Frequently Asked Questions

Note: These questions are current as of Oct. 25, 2013.

Electronic Visit Verification (EVV)

What is EVV?
Electronic Visit Verification (EVV) is a telephone and computer-based system that electronically verifies that service visits occur and documents the precise time service provision begins and ends.

Who is paying for EVV?
The Texas Department of Aging and Disability Services (DADS) has procured the basic EVV system.

The implementation of the EVV system affects what areas?
EVV use is mandatory for providers of impacted services in the following regions:

  • DADS Region 9 — Midland, Odessa, San Angelo, and the surrounding areas.
  • DADS Region 2 — Abilene, Wichita Falls and the surrounding areas.
  • DADS Region 4 — Longview, Tyler and the surrounding areas.
  • DADS Region 3 — Dallas, Fort Worth, Denton and the surrounding areas.
  • DADS Region 7 — Austin, Waco, Temple and the surrounding areas.
  • DADS Region 5 — Beaumont, Nacogdoches, Jasper and surrounding areas.
  • DADS Region 6 — Houston, Conroe, Bay City and the surrounding areas.

Click here for a map that identifies the DADS regions (PDF format).

When will the EVV system be used in other regions?
The list above contains all available information regarding regions impacted by EVV at this time. All updates regarding EVV will be made available via the DADS EVV website.

What is included in the EVV system being funded by DADS?
The procured system includes basic call-in and call-out functionality including access to the Santrax Telephony Website for reports, visit maintenance and exports.

Which providers must participate in EVV?
All providers that are providing the following services to individuals impacted by the EVV system are expected to participate:

  • personal assistance services and in-home respite in the Community Based Alternatives (CBA) Program;
  • residential habilitation and in-home respite in the Community Living Assistance and Support Services (CLASS) Program;
  • in-home respite and flexible family support services in the Medically Dependent Children Program (MDCP);
  • the Primary Home Care (PHC) Program as described in 40 TAC §47.3(20);
  • the Community Attendant Services (CAS) program as described in §47.3(3), and
  • the Family Care (FC) services program as described in §47.3(11).

A full list of applicable service codes can be found on DADS EVV website.

Who do I contact if I need talk about assistive technology and accommodations?
If you use assistive technology, and need to discuss accommodations related to the EVV system or materials, please contact Sandata Customer Service, toll-free, at 1-855-781-2079.

Whose telephone will be used, will it be a long-distance call and are there charges incurred with this call?
The attendant should use the individual's landline home telephone to conduct the call-in and call-out. These calls are toll-free.

What about individuals who do not have phones in their homes or refuse the use of their phones?
There will be instances when an individual does not have a phone or does not allow the attendant to use their phone. In most circumstances, the provider should request a Fixed Visit Verification Device (FVV Device) in order to capture the time the attendant begins and ends a shift. Until an FVV Device is approved and installed, the attendants should continue to record their time in and out manually, and provide that information to their agency EVV administrator. The administrator will then input that information into the EVV system using the EVV web-based Santrax Visit Maintenance Functionality. For more information regarding FVV Devices and procedures, please visit the FVV Device website.

What if the attendant does not arrive at the scheduled time?
If the attendant arrives late or forgets to log into the system immediately, the attendant should still conduct the EVV call-in as usual. The EVV system will identify the exact time an attendant made the call. For this type of situation, necessary adjustments or notes related to the visit should be added by the system administrator as necessary. If the attendant fails to arrive to provide necessary services, EVV reporting functions will allow the provider to identify the situation and take appropriate action in accordance with program rules.

What if the attendant forgets to call-in and call-out?
The agency would need to use the Santrax Visit Maintenance functionality to verify and resolve the visit.

What is the state requesting so far as including time sheets in individual charts?
Other than the creation of Texas Administrative Code (TAC) Chapter 68, which allows DADS to mandate EVV use, and changes to TAC Chapter 41, which allows use of EVV in the Consumer Directed Services (CDS) option, the DADS EVV Initiative does not modify any rules or requirements related to the impacted programs. As such, providers will still be expected to comply with all service delivery documentation requirements outlined in existing program rules.

