences of impeding upon an individual’s privacy rights.
“Our position is strongly in favor of legislation that would require a delay because of the troubling things that we have seen with implementation of EVV systems in many states.
“In Ohio there have been several instances where the systems being used for EVV also have audio and video recording functionality. That’s a concern because we are obviously talking about very private services that are going on, personal hygiene or toileting. We’re concerned about privacy andwhat happens with that information. Who has access to it? Does the state have access to it?”
What is the timeline with the bill’s passage?
“We have had bipartisan support in both the House And the Senate on the delay. I think because of the realization there were some real unintended consequences through implementation, nothing was said on the Floor in opposition of the delay. There continues to be concerns by some of the members who recommended EVV in the first place, that it can be a tool for taking a look at some rare and occasional instances of fraud. What we anticipate now that the bill has passed the House, is that a similar bill will be voted on in the Senate sometime after the 4th of July recess. We are hopeful from the meetings that we have had, that the bill will pass the Senate. I am relatively hopeful that we will see this bill become law.”
Why are these bills significant?
“The passage of the bills that will ultimately delay implementation of EVV is step one of a two-part fix. But it is an important first step. The delay of implementation will allow for stakeholder input. It is important that individuals who are receiving services and family members have the opportunity to have their voices be heard. It is also important to have the industry hear from families so they can create products that don’t violate privacy in the way that some of the tools that have been used; some states are experiencing that consequence.”
What is the second step?
“The second thing is we will be working with the legislators on is to go back in and make a legislative fix. It’s not a huge change to the underlying legislation. All we would need to do is remove the language requiring EVV systems to have geotracking. While CMS (Centers for Medicare and Medicaid Services) guidance clarified that states do not have to have a geotracking component in the implementation of EVV, it did not say that they cannot. We know that we need to go in and make that legislative fix to remove any misconceptions that EVV has to require a tracking component.”
Why is eliminating geotracking important?*
“Eliminating language in relation to geotracking is very important because it eliminates the ambiguity for states. Eliminating that ambiguity will help states move forward in a more streamlined process. From a rights perspective, removing the geotracking component of EVV is extremely important. There are a lot of unintended consequences that come along with the use of geotracking, including the fact that the phone system requires the use of a landline. That can have unintended consequences of isolating an individual, requiring them to stay home to receive services when we want to continue to provide support services out in the community. There are other ways of doing electronic timesheets that don’t have geotracking. The underlying root of why a lot of folks were proposing EVV was making sure services that are bring reported are actually provided. We support that assertion. But in order to make sure services were rendered, we don’t need to know where they were rendered.”
*Please note the Colorado plan does not require or mention geotracking or any other tracking component.
What is your opinion of state’s still implementing EVV in January of 2019?
“What I am hearing is states being gratified for this delay. If they were pushing forward, this is a pivot point. I would hope Colorado looks to its fellow states and follows a similar path. There’s no reason to rush into something when we know the industry and stakeholders are going to be making a lot of improvements over the next couple of years. There could be some unintended consequences if they push through with implementation whether it’s a soft rollout or hard rollout.”
Catherine Strode is Advocacy Denver’s Communications and Policy Specialist. She holds a Masters degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes Policy Perspective, featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.