HomeMy Public PortalAboutC-09-002 - Long Beach Memorial Medical CenterAGREEMENT
THIS AGREEMENT is effective as of the first (1st) day of July, 2409, by and between the City
of Carson, a municipal corporation (the "City"), and Long Beach Memorial Medical Center, a
California non-profit public benefit corporation (the "Operating Agency").
RECITALS
A. The City desires to offer the Philips Lifeline Personal Response System, formerly known
as Lifeline Personal Response System ("Lifeline") Program on a grant basis to elderly
disabled persons with serious health problems who reside within the City;
B. The Operating Agency represents that it has the equipment and personnel to provide this
high quality service to said elderly and disabled citizens;
C. The Operating Agency represents that it is a Corporation, organized and existing under
the laws of the State of California and represents and warrants that each individual
executing this Agreement on behalf of said corporation does so in accordance with a duly
adopted resolution of the Board of Directors of said corporation, and that this Agreement
is binding upon said corporation in accordance with its terms.
NOW, THEREFORE, the City and the Operating Agency agree as follows:
I. SCOPE OF SERVICE TO BE PROVIDED BY THE OPERATING AGENCY
A. Program DevelopFnent
The Operating Agency shall plan, develop, operate, and manage the Lifeline Program in
compliance with Federal, State and local government codes, regulations, and directives
applicable to such a project and as defined in this Agreement.
B. Locations and. Operations
1. The Lifeline Program shall be in continuous operation twenty-four (24)
hours per day in conjunction with Lifeline Central monitoring services.
2. The Operating Agency shall provide the trained staff to install and service
equipment during the term of this Agreement.
3. Lifeline Central shall provide the trained staff to monitor alarm signals
and respond to said signals.
C. Central Emerg—ency Res onse Center
The Operating Agency shall provide for the monitoring of the home
communications through Philips Lifeline Central monitoring services.
Carson 2009 lifeline Agrnt City.doc.02117/10
The Operating Agency shall pay the costs required from the utilization of
Lifeline Central services.
2. The Operating Agency shall provide the City with a monthly subscriber
listing, an alarm history and/or installation/termination activity.
3. Lifeline Central operations are as detailed in Exhibit "A", which is
attached hereto and incorporated by reference as though fully set forth.
D. Subscriber's Home Unit
The Home Unit Communicator (the "Communicator") shall consist of a portable
button carried or worn by the subscriber and a communicator attached to the
subscriber's phone.
1. The portable button shall have the ability to send a wireless signal up to
two hundred (200) feet.
2. The Communicator shall have a receiver to receive the signal, a manual
button for signaling an alarm directly, a timer for indicating a specified
period of inactivity in the home, a reset button for signaling the arrival of
help, a digital dialer, audible and visual indicators, and a rechargeable
battery with charger sufficient to provide at least two (2) hours of
operation.
3. The Communicator shall have the ability to indicate whether the signal is
active, passive, or a reset signal. It shall also be programmed to make
multiple attempts to reach Lifeline Central.
4. The equipment shall be such that both the visually and hearing impaired
person may be served by this system.
5. An inactivity alarm shall be able to adjust to intervals of twelve (12) or
twenty-four (24) hours or to be turned off completely.
E. Training of Staff. Volunteers and Subscribers
The Operating Agency shall provide training for staff and volunteers in
the installation, use and service of the Communicators and in the
maintenance of subscriber and voluntary emergency responder
information.
2. The subscriber and voluntary emergency responders shall be instructed in
the use of the Communicator. This instruction shall take place on site in
the subscriber's home, at the time the Communicator is installed.
Carson 201)9 Lifeline Agml Ciry_doc.01/17/10 2
F. Subscriber Information Records
The Operating Agency shall provide for an accurate subscriber information
recording system. Each subscriber shall complete a Lifeline Central Subscriber
Agreement which shall be Forwarded to the Operating Agency at the address set
forth in Section VII.
The Lifeline Central Subscriber Agreement (see Exhibit "B" attached)
shall be used when adding a new subscriber to Lifeline Central. This form
is used to create a response record on which Lifeline Central will provide
its monitoring service. This form must be completed and provided to
Lifeline Central at least four (4) hours prior to the installation of the
Communicator.
2. The minimum information requirements are: subscriber number, program
code, subscriber name, subscriber address, subscriber phone, police phone,
fire phone, ambulance phone, responder name and responder phone.
3. Subscriber information may be modified utilizing the Subscriber
Information Change Form (see Exhibit "C" attached). The Operating
Agency shall obtain modified information and provide said information to
Lifeline.
4. Subscriber information and required reports will be kept confidential by
the Operating Agency. Subscriber information will be made available to
the City upon request in accordance with federal and state laws and
regulations.
S. The Operating Agency shall inactivate a subscriber at the time that the
subscriber's unit is removed from the subscriber residence. The Operating
Agency shall maintain possession of the removed unit.
G. Agreement with Subscriber
The Operating Agency shall provide the Communicators as specified in this
Agreement, funded by Federal Community Development Block grant funds from
the County of Los Angeles in accordance with this Agreement, to selected eligible
subscribers at no cost to the subscriber. The Operating Agency shall enter into a
non-financial written agreement with the subscriber. An executed copy of each
such agreement shall be submitted to the City within five (S) working days
following execution. In the event that the subscriber no longer requires the
equipment or leaves the City, the Operating Agency shall remove the
Communicator from the subscriber's residence and retain possession of the
equipment.
Cam= 2009 Wellne Agmt 0tYAX-.02/17/10
H. Installation and Maintenance of Lifeline Equinment
The Operating Agency shall be responsible for the installation and maintenance of
the Lifeline equipment used to provide service in accordance with this
Agreement. Installation and maintenance shall be in accordance with the
manufacturers recommendations and specifications, copies of which shall be kept
on file by the Operating Agency.
I. Monthly Reportingand ,Billing Requirements
On or before the Fifth (5th) day of each month, the Operating Agency shall submit
to the City a list of those individuals participating in the City's grant, along with
an invoice for Lifeline service for the previous month,
ilI. SCOPE OF SERVICES TO BE PROVIDED BY THE CFI'Y_
A. Subscribers Screening
The City shall maintain its method for screening potential subscribers to
determine their eligibility. The screening shall determine residency, age, annual
income and a needs assessment to determine the degree of social isolation,
functional abilities and medical vulnerability. Records of such screenings shall be
kept on file by the Operating Agency.
B. Subscriber Eligibility
Services shall be provided by the Operating Agency to those persons designated
in writing by the City.
C. Payment to the Operating Agency
1. The Operating Agency shall be paid a monthly rental charge of Thirty
Three Dollars ($33) per unit in service. A one (I) time installation fee of
Fifty Dollars ($50) will be charged for each new subscriber.
2. The City will process monthly invoices from the Operating Agency for all
units provided under this Agreement. The City shall pay all undisputed
charges within thirty (30) days from receipt of invoice. A disputed charge
shall be paid within thirty (30) days after any resolution of such disputed
charge which results in the City acknowledgment of its validity.
D. Monitoring and Evaluation by the Cit
The City shall, through its designated representative, monitor and evaluate the
Operating Agency's performance of its duties under this Agreement.
Canon 2009 Lifeline Agml City.dw,02117110 4
Ill. TERM OF AGREEMENT
This Agreement shall commence on the first (1st) day of July 2009 and shall terminate on
June 30, 2012 unless terminated sooner as provided herein. A yearly review of this Agreement
will be conducted by both parties.
IV. TE&T-1.0N
The parties agree that at any time during the term of this Agreement either party may terminate
this Agreement or any part hereof with or without cause upon giving the other party at least
thirty (30) days written notice prior to the effective date of such termination, which date shall be
specified in such notice.
V. INDEMNIFICATION,
Except liability arising from the sole negligence of the City. The Operating Agency is an
independent contractor and shall indemnify, defend, keep and hold the City, including its
officers, agents, servants, and employees, harmless from any and all costs, claims, liability,
damages, or expenses, including the costs of suit and reasonable attorneys' fees arising out of the
operations, acts, or omissions of the Operating Agency, its agents, servants or employees.
