T.K. Small vs Electronic Visit Verification (EVV)

ICS Board Member T.K. Small vs Electronic Visit Verification (EVV)

The Congress members who wrote the 21st Century CURES Act lauded it as a plan to increase efficiencies in national healthcare spending, resulting in savings that they claimed could be poured into research for actual cures for diseases.

A small, not well-known part of the CURES Act requires states to set up a plan for adopting Electronic Visit Verification (EVV) to monitor the services personal care assistants and home care workers provide to their clients. EVV uses software and devices that record a number of data points around a home care worker’s visit: the date, location, names of the worker and the person receiving the service, type of service provided, and the time the service provision begins and ends.

New York State has announced that the Department of Health (DOH) will be implementing EVV for home care workers beginning in January 2019.

Privacy Concerns

ICS Board member Thomas “T.K.” Small is not happy with this plan. “This is unhelpful, at best,” he says.

At worst, T.K. views EVV as an unnecessary invasion of the worker’s and the client’s privacy. This is the same complaint consumers have made in Ohio, where EVV is already in place. There, the system makes use of “repurposed, military-grade cellphones with GPS monitoring capability — devices that are supposed to stay with the Medicaid client whenever and wherever they receive services,” according to an article in the Columbus Dispatch. One very active client told the Dispatch, “For my job, I travel all over the state. For them to know where I am every moment of the day is completely ridiculous.”

As policy director for the financial intermediary (FI) Concepts of Independence, which helps many ICS members maintain their consumer-directed personal care assistance service (CDPAS), T.K. is especially unhappy about the threat EVV poses. By imposing an electronic guardian over the consumer-worker relationship, T.K. told a recent meeting of the Civics League for Disability Rights, “EVV flies in the face of what consumer-directed means.”

T.K. and Concepts are leading a campaign to make the state delay implementation of EVV for one year. “The state is doing a poor job of preparing stakeholders—consumers, FIs, workers and home care agencies—for this big change,” he says. “There are now only six months left to implement it, and the state has not even contacted us to set a date to meet about how it should be implemented, as required by the law.”

As time runs out for proper implementation of EVV, the state runs the further risk of losing Medicaid funds as a penalty.  And New York is far from the only state running behind schedule.

Legislation to Delay EVV

Two bills in Congress–US Senate bill S2897 and HR6042 in the US House of Representatives—have been introduced to delay implementation of EVV and the penalty for failure to do so for one year.  Just this week, on June 19, the House passed their version of the bill. T.K. has asked members of the Civics League and anyone else interested in protecting consumer-direction and privacy rights to contact Senators Schumer and Gillibrand to sponsor and support this legislation.

For more information about T.K.’s campaign to delay EVV, follow this link.

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