UPDATE:

The Budget, as a document, has to go to a Conference Committee because the House and Senate versions differ.

The bad language in the budget removing the EVV exemption for live-in caregivers is still in the budget proposed by both Chambers.

The budget, as a document, must go to a Conference Committee because the House and Senate versions differ.

We are asking the Budget Conferees to remove that harmful language requiring live-in caregivers to use EVV.

IF you are represented by anyone on the Conference Committee contact: tchampion@virigniaautismproject.org

URGENT ACTION

We are contacting the members of the conference committee in both the House and the Senate to ask them to remove the damaging EVV language.

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Email subject: PLEASE Listen and Remove Harmful EVV Language

Dear Members of the Budget Conference Committee,

I respectfully request that you remove the following language from Item #291 in the budget:

“The Department of Medical Assistance Services shall seek federal authority through the necessary waiver(s) and/or state plan amendments…to eliminate the live-in caregiver exemption from electronic visit verification requirements…”

The Centers for Medicare and Medicaid Services (CMS) says that live-in caregivers are not considered visitors and allows states to grant an exemption from the EVV requirement to record hours in an EVV device for live-in caregivers. 

Since you passed legislation granting live-in caregivers this exemption effective January 1, 2021, live-in caregivers have been able to provide care without the constant interruption of clocking in and out.

EVV electronically verifies that home and community-based services are delivered to the client. This is easily verified by a live-in caregiver by other means than using EVV to clock in and out for shifts and tasks. Requiring a live-in caregiver to use this system is burdensome and takes the focus away from providing care.

DMAS alleges a savings by removing this exemption; however,

1) These alleged savings were not supported by documentation by DMAS nor by the Department of Planning and Budget.

2) These alleged savings to the Commonwealth will be realized only when recipients do not receive necessary care.

3) Interim DMAS Director Jeff Lunardi said on February 6, 2026 that the removal of the EVV exemption is "not a significant amount of savings". VIDEO

4) The Department of Planning and Budget (DPB) stated that no records were supplied by DMAS to substantiate the alleged savings and the DPB did not produce their own records. So this number has no substantiation. 

While the savings are not significant to the Commonwealth, the burden for live-in caregivers is significant and this is why the exemption was granted in 2020 by the Legislature.

ADD anything below as a talking point or end with:

Requiring live-in caregivers to use electronic visit verification (EVV) would return Virginia to a system it dispensed with for live-in caregivers in 2020. CMS recognizes that EVV is a burden for live-in caregivers and allows this exemption.

Please remove this harmful language from the final Budget. 

Sincerely,

XXXX

Additional Talking Points If Needed:

This is important to me because I am the live-in caregiver for my son/daughter/family member/spouse/parent.

ADD one or two of these TALKING POINTS or add your own:

• Live-in caregivers do not "visit," and the use of a "visit" monitor system does not capture the ongoing presence and involvement of the caregiver.
• Care is continuous, not clock-based, and using EVV misrepresents how care actually happens and forces caregivers to log artificial “shifts” that don’t reflect reality.
• EVV is designed for an attendant who “visits” to provide intermittent support. Live-in caregiving is continuous and cannot be chopped up into visit tasks.
• If there is a need for oversight, care recipients and families can easily verify that care occurred. 
• Live-ins are on call 24/7. Shift workers are not on call and clock out at the end of a shift. Live-ins cannot clock out. It’s unreasonable to expect a live-in caregiver to clock in and out for every issue addressed around the clock.
• The EVV system was created to track shift-worker attendant time and movement to help prevent fraud. There is no potential fraud component for live-in caregivers. 
• EVV tracks location. The live-in caregiver will be at the location, so there is no point in the location tracking aspect. The task tracking is easily verified by other means.  
• Live-in caregivers are working around the clock far more hours than they are being paid.
• Live-in caregivers provide care intermittently throughout the day and night
• Live-in caregivers respond to unpredictable needs such as: seizures, elopement, behavioral crises, toileting, medications, and much more.
• Overnight and on-call hours are hard to document.
• Live-in caregivers must remain available at all times and may be awakened multiple times per night for seizures, medical needs, or elopement.
• Live-in caregivers are tied up with all too common urgencies and emergencies around the clock, day and night. They shouldn't be forced to direct their energy to a time clock and away from the person receiving care. 
• EVV does not add anything to the quality of care or even accountability, since care recipients and families can easily verify that care occurred without EVV.
• Many live-in caregivers are family members who left paid employment to provide care and save Virginia significant institutional care costs.
• Requiring these live-in caregivers to use EVV will push many toward institutional care instead.
• It shows bad faith for Virginia to now remove that exemption, and it will make caregiving feel punitive and distrustful.