VI. INSI RMCE
The Operating Agency shall maintain and keep in full force during the term of this Agreement,
for the benefit and protection of the City, insurance with a company satisfactory to and in a form
approved by the City in the aggregate amount of Fifteen Million Dollars ($15,000,000) in excess
of a Four Million Dollars ($4,000,000) self-insured retention per occurrence for comprehensive
general and professional liability insurance and a Two Million Dollars ($2,000,000) self-insured
retention per occurrence for Workers' Compensation insurance. Insurance coverage shall
include Workers' Compensation insurance as required by law; comprehensive general,
accidental, professional liability and products liability. The excess policy of insurance shall:
1. Be issued by an insurance company which is admitted to do business in
the State of California;
2. Flame and list as additional insured the City, its officers and employees;
3. Provide that the policy may not be cancelled unless a thirty (30) clay
written notice of cancellation is first given to the City;
4. Contain a severability of interest clause;
5. Cover the operation of the Operating Agency pursuant to the terms of this
Agreement.
An endorsement shall be provided to the City evidencing the coverage specified herein and shall
be furnished by the Operating Agency to the Risk Management Director of the City prior to the
commencement services under this Agreement. All insurance endorsements shall specifically
Carson 2009 Lifeline Agnit City.da;.UJl7/10 5
provide that the insurance coverage shall not be cancelled or changed except after the expiration
of thirty (30) days from the receipt of written notice by registered mail addressed to the, City of
Carson, Public Services Department, 3 Civic Plaza, Carson, California 90745. The certificates
shall bear the actual manual signature of authorized agent of the insurer.
An endorsement shall be provided to the City evidencing the coverage specified herein and shall
be furnished by the Operating Agency to the Human Resources Officer of the City no less than
ten (10) days prior to the commencement of this Agreement. All insurance endorsements shall
specifically provide that the insurance coverage shall not be cancelled or changed except aper
the expiration of thirty (30) days from the receipt of written notice by registered mail addressed
to the Human Resources Officer, City of Lomita, 24300 Narbonne Avenue, Lomita, California
90717. The certificates shall bear the actual manual signature of authorized agent of the insurer.
VII. NOTICES
All notices or other communications that either party may desire or may be required to deliver to
the other party may be delivered in person or by depositing the same in the United States mail,
postage prepaid, certified or registered mail, by overnight courier, or by electronic facsimile,
addressed or delivered as follows:
If to: City of Carson
If to: Long Beach Memorial
Memorial Medical Center
3 Civic Plaza
Carson, California 94745
Attention: Human Services Manager
Name:
2801 Atlantic Avenue
Long Beach, California 90806
Attention: Kathy Vinton
Executive Director Corporate & Primary
Health Services
Either party may change the address to which notices are to be delivered by giving notice
hereinabove provided. Any notice shall be deemed to have been given, if hand delivered, or sent
by overnight courier, as of the date delivered or if sent by electronic facsimile when confirmed in
writing, or if mailed as provided herein, on the third (3rd) day after mailing.
VIII. SUCCESSORS AND ASSIGNS
The Operating Agency shall not assign or delegate this Agreement, nor assign or delegate any
interest in this Agreement without prior written consent from the City. Any attempt or purported
assignment in violation of this Section shall be deemed void and of no force and effect.
IX. NO OTHER AGREEMENTS
This Agreement contains all of the agreements between the City and the Operating Agency and
replaces all prior agreements between them, provided however, that the parties agree to be bound
by all provisions of the Carson Municipal Code, resolutions, ordinances and regulations of the
City, Federal and State laws now in effect or hereafter enacted.
Carson 2009 Likline Agmt City.doc,o2l17110 6
Y. RIGHT TO AUDIT BOOKS AND RECORDS
The City reserves the right to review, audit, and inspect the books, records, invoices, and any
other written documentation of the Operating Agency relating to the Carson Lifeline Program.
Operating Agency shall retain such documentation for the entire three (3) year period following
final payment under this Agreement.
XI. REGULATIONS
The Operating Agency agrees to comply with the Civil Rights Act of 1964, Title VI,
nondiscrimination in Federally Assisted Program; Section 3 of the Housing & Urban
Development Act of 1968, Employment Opportunities for Lower Income Persons in Connection
with Assisted Project; Section 109, Title I of the HCDA of 1974, Nondiscrimination;
24 CFR 570.611, Conflict of Interest; Age Discrimination Act of 1975; Section 504 of the
Rehabilitation Act of 1973; and all other applicable federal regulations. In the event of it
violation. the Operating Agency agrees that the City has the right to take such action against the
Operating Agency as may be necessary to enforce this covenant. Lang Beach Memorial Medical
Center is an Equal Opportunity Affirmative Action Employer.
XIL INDEPENDENT CONTRACTOR
Neither the City nor any of its employees shall have any control over the manner, mode
or means by which Operating Agency, its agents or employees, perform the services
required herein, except as otherwise set forth herein. City shall have no voice in the
selection, discharge, supervision or control of Operating Agency's employees, servants,
representatives or agents, or in fixing their number, compensation or hours of service.
Operating Agency shall perform all services required herein as an independent contractor
of City and shall remain at all times as to City a wholly independent contractor with only
such obligations as are consistent with that role. Operating Agency shall not at any time
or in any manner represent that it or any of its agents or employees are agents or
employees of Agency. City shall not in any way or for any purpose become or be
deemed to be a partner of Operating Agency in its business or otherwise or ajoint
venturer or a member of any joint enterprise with Operating Agency.
XIII. CONFIDENTIALITY
To the extent permitted by law, information gained or work product produced by
Operating Agency in performance of this Agreement shall be considered confidential,
unless such information is in the public domain or already known to City. Operating
Agency shall not release or disclose any such information or work product to persons or
entities other than City without prior written authorization from the City Manager, except
as may be required by law.
XXIV. CALIFORNIA LAW
This Agreement shall be interpreted, construed and governed both as to validity and to
performance of the parties in accordance with the laws of the State of California. Legal
Carson 2009 Lircline.lgmt City.doc 02/17/10 7
actions concerning any dispute, claim or matter arising out of or in relation to this
Agreement shall be instituted in the Superior Court of the County of Los Angeles, State
of California, or any other appropriate court in such county, and Contractor covenants
and agrees to submit to the personal jurisdiction of such court in the event of such action.
In the event of litigation in a U.S. District Court, venue shall lie exclusively in the Central
District of California, in Los Angeles.
?!FXV. ENTIRE AGREEMENT
This Agreement, including the attached Exhibits "A" through "C is the entire, complete,
final and exclusive expression of the parties with respect to the matters addressed therein
and supersedes all other Agreements or understandings, whether oral or written, or
entered into between Operating Agency and City prior to the execution of this
Agreement. No statements, representations or other Agreements, whether oral or written,
made by any party which are not embodied herein shall be valid and binding. No
amendment to this Agreement shall be valid and binding unless in writing duly executed
by the parties or their authorized representatives.
[SIGNATURES ON FOLLOWING PAGE]
Carson 2009 Lifeline Agml CityAx.02/17110 a
IN WITNESS WHEREOF, the City and Operating Agency have caused this Agreement to be
executed the day and year first above written.
