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

Last reviewed: 2026-09-10

The Washington State Department of Social and Health Services (DSHS) covers Personal Emergency Response Systems (PERS) as an environmental support under the Community Options Program Entry System (COPES) and Developmental Disabilities Administration (DDA) waivers. Approval requires enrolling as a non-medical vendor through the Health Care Authority's ProviderOne system and executing a direct contract with DSHS or a regional Area Agency on Aging (AAA), rather than obtaining a facility or agency license from the Department of Health.

Applicants must demonstrate 24/7 monitoring capacity and submit proof of commercial liability insurance before DSHS will issue a contract. The state does not limit the number of PERS providers through Certificates of Need or closed procurement windows, allowing any qualified vendor to apply at any time.

1. Service Definition and Scope

PERS in Washington provides electronic devices that enable clients at high risk of falls or institutionalization to secure help in an emergency. The service includes the equipment, installation, monthly monitoring, and ongoing maintenance.

The specific equipment authorized is determined by the DSHS case manager based on the client's assessed need and living situation.

• Equipment Types: In-home landline units, cellular units, and mobile GPS devices with fall detection.
• Monitoring Standard: 24-hour response capability, 7 days a week.
• Maintenance Requirement: Replacement of malfunctioning devices within 24 hours of notification.
• Testing: Monthly system performance checks.
• Instruction: Providing instruction to the participant about how to use the device.

2. Regulatory and Oversight Agencies

Oversight is split between the Health Care Authority (HCA) for Medicaid enrollment and DSHS for waiver contracting and service standards.

Regional Area Agencies on Aging (AAAs) also play a role in contracting and authorizing services for COPES waiver clients.

• Health Care Authority (HCA): Manages ProviderOne enrollment (https://www.hca.wa.gov).
• DSHS Aging and Long-Term Support Administration (ALTSA): Oversees COPES and adult waiver standards (https://www.dshs.wa.gov/altsa).
• DSHS Developmental Disabilities Administration (DDA): Oversees DDA waiver standards (https://www.dshs.wa.gov/dda).
• ProviderOne: The MMIS portal for enrollment and billing (https://www.waproviderone.org).

3. Gatekeeping Prerequisites: Who Can Even Apply

Washington does not require a Certificate of Need, regional sponsorship, or competitive procurement (RFP) to become a PERS provider. Enrollment is open year-round to any business that meets the vendor qualifications.

Providers must establish their business entity in Washington and secure appropriate insurance before applying for a Medicaid contract.

• Certificate of Need: None required for PERS vendors in Washington.
• Procurement Windows: Open enrollment; no closed networks or moratoria.
• Business Registration: Must be registered with the Washington Secretary of State and Department of Revenue.
• Insurance: Proof of current commercial general liability insurance is required before contracting.

4. Licensure and Certification Requirements

Washington does not issue a specific state license for PERS providers. Instead, providers are approved through the Medicaid enrollment and DSHS contracting process as non-medical vendors.

Providers must attest to meeting all DSHS standards for equipment reliability and response times.

• State Licensure: No distinct Department of Health license exists for PERS.
• Vendor Status: Approved as an atypical/non-medical vendor.
• Contracting: Must sign a DSHS contract or AAA subcontract.
• Attestation: Must sign the DSHS PERS requirements attestation form.

5. Medicaid Provider Enrollment

Providers must enroll through the HCA's ProviderOne portal. As an atypical provider, a National Provider Identifier (NPI) is not strictly required for PERS, but a ProviderOne ID is mandatory.

Enrollment requires submitting a completed provider intake form and required attachments.

• System: ProviderOne portal.
• Agreement: Core Provider Agreement (CPA) with HCA.
• Provider Type: Enrolled under the specific atypical vendor taxonomy for PERS.
• Application Fee: Subject to standard Medicaid application fees unless waived.

6. Staffing, Training and Background Checks

Because PERS is an equipment and monitoring service rather than direct hands-on care, staffing requirements focus on the response center's capacity rather than clinical credentials.

Installers who enter client homes must pass background checks and be trained to instruct clients on device usage.

• Response Center Staff: Must be available 24/7 to answer signals.
• Background Checks: Required for staff entering client homes for installation.
• Training: Installers must be trained to instruct clients on device usage.
• Contact Updates: Must update responder and contact names at least twice a year.

7. Documentation, Policies and Records

Providers must maintain records of all installations, tests, and emergency signals. DSHS requires specific documentation to verify service delivery.

Signal logs must be retained and made available for state review upon request.

• Installation Record: Signature from client or representative verifying receipt of the unit.
• Signal Logs: Clock printer or digital log of the time and date of emergency signals.
• Client ID: Must record the client's ProviderOne ID on signal logs.
• Testing Logs: Documentation of monthly device testing.

8. Billing, Rates and Claims

Billing is submitted through ProviderOne using specific HCPCS codes for installation and monthly monitoring. Rates are published in the DSHS/HCA fee schedules.

Providers cannot charge Medicaid more than they charge the general public for the same service.

• System: Claims submitted via ProviderOne.
• Installation Code: S5160 (Emergency response system; installation and testing).
• Monitoring Code: S5161 (Emergency response system; service fee, per month).
• Rate Limits: Cannot charge Medicaid more than the general public rate.

9. Approval Sequence and Timeline

The process begins with business registration, followed by ProviderOne enrollment, and concludes with DSHS contracting.

Timelines vary based on HCA processing volumes, but typically take several weeks from application submission to contract execution.

• Step 1: Register business in Washington.
• Step 2: Submit ProviderOne application to HCA.
• Step 3: HCA review (typically 30-60 days).
• Step 4: Execute contract with DSHS ALTSA/DDA or local AAA.

10. Common Denials and Survey Findings

Denials usually stem from incomplete applications or failure to demonstrate 24/7 monitoring capacity. Contract terminations can occur if providers fail to maintain equipment.

Audits frequently focus on documentation of monthly testing and timely replacement of broken units.

• Insurance Lapses: Failure to provide proof of current liability insurance.
• Incomplete Forms: Missing signatures on the PERS attestation form.
• Maintenance Failures: Not replacing broken devices within the 24-hour window.
• Documentation Errors: Missing client signatures for installation.

11. Key Contacts and Resources

Primary resources for prospective PERS providers include the HCA provider enrollment team and DSHS waiver program managers.

Providers should consult the specific waiver appendices for detailed service limitations.

• HCA Provider Enrollment: https://www.hca.wa.gov/billers-providers-partners/become-apple-health-provider
• ProviderOne Portal: https://www.waproviderone.org
• DSHS ALTSA: https://www.dshs.wa.gov/altsa
• DSHS DDA: https://www.dshs.wa.gov/dda

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