What will prevent a provider from calling-in without being at the individual's home?
The provider will be responsible for inputting the individual's landline home telephone number into the EVV system. After that number has been entered into the database, the Santrax system will be able to determine if the EVV call was made from the specified telephone line/number or from a different number. If the call was made from a different telephone number, the Santrax system will flag the visit as needing additional system administrator attention via the Santrax Visit Maintenance functionality.

What if the individual is in the hospital? According to program rules, if an individual is hospitalized, attendants are not to report for their scheduled shift.
Program rules related to hospital stays remain in effect with an EVV system. If an individual is in a hospital and attendants do not provide services in the individual's home, a visit would not be called into Santrax. If a scheduled visit did not occur due to an allowable reason, the system administrator via the Santrax Visit Maintenance functionality would note that rationale in the EVV system.

Will the attendant have to input the tasks provided when calling back to end the shift?
No. At this time, DADS has determined that documentation of tasks is not required for EVV.

If tasks documentation is not required, how do we know they've followed the Service Delivery Plan?
Program rules related to service delivery documentation remain in effect with the EVV system. The EVV system is designed to document the visit information that the time sheet was previously recording. The EVV system will not replace other types of service delivery documentation required by program rules.

What type(s) of communications will be provided to individuals receiving services?
DADS will be mailing an EVV notification letter to all impacted individuals and the letter will also be posted on the DADS EVV website for reference. This notification letter will inform individuals receiving services that attendants will need to use the individual's landline home telephone to document visit arrival and departure. The letter will emphasize that EVV calls are toll-free and the individual receiving services will incur no costs related to EVV implementation or use. DADS encourages providers to reference and reinforce this very important information with individuals receiving services.

Does DADS mandate or endorse use of services beyond what was procured by DADS? For example, does DADS mandate that providers purchase scheduling software? Will DADS reimburse providers for other such services?
No. DADS does not mandate, endorse or reimburse for any services other than the DADS-purchased EVV system.

Can providers continue to use their existing non-DADS procured EVV system?
All providers impacted by the implementation of EVV are required to use the DADS-procured EVV system. Providers may also continue to use their existing EVV vendor with whatever services/software they choose, but providers should note that DADS will not accept visit verification data generated by another system.

For MDCP respite and flexible family support services, will you clarify that this is respite and flexible family support provided by the attendant and not registered nurses or licensed vocational nurses?
At this time, MDCP respite and flexible family support services that are provided by registered nurses or licensed vocational nurses do not fall within the scope of EVV.

If we have several locations, will we receive separate call-in numbers?
If your agency has several locations where the EVV system is implemented, Sandata encourages you to contact the Sandata Customer Service line at 1-855-781-2079 to discuss how best to set up your particular EVV system. Sandata is able to set up multiple locations for a single agency, or one single EVV system if you prefer. There is key information Sandata will need to gather from you to determine the best EVV set up for your agency in this situation.

Will the location of the individual receiving services be tracked by the EVV system?
No, the EVV mandate is limited to documentation of services provided within an individual's home.

Will the individual's ability to define his/her service schedule and determine where he/she would like to receive services (e.g., individuals receiving services at school, while shopping, etc.) be limited by EVV?
No. The use of EVV does not change the way and location in which services are delivered. Individuals will still be allowed to receive services in accordance with existing program rules, and providers will still be expected to ensure that services are delivered in accordance with program rules, regardless of the mandated EVV system.

Will EVV processes correspond to various oversight/survey processes, e.g., would state surveyors for licensure purposes accept the EVV log rather than a time sheet in the chart?
DADS rules currently allow for the use of electronic record keeping. In fact, some providers already use EVV systems. DADS accepts EVV logs that comply with existing program rules as appropriate documentation.

