1-Minute Action: Send EVV Comments by June 4

Tell Ohio "NO" to GPS surveillance of people with developmental disabilities.

The Ohio Department of Medicaid has proposed adding new conditions to the Ohio Administrative Code that would threaten the privacy of people with developmental disabilities. None of the proposed additions are required by federal law, and ODM has admitted the changes were not based on scientific data, but were submitted by unnamed "stakeholders."

Send your comment by June 4, 2026 to both of the following email addresses:

rules@medicaid.ohio.gov

CSIPublicComments@governor.ohio.gov

It only takes one minute to participate, and we have written a suggested comment you can use (or write your own).

Comments are public records. Do not include the name or private health information of any Medicaid recipient without permission.

Suggested comment is below.

To Line: rules@medicaid.ohio.gov; CSIPublicComments@governor.ohio.gov

Subject Line: Public Comment Regarding Proposed EVV Rule Changes

Dear Common Sense Initiative and Ohio Department of Medicaid,

I am writing to strongly oppose ODM’s proposed amendments to Ohio Administrative Code 5160-32-01 and 5160-32-02 regarding Electronic Visit Verification (EVV).

These proposed changes would remove Ohio’s live-in caregiver exemption, require providers of per diem services such as Shared Living to use EVV, and require GPS location capture at the start and end of services. ODM’s own Business Impact Analysis admits that federal law does not require any of these measures. ODM also admits that no scientific data was used to develop this proposal.

This rule change should not move forward.

Mandatory GPS tracking of disabled people and their caregivers inside their own homes is invasive, unnecessary, and deeply inappropriate. This proposal is especially alarming because GPS tracking of the care worker effectively means GPS tracking of the disabled person, since the two people are together. The live-in caregiver exemption exists for a reason. When a caregiver and recipient reside in the same home, GPS data provides little or no information about whether services are actually being delivered. The caregiver's location is already known because they live there. Eliminating the exemption imposes a significant privacy burden on disabled Ohioans while providing little or no corresponding program integrity benefit. Disabled people should not be subjected to government-mandated GPS location tracking as a condition of receiving medically necessary services.

This proposal raises significant privacy and constitutional concerns. Conditioning access to Medicaid waiver services on GPS tracking inside the home may implicate Fourth Amendment protections and raises questions about whether disabled Ohioans should be required to surrender location privacy as a condition of receiving medically necessary services.

The proposed expansion to per diem services is also unworkable. Shared Living and similar per diem models are not the same as 15-minute shift care. These caregivers often provide intermittent, flexible support throughout the day: morning routines, meals, bathing, supervision, evening care, overnight availability, and emergency response. The entire point of a per diem model is that care is not neatly divided into clock-in/clock-out shifts.

Will Shared Living providers be expected to log in and out every time they assist someone for five or fifteen minutes? If the individual goes to a job or day program, is the Shared Living provider still required to remain logged in? If so, the state may collect private, personal location data while the per diem provider is off duty and not providing any Medicaid services. Alternatively, if Shared Living providers are expected to log in and out many times per day, the rule creates an impossible administrative burden that does not match how per diem care actually works.

ODM’s proposal goes far beyond federal requirements, removes an important privacy protection, expands EVV into service models where it makes no sense and serves no legitimate purpose, and imposes new burdens without scientific evidence. It risks destabilizing care for disabled Ohioans who already face severe caregiver workforce shortages.

Most troubling, ODM admits that no scientific data was used to develop these proposals and that no alternative approaches were considered. Before imposing GPS surveillance requirements on disabled Ohioans and their caregivers, the Department should be required to provide evidence that the measures are necessary and explain why less intrusive alternatives were rejected. According to ODM's own Business Impact Analysis, it has done neither.

Further, ODM states that the proposed changes originated from “stakeholder” recommendations, but does not identify which stakeholders recommended which changes, nor does it explain the basis for those recommendations. Given the significant privacy implications of these proposals, Ohioans deserve transparency regarding who advocated for expanded EVV requirements and whether any recommending stakeholders have a financial interest in expanded EVV compliance, technology, data collection, or related services.

Ohio must protect Medicaid dollars, but program integrity cannot come at the expense of privacy, dignity, constitutional rights, transparency, and access to care. The state should target actual fraud with evidence-based approaches instead of imposing blanket GPS surveillance on tens of thousands of disabled Ohioans, caregivers, and family members who have not been accused of any wrongdoing.

I respectfully request that CSI and ODM reject these proposed changes and preserve the live-in caregiver exemption, reject mandatory GPS tracking, and exclude per diem services from EVV requirements unless and until ODM can demonstrate a lawful, evidence-based, narrowly tailored need.

Sincerely,

[ADD YOUR NAME]