EVV Public Meeting: Updates on EVV Implementation and Provider Options

Electronic Visit Verification (EVV) Public Meeting August 13, 2019

EVV Public Meeting • All phones are muted • Questions should be submitted through the chat feature • We will address as many questions as possible at the conclusion of the presentation

EVV Public Meeting • DHS is currently reviewing new CMS guidance released August 8, 2019 • Updates will be provided by the next public meeting • Respite Camp provided by ODP is no longer included for January 1, 2020 EVV implementation; all other Respite services are still required as noted on the DHS EVV website • Full up-to-date list of personal care services is available on the DHS EVV website

EVV Public Meeting Fee-For-Service (FFS) Programs • Office of Development Programs: • Consolidated, Person/Family Directed Support Waiver (P/FDS), and Community Living Waivers, and Intellectual Disabilities/Autism (ID/A) Base Services, Adult Autism Waiver • Office of Long-Term Living Programs: • OBRA Waiver, Act 150 Program

EVV Public Meeting Fee-For-Service (FFS) Providers Two EVV Options Available • Option 1 • DHS Sandata System • Mobile Application or Telephony Visit Capture • Web Portal for Visit Corrections at Provider Level • No cost • Option 2 • Alternate EVV System • Must integrate with DHS Aggregator • Must capture required data items identified in the Alternate EVV technical specifications and DHS Addendum • Providers are responsible for any costs

EVV Public Meeting Alternate EVV Systems • The Sandata approval process for Alternate EVV systems ensures EVV transactions are: • In the correct format, • Contain the required data in mandatory fields, and • Can successfully pass into and be stored in the DHS Aggregator. • Providers using a Sandata-approved Alternate EVV system will be required to complete web-based training as a condition of certification.

EVV Public Meeting Alternate EVV Systems • Providers interested in utilizing an Alternate EVV system, or have questions specific to Alternate EVV, should contact the Sandata Alternate EVV support team to ensure the data interfaces will align before January 1, 2020. Contact information is as follows:Phone: 855-705-2407Email: PAAltEVV@sandata.com

EVV Public Meeting Participant-Directed Services • OLTL Programs: • Training for PPL’s Alternate EVV system, Time4Care, began this month (August 2019) • ODP Programs: • PALCO agreement is still being reviewed and updates will be provided in the future

EVV Public Meeting Community HealthChoices (CHC) Program • Community HealthChoices 1915c Waiver

EVV Public Meeting • CHC providers should work with the CHC-MCOs to identify requirements the CHC-MCOs may have • CHC-MCOs are offering HHAeXchange free of cost for CHC providers • HHAeXchange will send EVV data to the DHS Aggregator • CHC providers working with an Alternate EVV system will need to integrate with HHAeXchange to send EVV data to the DHS Aggregator • Providers must work with each of the appropriate CHC-MCOs to integrate an Alternate EVV system with HHAeXchange CHC Providers

EVV Public Meeting • Questions about HHAeXchange should be directed to CHC-MCOs • CHC providers DO NOT need to receive DHS Sandata EVV training CHC Providers

EVV Public Meeting CHC Providers NOTE: CHC EVV data only flows from CHC-MCOs HHAeXchange to the DHS Aggregator. The DHS Aggregator does not send info to CHC-MCOs HHAeXchange. CHC-MCOs EVV Data Collection (HHAeXchange) Alternate EVV Systems Fiscal Employer Agent EVV System (PPL/Time4Care) DHS Aggregator HHAeXchange EVV System

EVV Public Meeting FFS & CHC Providers • Providers operating in CHC and FFS may use an Alternate EVV system. However, any Alternate EVV system will need to work with both HHAeXchange (for CHC participants) and Sandata (for FFS programs) to ensure compatible reporting of EVV information. • Providers may work directly with HHAeXchange or Sandata to discuss options to expand the scope of the existing (free) systems to include both CHC and FFS program needs. • Providers will be responsible for costs associated with any upgrades to the existing (free) systems.

EVV Public Meeting DHS Aggregator Fiscal Employer Agent Alternate EVV System(s) (FFS) CHC-MCOs EVV System (HHAeXchange) DHS Aggregator Alternate EVV Systems (FFS) DHS Sandata EVV System (FFS)

EVV Public Meeting DHS Aggregator • The DHS Aggregator does not submit claims. • The DHS Aggregator is validated against during claims processing when an EVV service is found on the claim(s) transaction. • The DHS Aggregator includes a read-only web portal for the provider to view their data, and a payer web portal which includes alerts, real time data views, and reporting.

