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Independent Living News & Policy from the National Council on Independent Living

NCIL Survey to Document the Impact of Electronic Visit Verification in the United States

The 21st Century Cures Act, passed into law December 2016, includes a provision requiring all states to implement Electronic Visit Verification (EVV) systems for home health care services and personal care services paid by Medicaid. Each state must have some form of EVV in use by January 1, 2020.

States are required to: ensure a robust stakeholder engagement process with consumers and independent providers of home care services; follow best practice guidelines; and ensure training is provided on use of EVV systems.

NCIL is conducting a survey on the impact of EVV in the United States. The intent and purpose of this survey is to collect information from end users of EVV systems (consumers and their home care providers) regarding their experience participating in their state’s EVV selection process and use of EVV on a regular basis. Please include as much information as you are willing to provide.

The survey is also available in Word and plain text.

The information you provide will remain confidential and only used as aggregate data. In instances where individual stories are used as examples, all identifying information shall remain anonymous. Your information will never be sold to another party.

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    To respond to all these complications brought about by the EVV and further, by the latest CMS EVV guideline, I have a few questions, please: Is IHSS AN ENTITLEMENT given to people with disabilities requiring personal assistance? If it is, why is its accounting micromanaged and seemingly weaponized to the nth level rendering it tremendously and intentionally burdensome to its recipients and providers?

    Consider this: Non-Disabled CEOs and politicians employ a lot of personal assistants to get anything done at home and at the office. Each of these operatives are paid without burdening their executive and political recipients with the mechanics, the technology and operational headaches of every pay period. They have Labor law experts, accountants, HR experts, IT specialists at their fingertips to get through the gobbledygook.

    In comparison, people with disabilities in need of personal services to survive, have none of those professionals nor do they have the tools that can match the micromanagement to the max of the IHSS in the bi-weekly processing of the payroll. The recipients are mostly disabled with physical, intellectual or mental disabilities. A majority are seniors with waning capabilities, mostly without the once robust and extended American family. It may sound ludicrous to compare the able CEOs needing assistants with the disabled needing assistants but is that more ludicrous than applying the same complicated payroll process to the once-simple and stress-free IHSS timesheet? We are talking of people with disabilities, hyper-segmented by the system based solely on disability and every consequence of it influenced by socio-economic and family factors! It is obviously intentional and sinister when programmatic obstacles like EVV thrown in as mandatory mandates are thrown in as wink-wink enhancements favoring the corporate IT industry! What happened to “if it ain’t broken don’t fix it?”

    Whose idea was EVV? Did we in the disability community clamor for even just a shadow of its invention? Why should or would we clamor for our demise? Why is the freedom and autonomy we used to enjoy at home as different from life in the nursing home being threatened now by EVV? When so-called programmatic enhancements result in actual obstacles to access to the program, it possibly becomes a violation of the Americans with Disabilities Act, Title II. Of course the experts are yet to weigh in. But these ADA violations can produce more devastating, even fatal repercussions as they can leave severely disabled persons unattended to for days, unfed, lying in their own feces and gasping for air!

    When one already qualifies for IHSS and a set number of hours are already awarded, what use is it to anyone, bureaucrats included, how these hours are spent over the week and month? For most of the same people who are on other entitlements, aren’t the programs simply given as a monthly stipend, like SSI for example? We do not have to sit in a futile exercise trying decipher how much was spent on what. It would be a silly exercise! Why do it then for IHSS? Why not just leave the consumer and his or her worker to work out the details of the set IHSS stipend? It would save millions of dollars! Disabilities don’t change very much and mostly people’s health get worse. As they do, it does not make sense for the government to complicate the program more unless the real agenda is to cut thousands of recipients and to restrict it to the fittest.

    Written by:
    —Lillibeth Navarro
    August 11, 2019
    Lillibeth Navarro
    Communities Actively Living Independent & Free (CALIF)
    Founder & Executive Director
    634 S. Spring Street, Second Floor
    Los Angeles, CA. 90014
    (213) 627-0477, Voice
    (213) 627-0535, Fax
    (213) 840-4199, cell
    Alternative email:

  2. John M. Cencora says

    This system is poorly designed and creates anxiety issues along with a ‘smart phone’ which I do not want, cannot afford or even need. I cannot leave my home. If my caregiver wants to take me someplace, the anxiety of checking in and checking out interferes with my quality of life. This system needs to STOP!

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