An Emergency Response Services (ERS) provider contracted with a managed care organization (MCO) must meet the following provider requirements:
- Have emergency monitoring capability 24 hours a day, seven days a week; and
- Be equipped to provide verifiable data using technology capable of producing a printed record of the:
- type of alarm code (test, accidental or emergency);
- unit subscriber number;
- date; and
- time of the activated alarm in seconds.
An ERS provider contracted with an MCO, prior to delivering the service, must meet the following service initiation requirements. Secure responders who:
- Go to the member's home if an alarm call is made to a provider; and
- Take appropriate action, including contacting public service personnel, based on the situation.
Attempt to secure the names of at least two responders from a member on or before the date the provider initiates services. The exceptions are as follows:
- If the provider is able to secure the name of only one responder from a member, the provider must:
- designate public service personnel in place of the member's second responder; and
- document the reason the provider could secure the name of only one responder.
- If a provider is unable to secure the names of any responders from a member, the provider must:
- designate public service personnel in place of the member's responders; and
- send written notification to the service coordinator of the inability to secure the names of any responders within 14 days after initiating services.
Administer an orientation to a responder according to the following requirements:
- Orient a responder in person, by telephone or in writing on the responder's responsibilities on or before the date the responder is first contacted by the provider and asked to respond to an alarm call;
- Document the following information concerning the orientation:
- name and telephone number of the responder;
- name of the member;
- date the responder was secured;
- date of orientation;
- method of orientation; and
- topics covered; and
- Ensure that a responder receives written procedures on how to respond to an alarm call and document the date the procedures were provided to the responder. The provider may mail the written procedures to the responder.
Replace a responder according to the following requirements:
- A provider must secure a replacement responder when a member's responder is no longer able to participate.
- If a member has two responders, a provider must secure a second responder within seven days after becoming aware that the member will no longer have two responders.
- If a member has one responder, a provider must secure a replacement responder within four days after becoming aware that the member's sole responder is no longer able to participate.
- If a provider is unable to secure any replacement responders, the provider must:
- designate public service personnel in place of the replacement responders; and
- provide the case manager with written notification within 14 days after the provider determines it cannot secure a replacement responder.
- A provider must document the date the provider:
- became aware that a responder was no longer able to participate; and
- secured a replacement responder.
Maintain a record of the names of current responders for each member.
Retain documentation of service initiation in a member's file.
A responder must comply with the following service requirements. Install the equipment according to the following requirements:
- During an initial home visit, an installer must:
- install and make an initial test of the equipment;
- ensure that the equipment has an alternate power source in the event of a power failure;
- install within limits set forth in manufacturers' installation instructions; and
- if necessary:
- purchase a telephone extension cord;
- connect and run a telephone extension cord not to exceed 50 feet between the wall jack and the equipment; and
- safely tack the telephone extension cord against the wall or floorboard to prevent a hazard to a member.
- An installer is not required to:
- adapt the physical environment in a member's home to make it compatible with the equipment;
- arrange or pay for relocation of the telephone; or
- purchase or install electrical extension cords. An installer must not use an electrical extension cord when installing equipment.
- A provider must document a failure to install the equipment, including the:
- reason for the delay;
- date the provider anticipates it will install the equipment or the specific reason the provider cannot anticipate a date; and
- description of the provider's ongoing efforts to install the equipment, if applicable.
Training a member on the use of the equipment must include:
- Demonstrating how the equipment works;
- Having the member activate an alarm call;
- Explaining to the member that:
- the member must participate in a system check each month;
- the member must contact the provider if:
- his telephone number or address changes; or
- one or more of his responders change;
- the member must not willfully abuse or damage the equipment;
- a responder can forcibly enter a member's home, if necessary;
- the procedures for filing a complaint against a provider; and
- Obtaining a signed release for forcible entry.
Service initiation due dates are as follows:
- The provider must initiate services within 14 days after the service effective date; and
- If a member is not available during the time frames, the provider must initiate services within 72 hours or document reason for delay.
An ERS provider contracted with an MCO must document any failure to initiate services by the due date. Documentation must include:
- The reason for the delay;
- Either the date the provider anticipates it will initiate services or specific reasons the provider cannot anticipate a service initiation date; and
- A description of the provider's ongoing efforts to initiate services.
A provider must maintain documentation of service initiation in a member's file.