BY ARIANA ABOULAFIA AND HENRY CLAYPOOL: Complete Post through this link…
ngd-How the government keeps tabs on those it deems unable to fight back…
In Arkansas, the Guardian reported on a disabled Medicaid recipient who depleted his savings to pay for a smartphone for his Medicaid-covered caregiver—and then had to pay even more to cover caregiver wages that were withheld due to technical glitches. In Ohio, the Mighty reported on someone who placed the electronic device meant to certify his caregiver’s activities in the refrigerator when not in use because he was concerned about privacy. And throughout the U.S., other outlets have reported on disabled people who have been forced to share photographs and biometric data with third-party apps if they want to continue receiving government support to pay for their in-home care.All of this is thanks to a program known as electronic visit verification, or EVV.
EVV ostensibly aims to reduce waste, fraud, and abuse in the Medicaid system by requiring that caregivers of disabled people “prove” that the covered individual is actually receiving their approved care. Under federal law, all states must require that health and home care providers utilize some form of electronic visit verification; if they do not, they risk a reduction in funding for their Medicaid programs.
Technology can intersect with disability in unique and devastating ways. For example, algorithmic bias—which shows up in employment via the use of algorithm-driven hiring tools and tests—can harm people with disabilities by unfairly screening them out of jobs. Because a significant amount of their health-related data may be stored on devices or apps, disabled people are also especially at risk when it comes to issues of data privacy—which have become even more important in the wake of the 2022 Dobbs decision. The use of surveillance technology in schools, like student activity–monitoring software and student threat assessment software, can lead to adverse consequences for disabled students, including a disproportionate chilling effect on speech both in and outside of school. As is the case with electronic visit verification, many of these concerns—data privacy, surveillance, and personal privacy—often manifest simultaneously, thus amplifying their effects.
In practice, EVV can look different depending on the state—for example, some states use mobile apps that require Medicaid-funded home-care workers to submit photographs of the disabled person to whom they are providing care periodically throughout the day. At times, those photographs must pass through facial recognition procedures to verify that the individual receiving care is actually who the worker says they are. A worker’s ability to be paid hinges upon successfully capturing, uploading, and verifying these photographs, regardless of whether the service recipient objects to the photography or facial recognition process. Many EVV schemes also use GPS to track caregivers’ locations, and by extension, the location data of the disabled people they work with. Often, the caregiver and care recipient both must prove they’re at the recipient’s home to properly verify the visit, which can limit the disabled person’s ability to leave home and engage in community activities.While EVV was initially required as an alleged attempt to prevent public benefits fraud, whatever preventative benefit it may provide (most of which seems, at this point, to still be largely speculative) is largely outweighed by its detriments. On the financial front, according to the Guardian, the state of Arkansas secured only three convictions for personal care-services fraud in 2020, recovering a total of $1,930; as of mid-2021, EVV had cost the state $5.7 million to implement. Outside of this, EVV creates a system in which disabled people who require Medicaid-funded in-home services are frequently surveilled by the government; their photographs or location data are uploaded to apps via their caregivers’ personal devices; the services they need and are entitled to are disrupted; and their independence, freedom to leave their homes, and legally protected right to participate fully in their communities is hindered. Disabled travel blogger and professional editor Karin Willison has written that “Electronic visit verification is the equivalent of putting an ankle monitor on people with disabilities and telling us where we can and can’t go. It turns having a disability into a crime.”ADVERTISEMENT