EVV Public Meeting DHS Sandata EVV System Process

EVV Public Meeting Sandata Mobile Connect

EVV Public Meeting DHS Sandata Telephony Visit Verification

EVV Public Meeting DHS Sandata EVV Web Portal

EVV Public Meeting Important Dates to Remember October 2019 Soft launch of DHS EVV system January 2020 Full implementation of system as required by Cures Act

EVV Public Meeting Exceptions For this initial phase of EVV implementation, exceptions are generated by the DHS EVV system when one of the 6 required items is missing. For providers using Alternate EVV systems, the technical specifications on the DHS EVV website detail the information that must be captured and submitted to the DHS Aggregator.

EVV Public Meeting Services • The DHS Sandata EVV system will only support the OLTL and ODP services outlined on the DHS EVV website. • A full list of service codes and modifiers may be found on the DHS EVV website. • Caregivers must check-in and check-out for each individual service provided to a participant. • Service provision should support/align with the service definition found in the approved waiver(s) AND the services’ duration, frequency and scope as described in the individual’s approved plan.

EVV Public Meeting Location • EVV requirements do not change current program requirements, this includes for travel and vacation. • Providers will be able to enter multiple addresses where services are provided into the DHS Sandata EVV system and these addresses can be updated at the provider level as needed.

EVV Public Meeting • The Sandata Mobile Application does require GPS to be enabled at check-in and check-out to capture the location. • Location is only required to be captured at check-in and at check-out. • Place of service is a required field on a claim and only one (1) code is permitted on each claim detail line to specify where the service was rendered. Location

EVV Public Meeting • Billing should align with check-in and check-out rules defined by the provider. • If one caregiver clocks in at one time while another does, this will generate an exception and will need to be fixed through the web portal by the administrator. • Shift corrections, such as a missed clock-in or clock-out, may be addressed in the provider portal. Time

EVV Public Meeting Time • Units of time for billing of services will continue to follow existing rules and practices: • OLTL allows for rounding of units of time. • ODP does not allow for rounding. ODP will issue a guidance document this month to clarify units of service.

EVV Public Meeting • More than one caregiver can use the same smart device to access the DHS Sandata mobile application. • A participant’s home phone, cell phone or smart device may be used for check-in/check-out if the participant has agreed to its use. • DHS is using a “bring your own device” model and is not providing phones or tablets for visit capture. • DHS is not providing reimbursement for phone or tablet plans. Individual Providing Service (Caregiver)

EVV Public Meeting Individual Providing Service (Caregiver) • For services with 2:1 staff to participant ratio, both caregivers must check-in and check-out for the same individual, same service, same date, same time, and same location. • Tasks may be entered in the notes section of the Sandata mobile application.

EVV Public Meeting • Visits that include more than one participant receiving the service at the same time, or group visits, may be captured in the DHS Sandata EVV system. Group visit set-up will be covered in the DHS Sandata training. • Signatures from participants are only required in those instances that currently require them, such as participant-directed services. Individual Receiving Service (Participant)

EVV Public Meeting • Participants are not required to allow caregivers to use a participant’s home phone, cell phone, or smart device. • Provider agencies should generate policies regarding caregiver requests to use participant personal devices. Individual Receiving Service (Participant)

EVV Public Meeting DHS Sandata EVV Training Classroom, Webinar, and Self-Paced Options Mandatory for FFS providers* Training to begin September 24, 2019 Registration to open August 26, 2019 *FFS providers using Alternate EVV systems will be required to take a Sandata training as part of the Alternate EVV certification process

EVV Public Meeting DHS EVV System Training • Provider training to be offered with phased in system use • Training will continue to be offered through full implementation • Locations, dates, times and registration instructions for the various trainings will be posted on the DHS EVV website

EVV Public Meeting • Provider checklist communication and training registration communications to be sent through DHS Listservs this month • A survey will be sent to help to determine which providers will be using Alternate EVV and which will be using the DHS Sandata EVV system • Updated Frequently Asked Questions (FAQ) will be posted this month Upcoming Communications

EVV Public Meeting Upcoming Public Webinars* September 17, 2019 October 22, 2019 November 26, 2019 December 31, 2019 *These dates are subject to change

EVV Public Meeting Questions regarding EVV can be sent to the EVV resource account at RA-PWEVVNotice@pa.gov

EVV Public Meeting: Updates on EVV Implementation and Provider Options