Would an individual receiving services be able to have a split schedule? In other words, would EVV allow for a situation in which an individual is receiving some services from one service provider in the morning and some additional services from a second service provider later in the day?
The use of EVV does not change the way in which services are delivered. Individuals will still be allowed to receive services in accordance with existing program rules and providers will still be expected to ensure that services are delivered in accordance with program rules, regardless of the mandated EVV system.

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Compliance

When will providers be subject to DADS EVV quarterly compliance reviews?
Beginning the seventh full month after the effective date of the contract or the date on which the provider is required to start using the EVV system, whichever is later, DADS will conduct quarterly compliance reviews to determine if services have been provided and documented in accordance with DADS EVV requirements.

Where can I get training to understand the compliance plan reports?
Sandata has developed the DADS Compliance Reports User Guide for provider agencies impacted by EVV. You can access this guide through the DADS EVV website at: http://www.dads.state.tx.us/evv/training.cfm.

How do I interpret the DADS VM Compliance Summary Snapshot report?
This report documents visit information with a focus on visits verified within program expectations. The Summary Snapshot report is based upon a three month period and when taken it will only reflect the visit maintenance completed within that three month period.

Summary snapshots are taken on the 16th of each month. The report timeframe will only reflect the visit maintenance completed in a three-month period prior to the 16th day of the month and year the report is generated.

In order for any and all visit maintenance completed for the previous three months to be captured by the Summary Snapshot report, the provider will need to perform the visit maintenance by 15th of the month.

For example:

On Oct. 12, 2013, a provider adjusts a visit that occurred in July 2013 in Visit Maintenance.

On Oct. 16, 2013, the Summary Snapshot report is taken in the Santrax system which covers the timeframe of July/August/September. In this example, the July data contained in the report will reflect the visit maintenance that occurred on Oct. 12 for the July visit.

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Fixed Visit Verification (FVV) Device

For EVV, attendants are required to make calls from the individual's landline home telephone to verify that services have been provided. However, not all individuals have a landline home telephone or want to let their attendants use their landline home telephone.
Sandata has developed a Fixed Visit Verification (FVV) Device for individuals who do not have a landline home telephone available for EVV calls. The FVV Device supports automatic visit verification without the use of the individual's home phone.

What are Fixed Visit Verification Devices?
The FVV Device is a small device that runs on batteries and is placed in the individual's home in a location that is convenient to access. DADS encourages providers to work with the individual to find a good location for the FVV Device. The FVV Device must not leave the home. If the individual chooses a different location for the device, he or she should contact the provider to move it. If the device is lost, stolen or removed from the home, the individual should contact the provider immediately. Examples of where the FVV Device can be placed include by the door, in a kitchen drawer or an easily accessible cabinet. The FVV Device can be taped in place so it will not move or get lost.

What does the FVV Device do?
An FVV Device will be used as an alternative method to attendants calling from an individual's home phone. The FVV Device will capture the date and time of the visit, as well as verify that the attendant provided services to the correct individual during that time. The FVV Device does this by generating a unique number each time the button on the device is pressed. This number represents a date and time value (the FVV value). After the visit is complete, the FVV values are entered into the EVV system by calling the Santrax system.

Is there a timeframe to call the Santrax system to enter the FVV number values?
Yes. The FVV device number values will expire in seven days from the date they have been generated; therefore, a call will need to be made into the Santrax system within seven days from the start of the visit.

For example, an FVV number representing a visit time of 2 p.m. on Monday, Oct. 7 will need to be called into the Santrax system before 2 p.m., Monday, Oct. 14 in order to register in the system as a valid FVV number.

What if the individual does not allow the provider agency to retrieve an FVV device from their home?
The provider agency must document the attempt(s) to retrieve the FVV device. The documentation must include the dates the attempt(s) were made and what types of contact the provider made with the individual (e.g. phone, mail, face-to-face) corresponding with the documented dates. The provider agency must keep a copy of the documentation in the individual case record. If the provider agency is unable to retrieve the FVV device after making and documenting attempt(s) to retrieve the FVV device, the provider agency must contact Sandata in writing stating they are unable to collect the FVV device and copy DADS at CPC@DADS.state.tx.us.

