I am writing with an urgent request pertaining to Electronic Visit Verification that is scheduled to start in the Commonwealth of Virginia with the Payroll beginning on September 26th.  Based on the chatter on social media among moms, dads, and guardians of those who are served by Medicaid Waivers in Virginia as well as the rest of the country, there are many who have questions and concerns about this new policy.   It would be beneficial to have a delay in the start of EVV to help allay fears of the stakeholders and allow all involved to understand things better.

The concerns that I have that are echoed by many other individuals is that the 21st Century Cures Act doesn’t mandate GPS tracking.  Why has Virginia (I know other states have too) put this in the policy?  Our loved ones are not required to receive services in one location. They have the freedom to receive services at home as well as the community.  Many feel that this is a huge invasion of privacy and really doesn’t prevent someone fraudulently logging in or out of a shift.  I know NC has issued iPads to the consumers for their caregivers to log in and out of.  To me that has a higher level of fraud prevention.  At this point Virginia wants the caregivers to log in and out on their own devices with no reimbursement of use (many have limited data plans and they pay for their own phones, data, and battery).  What is the GPS data going to be used for?  Will there be biometrics that highlight when a caregiver signs in at a “unusual place” such as Busch Gardens vs. the consumers home?  Will they be scrutinized in the pay periods following?  Is the GPS location a violation of HIPPA?  When you admit your child to the hospital you have to sign forms allowing others to know they are there.  Won’t the GPS show when the consumer is receiving medical care?

Another great concern of mine is that if my caregivers fail to sign in repeatedly or have to edit their entries, that DMAS could remove my child’s waiver.  A loss of services that the waiver provides could create a detrimental domino effect to the families of Virginia.  Parents or guardians could lose their jobs because they will have to stay with their loved ones or they will be faced with the choice of institutionalizing their family member.

I have two requests that are time sensitive.  I believe if  Virginia asks for a “Good Faith Effort Exemption Request” (https://www.medicaid.gov/medicaid/hcbs/guidance/electronic-visit-verification/index.html) it would be beneficial to the stakeholders and all involved.  Virginia would not be alone in this request.  Sixteen other states have already applied for it and it will postpone the start until 2021.  The second request that I have is that the those who care for their own family member in their home (they both live in the same residence) be exempt from the EVV policy.  The federal law does allow the live in caregiver to be exempt from this requirement and Virginia is not honoring it.

Here are the FAQ from CMS about EVV

https://www.medicaid.gov/federal-policy-guidance/downloads/faq051618.pdf