1) Functional Capacity
A) Verification of Hours Worked
i) The system must maintain accurate time
reporting and allow for review/approval of time by the participant or
participant designee, including participants with visual and physical
disabilities.
ii) The system must
allow the participant or designee to manually or electronically verify that
services were delivered and that time reporting is accurate.
B) Multiple Input Options
i) The system must include electronic
verification options, including a cellular phone or other mobile devices with
activated global positioning systems, telephony/IVR, or an alternative
auditable technology, when a phone is not available in the participant's home,
such as, but not limited to, a fixed visit verification system installed in the
participant's home for authentication purposes.
ii) The electronic verification options must
include the ability to create and manage related work schedule timesheets and
participant service calendars, as authorized in the participant's
person-centered plan of care.
C) Flexibility
i) The system must support the addition of
services, participants, and homecare aides, as needed.
ii) The system must accommodate multiple
participants and/or service provider agencies.
iii) The system must accommodate multiple
work shifts (e.g., more than 1 participant and/or homecare aide in the same
home or at the same phone number; participants and homecare aides who live at
the same address; multiple work shifts per day per participant/homecare aide
combination; homecare aides who work for multiple participants; and
participants who have multiple homecare aides).
D) Capacity
i) The system must record new EVV
data.
ii) The system must retain
all EVV data for up to 6 years from the last date of service.
iii) The system must retrieve archived data
in a timely manner.
E)
Tracking
i) The system must document and
track unedited sign-in and sign-out times of all homecare aide
visits.
ii) The system should allow
for multiple sign in/out activities per day to accommodate time tracking for
breaks in service, meals, and other service provider agency reporting
requirements.
F)
Recording Increments: The system must record homecare aide visits in
quarter-hour increments and bill to the nearest quarter-hour, consistent with
the federal Fair Labor Standards Act (
29
USC 201 ) and related regulations (
29 CFR
785.48(b) ).
G) Identification (ID) Capture: The system
must electronically capture all relevant service visit data, including:
i) participant ID;
ii) service provider agency ID;
iii) homecare aide ID;
iv) date and time that service delivery
begins and ends;
v) location of
the service; and
vi) CCU and Care
Coordinator ID.
H)
Access: The system must be accessible for input and/or service approval
24-hours per day, 7 days per week for participants and homecare aides with
hearing, physical or visual impairments.
I) Alerts: The system must notify supervisory
staff at the service provider agency of any untimely and missed shifts or
deviation in schedules.
2) Billing Integration and Data Sharing
A) Real-Time Data
i) The system must enable service provider
agencies to obtain real-time data to arrange regular scheduled
visits.
ii) The system must enable
service provider agencies to respond in a timely manner to missed visits to
ensure reliability in the delivery of care.
iii) The system must enable the use of the
recorded EVV data for billing, verification, automated billing, and improved
administrative efficiencies.
B) Secured Transaction Data
i) The system must enable service provider
agencies to upload transactions data to the Department in a secured manner that
would facilitate, at a minimum, daily billing data.
ii) The system must enable service provider
agencies to securely handle internal billing and/or payroll functions pursuant
to the recorded EVV data.
C) Modifications and Adjustments
i) The system must track and report
modifications after the direct care staff input their time.
ii) The system must record justification of
manual time reporting adjustments or exceptions.
D) Reports and Queries
The system must create user-friendly reports and data files
that enable the service provider agency and Department staff to run data
queries and facilitate management reports.
3) Data Storage and Security
A) Confidentiality
The system must be compliant with electronic data interchange
standards for electronic healthcare transactions pursuant to the Medicaid
Information Technology Architecture under the Health Insurance Portability and
Accountability Act to ensure security of confidential participant information
and medical data.
B) Backup
and Recovery
i) The system must maintain
reliable backup and recovery processes in the event of a system malfunction or
disaster situation.
ii) The system
must provide an alternative system for timekeeping due to a service provider
agency's temporary failure or inability to use the system for a start or end of
the homecare aide's shift.
4) Electronic Reporting Interface
A) The system must be able to provide a
secured interface to transmit the EVV visits to the Department's electronic
Community Care Program Information System.
B) The interface file must include the
homecare aide's Social Security Number or another unique personal identifier
acceptable to the Department, visit start times and end times, and any other
billing data required by the Department.
5) Disaster Recovery
A) The EVV system must maintain a Disaster
Recovery Plan that complies with electronic data interchange standards for
electronic healthcare transactions pursuant to the Medicaid Information
Technology Architecture under the Health Insurance Portability and
Accountability Act, identifying every resource that requires backup, to what
extent backup is required and that conducts backup minimally on a daily basis
in the event of a system failure.
B) The plan must include offsite electronic
and physical storage in the United States, preferably in Illinois, and should
include, at a minimum, the following:
i)
recovery procedures for all events ranging from a minor malfunction to a major
disaster;
ii) for offsite
environments, roles and responsibilities of vendor and outsourcer
staff;
iii) checkpoint/restart
capabilities;
iv) retention and
storage of backup files and software;
v) hardware backup for the main
processor;
vi) application and
operating system software libraries, including related documentation;
vii) identification of the core business
processes involved in the system;
viii) documentation of contingency
plans;
ix) definition of triggers
for activating contingency plans; and
x) plan for replacement of hardware and
software.
6)
A system is subject to review and audit by the Department.