Revision 06-2; Effective June 9, 2006

When Form 2101, Authorization for Community Care Services, is received, the provider:

• contacts the individual to make an appointment to install the emergency response home unit equipment; and
• prepares a file on the individual, which includes applicable provider forms (individual information, home entry release statement, ownership of equipment statement and complaint procedure).

5210 Securing Responders

Revision 06-1; Effective April 10, 2006

The provider refers to the Comments section of Form 2101, Authorization for Community Care Services, to determine if the case manager identified potential responders for the individual. The provider begins to identify responders during the initial contacts while arranging for a home visit. The provider may ask the individual if there is a relative, friend or neighbor willing to participate. If one or more responders are identified for an individual, the provider may request that the person(s) be present on the day the equipment is to be installed to learn about the service and the responder's responsibilities. If the responders are unable to be present, the provider may orient the responders by telephone or in writing on or before the date the responder is first contacted and asked to respond to an alarm call. The provider must document the required information. More information regarding responder orientation can be found in Chapter 52 Contracting to Provide Emergency Response Services.

If two responders are not secured for the individual, the provider will:

• identify the individual's sole responder and document the reason(s) why two responders were not secured for the individual; and
• document the date the written procedures were mailed to the sole responder; or
• designate public service personnel in place of the individual's responders; and
• send written notification to the case manager of the inability to secure the names of any responders within 14 days after initiating services.

5220 Home Visit

Revision 06-1; Effective April 10, 2006

During the home visit, the installer connects the equipment and obtains the information needed to complete the applicable provider forms.

If the provider is unable to complete installation, document the reason for the delay, the anticipated date the equipment will be installed, and a description of ongoing efforts to install the equipment, if applicable.

After installing the equipment, the provider demonstrates the equipment and allows the individual to activate an alarm call to familiarize him with the equipment. The provider explains the individual is responsible for the following service delivery requirements:

• participating in the monthly systems checks;
• contacting the provider if he moves or has his telephone number changed; and
• contacting the provider if he becomes aware of changes related to responder(s).

The installer provides the individual with a written copy and an explanation of the complaint procedures.

The case manager must discuss service delivery requirements with the individual. If the individual refuses to sign the release statement, the case manager must withdraw the referral.

5230 Provider Follow-Up Procedures

Revision 06-2; Effective June 9, 2006

The provider:

• documents the day that services began.
• maintains ongoing communication with the case manager and the regional contract manager by discussing:
  • individual-specific issues with the case manager; and
  • contract management issues (overall service delivery, policies and procedures) with the regional contract manager.