The agencies and homes and caseworkers are the ones committing the fraud that exists now, not the families.  One should not have to trade basic human rights to have care their taxes already fund, trade basic human dignity and privacy for incontinence supplies, DME, or medications.  This is no different than the mindset that set socialist Germany against it's disabled, and that led to the idea that the disabled were too costly to keep funding.  The Cures act and it's EVV is of the same thinking.