A law signed by President Obama in December 2016, with the disguise of bringing new efficiencies, cost savings, and care improvements to personal care and home healthcare sectors. This law is known as the 21st Century Cures Act (Section 12006) and includes a wide ranger of measures one of which is the implement of Electronic Visit Verification (EVV) to manage personal care services to start no later than January 1, 2019 and all other home healthcare services by January of 2023. Per Section 12006 (a)(4)(B) of the Cures Act reduction will not be made to the states that can demonstrate good faith efforts to comply with the technology and adopt it or if they encountered "unavoidable delay" with implementing the system.
So how does EVV work exactly? Now that's the dark Black Mirror plot. It's a phone device that will have GPS, it also has video and sound capabilities. It will track care provider time by a "check in" and a "check out." Your location will be linked to a home caller ID with a home phone number, and will require Wi-Fi. Your location will be monitored at all times. It's a good sell. They'll tell you all this:
It's not at all an invasion of privacy
It' does not go against HIPAA because it's monitoring all home health care in a home setting
It will reduce fraud and prevent providers for billing for time they aren't with the client
It will provide better client care because big brother is watching
It prevents inaccuracy and double billing
It makes sure the care provider is indeed following all stipulated care plans
It gives the State control over overlapping services and unauthorized services and audits of providers can be conducted remotely via submission of their original data
What they aren't telling you:
It has camera and microphone capabilities on software directly invading privacy and 4th amendment rights (in many software cases these features cannot be disabled for care plan visits and logged care, meaning you are recorded the entire time see a video here for demonstration and verify-ability
The excessive amount of money invested and cost in implementing EVV.
The NCIL (National Council of Independent Living) is opposed to this as discriminatory, an undermining of independent living and consumer direction, and and an invasion of privacy of those with disabilities receiving in home care and PCA services.
It is expensive, burdensome and less effective than traditional methods that are currently in place.
It involves random checks
It will restrict access for those with disabilities in the community since they are being monitored at home via GPS
This will drive providers to quit who wish to protect their privacy over providing care to those with disabilities leaving these individuals at a higher risk for institutionalization rather than being cared for in a home setting.
EVV systems put people on house arrest because they are not allowed to leave home as their attendants will not be paid otherwise
It could cause those with disabilities to lose their services if they are even so much a minute late to be scheduled at home for care
You will be tied to a phone if your battery suddenly dies there is no back up plan and you will go without documented services and provider will not be paid and potentially accused of fraud.
EVV will require voice and speech recognition and if a client has difficulties with speech could also be accused of fraud.
EVV may impose significant liability on States in the form of joint employment. For instance in our state many parents are managed by home health care agencies and our wages are paid through Medicaid to provide in home care to our own children. The State may be found to be a joint employer under the FSLA. The new FLSA companionship rule provides: joint employers are required to pay overtime to personal care and home health workers. As a result, States are likely to encounter a significant financial liability for unpaid overtime costs.
EVV inevitably is going to lead to countless class action lawsuits and violates current laws
Personal data is required to be turned over and managed by 3rd party agencies on behalf of the State. Meaning your social security number is handed over, your home phone number is handed over, your personal email is required, your voice and and in some cases facial recognition required.
- Intrusion of solitude: physical or electronic intrusion into one's private quarters
- Public disclosure of private facts: the dissemination of truthful private information which a reasonable person would find objectionable
- False light: the publication of facts which place a person in a false light, even though the facts themselves may not be defamatory
- Appropriation: the unauthorized use of a person's name or likeness to obtain some benefits
|Sandata EVV phones one for each child with special needs that resides in the home provided by a family currently using the system. Isn't that crazy - look at that!|
I'm already participating in an electronic signature of care plans which is done through a health care agency plan however the terms of what we are doing now, compared to EVV are very different. We are currently under a consumer directed plan, and not agency driven plan like EVV will be. Under a consumer directed plan the client can go anywhere in the community (i.e. home, employment, to the grocery store, to get lunch etc.) under an Agency plan it's house arrest sometimes sprinkled with community approved sites if you've gotten prior permission. But let's be clear you aren't likely leaving your home under an agency plan. Under consumer directed plan for instance a client can be out of the home while a caregiver is paid to assist with groceries and laundry. You can't do that if you're under an agency directed plan that has a GPS on your every blink and requires you to be confined to home for every care plan and all services. And does the government really need to know the intimate details of my son's incontinent care and bathing? Would you like the government to watch you pee or take a bath? Would that sound appealing to you? Not to mention I homeschool his little brother - what about his brother's privacy rights? It's not just Noah in the home. I'm here, his brother is here, his dad is here. We all have privacy rights too just because we happen to have a child that is severely disabled does not mean that any of our rights to privacy are automatically voided.
And I meanwhile the real perpetrators of fraud, the very caseworkers, non-profit community centered boards, CEO's and those managing tax payer dollars in Medicaid funded programs are dodging public audits to even show you where the money is all going. In my state alone, a CCB caught with their hand in the cookie jar, with personal travel expenses, internet services, and Costco memberships, just to name a few. You can familiarize yourself with that information by clicking this highlighted link and this highlighted link.
So ask yourself this. Who is really causing fraud to occur. And who should we really be looking at first? I say we start at the top and demand a GPS of all caseworkers, what they are doing with their time get them to report where the money is going that doesn't come to our kids. Because I'd like to know. Would you like to know? You should. Your taxes should be going to the right place and not into the pockets of those managing Medicaid funding. And if you want to know just how much Colorado is pouring into EVV rather than putting that towards the care of those with disabilities you can find that information here.
Fingers are certainly being pointed in the wrong direction. Let's put a GPS on them and confine them in their homes. That sounds just lovely doesn't it? Turn about should be fair play right? Let's see how this all feels if the shoe is on the other foot. And that my friends would be the ultimate plot twist in this real life Black Mirror episode. Let this GPS surveillance system be implemented for everyone nationwide and see how everyone likes it and let any and all content be submitted to the government to be used however they wish.
A quote that often comes up in the context of new technology and concerns about government surveillance is Benjamin Franklin's words: "Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety."
Noah's Miracle by Stacy Warden is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.