Date :
ATTEST:
City Clerk
.4l- «-ra
Approved as to form:
ALESHIRE & WYNDER, LLP
City Attorney
Carron 2009 Welinc Agmt City doc.(Wj7/[f}
CITY OF CARSO
By; .../�
Mayor ,Jing/
LONG BEACH MEMORIAL MEDICAL
CENTER
By:
Pamela Chevreaux
Title: Vice President Ambulatory Services
r�By:
T,Umra Kaplan
Title: Chief Operating Officer
Approved as to form:
By:
Title: __Sr. Associate Counsel. MH
Date: ___February 17. 201 Q
9
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
STATE OF CALIFORNIA
COUNTY OF
On before me, , personally appeared proved to me on
the basis of satisfactory evidence to be the person(s) whose names(s) is/are subscribed to the within instrument and
acknowledged to me that he/shelthey executed the same in his/her/their authorized capacityGes), and that by
his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted,
executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
Signature:
OPTIONAL
Though the data below is not required by law, it may prove valuable to persons relying on the document and could
prevent fraudulent reattachment of this form
Carson 2009 Lifeline Agmt City,doc.02117/lo
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
jU
CAPACITY CLAIMED BY SIGNER
❑
INDIVIDUAL
❑
CORPORATE OFFICER
TITLE(S)
❑
PARTNER(S) ❑ LIMITED
❑
❑ GENERAL
ATTORNEY-IN-FACT
❑
TRUSTEE(S)
❑
GUARDIAN/CONSERVATOR
❑
OTHER
SIGNER IS REPRESENTING:
(NAME OFPERSON(S) OR ENTTTY(lES))
Carson 2009 Lifeline Agmt City,doc.02117/lo
DESCRIPTION OF ATTACHED DOCUMENT
TITLE OR TYPE OF DOCUMENT
NUMBER OF PAGES
DATE OF DOCUMENT
SIGNER(S) OTHER THAN NAMED ABOVE
jU
EXHIBIT "A"
SCOPE OF SERVICES AND OPERATION
Page i of I 1
01fIQ7/(M1/68439.01
EXHIBIT "A"
page Of ,r.
Basic Response Protocols '
Here is how the process works;
L CareSystem identifies all subscribers that have not sent a Personal Help Button initiated
signal within a set period of days and schedules outbound calls to those subscribers. No
outbound Check -In calls are made before 9 AM or atter 7 PM in all time zones. (For
example, calls can be made to California up to 10 PM EST.)
2. Up to three calls are made over a three-day period to remind subscribers to send a check-in
signal. If, after the third attempt we are unsuccessful in contacting the subscriber,
CareSystern automatically faxes a Communication Report to your program requesting your
assistance in contacting the subscriber. It is important that you or your staff members make
an attempt to contact the subscriber after we have made three failed attempts.
If in response to an outbound Check -In call, a subscriber presses the panel Help Button on
the home communicator instead of pressing the PHB, the Personal Response Associate will
ask the subscriber to immediately re -signal with the PHB. The case will remain open and
logged as "Pending PHB." If the subscriber does not test within the following IS minutes,
the system will redeliver the call to a Personal Response Associate. The Personal Response
Associate will call the subscriber back to ensure that the PHS is functioning properly. If the
subscriber does not answer the phone, the Personal Response Associate will follow the
standard Help Needed protocol and call responders.
Language line
If a subscriber has been identified as having a specific foreign language need, all the incoming
signals will be highlighted with that specific language need. CareSystem enables the Personal
Response Associate to maintain stay -on-line voice contact with the subscriber while putting the
subscriber on hold and calling Language Line to ask for an interpreter (based upon the
subscriber's language preference). The Personal Response Associate will discuss the nature of
the subscriber's call with the designated interpreter and then conference in the subscriber, all
through CareSystem. The personal Response Associate will then find out exactly what the
subscribers needs are and follow the established protocols.
TN/TDD
If an incoming signal is coming from a TTY/TDD subscriber, CareSystem, using Skills_
Based Call Routing, will immediately forward the call to a Personal Response Associate who
is specially trained to handle the call. The Personal Response Associate will call the TTY
Relay telephone number listed in the subscription. The relay operator will send the subscriber
a typed message to his/her TTY machine. If the subscriber does not respond with a typed
reply the Personal Response Associate will follow standard Help Needed protocol and call
responders.
I . If responders are unavailable, the Personal Response Associate will contact the local
police, emergency medical services or fire department and request assistance.
page 2., of , I..
Lifeline Customer Support Service
Lifeline Response Center
The three major components of a superior Response Center are its staff, the monitoring
platform, and its protocols and procedures. Each component was designed to ensure the
safety of our subscribers who receive Lifeline's Personal Response Service. Starting in 1997,
Lifeline has made significant and ongoing investments in Cam System,
ourstate-of-the-art
monitoring platform. CareSystem has enabled Lifeline to continuously improve the service
that we provide to your program and subscribers.
Personal Response Associates
Lifeline's Response Center Personal Response Associates (formerly known as Lifeline
Monitors) are the Ivey to our ability to provide personalized response to individuals who want
to stay independent in their own homes. Lifeline founded the personal res
response to the critical need to provide a service that offers aging P� industry in
them to remain in the homes that they love — independently. Unlike seniors
Support the to allow
nies
whose primary business is to monitor properties for break-ins or fire, Lifeline �m its
founding in 1974 has focused on people as individuals and their needs for personalized
response in situations of medical crisis or personal need. Therefore, Lifeline views its
Response Center staff as the key component in providing the best quality service. In 1996,
Lifeline instituted "Priority One" an organization -wide mission to provide "even more caring
and responsive support to our subscribers." Priority One focuses on implementing procedures
and policies that maximizes the teamwork within the Response Center to meet and exceed
every need of our subscribers. Lifeline utilizes contemporary management styles and
techniques to enrich the work environment and maximize Personal Response Associate
satisfaction and retention.
Our professional monitoring staff is trained to be responsible for.
• Processing and documenting all incoming subscriber signals in accordance with Lifeline
Monitoring Services Response protocols.
• Coordinating and documenting subscriber assistance as needed.
• Documenting equipment problems and other subscriber needs
resolution. to ensure follow-up and
• Provide assistance and reassurance to all subscribers in response to the subscribees need.
tllMR51I "H"
page --� - of Z b
Lifeline Customer Support Service
Training
It takes time to become a fully participating Personal Response Associate. Getting acquainted
with the way we work together and gaining familiarity with ourspecifrc performance goals
are important to the reliability and quality of the service we provide to our subscribers. To
maximize effectiveness, productivity and job satisfaction, our trainers provide our Personal
Response Associates with thorough, detailed, specific, step-by-step training in all aspects of
the job responsibilities and organizational relationships, with opportunity for repeated
practice when needed.
Lifeline utilizes a combination Of classroom study, simulated call experience and hands-on
experience to ensure that our Personal Response Associates are the most highly trained and
skilled in the industry. All new Personal Response Associates undergo 80 hours of intense
classroom study.
Lifeline's Response Center utilizes a three-level training program that results in dedicated
staff trained to handle any type of subscriber call.
All Personal Response Associates undergo a rigorous.tmining process before they are
allowed to respond independently to any incoming signal. They first undergo SO hours of
classroom training which covers emergency response protocols, equipment; product
installations, listening, writing, speaking, conflict resolution and monitoring skills. Personal
Response Associates must demonstrate proficiency in, these areas for them to
continue in the training process.
Dedicated Learning Facility
Once the classroom study is complete, Personal Response Associates then
advance to learning how to use CareSystem as well as apply what they have
learned from their classroom study in our dedicated learning facility. This
on-site dedicated learning facility enables Lifeline to maximize their
learning, consistency and retention of skills prior to sitting -in on actual
subscriber calls.
The Learning Center is equipped with IS stations which run the actual CareSystem
monitoring application from a training database. Actual calls are simulated, enabling the
trainees to hone the protocols and customer interaction skills that they have learned from
their classroom study while becoming proficient with the computer and moving between the
different monitoring screens used by CareSystem. This provides Personal Response
Associates with more knowledge and proficiency so when they listen in on actual calls, their
learning is focused on reacting to subscriber needs rather than learning the system.
The Learning Center is used for both the initial training process for new Associates and in the
ongoing training as part of the certification process and skill development.
EXHIBIT "A"
page of
Lifeline Customer Support Service
Mentoring Program
Once the Personal Response Associates have completed the first two phases oftraining, they
are assigned to an experienced Associate who will provide additional instruction and
mentoring. During this phase, the new Associates usit-in" on actual calls. In addition, they are
educated in stress management and gerontology at this time.
Our Personal Response Associates produce work of high quality
accuracy of details and needs of our subscribers. They are mohvgtcdr6y a stronwe attention
g t�� of to the
duty they derive from doing good work for the subscriber as dictated by our Priority One
Mission.
