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

Last reviewed: 2026-09-10

In New York, Personal Emergency Response System (PERS) services are overseen by the Department of Health (DOH) and the Office for People With Developmental Disabilities (OPWDD) under the Comprehensive Home and Community-Based Services (HCBS) Waiver. The state does not issue a distinct facility or agency license for PERS; instead, approval is achieved strictly through Medicaid provider enrollment and authorization by the relevant waiver operating agency.

To become an approved PERS provider, an entity must first meet the state's structural prerequisites, which include obtaining not-for-profit status or operating as a governmental entity, and securing authorization from the local Developmental Disabilities Services Office (DDSO). Providers must demonstrate character and competence, comply with Title 14 of the New York Code of Rules and Regulations (NYCRR), and execute a Provider Agreement approved by the DOH.

1. Service Definition and Scope

New York defines Personal Emergency Response Services (PERS) as the provision and maintenance of electronic communication equipment in the home of an individual which signals a monitoring agency for help when activated by the individual, or after a period of time if a timer mechanism has not been reset. The service is designed to decrease the risk of institutionalization by providing 24-hour emergency response for individuals who live alone or are at risk of falls.

PERS is covered under the OPWDD Comprehensive HCBS Waiver and other Medicaid programs. It includes both the initial installation of the equipment and the ongoing monthly monitoring service.

2. Regulatory and Oversight Agencies

The New York State Department of Health (DOH) serves as the single state Medicaid agency with overall oversight responsibility for the HCBS waiver and Medicaid provider enrollment. The Office for People With Developmental Disabilities (OPWDD) operates the Comprehensive HCBS Waiver and manages the initial review of provider qualifications.

Local Developmental Disabilities Services Offices (DDSOs) and county social services districts play a critical role in authorizing services and approving local PERS plans.

3. Gatekeeping Prerequisites: Who Can Even Apply

New York imposes strict structural prerequisites for entities seeking to provide OPWDD HCBS Waiver services. An applicant must be an incorporated not-for-profit agency or a governmental entity. For-profit companies cannot apply directly to be OPWDD waiver providers.

Additionally, prospective providers must contact their local DDSO to initiate the character and competence review process. A PERS provider may be a certified home health agency, a long term home health care program, an area agency on aging, a police department, a fire department, an ambulance service, a hospital, or any other entity capable of providing PERS directly or through subcontracts.

4. Licensure and Certification Requirements

New York does not issue a distinct facility or agency license specifically for PERS providers. Instead, providers must meet the standards established for the waiver service, apply to, and be approved by OPWDD and DOH for participation in the waiver.

Providers must operate in accordance with Parts 624, 633, 635, 636, 686, and 671 of Title 14 of the NYCRR as applicable. The OPWDD Division of Quality Assurance reviews the application and requests formal issuance of a provider agreement from the DOH.

5. Medicaid Provider Enrollment

To be reimbursed for PERS, providers must enroll in the New York State Medicaid Program through the eMedNY system. Enrollment requires compliance with Federal regulations at 42 CFR 455 Subpart E regarding Provider Screening and Enrollment Requirements.

The DOH conducts the final review and approval, assuring that the provider has met all certification requirements and executing the Provider Agreement.

6. Staffing, Training and Background Checks

While specific staffing ratios for PERS are not detailed in the same manner as direct care services, providers must demonstrate the competence and character to deliver services according to waiver standards. This includes ensuring that any staff or subcontractors handling emergency signals are capable of 24-hour response.

Providers must adhere to OPWDD guidelines regarding character and competence assessments for all individuals involved in service delivery.

7. Documentation, Policies and Records

PERS providers must maintain documentation supporting all claims as required by 18 CRR-NY 540.7(a)(8). Social services districts must submit a PERS plan to the DOH on a required form and cannot authorize services until the plan is approved.

Providers must also comply with monthly contact requirements and service standards outlined in the OPWDD Waiver Guide.

8. Billing, Rates and Claims

PERS reimbursement typically consists of a one-time installation fee and a monthly rental or monitoring fee. Social services districts must submit all negotiated PERS rates to the DOH for approval.

Claims are processed through the eMedNY system. During emergencies such as the COVID-19 pandemic, New York utilized Appendix K to temporarily increase payment rates or modify billing processes.

9. Approval Sequence and Timeline

The approval sequence begins with the prospective provider obtaining not-for-profit status and contacting the local DDSO. The DDSO conducts an initial review of character and competence.

Following DDSO approval, the OPWDD Division of Quality Assurance reviews the application and forwards it to the DOH. The DOH conducts the final review, enrolls the provider in eMedNY, and issues the Provider Agreement.

10. Common Denials and Survey Findings

Applications are commonly delayed or denied if the entity fails to meet the strict not-for-profit or governmental status requirement for OPWDD waiver services. For-profit entities attempting to enroll directly will be rejected.

Additionally, failure to pass the character and competence review by the DDSO, or failure of the social services district to have an approved PERS plan on file with the DOH, will prevent authorization of services.

11. Key Contacts and Resources

Prospective providers should begin by contacting their local DDSO and reviewing the OPWDD and eMedNY websites for current manuals and enrollment forms.

The eMedNY Call Center is the primary contact for technical assistance with the Medicaid enrollment application.

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