What if the individual who is participating in the CDS Option transfers to another financial management services agency (FMSA) or transfers to the agency option and does not send the FVV device back to Sandata?
The FMSA must document the request(s) made to the CDS employer to send, using the self-addressed stamped envelope included in the starter kit, the FVV device back to Sandata. If the employer does not have the original pre-paid envelope, they should call Sandata at 1-855-781-2079.

The FMSA documentation must include the date(s) of the attempt(s) and what types of contact the FMSA made with the CDS employer (e.g., phone, mail, face-to-face) corresponding with the documented date(s). The FMSA must keep a copy of the documentation in the individual case record. The FMSA must contact Sandata in writing, and copy DADS at CPC@DADS.state.tx.us, stating that they are cancelling the FVV for the individual and requested that the individual return the FVV device to Sandata.

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Santrax System

What is a Santrax ID?
The Santrax ID is an identification number that is assigned to each attendant within the EVV system. The Santrax ID must be a numeric code with a specified number of digits. The provider agency will determine the Santrax ID based on the EVV recommended Santrax ID format. The ID is used to identify staff within the Santrax system.

Are new employees assigned a temporary number?
The provider/FMSA should enter new employees into the Santrax EVV system as soon as possible so calls can be successfully recorded in the system. It is not recommended to use a temporary number and then assign a real number as this would result in conflicting information in Santrax.

Does the Santrax phone system have the capability to play in Spanish?
Yes. Sandata will provide each provider and FMSA with two toll-free phone lines with English prompts, and one toll-free line with Spanish prompts.

What occurs if the toll-free line doesn't work or a busy signal is received?
Sandata will provide a total of three toll-free phone lines (two English and one Spanish) to ensure you have continuous telephony access. If an attendant does run into an issue when attempting to call into a toll-free phone line, he or she should call into the alternate toll-free line.

Is there a Customer Service number to support EVV related calls?
Yes. The Sandata EVV Customer Service Line is open Monday through Friday, 7 a.m.-5 p.m., Central Time. The toll-free number is 1-855-781-2079. If you reach the EVV Customer Service Line after hours, you can leave a message and customer service staff will return your call the next business day. Sandata customer service staff are fully trained on the Santrax system and will be able to assist your with your Santrax user questions.

Does the Visit Maintenance Screen also capture services provided outside the home?
Yes. In those circumstances, the attendant should record their time in and out manually and provide that information to their EVV administrator or Consumer Directed Services (CDS) employer. The administrator or CDS employer will then input that information into the EVV system using the EVV web-based Santrax Visit Maintenance system. The EVV administrator or the CDS Employer could also enter a schedule and then, using visit maintenance, approve the hours worked. The details of that process will be included in the upcoming EVV training sessions.

Do all of the Sandata staff have Health Insurance Portability and Accountability Act (HIPAA) training and is the information regarding the individuals receiving services kept confidential?
Sandata has internal HIPAA policies that comply with security and privacy standards. All Sandata employees take an annual HIPAA training and test and all information is kept confidential in accordance with these requirements.

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Claims Submission

How will EVV impact my DADS claims submission?
The EVV system will support the generation of an export file of all completed visit information intended to support the claims submission process. You will need to use information from the EVV system for your claims submission process.

Will providers/FMSAs have the opportunity to review call and visit information before the billing export is generated?
Sandata will provide each provider and FMSA a unique account number and user ID and password that will allow the provider/FMSA to login directly to Santrax. This access will allow providers, FMSAs and CDS employers to review and edit data related to applicable visits as necessary. These activities can be conducted prior to export generation. Detailed information regarding visit maintenance will be provided during the EVV training.

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Training

When will training be offered?
There will be three types of training offered: classroom, webinar and self-paced computer training. All training schedules and registration information can be accessed at the DADS EVV training website.

Will providers get a handbook during the training with the information discussed during the introductory webinar?
Sandata will provide printed training materials, including a printed version of the introductory webinar, and will ensure additional materials are easily accessible within the Santrax system to support training needs.

