​​​​​​​​​​​​​​​​​​​​​​​​​Electronic Visit Verification Phase II

What is EVV?

Electronic Visit Verification (EVV) is a telephone and computer-based solution that electronically verifies in-home service visits. EVV solutions must verify the following six data elements:
  • Type of service performed
  • Individual receiving the service
  • Date of the service​
  • Location of service delivery
  • Individual providing the service
  • Time the service begins and ends

DOES EVV apply to me?

Provider Types and Code​s​​​ ​-This document outlines the providers that will be impacted by EVV.  Please reference this document to verify if your program will need to comply with EVV requirements.

​​​Background

The 21st Century CURES Act, signed into law in 2016, requires that States set up an EVV system to verify that services for all Medicaid-funded personal care and home health care services occurred. Pursuant to Subsection (l) of Section 1903 of th​​e Social Security Act (SSA) (42 U.S.C. 1396b), all states must implement EVV for Medicaid-funded personal care services (PCS) by January 2020 and home health care services (HHCS) by January 2023. On October 22, 2019, CMS approved the State's Good Faith Effort (GFE) request for PCS, and will not apply Federal Medical Assistance Percentage (FMAP) reductions in calendar year 2020.  California's GFE approval letter from CMS is available on the EVV CMS GFE Webpage.​

PCS was implemented on January 1, 2022 and providers of Medi-Cal home and community based personal care services must be registered, trained, and using either the CalEVV system or an alternate EVV system. HHCS is anticipate​d to be implemented by January 1, 2023.  Stakeholder meetings will continue and will provide the opportunity to discuss the State's approach to EVV, the steps providers will need to take, and the EVV training that will be offered. ​

EV​V Policy​​​

​Provider Self-Registration Portal

​Provider Self-Registration Portal Link​

Provider Agencies and INPs who provide PCS and HHCS are required to register in the Provider Self-Registration portal. Please refer to the quick reference guide or instructional video to help complete your registration if needed. 

Fee For Service (FFS) and Individual Nurse Provider (INP) Self-Registration Process

Please follow below mentioned instruction if you are registering as a Fee For Service (FFS) provider OR an Individual Nurse Provider (INP) that does not associate with the California Children's Services (CCS) program and/or the Home and Community Based Alternatives Waiver:

  • ​For Provider Identifier Section
    • ​ADD
      • ​DEPARTMENT – FFS or INP provider will select “DHCS via MCP"
      • JURISDICTIONAL ENTITY / JURISDICTION – FFS or INP provider will select “DHCS"
      • IDENTIFIER TYPE – DHCS providers will select National Provider Identifier (NPI) for each provider
      • IDENTIFIER – NPI is 10 digits in length

​Exclus​ions

The following services are not subject to EVV requirements:

  • HHCS or PCS that do not require an in-home visit are not subject to EVV requirements.
  • HHCS or PCS provided in congregate residential settings where 24-hour service is available are not subject to the EVV requirements.
  • HHCS or PCS rendered by an individual living in the member's residence does not constitute an “in-home visit" and is not subject to EVV requirements.
  • Any services rendered through the Program of All-Inclusive Care for the Elderly or Hospice services.
  • HHCS or PCS that are provided to inpatients or residents of a hospital, nursing facility including skilled nursing facility or residence of nursing facility, intermediate care facility for individuals with intellectual disabilities, or an institution for mental diseases.
  • Durable Medical Equipment is not subject to EVV requirements.

 Please note, PCS or HHCS rendered by an individual living in the member's residence does not constitute an “in-home visit" and is not subject to EVV requirements. DHCS defines a “live-in caregiver" as a caregiver who regularly remains in the recipient's home for more than 24 hours at a time, during which they are available to provide authorized PCS and/or HHCS. 

​​Resources/Training​

Frequently Asked Questions (FAQ)​

Quick Reference Guide for Adding and Managing Provider Identifier(s) ​– Step by step process on how to add or edit services within a CalEVV account.

Bulk Upload Process and Spreadsheet​ ​- Using a provided excel file users can create an upload file containing either client and employee data. This file can be loaded into the Sandata EVV system to quickly add a large amount of client/employee records.

CalEVV System Training – The external link below now enables you to access recorded training sessions hosted by Sandata Technologies on 19 various topics. Each recording is less than 20 minutes, includes transcripts and can be accessed at any time by new staff or as a refresher to current staff.