Lifeline's training process is extensive and time consuming; however, we recognize that we
need to invest the time with our people to successfully realize our goals of the most highly
trained and skilled Response Center staff.
• PEFIBMKRESFOFMASS=7ECbnMTMNPROOM
To ensure the success of our extensive training process, Lifeline utilizes certification
milestones.
LEVEL I certification is required of all new personnel generally within 14 days of hire. This
level must be attained before the new staff member is allowed to
respond any incoming signal. In order to obtain Level I Certification, the persana,,Resp ndeently to
equipment,
must demonstrate proficiency in 15 areas, including emergency response protocols,
� u pment, handling a welcome call, listening, writing, cont g resolution, and monitoring
skills.
LEVER, 2 certification is achieved within
completed by the Persona! Response Asso90 days Of hire- The Leve! 2 is an assessment
ciate to ensure they have the required knowledge
ofprotoeol, gerontology, equipment and customer service skills.
be renewed annually. Level 2 Certification must
Personal Response Associates also receive in-service training. re Each month training modules
aoffered on Protocol, Equipment, Using TTY Relay and Languae Line, Mentoring New
Employees, and Customer Service Skills. g
Personal Response Associates are reviewed monthly by the Quality Assurance team who
randomly selects taped incidents and welcome calls ham each Personal Response Associate
on a monthly basis. They listen and determine whether key points are appropriately covered
during the calls. Some key point examples are: maintaining a caring tone of voice,
identifying program name and using the subscriber's preferred name. The Quality Assurance
team also audits the Personal Response Associate's documentation within the case.
MWO
EXHIBIT "A"
,
page � of ,
Lifeline Customer Support Service
Lifeline Response Center— CareSystem
The next component of Lifeline Monitoring Services is CareSystem. CareSystem integrates
hardware, software, telephone equipment and protocols and procedures into the industry's
most advanced, state-of-the-art response monitoring platform and monitoring service. This
platform is in operation on Lifeline's two fully redundant response centers.
Enhanced System Reilability
The First element of CareSystem is its enhanced system reliability. We have developed
CareSystem to be highly fault tolerant in a continuously operating environment. In simple
terms, this means it can easily handle the volume of calls coming into the Response Center
each day (with the ability to handle many more), while continuing to operate 24-hour3-a-dsy,
365 -days -a -year.
In the event that any of the primary system components of CareSystem fail,we have a fast,
automated recovery process that would be virtually seamless to ourprograrn and
subscribers. The recovery process would result in uninterrupted service delivery.
Computer Telephony Integration — Skllls49ased Call Routing '
The second element of CareSystem is called Computer Telephony
Integration (CTI), which enables skills -based routing. CTI is a
software layer component that has been added to CareSystcm. This
component has the ability to recognize incoming calls and route
them to the ePPrOPriate Personal Response Associates. For examples
when a subscriber is in need of assistance and pushes her Personal
Help Button, the CTI layer will recognize that call as high priority
and, in turn, know what skills are required to handle that call.
The CTI layer also routes specific calls to specific Personal Response Associates. For
example, those calls corning in from non-English speaking subscribers are automatically
routed to the appropriate bi- or multi-lingual Associates based on their availability. The same
applies to our hearing impaired subscribers, whose calls will be routed to those Personal
Response Associates trained in using TDDfM devices. Skills -based call routing will result
in subscribers receiving optimum service from our Personal Response Associates.
Automatic Number Identllleation (ANI)
CareSystem utilizes technology and service from AT&T that enables CareSystem to record
the originating telephone number of calls that come through the telephone switch. This
capability is a more extensive application but is similar to "Caller 11D." This new capability is
a significant enhancement in maximizing the safety of our subscribers. Please note that
Automatic Number Identification (ANI) will only work from areas in the US that support
Caller ID. Today, over 95% of local telephone service providers support this technology.
This is not guaranteed — we don't always have the ANI, or an AN] that is a valid number for
us to call back.
hXWISIT "A"
page p of 117)
Lifeline Customer Support Service
Relational Database
The third element of the system is its relational database. CareSystem runs off a database that
sets the industry standard and is very focused on data integrity. The database has the ability
to systematically catch problems, such as failure to enter required information. This enhances
data quality and the integrity of the reports that our programs receive from Lifeline. In
addition, the database enables us to capture more information on our subscribers and add it to
the information that we use in the future.
Enhanced Flexibility
The fourth element is the flexibility of the system. CareSystem allows Lifeline to easily
expand the data fields in the database to add new types of information.
'This enhanced flexibility also allows us to add new services without having to completely
rebuild the design of the system. This will be critical as we introduce new services in the
future to further benefit your subscnbers, as well as further meet the needs of your referral
sources and your organizations.
Case Management Design
The fifth element of CareSystem utilizes a case management approach in organizing the
information, activities, calls and follow=through required by Personal Response Associates to
provide Optimum service to your subscribers. CamSystem's case management design requires
that each subscriber situation — including rnaiinenance and check-in.calls — achieves an
outcome before the "case" is considered resolved; CareSystem links all related subscriber
calls, activities, and information that are pertinent to formulating a response to a subscriber
situation and ensures that the loop df actions required to.properly service a subscriber is
completed. For more information on Ca"System's Case Management Design, see Section 6.
Lifeline Response Center protocols and Procedures
The process of establishing the proper protocols pulls together the people and the technical
aspects Lifeline's two Response Centers. This permits us to provide the high quality response
to calls we receive. Protocols allow us to provide appropriate and consistent response no
matter what the circumstance.
We have established tight protocols and procedures while at the same time keeping the
personal touch that is so important when providing personal response services. A Personal
Response Associate will immediately attempt to make voice contact and assess the nature of
the call. if the subscriber is merely performing their monthly check-in, we thank the
subscriber and note the monthly check-in call in our file, then close the call.
=Anitli C ..A„
page —2— of
Lifeline Customer Support Service
NOTE: PLEASE REFER TO SECTION 4 FOR A REVIEW OF THE BASIC PROTOCOLS FOLLOWED BY
LIFELINE'S RESPONSE CENTER.
In addition, each shift is briefed on occurrences during the previous shift, and potential
problems discussed, such as major systems of adverse weather or geological conditions,
national issues and local holiday observances.
with Lifeline's Response Center you are assured ofexeellent persona) response service.
Our
facility Offers state-of-the-art technology, and our staff are professional yet extremely
personable, never needing to sacrifice the warmth of the service to achieve efficiency. Our
Protocol thave
v been developed to ensure your subscribers, safety while still allowing for the
EXHitst t , N►
page J2 of .� _
Lifeline Customer Support Service
Lifeline Customer Support Services
Lifeline ensures that your subscribers receive a professional, personalized and timely
response to their calls by our certifted Personal Response Associates. Their only
responsibility is to ensure that your subscribers receive the help they need. Our commitment
to you and your subscribers does not stop there. In addition to ensuring that your subscribers
receive top quality Personal Response Service,
receives by partnering with Lifeline. there are other services that your program
InsbO Notification Reports - Keeping You In Touch
These are a series of faxed reports that provide rapid communications between Lifeline
Monitoring Services and your Lifeline Progr'anm as events occur, 24-hours-a..da 7� _
week. These reports are also available on our on-line subscriber information source, yr
CarePartners Connect.
I. Patient Incident Notification Report— This round-the-clock report provides your
Program with immediate information regarding a subscriber incident. Any time a
responder or EMS is sent to the subscribers home and provides assistance, we will send
YOU a complete and comprehensive review of the incident that has occurred.
2. Urgent Communication Report — This report provides your program with critical
information about your subscribers' equipment as soon as our Response Center staff
identifies a potential problem. Reports communicate low battery signals or other
equipment service needs as we become aware of them. This
hours -a -day so you can plan your service calls more effectivelly�rt is also Provided 24-
3. Communication Report— A non -urgent report that documents any new information or
requests that we received from the subscriber during a call into the lifeline Response
Center. It might communicate the subscribers request for a new wristband or that she
has changed one of her responders. On occasion, it may include a comment or concern
that our Response Center staff has regarding the subscriber.