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Consumer Directed Services

Is EVV required for CDS employers?
Beginning June 1, 2012, EVV is no longer mandatory for CDS employers. Until further notice, CDS employers can choose if they want to use the EVV system or use paper time sheets. The choices are:

  • Phone and Computer (Full Participation): The telephone portion of EVV will be used by your Consumer Directed Services (CDS) Employee(s) and you will use the computer portion of the system to perform visit maintenance.
  • Phone Only (Partial Participation): This option is available to CDS Employers who can participate in EVV, but may need some assistance from the FMSA with visit maintenance. You will use a paper time sheet to document service delivery. Your CDS Employee will call-in when they start work and call-out when they end work. Your FMSA will perform visit maintenance to make the EVV system match your paper time sheet.
  • No EVV Participation: If you do not have access to a computer, assistive devices, or other supports, or you do not feel you can fully participate in EVV, you may choose to use a paper time sheet to document service delivery.

CDS Employer will need to document their choice. FMSAs will be contacting CDS employers to document the CDS employers choice.

Is there still an expectation for completion of a Service Delivery Log for the Consumer Directed Services option in the Medically Dependent Children Program?
No, for MDCP EVV services, parents are not required to keep a copy of DADS Form 1745, Service Delivery Log with Written Narrative/Written Summary, in the in-home record. Effective March 15, 2012, the EVV report, called "Visits Summary by Client" report replaces Form 1745 in the in-home record. See Information Letter 12-15 to see instructions for producing this report.

How often are CDS employers expected to respond to gaps or make resolution in the EVV system?
CDS employers can determine how often they want to review the Santrax EVV system and make corrections or updates to the visit information. The Santrax EVV system will maintain the information so that CDS employers can make updates daily or weekly, as desired. It will be important to ensure all updates are made by the end of the payroll period. Payroll will be based on the information in the EVV system.

CDS offers a flexible schedule. Will employers now be expected to adhere to a set schedule?
The use of EVV does not change the way in which services are delivered. The use of EVV will not require that CDS employers adhere to a fixed schedule, unless required by program rules. Generally, it will be the CDS employer's decision to use a schedule to manage their employee(s). If services are delivered entirely in the community, the CDS employer will need to enter the schedule determined by the CDS employer.

Will the implementation of EVV remove the CDS employer's authority to approve time worked by the employee?
No. Ensuring that CDS employers have access to the EVV system to review and approve employee time has been an important consideration in the development of technical guidelines regarding EVV.

Have the direct service workers (CDS employees) been trained in the system? Have they been informed/prepared for its implementation? Who will train them?
For the CDS option, CDS employers or their designated representatives who chose full participation or partial participation with EVV are responsible for providing all training to their employees. This includes the training on how to make the EVV calls when the CDS employee starts and ends work. For those CDS employers opting for FULL participation in EVV, important materials and instruction needed to train employees will be delivered at the CDS employer training session to be held by Sandata staff. For CDS employers opting for PARTIAL participation in EVV, your FMSA will send you the Call Reference Guide that you can use to train your CDS employees.

The Santrax EVV training materials are currently available on the DADS EVV website, including the Santrax Telephony Demo and Helpful Hints. This information can be provided to your CDS employee(s) immediately if you would like to share more details about the upcoming EVV call process.

Will this system eventually be required for CDS participants in the Home and Community-based Services (HCS) waiver?
The HCS program is not in the scope of EVV at this time.

If and when EVV rolls out to other regions, will HMOs be included?
EVV is a DADS initiative. STAR+PLUS is operated by the Texas Health and Human Services Commission and would not be within the scope of the DADS EVV initiative.

Will the EVV System also handle bonuses or paid vacation days?
The EVV system records time worked. To request bonuses or other benefits, you will need to work with your FMSA. To help you keep track of hours used for bonuses, if budgeted, there is a EVV report that you can view that will show the numbers of hours worked and the dates of service delivery.

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Updated: September 22, 2014