Electronic Visit Verification Client Care Session T 16

Electronic Visit Verification & Client Care Session – T 16 32 nd 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! All CCP In-Home Service Providers and Home Service Program Personal Assistants (PA’s) must comply! Presentation Overview q Statutory Provision q Purpose, Rationale & Opportunities q IL Department on Aging (IDo. A) and Human Services (DHS) EVV Models q Permissible EVV Technology for CCP q CCP Network Compliance by Key Indicators q Next Steps q Q&A’s by IDo. A, DHS and EVV Providers 2

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 097 -0689 Public Act signed on June 14, 2012 a. k. a. Save Medicaid Access and Resources Together (SMART) Act, Sec. 5 -5 f. , 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 q Service delivery assurance to vulnerable older adults and persons with disabilities q Accountability at the point-of-service and overall management q Budgetary / Efficiency Cost Savings q Improved billing, payroll and related administrative efficiencies at multiple levels q Fraud mitigation and prevention q Improved reporting and data collection q Timely documentation of service tasks to help inform client care and health outcomes 4

FY 14 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 FY 14 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 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 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 AMPERSAND INTERNATIONAL ACCESSIBLE SOLUTIONS PHONE WORKS EPAY Systems, Inc. CARE MONITORING 2000 AUGUST SYSTEMS CAREWATCH GENERATIONS VISIT CARETIME ICASP ARIEL PARTNERS HOME TRAK, INC ADP CARE ANYWARE DIAL N DOCUMENT ANKOTA, INC Cell. Trak Mc. KESSON HOMECARE 7

CCP Electronic Visit Verification &/or Related Important Policy Actions & Timeframes EVV Standards Released to the Aging Network 7 -Minute Rounding (Policy Instruction Memorandum) CCP Service Authorization Guidelines Compliance Procedures Policy (PIM) CCP Electronic Visit Verification Effective Date Client and HCA Notification Letters LEP translated client letters are available) Emerg. Rulemaking 1 st Notice published (amends Sec. 240 -1530; Adds 240 -1531) INH Compliance Notification first filling with IDo. A INH Compliance Notification 2 nd Filing with IDo. A DHS / IDo. A Joint Letter to providers servicing both agencies Client Verification PIM (Capturing Service Tasks & e. Service Calendar allowance) Rulemaking 2 nd Notice Published Prevention of Contract Action Notification Letter FY 13 / April 1, 2013 April 2, 2013 June 28, 2013 FY 14 / July 1, 2013 July 5, 2013 July 19, 2013 July 31, 2013 September 30, 2013 October 18, 2013 October 29, 2013 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 Contract Agreements Compliant Lacking Updated Compliance Forms(s)/Not Compliant Service Units/Hours (based on FY 13 Data) Compliant Lacking Updated Compliance Forms(s)/Not Compliant Caseload (based on FY 13 Data) Compliant Lacking Updated Compliance Forms(s)/Not Compliant 107 57 50 244 146 98 40. 1 million 34. 9 million 5. 2 million 99, 600 87, 000 12, 600 100% 53% 47% 100% 60% 40% 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. 0% 40. 0% 35. 0% 30. 0% 25. 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

IDo. A’s Next Steps q Issuance of non-compliance notices Updated IL-402 -1152 EVV Compliance Form per INH agreement must be received by IDOA by 12/27/31 q Suspension of Intake for non-compliance WILL begin January 1, 2014 q Field monitoring and added contract action for non-compliance q Ongoing monitoring by providers of their HCAs; reducing sign-in/out exceptions, and addressing other implementation issues (e. g. , training, internal policy development, etc). q Tracking EVV data and developing reporting requirements / Best Practices q 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_INFOProvider. Only. asp or call the Senior Help. Line 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