Title
Receive an oral report from the Department of Social Services Aging and Adult Services Branch on the implementation of the federally mandated Electronic Visit Verification for In-Home Supportive Services providers.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
Receive an oral report from the Department of Social Services Aging and Adult Services Branch on the implementation of the federally mandated Electronic Visit Verification for In-Home Supportive Services providers.
SUMMARY/DISCUSSION:
The Aging and Adult Services’ (AAS) mission is to empower and serve the aging population and persons living with disabilities to live safely and with dignity. The In-Home Supportive Services (IHSS) Program helps eligible aged, blind and disabled individuals who are unable to remain safely in their own homes without this assistance. IHSS is an alternative to out-of-home care.
The California Department of Social Services (CDSS) has begun the phased implementation of Electronic Visit Verification (EVV). EVV is a federal mandate that requires all states to implement EVV for Medicaid-funded personal care services by January 1, 2020 or January 1, 2021 with a federally approved good faith exemption. California has been approved for a good faith exemption. Federal penalties result if states do not meet EVV requirements. To date, CDSS is still moving forward with EVV roll-out despite COVID-related Shelter in Place orders.
EVV requires an electronic record of certain information about services being performed by IHSS providers. Once EVV is implemented, providers will be required to provide the following new information, in addition to their hours worked:
• Start Time - The time you began the first IHSS service for your recipient that day,
• End Time -The time you completed the last IHSS service for you recipient that day, and,
• Location - Where the services were performed that day, in the recipient’s home, in the community (anywhere other than the recipient’s home) or both.
This change will affect all IHSS recipients and providers in Monterey County. EVV will replace paper timesheets in Monterey County, and providers and recipients will submit and approve timesheets through one of the following electronic methods:
• Online using the Electronic Services Portal (ESP) at: www.etimesheets.ihss.ca.gov. The ESP supports any device with internet access, including smartphones, tablets, laptops and computers.
• By phone using the Telephone Timesheet System (TTS). If providers and recipients do not have access to the internet or do not want to use the internet, TTS is an automated telephone system that allows them to submit and approve timesheets using a land line or mobile telephone.
EVV is available in English, Spanish, Armenian and Chinese. CDSS began rolling out EVV with Los Angeles County, from June through December 2019. EVV will be rolled out to all counties by the end of this year. Monterey County was part of the third wave of counties from May 1 through June 30, 2020. Originally, all providers and recipients were expected to be using either electronic or telephone timesheets by June 30, 2020. However, due to the reduction in in-person supports due to the Shelter In Place and closure of IHSS offices, the time has been extended to no later than December 31, 2020.
Moving to an electronic-based system benefits both the counties and IHSS/WPCS providers and recipients. Once EVV is completely implemented, counties will see:
• Reduction in timesheet errors - the ESP and TTS will not allow a provider to submit a timesheet with an error. The number one reason counties must replace timesheets is that there is a missing signature. EVV completely eliminates this error.
• Eliminates counties having to issue and replace paper timesheets - timesheets are available on both the ESP and TTS for providers to access without any county action needed. Timesheets will no longer be lost in the mail or accidentally destroyed, requiring them to be reissued.
• Reduction in violations for providers - the ESP and TTS provide real time feedback to the provider of potential violations. The most recent data shows that the violation rate for providers utilizing paper timesheets is 0.68%. This rate has been greatly reduced for providers using electronic timesheets where the violation rate is 0.09%.
• Eliminates “Where’s My Timesheet/Payment” calls - providers can check their timesheet and payment status 24 hours a day, 7 days a week on both the ESP and TTS.
Providers will also see the following benefits when they begin utilizing EVV:
• No more time spent mailing timesheets or paying for postage
• Faster payments - CDSS has seen providers get paid in 3-4 business days if they submit their timesheet electronically and enroll in direct deposit.
• No more waiting on hold - providers no longer need to contact the county and state help desks for payment status. Providers can check the status of their timesheets and payments whenever they want on ESP and TTS.
• Sick leave claims and direct deposit - providers can submit their sick leave claims and enroll in direct deposit through the ESP.
Monterey County staff have made many efforts to assist IHSS providers and recipients to make the transition to electronic and telephone timesheets. Some of these have been suspended during the Shelter in Place orders related to COVID-19. Telephonic outreach continues to take place at this time. The following are some of the methods that have been used:
• Since Spring 2019, Payroll staff have provided group Electronic Timesheet classes for providers and consumers
• Since August 2019, providers have been assisted to sign up for Electronic Timesheets during the registration office visit with Payroll staff
• Since Summer 2019, designated staff have been performing outreach to providers and recipients, including home visits to sign recipients up
• In January 2020, two temporary Office Assistants were hired with the additional EVV state funding to provide 1:1 and group assistance to clients in signing up for electronic or telephone timesheets
• In January 2020, group Electronic Timesheet classes expanded to include staff at all levels providing trainings in Marina, Salinas, and King City, 3-4 trainings a week
• New Provider Orientation incorporates information on EVV
• iPads are available for use by clients in each of our offices
The result of these efforts is that registration for electronic or telephone timesheets by both IHSS recipients and providers has increased from 20% in Summer 2019 to 85% as of June 2020. Given that there are nearly 10,000 recipients and providers in the program, this is a huge accomplishment, but there are still 1500 more people to sign up by the end of the year. We have been able to engage the SEIU Local 2015 providers’ union to assist with our efforts by reaching out to providers, and we appreciate the Board’s support as well.
OTHER AGENCY INVOLVEMENT:
No other agency was involved in the development of this report.
FINANCING:
Monterey County received a small allocation from California Department of Social Services of $32,393 for administrative activities related to the implementation of EVV to conduct outreach, training, and technical assistance in the utilization of this new automated system. Costs are claimed through Social Services quarterly County Expense Claim. There is no impact to the County General Fund associated with this report.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
This information clarifies the requirements for providers and recipients of In-Home Supportive Services regarding the federal mandate requiring electronic visit verification and the County’s efforts to transition providers and recipients from paper timesheets to electronic and telephone timesheets.
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Prepared by: Emily Nicholl, IHSS Program Manager, x4720
Approved by: Lori A. Medina, Director, 4430