4. CPA Report — This report verities information received about a new subscriber thahas
t
been added to your program by our Data Entry department. When a subscriber is added,
it will be confirmed to you via facsimile. These reports will be faxed during normal
business hours.
""ese reports are detailed further in Section 8 of thzs handbook}
C1
EXHIBIT "Ar•
Page — of
Lifeline Customer Support Service
Lifieline Support Services
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tXHIB1T "A"
Pageof
.��•..
Lifeline Customer Support Service
Lifeline SupPatt Services — CoWnued
Name.Key
Inactivity
Service
PROMrnew Scwice
• Allows a subscober b set a timeron flair unit
The subsaftr Mn reset the imer la inc ate
that they are ok and do nd need helps, if ft
timer is not resd when the finer agpi ee. the
writ wit send a sipnat to Lifeiret
• Assists subscriber: who may lose
monsciauOM or be dhmwbe unable to press
their Persarat help bLOM h case of emerge
due to a heath proal n
Sulable for asmal Perleta9edav6eabee
who as at NO risk for heath probWm but am
menlagy alat who have imledcrit d have
acf Adw; WW ars w mad memory boas; and
who tree in an edated or 3m*m ed area
Key
• Sables Im by alw ft Lffelm b pet help b a
subscriber without than pushing the* personal
Help Button.
Prmv" reuaranoe b subscribers and their
fainly members that Lyefne is in d,*cargsd
with he 3uhWd! r and nil get help N needed,
When a home communicator is manufactured, there are several items automatically
programmed into it Throughout the life of the home communicator, these items might need.
to be changed or re -programmed. As a Lifeline Monitoring:Services customer, these
reprogramming changes may be made over the telephone free -4 -charge using either
Automated PROMIine or operator -assisted PROMline by calling (800) 225-1503.
The information stored in the home communicator which can be changed includes:
■ Unit Number
• Program Code
• Lifeline Monitoring Services Telephone Number # 1
• Lifeline Monitoring Services Telephone Number #2
• Ringer On/Ofi(some models)
Some of these settings can be modified only through Operator -assisted PROMline.
Operators are available Monday - Friday, 8:30 AM - 6:00 PM t:sT.
EXHIBIT "A"
page J-. - of
Lifeline Customer Support Service
Automated PROMline - Pmming you 1 vbk to WWmm y ==wtabIS at any time
This service is a fully -automated voice menu system that allows you to reprogram your units
any time of the day. any day of the week, 365-days-per-year.it erefoyou can schedule an
re
installation after normal business hours (as long as Lifeline Monitoring Services Customer
Service has received the subscriber's Care Plan Agreement). weekends and holidays t
basically, anytime that is convenient for you, your subscribers, or their caregivers.
NOTE: TO UTILIZE THE AUTOMATED PROMLINE SERVICE, TOUCHTONE SERVICE MUST BE AVAILABLE
AT THE SUBSCRIBER'S HOME AND COMMUNICATOR MODELS WITH SELECTABLE PULSEITONE
SWITCHES MUST BE SET TO TONE.
The changes that can be made on the Automated PROMIine service include:
1. Dialing status change
2. Ringer status change
EXHIBIT "A"
page J z of
Lifeline Customer Support $ervice
Features and Benefits of the Lifeline Monitoring
tor�ng
Lif�[iate st ff :nsptoy�` b
:Fns u :S Ug subsmjer,. '"rt for bath
814:ir•igual Personal
Response Asgoctaties p�n�,RMci. internal bi-lingual capahilities Lifeline -
e Llne .* �ociates have ability to
$ uag ~'>rie? services abil' �.1n
conferencing - qulcdy, enabling the Persoi�sl Re,Tponse
with trtcotat " fra9n fu yth non-English spGalring n'bas
nghidlees of what Iatguage-the subscigbe r VeaIcL
Telecommunication Care.SYstem immediately routes calls frorn subscribers using
devices for the deaf TDDs to Personal Response Associates who are trained to
(TDD) handle response to our hearing and speech impaired subscribers
through the use of TDDMY devices -
Toll -Free Lines Call •L-if-eli�e regarding any inquiries on our $00 numbers or fax
Y� Care Plan on our toll free goo fax line -- you will incur no
costs.
Benefits
ervice by
Lifeline's Response Center is staffed by teams of dedicated
Personal Response Associates
Personal
rResponseAssociates
committed to providing high -
quality service available at the press of a button 24 -hours -a -day,
365 -days -a -year. They ensure thateveryane
ofyoursubscribers
is provided with assistance that is both appropriate and timely.
nazed
ppo nebyour
Aff sabso�ilier:wlls-fbr. assistance
Life1ir**ogam by hi � a'S``�'in the neap of
enbeaus, cariag�
ccrtied inbnitars, .Y, and �jly_
Skills -Based Call
CareSystam automatically routes calls to Personal Response
Associates wed on their skill set
Routing
and availability. For example,
calls from subscribers who speak only Spanish will be
automatically routed to an Associate fluent in Spanish (see next,
benefit).
Lif�[iate st ff :nsptoy�` b
:Fns u :S Ug subsmjer,. '"rt for bath
814:ir•igual Personal
Response Asgoctaties p�n�,RMci. internal bi-lingual capahilities Lifeline -
e Llne .* �ociates have ability to
$ uag ~'>rie? services abil' �.1n
conferencing - qulcdy, enabling the Persoi�sl Re,Tponse
with trtcotat " fra9n fu yth non-English spGalring n'bas
nghidlees of what Iatguage-the subscigbe r VeaIcL
Telecommunication Care.SYstem immediately routes calls frorn subscribers using
devices for the deaf TDDs to Personal Response Associates who are trained to
(TDD) handle response to our hearing and speech impaired subscribers
through the use of TDDMY devices -
Toll -Free Lines Call •L-if-eli�e regarding any inquiries on our $00 numbers or fax
Y� Care Plan on our toll free goo fax line -- you will incur no
costs.
EXHIBIT "A"
page _ of
Lifeline Customer Support Service
Features and Benefits of the Lifeline Monitoring
Service — Continued
Lifeline's CareSystem platform utilizes several layers of back-
up systems to ensure that if one system fails, the back-up
Redundant Systems systems are immediately available, ensuring non -interrupted
service to your subscribers. In addition, a second fully
redundant operational response center provides added capacity
and functions as a backup to the primary response center.
Every Incidgnt involving your $u4cribers is cam
documented a i.i(ha ptrjY i ceive,
lrtstant Notiflcatlon ppehs: Yourprugram immpdiate�r rrcciycs
Reports • a computer-generated report that is irrunediately faxed to yogi
program, krepirig all'reievartf irtdivi uals irdomred, In additio
yqu receive:InstAnt Notification Rc#ob for both urge* follow
up (Lc•. a PRO •that rieeds•to bE -
• -• follow-up, �.c., iftf�= sr�EiscrZ ��d} and non -urgent , -
. _ - � . 'Ixi hss a question on billm�. .
Notlflcatlon of famliy or Each subscriber is asked to identify an individual to be notified
caregiver regarding a
if assistance is required. This contact is called a "notify" and is
subscriber's need for documented on the subscriber's Care Pian Agreement. Our
assistance Personal Response Associates will attempt to contact these
individuals for up to 24 hours after the actual assistance occurs.
EXHIBIT "A"
page i. •' of
Lifeline Customer Support Service
Path of an Inbound Signal
The following is an overview of how the signal from a subscriber's communicator reaches
the Personal Response Associate in Lifeline's Response Center.
A Subscriber signal is sent by pushing the Personal Help Button or the help button on the
communicator.
I. The communicator dials the pre-programmed 800 number.
2. The call enters Lifeline at our telephone switch which determines that the call is
originating from a Lifeline communicator.
3. Care5ystem receives data from the communicator, identifies the subscriber and pulls the
subscription data from the database. CareSystem also determines the call priority and
skills -based need and forwards the call and the subscription data to the Associate's
desktop application.
4. The Personal Response Associate has access to the subscriber data and establishes voice
contact with the subscriber to handle the incoming call.
EXHIBIT "A"
page J, ) of ' 1.