CalEVV Training Videos ​

Videos include:​

  • CalEVV Introduction
  • Sandata on Demand & Bulk Upload
  • System Overview: Initial Login Process
  • System Overview: Navigating CalEVV
  • Data Entry: Clients
  • Data Entry: Employees
  • Visit Capture: Mobile App Initial Login
  • Visit Capture: Creating Visits with the Mobile App
  • Visit Capture: Telephonic Visit Verification
  • Visit Maintenance: Visit Maintenance Introduction
  • Visit Maintenance: Visit Details Tab
  • Visit Maintenance: Exceptions
  • Visit Maintenance: Manual Entry
  • Group Visit Agency: Group Visit Introduction and Search​
  • Group Visit Agency: Visit Maintenance for Group Visits​
  • Group Visit Agency: Manually Entering a Group Visit in the CalEVV Portal
  • Group Visit Caregivers: Creating Group Visits with the Mobile App
  • Group Visit Caregivers: Joining a Group Visit with the Mobile App
  • Group Visit Caregivers: Group Visits using TVV

Alternate EVV Specif​​​ications​

Stakeholder Engagement / Informational Webinars

​Future webinars will continue to discuss the State's approach to EVV as well as the steps that providers will need to take to implement EVV and the EVV training that will be provided.  All of the EVV training materials, policy, and technical requirements will be posted to this webpage. For upcoming and past webinars, please visit the DHCS EVV Phase II Stakeholder Meetings webpage for information.  Please send a request to EVV@dhcs.ca.gov to be added to the EVV Phase II stakeholder distribution list.

EVV Implementation

EVV will impact all PCS and HHCS provided under the Medi-Cal State Plan and various Medicaid Home and Community-Based Service waiver programs.  These services are provided in California through programs managed by the Department of Health Care Services (DHCS), the California Department of Social Services (CDSS), the Department of Developmental Services (DDS), the California Department of Public Health (CDPH), and the California Department of Aging (CDA). Note:  Hospice and Behavioral Health Treatment (BHT) are not subject to EVV requirements.

California is implementing EVV in two phases:
 
Phase I: This Phase is for the In-Home Supportive Services (IHSS) program and Waiver Personal Care Services program, focused on EVV implementation for programs that currently use the Case Management Information & Payrolling​ Systems (CMIPS II) and Electronic Time Sheet System (ETS). Further information about Phase I is available on the CDSS EVV website.
 
Phase II: This Phase is focused on identifying a solution to implement EVV for non-CMIPS and agency PCS, and self-directed and agency HHCS.  This includes programs at DHCS, DDS, CDPH, CDSS, and CDA as listed below:
  • DDS 1915(c) Home and Community-Based Waivers, including the Self-Determination Program
  • DDS 1915(i) State Plan Home and Community-Based Services
  • DHCS 1915(c) Home and Community-Based Alternative Waiver
  • DHCS Home Health Care Services
  • CDA/DHCS Multipurpose Senior Services Program (MSSP) 1915(c) and 1115 Waiver
  • CDPH/DHCS 1915(c) AIDS Medi-Cal Waiver
Phase II implementation of EVV requires the State to deploy an EVV solution for PCS and HHCS providers not included in Phase I.  This includes PCS through provider agencies, individual providers, and some providers of self-directed services, and all HHCS.  EVV Phase II will follow the "Open Vendor" EVV approach that will allow providers to choose between the State's EVV solution or an alternate EVV solution that meets state and federal EVV requirements.  The State is working towards selecting a vendor and procuring an EVV solution.

Note: There are two models for the provision of PCS and HHCS, the Self Directed/Individual Provider Model and the Agency Provider Model.
 
The Self Directed Model, also known as the Individual Provider Model, supports the provision of PCS by an individual provider. This model gives the recipient, or their authorized representative, the autonomy to hire or fire a provider of their choosing as well as to instruct them on how to facilitate their PCS needs.
 
The Agency Provider Model supports the facilitation of PCS and/or HHCS by an authorized agency who is responsible for hiring, firing, and training personnel to facilitate services on behalf of an eligible Medi-Cal beneficiary. Agency Providers are employed by commercial agencies who manage their work, process payroll, and issue their paychecks. These agencies can either have contracts with counties or enroll through DHCS as a Medi-Cal provider

Resourc​es

For updated federal guidance on EVV, please refer to the CMS EVV Webpage.

Contact Us

Please direct your comments, questions, or suggestions regarding the EVV Phase II, or to be added to the EVV Phase II stakeholder process interested parties e-mail list, to EVV@dhcs.ca.gov.

For technical assistance please call or email your Customer Support team at 1-855-943-6070 or CACustomerCare@sandata.com  ​

For Alternate EVV assistance please call or email your Customer Support team at 1-855-943-6069 or CAAltEVV@sandata.com

Last modified date: 11/4/2022 12:05 PM