(a) Purpose. This section establishes the requirements for ERS, a service provided under the Older Americans Act and funded, in whole or in part, by DADS.
(b) Eligibility. A AAA must ensure that a program participant who receives emergency response services:
  (1) is 60 years of age or older;
  (2) meets at least one of the following criteria:
    (A) lives alone;
    (B) is routinely alone for eight or more hours during a 24-hour period; or
    (C) lives with an incapacitated person who is not able to call for help or otherwise assist in an emergency;
  (3) lives in a place other than an LTC facility, personal care home, foster care setting, or any other institutional setting where 24-hour supervision is available; and
  (4) is at risk, such as being prone to falling or having an existing medical condition that may be life-threatening if the program participant does not receive immediate assistance.
(c) Requirement for licensed vendor to provide services. A AAA must enter into a vendor agreement for the provision of ERS with an entity licensed:
  (1) by the Public Security Bureau of the Texas Department of Public Safety as an alarms systems company; or
  (2) by the Department of State Health Services as a personal emergency response system provider.
(d) Service authorization. Before ERS are provided by a vendor to a program participant, a AAA must ensure that the vendor obtains authorization for the services from the AAA in accordance with §83.3(o)(2)(B) of this title (relating to System of Access and Assistance).
(e) Service activities. A AAA must ensure that the vendor:
  (1) coordinates and oversees the installation and management of the electronic monitoring system;
  (2) initiates services within 14 days after the service effective date on the authorization, unless prohibited by factors beyond its control such as a natural disaster; and
  (3) if a program participant is not available to receive services during the time frame described in paragraph (2) of this subsection, initiates services within 72 hours after being notified the program participant is available.
(f) Responder requirements.
  (1) A AAA must, before emergency response services are initiated, obtain or must ensure that a vendor obtains from the program participant as many names, as possible, of persons who will serve as responders.
  (2) A AAA must designate or must ensure that a vendor designates public service personnel as the responder of last resort for each program participant.
(g) Prerequisites to service. A AAA must ensure that, before initiating ERS, a vendor:
  (1) ensures the program participant:
    (A) has the capacity to properly operate the electronic monitoring system;
    (B) has a telephone with a private line, if the electronic monitoring system requires a private line to function properly; and
    (C) signs a release statement allowing a responder to make a forced entry into the program participant's residence to respond to an activated alarm call when there are no other means of entering the residence;
  (2) installs the electronic monitoring system;
  (3) trains a program participant on the use of the electronic monitoring system, including:
    (A) demonstrating to the program participant how the system works; and
    (B) demonstrating to the program participant how to activate an alarm call; and
  (4) explains to a program participant:
    (A) that the program participant must participate in a system check each month;
    (B) that the program participant must contact a service provider if:
      (i) the program participant's telephone number or address changes; or
      (ii) one or more of the program participant's responders changes;
    (C) that the program participant must not willfully abuse or damage the electronic monitoring system;
    (D) that a responder may forcibly enter a program participant's residence if necessary; and
    (E) the procedures for filing a grievance against a service provider.
(h) Program participant file. A AAA must ensure that a vendor maintains a file for each program participant that includes:
  (1) the name, telephone number, address, and medical condition of the program participant;
  (2) the name and telephone number of the program participant's physician or primary health care provider;
  (3) the name and telephone number of each responder;
  (4) a record of all completed and attempted system checks;
  (5) a record of each alarm call;
  (6) a copy of all required notices sent to the AAA;
  (7) a signed release as required by subsection (g)(1)(C) of this section;
  (8) the program participant's acknowledgment the equipment belongs to the vendor;
  (9) if applicable, documentation showing approval from the AAA for the continuation of ERS after the time period authorized in accordance with subsection (d) of this section; and
  (10) if applicable, documentation stating that service delivery was suspended and the reason for the suspension.
