Delaware - Personal Emergency Response System — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Delaware Division of Developmental Disabilities Services (DDDS) and the Division of Medicaid and Medical Assistance (DMMA) authorize Personal Emergency Response System (PERS) delivery through the Lifespan Waiver and Diamond State Health Plan Plus (DSHP-Plus) managed care program. Approval requires vendors to secure a contract through the state's quarterly Request for Proposal (RFP) procurement cycle via the DMS Procurement Office before initiating Medicaid enrollment.

PERS vendors supply installed or wearable monitoring equipment featuring 24-hour emergency response capabilities for waiver participants who live alone or require continuous risk mitigation. Applicants must demonstrate compliance with DDDS Provider Standards for Home and Community-Based Services and maintain active registration in the Delaware Medical Assistance Portal (DMAP).

1. Service Definition and Scope

In Delaware, PERS is defined as an electronic device used by a participant to call for help in an emergency, connecting to a designated person or 24-hour call center. The service includes the equipment, installation, participant training, and ongoing monitoring.

The service is designed to increase independence and community integration for individuals who live alone or are at high risk of falls, ensuring they can remain safely in their own homes.

• Equipment: Installed base units or wearable devices with two-way communication capabilities.
• Monitoring: Continuous response center availability 24 hours per day, 7 days per week.
• Maintenance: Requirement to replace a malfunctioning PERS device within 24 hours of notification.
• Target Population: Waiver participants living independently or requiring fall risk mitigation.
• Exclusions: Cannot be used by a participant who lives in a provider-owned or controlled setting unless a specific transition plan is in place.

2. Regulatory and Oversight Agencies

The Delaware Department of Health and Social Services (DHSS) oversees PERS providers through its developmental disabilities and Medicaid divisions. Providers must interact with multiple state portals for procurement and enrollment.

Managed care organizations also play a regulatory role for providers serving the DSHP-Plus population, requiring separate credentialing.

• Division of Developmental Disabilities Services (DDDS): Administers the Lifespan Waiver and sets HCBS provider standards (https://dhss.delaware.gov/ddds/).
• Division of Medicaid and Medical Assistance (DMMA): Manages the state Medicaid plan and oversees the DMAP portal (https://dhss.delaware.gov/dmma/).
• DMS Procurement Office: Manages the quarterly RFP process for HCBS providers via Bonfire (https://dhss.bonfirehub.com/portal/?tab=openOpportunities).
• Delaware Medical Assistance Portal (DMAP): Processes fee-for-service Medicaid enrollments (https://medicaid.dhss.delaware.gov).

3. Gatekeeping Prerequisites: Who Can Even Apply

Delaware restricts HCBS provider enrollment to entities that successfully navigate the state procurement process. Standalone Medicaid enrollment applications submitted to DMAP are rejected without prior DDDS authorization.

Providers must monitor the state's procurement portal and submit proposals only during designated review windows.

• Procurement Cycle: Applicants must submit proposals through the DMS Procurement Office RFP process, which reviews submissions once per quarter.
• Bonfire Registration: Vendors must register on the Delaware Bonfire portal to access open HCBS opportunities and submit their proposals.
• DDDS Authorization: Successful RFP respondents receive formal authorization to proceed to DMAP enrollment; without this, enrollment is blocked.
• Managed Care Contracting: DSHP-Plus participation requires separate credentialing and contracting with Highmark Health Options or AmeriHealth Caritas Delaware after state enrollment.

4. Licensure and Certification Requirements

Delaware does not issue a specific healthcare facility license for PERS vendors. Instead, providers are certified through the DDDS authorization process and must meet general business and HCBS standards.

Vendors must attest to state standards and maintain compliance plans rather than undergoing traditional facility surveys.

• State Licensure: No distinct PERS healthcare license exists; providers operate under standard Delaware Division of Revenue business licenses.
• DDDS Provider Standards: Vendors must attest to and comply with the DDDS Provider Standards for Home and Community-Based Services.
• Medicaid Compliance Plan: Agencies must submit an Essential Elements to a Medicaid Compliance Plan document during the application phase.
• NPI Registration: Providers must obtain a National Provider Identifier (NPI) via the NPPES registry before applying.

5. Medicaid Provider Enrollment

Following DDDS authorization, vendors enroll through the Delaware Medical Assistance Portal (DMAP). The process requires specific tracking numbers and adherence to fee-for-service guidelines.

Providers must ensure all organizational data matches their RFP submission and NPI registry exactly.

