Provider Notice issued 05/10/2023

This notice provides an update to the request for an exemption of the Electronic Visit Verification (EVV) for the Home and Community-Based Services (HCBS) waivers for the Department of Human Services – Division of Developmental Disabilities (DHS-DDD) Adults with Developmental Disabilities and Children and Young Adults with Developmental Disabilities Supports programs.

The EVV is a federal mandate by the 21st Century Cures Act (the “Cures Act”). The Cures Act requires EVV for all Medicaid funded Personal Care Services (PCS) and Home Health Care Services (HHCS) that require an in-home visit by a provider.

Personal care services (PCS) consist of services supporting Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Examples of ADLs are bathing, dressing, toileting, transferring, and personal hygiene. Examples of IADLs are meal preparation, money management, shopping, and telephone use.

Home health care services (HHCS) consist of nursing services, home health aide services, medical supplies, equipment and appliances that require an in-home visit for set up and physical therapy, occupational therapy, and speech pathology and audiology services.

The Centers for Medicaid and Medicare Services (CMS) allows states to determine to allow the exemption of EVV for live-in caregivers in the HCBS Waiver programs.  As the State’s Medicaid oversight agency, the Department of Healthcare and Family Services (HFS) initially made the decision not to allow an exemption to EVV for live-in caregivers for the DHS-DDD HCBS waiver programs.

However, to prepare customers for the implementation of an EVV system for customers of the DHS-DDD HCBS waiver programs, DHS-DDD recently held a series of listening sessions to solicit feedback from caregivers, family, advocacy groups, and other interested parties (“stakeholders”) on EVV.

Due to feedback from these listening sessions and ongoing discussions with stakeholders and other interested parties, HFS has reversed the initial decision and will allow live-in caregivers to be exempt from EVV requirements in the DHS-DDD HCBS waiver programs.

HFS and DHS-DDD will continue to partner with our EVV vendor (HHAeXchange) to help Illinois achieve compliance with the federal mandate. Through this collaboration, additional provider training, education, and supports will be offered. 

As the Departments work to develop specific policy and criteria for those that qualify for the exemption, stakeholders are encouraged to sign up for DHS-DDD’s listserv communication to stay up-to-date with EVV information, as well as other information related to the DD waivers (https://www.dhs.state.il.us/page.aspx?module=17&item=110637&surveyid=1458).

Live-in caregivers and Personal Support Workers (PSWs) who currently work with the ACCES$ system will receive updates directly from ACCES$ as well as through DHS-DDD’s listserv communication mentioned above.  These updates could include future next steps individuals and families may need to take in order to qualify for an exemption. 

The Department of Healthcare and Family Services would like to thank everyone who attended the DHS-DDD listening sessions and shared feedback.

Kelly Cunningham, Administrator

Division of Medical Programs