Basic Response Protocols
Lifeline Monitoring Services: Protocols Overview
The protocols and procedures that Lifeline Monitoring Services follow are the cornerstone to
the operation. Establishing the proper protocols pulls together the people and the technology
utilized in providing Lifeline Monitoring Services. The protocols and procedures permit us to
provide the highest quality response to each and every call. Protocols allow us to ensue:
appropriate, consistent and caring responses, no matter what the circumstance is.
We have established very tight protocols and procedures, while at the some time keeping the
personal or high -touch feel that is so important when.providing personal Response Services.
EXHIBIT "A"
page . t +; of t
Basic Response Protocols
Communicator Signals
Types of signals received by Lifeline Response Center Services
There are various signals that are received from subscribers' home communicators into the
CateSystem monitoring platform. Each of these signals have a unique response protocol that
is followed by our Personal Response Associates.
The types of signals received from the home
communicators are:411
Ric
a -
1. Help Needed�-
2.
Help Still Needed
3.
Responder Check
4.
Home Unit Reset
S.
Inactivity Alarm
6.
Smoke Detected
7. Follow Up Required
S. Low Battery Home Unit
9. Low Battery PHB
10. Low Battery Smoke
1 I. No AC Home Unit
12. Supervision Failure Alarm
The following summarizes the protocols followed for the various signals received and
situations encountered.
Help Needed - Emergency/Assistance Needed protocol
If a subscriber needs assistance from either a responder (usually a family member or
neighbor) or Emergency Medical Services, our Personal Response Associates will make the
necessary contacts while at the same time making sure the subscriber feels cared for.
CareSystem will open a Case for the subscriber incident and link all subsequent signals
pertaining to the open case. The case will not be closed until all the necessary actions are
performed by the associate (i.e., the appropriate responder has arrived in the subscriber's
home and has either pressed the Reset button or sent in another Help Signal, so that an
associate can call back and follow -tip on the status of the subscriber).
EXHIBIT "A"
page . ,' of
Basic Response Protocols l qb
Help Needed - EmeMencylAssistance Needed Protocol - Continued
Once all actions have been performed by the Personal Response Associate to take care of the
subscriber's situation, the associate will contact the designated "notifies" (notifies are
individuals who wish m be contacted whenever the subscriber needs assistance once the case
is closed), and CareSystem will immediately fax a Patient Incident Report to your program
that summarizes the incident, allowing you to stay informed about the condition ofyour
subscribers_
If an ambulance is dispatched to the subscriber's home and we have allergy information on
file for the subscriber, we will offer that information to the dispatcher. We will also leave our
800# for any follow-up by the EMS once they are on-site at the subscribers home. Our
Personal Response Associates will also make every attempt to contact a responder with a key
(if no hidden key location is provided) to minimize any unnecessary forced entries.
Help Needed- No Assistance Needed Response Protocol
All incoming Help Needed signals are handled in the same way. The Personal Response
Associate will attempt to make voice -to -voice contact with the subscriber and ask the
question, "Mrs. Smith, this is Bob from General Hospital Lifeline; do you need help?" If,
through contact with the subscriber, a call is determined to be a non -emergency our
associates will provide the some level of response to that subscriber as in the case of an
actual emergency (examples of non -emergencies include monthly check -ins, accidental
activations, or subscribers wanting to make contact). This reinforces the value of the Lifeline
service to your subscriber. Our associates make sure all callers' needs am met with a
consistent sense of urgency because we know every subscriber wants to feel important and
cared for.
If the subscriber has a remote resetable communicator, our personal Response Associate will
reset the communicator remotely through CareSystem. This eliminates the need for the
subscriber to take any further action. The subscriber is now able to send a new signal if
necessary.
If the subscriber has a non-resetable communicator, it is already in the ready mode. The
subscriber is now able to send a new signal if necessary.
For all other resetable models, the Personal Response Associate will ask the subscriber to
press the "Reset" button.
EXHIBIT "A"
page r ;A of
Basic Response Protocols I a
Help Still Needed Signals Protocd
A Help Still Needed signal is generated every 32 minutes. If reset able unit is not reset atter
sending a Help Needed signal or Inactivity Alarm. Up to four Help Still Needed signals can
be received on any one Help Needed signal or Inactivity Alarm.
• If a responder is indicated to be en -route, then the Personal Response Associate will
call into the subscriber`s home to determine if the responder has arrived.
• Or if no contact can be made with the subscriber, then the responder will be called to
determine the subscriber status. If no answer is received at the responder's number,
then a second responder will be contacted to go to the subscribefs home.
• If the situation in the subscriber's home requires no more assistance, the Personal
Response Associate will remind the contact person to press the Reset button, the
associate will close the call and CRmSystem will fax a Patient Incident Notification
Report if assistance was rendered.
This is a signal designed for units without a Reset — L5200 and L6200. It is scheduled by
CareSystem to be delivered once every 30 minutes whenever the original Help Needed signal
was left open awaiting resolution.
Once the call is closed a Patient Incident Notification Report will be faxed if assistance was
rendered.
Inactivity Alarm PmtoM
When the inactivity timer on the communicator activates at 12- or 24-hour intervals, the
home communicator will beep (or in the case of the CarePartner Telephone and CarePartner
6500, will state "Please press reset') for five minutes prior to calling into Lifeline's Response
Center in an attempt to alert the subscriber for the need to reset the communicator. If the
subscriber does not press the Reset, the communicator automatically dials into the Response
Center. Once the call is received and handled by CareSystem, it is identified as an incoming
Inactivity Alarm.
t,&M1ti1T "A"
page �1 ` Of
Basic Response Protocols I a
Inactivity Alarm Protocol - Continued
A Personal Response Associate handles the Inactivity Alar signal in the same way as a
Help Needed. signal. The associate calls the subscriber's home through the internal dialing
capability of CareSystem. On those communicators that ring through after one to three rings,
the associate responds the same as when a Help Needed signal is received. ("Mrs. Smith,
no contact is made, the
this
is Bob from General Hospital Lifeline; do you need help7'5 If
associate initiates a second call to the subscribers home. If again no contact is made, the
associate starts calling the responders in the specified order.
• If a responder is contacted, he or she is asked to go and check on the subscriber.
• If no responders are available, the Personal Response Associate rails the designated
hospital to see if the subscriber is hospitalized or in the emergency mom.
• If the subscriber cannot be located, then the Personal Response Associate calls the
police and requests a "well-being" check on the subscriber and provides the hidden
key location if it is identified in the subscriber records.
The case cannot be closed until a Reset is received from the subscribers communicator. If no
Reset signal is received, a Personal Response Associate follows -up with the responder or
EMS that was asked to check on the status of the subscriber.
If a subscriber has a Lifeline smoke detector and smoke is detected, a Smoke Detected signal
will be generated. The Personal Response Associate will first attempt to call the subscriber. If
the subscriber indicates a fire, or we make no contact, or if there is a suspicion of a rim (if the
subscriber appears confuseA the fire department will be notified. If the subscriber indicates
that it is a test or accidental alarm, the subscriber will be asked to reset the unit.
Home Unit Reset Protocol
A Home Unit Reset signal is generated by a resetable unit when the Reset button is pressed
following a Help needed signal or Inactivity Alarm. Upon receipt the Personal Response
Associate will quickly review the Case History to determine the actions taken sofar and
make voice -to -voice contact with either the subscriber, responder, or EMS at the subscriber's
home. The associate asks for information regarding the status of the subscriber. For example,
if the subscriber is being transported, the associate asks where the subscriber is being
transported and requests that the communicator be set in the AWAY position (if applicable}.
Once it has been established that no further assistance is required, the Personal Response
Associate will contact the notifies.
tX1 WIT "A"
page _"� Df
Basic Response Protocols I a
Maintenance Signals
Low Battery Home Unit (LBHU)
This signal is generated by the home communicator once every 24 hours and indicates that
the internal battery needs to be replaced. The signal will not be delivered to a personal
Response Associate unless it is attached to another signal, e.g., Help Needed. A
communication log will automatically be sent to the local program upon the receipt of the
first LBHU and then again after every 12th consecutive LBHU until the battery is replaced.
