Home Health Care Technology

Gary Tonks, CEO of The Arc of Ohio, Discusses EVV and the Strength of “Nothing About Us Without Us”

A Conversation with The Arc of Ohio

The Arc of Ohio is a statewide membership association made up of people with intellectual and developmental disabilities, their families, friends, interested citizens and professionals in the disability field. Together with our individual members and local chapters, we represent more than 330,000 Ohioans with intellectual and developmental disabilities and their families. Ohio Law recognizes The Arc of Ohio as the organization to represent families in legislative decisions.”

Sinq Technologies had the honor of interviewing Gary Tonks about Ohio’s implementation process of Electronic Visit Verification. Ohio is an interesting study into the effects, trials and tribulations, and confusion created by the Cures Act EVV mandate. As a home care technology company, Sinq wanted to dialogue with The Arc of Ohio in order to understand their position on EVV and learn from them how technology can be more collaborative with vulnerable populations.


Q: As technology becomes more commonplace within home health care and in the lives of I/DD individuals, and paper worklogs, time sheets, and the like are being eliminated, do you believe the right of privacy and technology can coexist, and if so, how do you envision such a process?

A: Yes, I do.  In fact, most of our families have embraced technology.  There was little or no notice in Ohio to the masses before EVV arrived in their mailbox; and, this was compounded by a series of ongoing miscommunications with recipients by the Ohio Department of Medicaid regarding other issues.

 Q: The topic of right to privacy for disabled individuals receiving care is very prominent with The Arc of Ohio and the Stop EVV movement.  Some people may say EVV is not intrusive and people should not worry about GPS and locating services if they are not doing anything wrong.  How would you respond to that argument?

A: Referencing poor communication from question 1., there was little or no communication prior to EVV arriving in mailboxes and a number of incorrectly mailed letters to Medicaid recipients that gave recipients reason not to trust the Dept of Medicaid.  There was also no effort to have the endorsement of organizations like The Arc or other disability organizations as part of any type of marketing campaign.

Q:  Can you explain for someone who may not know anything about the daily lives of I/DD individuals the challenges care givers experience with logging in and out at various locations? Do care takers or family members have to log in when their client or loved one goes on vacation or to a relative’s house?

A: This has been one of the major questions left unanswered.  People with disabilities lead active included lives, yet EVV in Ohio assumes an institutional bias with strict routine schedules.  That is simply not how people with disabilities live outside of institutional settings.  One staff person may assist in the home and then another assumes that role at the local mall, while a third may assist at a restaurant with none of those staff literally passing a baton.

Natural unpaid supports or no supports at all may be used in between paid staff.  In addition, there are individuals with intellectual or physical limitations that may be unable to operate EVV.  Additionally, there is a large section of Appalachian Ohio where EVV will simply not work.

As I travel Southern and Southeastern Ohio, there are literally hours on no reception. I was meeting with families 45 minutes from Cleveland on Wednesday evening with no cell phone reception. Family members of adults can be paid providers in Ohio.  They do this and provide free natural supports often within the same day. This also complicates implementation. Again, I want to stress how this was rolled out and the attitude now of continued implementation even with a delay from Congress.

The other factor is the millions of dollars already spent on one company; and, that one company specifically being named in Administrative Rule.One must understand, EVV implementation follows months of an attempt to eliminate Independent Providers due to Wage and Hour potential violations by the State of Ohio using the excuse of rampant fraud rather than an open discussion of Wage and Hour Law.

Q: As reported in various news articles and press releases, Ohio has seen its share of problems with the implementation process of EVV.  What is your opinion of the state of affairs in Ohio in relation to EVV?

A: It is a public relations nightmare.  This would take an expanded conversation of what has occurred within the Ohio Department of Medicaid during the last several years.

Q:  Do you feel that I/DD individuals are being overlooked during the EVV implementation process?  If so, what can be done to improve the dialogue between EVV vendors and organizations such as The Arc of Ohio?

A: Yes.  We and others have purposely avoided participation in the EVV stakeholder meetings sponsored by the Dept of Medicaid to avoid any implied endorsement.  No EVV vendor other than you have bothered to contact us.

Q: Colorado has announced that it will not delay implementing EVV until 2020, but will start January 1, 2019 with the same vendor Ohio uses.  What would be your advice for providers, clients, family members, and stakeholders while they begin the process?

A: Prepare people now and seek the endorsement of Advocacy organizations before you begin the process.  Given this is August, they are already missing the boat if they choose not to delay.

(An individual from a Colorado disability organization also stressed frustration with EVV implementation. The person did say they were involved with the process, but not to the extent they desired.)

Q: In a recent article, you stated that there seems to be a disconnect between Ohio’s EVV vendor and citizens when it comes to questions or concerns about EVV software.  For example, you stated that it is unclear about EVV in rural areas with no internet.  Do you believe such information is not being communicated well by the vendor, or are the providers and caregivers to blame for the miscommunication?

A: Again, there is mistrust of the Ohio Dept of Medicaid due to other factors, and there was no stakeholder endorsed marketing plan. The fact that millions of dollars were invested PRIOR to Advocacy participation reinforces the mistrust.   And, there is NO internet connection in areas of this state.

Q: If you could work with an EVV technology department and present the ideal situation to make all parties happy, what would your input be?

A: There is a saying in our community, “Nothing about us without us.”  This involves active participation prior to a vendor contract and prior to an EVV arriving in an individual’s mailbox.

Q: Would you like to add any information not discussed, any news related items, or important details to better the understanding of the goals of The Arc of Ohio?

A: While The Arc of Ohio is the lead civil rights organization on behalf of Ohioans with I/DD and their families, we are also mainstream in our views and reasonable.  Ohio’s DD community is strong, vocal and politically active.  Our input prior to implementation and the input of others would have resolved many of these issues.

Sinq would like to thank Gary Tonks for his time, willingness to discuss EVV and Ohio, and his insightful thoughts.

The Arc of Ohio website: https://www.thearcofohio.org/

About Sinq Technologies

Sinq’s collaborative software technology platform was built with purpose in mind. Sinq’s Care Plan Transparency, Care Gap Management, EVV / EvS, and Change in Care Monitoring makes Sinq’s software stand out within the industry, and with Payors, Providers, and Plans. We can help you become compliant, but our expansive software offers long-term solutions for the betterment of your agency and clients. Call today for more information, a free demo, or a consultation at (847) 325-5007, or talk directly to Matt at (630) 596-6721, email Matt at mtipples@sinq.io, or visit us at www.sinq.io


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