Case Study: Statewide Electronic Visit Verification

Project Overview

Propoint Technology, Inc. (Propoint) was contracted to provide project management, analysis, testing, and communication services for the implementation of the Electronic Visit Verification (EVV) system. These services supported the implementation of a minimum viable product from start to deployment in four months. Propoint subsequently supported a full-feature implementation and several post-implementation activities.

Medicaid is a critical government resource for individuals and families seeking subsidized medical services. The growth of the Medicaid program has led to increased oversight and regulation. The 21st Century CURES Act mandated that states were required to implement an Electronic Visit Verification (EVV) System to comply with this federal mandate. An EVV System verifies that all Medicaid-funded Personal Care Services (PCS) and Home Health Care Services (HHCS) are provided to the client at the date and time recorded. ?

Propoint provided a consulting team to assist the Office of Technology and Solutions Integration (OTSI) in implementing an EVV System for the State of California through the EVV Phase II Project (CalEVV). The CalEVV implementation required collaboration among five California Sponsor Departments with differing needs, as well as the OTSI and external vendors.

The Sponsor Departments involved in the CalEVV solution included:

• Department of Health Care Services (DHCS)
• Department of Developmental Services (DDS)
• Department of Public Health (CDPH)
• Department of Aging (CDA), and
• Department of Social Services (CDSS)

OTSI served as the contract administrator and provided project management oversight.

Vendor partners that were involved in the CalEVV implementation included:

• Sandata Technologies, LLC – EVV Solution provider
• Propoint Technology, Inc. – Project management and implementation support
• Other consultants provided PMO administration and technical consulting

Customer Pain Points

The Federal implementation mandate required the CalEVV solution to be implemented and usable by a specific deadline. Due to unexpected delays experienced during the software solution procurement and contracting process, California had just four months to complete the initial implementation to avoid federal penalties. In addition, the five sponsor departments needed to reach agreement on the functional requirements. This required focused collaboration and critical project scheduling. It was a large lift in a short period of time, but the joint effort succeeded.

CalEVV needed to implement visit verification for all Medicaid PCS and HHCS client visits. The system requires the capture of client visit data in real-time using either a smartphone app or a landline in the client’s home. To prevent fraud and confirm the service, the Provider employee logs the service when arriving at the client’s home, and then again when the visit is concluded. Thus, the system can electronically store when, for how long, and where (using GPS) a visit occurs. The solution was also designed to verify additional visit information:

• Client receiving the service
• Date of service
• Applicable service code
• Location of service
• Employee providing the service
• Service timeframe

To be successful and meet federal requirements, the EVV solution needed to incorporate an “open vendor” model and support a self-directed/individual provider or agency provider model.

Overall project management and direction were the responsibility of the OTSI. They recognized that additional resources were needed to complete the project in such a short period.

Propoint's Support

Propoint was contracted to supplement OTSI personnel and ensure the project was implemented within the tight regulatory deadlines.

Propoint’s integral support to the implementation addressed four areas of need:

• Project Management Services
• Business Analysis
• Software Testing
• Stakeholder Communication and Stakeholder Training

These services directly supported the implementation of a Minimum Viable Product (MVP) from start to deployment, within the four months required to meet the federal deadline. This ensured California would receive federal reimbursements for client visits.

Project Management Services: Propoint focused on the management of project scope, budget, schedule, risks, and issues. Federal guidelines had to be met by a specific date which led to an extremely condensed project schedule.

Test Management: Propoint provided a Test Manager who was responsible for test management, user and vendor test coordination, and test execution.? Propoint developed a Test Plan and worked with Sponsor departments for user testing and acceptance.

Business Analysis: Propoint provided a Business Analyst who administered a requirements traceability matrix ensuring the project work and requirements aligned.

Stakeholder Communication and Stakeholder Training: The Propoint team provided coordinated project communications and user training. This training ultimately assisted in platform adoption.

Project Results and Benefits

The implementation of the new CalEVV system streamlined the collection of client visit data by providing multiple data collection methods, GPS location, and other valuable features. PCS and HHCS Providers now also have greater options when interacting with the Cal EVV solution through the “open vendor” approach. Propoint’s project management, business analysis, testing, and communications support were integral in meeting the strict federal timelines to avoid penalties by deploying a working MVP product in just four months. After this large-scale implementation, the platform continues to be fully functional and stable. Propoint has been selected to assist with the maintenance and operations lifecycle of this system into the future.

Learn More

Project support can come in various forms and stretch across all lines of business. While we provided project management, analysis, and testing in this case study, we also have experience providing transition services and change management to California’s Electronic Benefits Transfer (EBT) services. Check out our Statewide EBT Support Case Study that outlines our project aiding California’s EBT services as they transitioned from their current vendor to a new solution.

If you would like to discuss how Propoint can best support your business and projects, please contact us at [email protected] or on LinkedIn.

About Propoint

Since 2005 Propoint has proudly delivered a full suite of information technology (IT) and management consulting services to a wide array of State of California departments and programs. We provide services that are tailored to individual client needs. Our philosophy is to listen first, ask the right questions, and then “get to the point” – providing our customers with the relevant and timely direction needed to reach core business objectives.