• Enrollment Portal: Applications are submitted electronically via the DMAP Provider Portal.
• Application Guide: Providers must follow the How-To Enrollment Guide for Fee-For-Service Providers to navigate the system.
• Required Identifiers: Submission requires the agency's NPI, Federal Tax ID, and appropriate taxonomy code for emergency response.
• Application Tracking: Unsubmitted applications can be resumed using the system-generated Application Tracking Number.
• Application Fee: Providers are subject to the federal Medicaid application fee unless they provide proof of payment to Medicare or another state.

6. Staffing, Training and Background Checks

While PERS is primarily an equipment service, personnel installing devices or responding to alerts must meet baseline state requirements to ensure participant safety.

Installers must be capable of training participants, and response center staff must be trained in emergency protocols.

• Background Checks: Installers entering participant homes must clear Delaware State Police criminal history checks.
• Response Center Staff: Must be trained in emergency triage and dispatch protocols to handle 24/7 alerts.
• Participant Instruction: Installers must be qualified to provide instruction to the participant on how to properly use and test the device.
• Exclusions: PERS cannot be provided by a relative, legal guardian, or legally responsible individual of the participant.

7. Documentation, Policies and Records

Vendors must maintain strict records proving equipment delivery, monthly testing, and emergency response logs to justify Medicaid billing.

Failure to maintain these records can result in immediate recoupment of funds during state audits.

• Delivery Verification: Must obtain the participant's or authorized representative's signature verifying receipt and installation of the PERS unit.
• Responder List: Must maintain and update a list of responders and contact names for each participant at least twice a year.
• Testing Logs: Must maintain documentation of monthly testing of the PERS device to ensure functionality.
• Maintenance Records: Logs showing replacement of malfunctioning devices within 24 hours of notification.
• Person-Centered Plan: The service and the chosen provider must be documented in the participant's DDDS Person-Centered Plan (PCP).

8. Billing, Rates and Claims

PERS is billed as a waiver service under specific procedure codes, typically split into a one-time installation fee and a recurring monthly monitoring fee.

Providers must ensure their rates do not exceed what they charge the general public for identical services.

• Billing System: Claims are submitted through the DMAP MMIS or the respective managed care clearinghouse.
• Installation Fee: Reimbursed as a one-time fee for initial setup, equipment delivery, and participant instruction.
• Monthly Rental: Reimbursed as a recurring monthly fee for continuous 24/7 monitoring and system performance checks.
• Public Rate Parity: Vendors cannot charge Medicaid more than they charge the general public; discounts offered to seniors must be applied to Medicaid participants.
• Budget Limits: PERS costs must fit within the participant's annual individual budget amount as determined by DDDS.

9. Approval Sequence and Timeline

The end-to-end process depends heavily on the quarterly RFP schedule managed by the DMS Procurement Office.

Providers should expect the process to take several months from initial Bonfire registration to final DMAP approval.

• Step 1: Review the DDDS Provider Application Manual and register on the Bonfire procurement portal.
• Step 2: Submit the RFP response during the quarterly review window.
• Step 3: Receive DDDS authorization and contract award from the state.
• Step 4: Submit the DMAP FFS Enrollment Application using the provided tracking systems.
• Step 5: Complete managed care credentialing with DSHP-Plus plans if applicable.

10. Common Denials and Survey Findings

Applications and ongoing compliance often fail due to missed procurement windows or inadequate documentation of service delivery.

State reviewers strictly enforce the 24-hour replacement rule for malfunctioning equipment.

• Premature Enrollment: DMAP applications submitted without prior DDDS RFP approval are automatically rejected.
• Incomplete Compliance Plans: Failure to submit the Essential Elements to a Medicaid Compliance Plan during the RFP phase.
• Maintenance Failures: Citations for failing to replace malfunctioning devices within the required 24-hour window.
• Testing Lapses: Missing documentation for the required monthly device tests, leading to claims recoupment.

11. Key Contacts and Resources

Prospective PERS providers should utilize the official Delaware portals and manuals to navigate the procurement and enrollment processes.

Monitoring the Bonfire portal is essential for catching the quarterly RFP windows.

• DDDS Provider Page: Official hub for HCBS provider information (https://dhss.delaware.gov/ddds/homepage/providers/).
• DMS Procurement (Bonfire): Portal for submitting quarterly RFP responses (https://dhss.bonfirehub.com/portal/?tab=openOpportunities).
• DMAP Provider Portal: System for fee-for-service Medicaid enrollment (https://medicaid.dhss.delaware.gov).
• Provider Application Manual: Comprehensive guide for DDDS applicants (https://dhss.delaware.gov/wp-content/uploads/sites/6/ddds/pdf/ProviderApplicationManualFinal07012024.pdf).
• NPPES NPI Registry: Federal portal for obtaining required provider identifiers (https://nppes.cms.hhs.gov/login).

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