A Low Battery Button signal indicates that the battery within the personal help button -may-
be running low and in need of replacement. Since theme are many reasons why a pHB may
send in a Use or premature LBB, nothing is done upon the receipt of the first LBB. A report
is generated each day and reviewed by a team of Customer Service RepnesrntaThe
tiv.
es
report includes the Warnes of every subscriber for whom we have received 3 consecutive
LBBB within 90 days (with no intervening clear Help Needed signal) and those from whom
we have only received one LBB and no other signal within the same 40_day period, The
representatives will take the appropriate action with either the subscriber or program
manager.
LOW Battery— Smoke
Each Lifeline smoke detector has a self -check cycle. If a low battery is detected, the smoke
detector will emit a signal to the home communicator. The homecommunicator, in turn, will
generate and send a Law Battery -Smoke signal to the Response Center. This indicates that
the batteries must be replaced.
No AJC Home Unit
ANoAIC Home Unit signal is sent by the home communicator to alert the Response Center
that the unit is not receiving electricity and is running on the back-up battery. ANO VC
Home Unit signal will come in attached to another (primary) signal, e.g., Help Needed,
Reset.
EXHIBIT "A"
page ����.. of
Basic Response Protocols
Supervision Failure Alarm
The SA400 Lifeline Smoke Detector continually transmits a signal to the home
communicator. If the home communicator does not receive this transmission at least once
during a 24-hour period, the unit will generate and send a "Supervision Failure Alarm" to the
Response Center. At the present time, this feature is only available on the L6600S and
L9500S home communicators. Personal Response Associates will troubleshoot with the
subscriber or responder in order to restore power to the unit. If unsuccessful a
communication log will be sent to the program.
EXHIBIT "A"
page of
Basic Response Protocols 1 a
Additional Protocols and Procedures
Welcome calls
A crucial component of our service is providing a warm welcome to new subscribers — many
of whom deny their need for the service and have subscribed at the insistence of family
members or caregivers. Some subscribers may be intimidated by the equipment during the
installation or may feel that they will not benefit from the service, It is important that all new
subscribers receive a consistent warn welcome to the Lifeline family.
When a program submits a Care Plan Agreement to Customer Service, the representative
enters the information and a Welcome case is created, The representative will set the
subscription status to "Pending Install." The case remains open waiting for the test signal to
be sent by the Home Service Representative.
When the signal arrives in the Response Center it will attach to the open Welcome rase,
alerting the Personal Response Associate that the call may be from a new subscriber. The
Personal Response Associate, however, will initially handle the call with the standard Help
Needed protocol until the Home Service Representadve or the subscriber eonfurns that the
call is indeed a new installation. Once it is determined that no help is needed and that the
subscriber is new to Lifeline, the Personal Response Associate will welcome the subscriber
and give a brief review of the features of monitoring services. if the subscriber is not
available for this greeting, the case will remain open until such time that the subscriber is
properly welcomed to the Lifeline service.
Check -In Galls
Lifeline recommends that every subscriber use his/her personal Help Button at least once a
month to ensure familiarity with the service and as a check that the equipment is functioning
properly. Your subscribers should be encouraged during the installation visit to perform the
monthly check-in call. Your Home Service Representative should emphasize that Lifeline
wants to hear from them monthly and that they are never "bothering' the Personal Response
Associates by checking in. If a subscriber does not periodically use the service, Lifeline
utilizes its check-in call process to contact the subscriber to ask them to send in a check-in
call. CareSystem's case management design enables Personal Response Associates to close
the loop in the outbound and inbound check-in call process.
EXHIBIT "B„
LIFELINE PROGRAM
SUBSCRIBER GRANT AGREEINIENT
Long Beach Memorial Medical Center ("Medical Center") and the Subscriber signing this
Agreement agree as follows:
1. The Medical Center shall install one (1) Philips Lifeline system (the
"Equipment") on subscriber's premises.
2. This Agreement may be terminated by either party upon written notice of thirty
(30) days. In case of default hereunder by either party, the Agreement may be
terminated by the non -defaulting party without notice.
3. This Agreement shall constitute the entire Agreement between Subscriber and the
Medical Center. No person installing, servicing or otherwise dealing with the
leased equipment is or shall be authorized to act in name or on behalf of the
Medical Center or to bind the Medical Center in any way.
4. Equipment remains the property of the Medical Center and is subject to its
possession and control. The Medical Center may supply new or reconditioned
equipment at its sole option. In the event of default by the Subscriber, the
Medical Center shall have the right to take possession of the Equipment without
demand or notice, where ever the same may be located without any court order or
any process of law.
5. This Agreement is not assignable by Subscriber, but may be assigned by the
Medical Center. Any attempt by the Subscriber to transfer by any means any of
the rights, duties or obligations of this Agreement shall be of no force or effect.
6. The Medical Center shall:
a) Install and periodically maintain and service the equipment.
b) Provide instruction on the use of the equipment.
c) Repair damaged or defective equipment or, in its sole judgment, replace
the equipment. The Medical Center shall have no obligation to make any
such repairs or replacements in the event the equipment is damaged or
destroyed by the negligence of the Subscriber or any other person not
controlled, directly or indirectly, by the Medical Center and in such event
the subscriber is responsible for replacement or repair of the damaged unit.
Subscriber shall be responsible for replacing lost or damaged PHS
(Personal Help Button).
Page 2 of 11
Ul W7lOp0[!6lf439.ot
PHILIPS
Lifeline Philips Lifeline Care Plan Agreement
❑ This is a PARTIAL Install Program Name Program Phone Number
❑ This is a FOLLOW-UP Install
Program Code I Household Phone # Model Type Unit # i
Salutation I Subscriber Last Name I First Name I Middle
Preferred Name Last Name Sounds Like Language Need?
❑ Spanish ❑ Other
Household Information
Residential Street Address/Apt #
Cily
Slate Zip Code
County
Household Hidden Key Location I + . Directions To Home
Responder One
Name (First/Last)
Language Need?
❑ Spanish ❑ Other
Street Address
City, State, Zip Code
Page I of 2
Installation Date
Accessories
Suffix
Gender Date Of Birth
❑ Male []Female
Y Phone Numbers (Do not list 914 or 800
CENTRAL DISPATCH
POLICE
FIRE
AMBULANCE ❑ Check II Prlvata
ALTERNATE AMBULANC.E
Be Provided If PO Box Listed)
Medical Conditions and/or Diseases
Responder Two
Name (FirstlLast)
Language Need?
❑ Spanish ❑ Other
Street Address
City, State, ZIP Code
❑ Healthcare Directives
ILC[ Inactivity Alarm Service
J1 Special Instructions. A
❑ State Funded
❑ Lifeline Smoke Detector
Name (First/Last)
Language Need?
❑ Spanish ❑ Other
Street Address
City, Stale, Zip Code
ree,
i Family Relation ❑ Have Key I Family Relation ❑ Have Key I Family Relallon ❑ Have Key
❑ Family Caregiver ❑ Family Caregiver
❑ Notify ❑ Notify [I Family Caregiver
❑ Reminder Contact ❑ Notify
Phone ❑ Reminder Canlacl ❑Reminder Contact
❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Cell
( ) ( ) (
Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Cell
All information contained in this report is considered private and confidential, and is intended solely for use by authorized Philips Lifeline representatives.
L 0930338 Rev. 05 (LMS)
All information contained in this report is considered private and confidential, and is intended solely for use by authorized Philips Lifeline representatives.
PN 0930338 Rev. 05 (LhIS)
I IFF -LINE COPY
PH[UPS
Lifeline Philips Lifeline Care Plan Agreement Page 2of2
Program Code Subscriber Last Name First Name
Household Phone # Program Name
Notify
Notify.
Name (First/Last) Family Relation
Name (First/Last) Family Relation
❑ Family Caregiver
❑ Family Caregiver
Reminder Contact
0 Reminder Contact
Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Call
Phone ❑ Home ❑ Work ❑ Cell Phone ❑ Home ❑ Work ❑ Celt
Primary Physician
Third Party Notify.