(i) Service delivery. A AAA must ensure that a vendor authorized to provide ERS:
  (1) is available and able to respond to an alarm call from a program participant 24 hours a day, seven days a week; and
  (2) in response to an alarm call:
    (A) attempts to contact the program participant, within one minute of the call, to verify an emergency exists before contacting a responder;
    (B) immediately contacts a responder if:
      (i) the program participant verifies there is an emergency; or
      (ii) the vendor is unable to reach the program participant;
    (C) documents an alarm call at the time it is received and after it is resolved and includes:
      (i) the name of the program participant;
      (ii) the date and time an alarm call is received, recorded in hours, minutes, and seconds;
      (iii) the time a monitor called the program participant in response to an alarm call, recorded in hours, minutes, and seconds;
      (iv) the name of the contacted responder;
      (v) a brief description of the incident; and
      (vi) a statement of how the incident was resolved;
  (3) notifies the responder within 24 hours after becoming aware of a significant change in the program participant's condition; and
  (4) notifies the AAA, in writing, of any significant change in a program participant's environment within seven days after becoming aware of the change, including:
    (A) a change of address; and
    (B) a change in the circumstances described in subsection (b)(2) of this section.
(j) System checks. A AAA must ensure that a vendor:
  (1) conducts a system check by activating the call button to test the electronic monitoring system at least once during each calendar month;
  (2) documents a completed system check, including the date and time of a completed system check;
  (3) completes a system check three times on three different days within one week if a system check fails to activate the electronic monitoring system;
  (4) contacts a responder or caregiver (other than public service personnel) to conduct a system check if the vendor is unable to complete a system check after three attempts to schedule with the program participant; and
  (5) if unable to conduct a system check, notifies the AAA in writing within 10 days after:
    (A) the date and time of each attempted system check;
    (B) the date and time of each attempt to contact a responder other than public service personnel; and
    (C) the reason the program participant was unable to participate.
(k) Equipment maintenance. A AAA must ensure that a vendor:
  (1) replaces or repairs faulty equipment in the program participant's electronic monitoring system within one business day after learning of the faulty equipment if the program participant is available to permit such repair or replacement;
  (2) if the program participant is not available as described in paragraph (1) of this subsection, replaces or repairs the equipment as soon as the program participant is available;
Cont'd...
(3) instructs the program participant or caregiver in replacing a battery;
  (4) visits a program participant's residence to check the electronic monitoring system equipment within five business days after the equipment has registered five or more "low battery" signals in a 72-hour period and replaces the defective battery during the visit, if necessary; and
  (5) documents and maintains a record of each instance of faulty equipment and low battery signal and includes in the documentation:
    (A) the date the vendor became aware of the faulty equipment or low battery signal;
    (B) the equipment or subscriber number;
    (C) a description of the problem; and
    (D) the date the entire equipment or a part of it was repaired or replaced.
(l) Suspension and termination of services. A AAA must ensure that a vendor:
  (1) suspends services before the end of the authorization period and removes the equipment from a program participant's residence, if the vendor becomes aware that:
    (A) the program participant moves to an area where the vendor does not provide services or that is not in the AAA's planning and service area;
    (B) the program participant is admitted to an LTC facility, personal care home, foster care setting, or any other institutional setting where 24-hour supervision is available;
    (C) the program participant moves to a noninstitutional residence and the requirements in subsection (b)(2) of this section are not met;
    (D) the program participant dies; or
    (E) the program participant requests for services to be terminated; and
  (2) if services are suspended and equipment removed from a program participant's residence in accordance with paragraph (1) of this subsection:
    (A) notifies the AAA within the next business day after such removal; and
    (B) sends a case information form requesting service termination to the AAA within seven days after the notification.
(m) Special reporting considerations. A AAA must ensure that a vendor notifies the AAA of any of the following events within one business day of learning that:
  (1) a program participant activated:
    (A) four false alarms that result in a response by fire department, police, sheriff, or ambulance personnel within a six-month period; or
    (B) 20 false alarms of any kind within a six-month period;
  (2) the program participant is away from the residence or is unable to participate in the service delivery for three consecutive months or more; or
  (3) the program participant is no longer able to operate the electronic monitoring system properly.

Source Note: The provisions of this §213.213 adopted to be effective September 1, 2008, 33 TexReg 7293; transferred effective November 15, 2020, as published in the Texas Register October 30, 2020, 45 TexReg 7721