Name (First/Last) Name (First/Last)
Fax Number
Phone Name (First/Last)
Fax Number
i
Preferred Hospital
Referral Sourcii
Hospital Name
Name (Firs)/Last) Phone
City, State Phone lAeouIaeol
Organization/Agency Name Position/Title
❑ Multiple Subscriber Household
Street Address City, State, Zip Code
(you must complete a separate Care Plan Agreement for each
Subscriber)
Name of Additional Subscriber
Coupon
Code
Subscriber Notes
A
B C
PiVer infonmatio,.
First Name (it applicable organization name) Last Name
Home Phone #
Street Address
{ )
Work phone #
City State Zip Code
{ )
Social Security Number Medicaid Number
Monthly Fee(s) One Time Fee(s)
$
Payment Frequency Payment Method
Monitoring Service Enrollment Fee $
$
❑ Monthly ❑ Invoice
Inactivity Service $
$
❑ Quarterly ❑ Credit Card
Shipping & Handling❑
Yearly Y ❑Debit Card
Card Type Name (as it appears on Card)
Card Number Expiration Date
❑ Visa
❑ Master Card
❑ American Express
❑ Discover
For Program Use Only (Not to be Entered by Data Entry)
Signature Of Subscriber Date
Signature Of Payer (If Different) Date
All information contained in this report is considered private and confidential, and is intended solely for use by authorized Philips Lifeline representatives.
PN 0930338 Rev. 05 (LhIS)
I IFF -LINE COPY
EXHIBIT "B"
7. Subscriber shall:
a) Provide and be responsible for suitable electrical and telephone service to
allow installation and operation of the equipment. A modular telephone
jack is required.
b) Make no alterations or repairs to the equipment.
c) Not move the equipment without written authorization of the Medical
Center.
d) Allow access to technical representatives identified by the Medical Center
to inspect the equipment, to provide periodic maintenance, and to remove
the equipment after default or after the termination of the lease term.
e) Not cause repeated or frequent inadvertent nor any willful false alarms.
f) Provide access for the Responders, e. g. provide a key.
g) Understand that in the event that an emergency signal is received, and if
the Responders are sent, particularly the fire or police, who may not have
access, that they may use forced entry if necessary to respond
appropriately to the emergency.
8. Subscriber acknowledges that he/she has received instruction on the use of the
Equipment, understands the use of the Equipment, and that the Equipment has
been installed and is functioning.
9. It is understood and agreed that the sole obligation of the Medical Center shall be
to install and maintain and service the equipment as set forth above and to
otherwise comply with the terms of this Agreement.
10. The Medical Center shall provide through Lifeline Central, twenty-four (24)
hours per day response to emergency calls. Upon receipt of the signal for help
from the Subscriber, Lifeline Central will attempt to contact the Subscriber by
telephone. If they cannot contact the Subscriber, then they will attempt to contact
responders. Should no responder be contacted, then municipal responders such as
policelparamedics will be contacted. Lifeline Central remains involved after
being signaled by the Subscriber until such time as the responders signal Lifeline
Central that they have arrived. The Medical Center has no duty under this
Agreement to provide emergency medical response to the Subscriber. The
Medical Center's sole duty is to contract with Lifeline Central to provide
monitoring services to the subscriber. The Subscriber agrees that the Medical
Center assumes no liability or obligation for any of Lifeline's activities in
providing monitoring services and assumes no liability or obligation for any
responder's activities in responding, and assumes no other liability or obligation
hereunder whether direct or indirect, incidental or consequential, which includes
without limitation any consequences for the failure of the Equipment to perform
the function for which it is intended. It is further understood and agreed that the
Medical Center makes no representations or warrantees either expressed or
implied with respect to the Equipment.
Page 3 of L i
0 H)U710001161439.0 r
Lifeline Subscriber
Street Address
City
Telephone Number
EXHIBIT "B"
State
Date
Long Beach Memorial Lifeline Date
Sponsoring Organization
Sponsor's Representative
UNIT IDENTIFICATION
Subscriber Number
MMC Number
Installed by
Installation date
Page 4 of 11
0100710001/6M39,01
Zip
EX)EIIBIT "B'•
ADDENDUM
1. Subscriber agrees to indemnify, hold harmless and defend Long Beach Memorial
Medical Center and the City of Carson, their officers, employees, members, trustees,
agents and servants against all claims, suits, losses, damages and costs, including but not
limited to, court costs and reasonable attorney fees, on account of injury or damage,
including death, incurred by Subscriber or anyone else as a result of failure of any
equipment or any failure in the performance of service under this Agreement.
2. Subscriber is advised when more than one (1) telephone exists where Lifeline equipment
is installed, it would be to Subscriber's advantage to have telephone company install an
RJ31 X jack enabling Lifeline unit to access phone line should any phone in the house be
off the hook. The Medical Center will install Lifeline unit upon request, even when
Subscriber does not wish special jack installed. However, as described herein, the
Medical Center will not be responsible for any equipment failure.
Subscriber Date
Long Beach Memorial Lifeline Representative Date
Page 5 of I 1
U 1UU7/OW [16&139 Dl
EXHIBIT "B"
MEMORIAL LIFELINE LEASE AGREEMENT
Instructions for completing the Lifeline Lease Agreement;
1. Please print or type all information neatly.
2. Provide the full name, mailing address and telephone number of the person who will be
responsible for payment (Lessee). This may be the subscriber or the subscriber's
representative (a relative, friend or organization).
Please provide the full name, mailing address and telephone number of the person
(subscriber) who will be monitored under this agreement. Please include building or
apartment numbers if applicable. With all telephone numbers, be sure to include the area
code.
4. Please read through the Lease Agreement.
S. Please sign and date the subscriber and lessee sections of the Lease Agreement. The
Long Beach Memorial Lifeline staff will sign and date it upon receipt and provide you
with a copy for your records upon installation.
Page 6 of 11
0IM71(M I/613434.0E
EXHIBIT "B"
yIEMORIAL LIFELINE LEASE AGREEMENT
This Lease Agreement and Agreement, made and entered into this day of ,
20_, by and between Long Beach Memorial Medical Center, hereinafter referred to as
LBMMC, and Lessee:
Name
Mailing Address
Phone U
SUBSCRIBER/E UIPMENT LOCATION:
Name
Address
Phone (_}
This Agreement may be terminated by either party with thirty (30) days' written notice after the
equipment has been in place for ninety (90) days. In case payment is not made by the subscriber
or Lessee, or in case the hospital does not perforin its responsibilities, this Agreement may be
terminated without notice.
THE TERMS AND CONDITIONS ATTACHED ARE PART OF THIS AGREEMENT.
PLEASE READ BEFORE SIGNING. THE LAWS OF THE STATE OF CALIFORNIA ARE
APPLICABLE TO THIS AGREEMENT.
Subscriber
Lessee
Date
Long Beach Memorial Medical Center, Lifeline Program
Long Beach, California
By
Title
Date
Page 7 of 11
0l WAN 1168439 01
EXHIBIT "B"
TERMS AND CONDITIONS
LBMMC and Subscriber, for and in the consideration of the mutual covenants and agreements
hereinafter set forth, hereby contract and agree as follows:
LBMMC agrees to provide, install and maintain a Lifeline Monitoring system, including
necessary equipment at the Subscriber's address shown above, subject to the terms and
conditions of this Agreement. The Subscriber hereby acknowledges the responsibility
and obligation to provide at no expense to LBMMC, suitable electric and telephone
service and to provide proper machine space requirements for the equipment.
2. The Subscriber (or Lessee) agrees to pay the prorated costs for the first (1st) month's
service, and installation charge, upon the signing of the Agreement and agrees to pay
LBMMC a monthly charge of Thirty Three Dollars ($33.00). Monthly charges shall be
paid when billed.
3. The equipment installed will at all times remain the property of LBMMC. LBMMC may
supply new or reconditioned equipment at its sole option. In the event of default by
Subscriber, LBMMC shall have the right to repossess the equipment without demand or
notice and without any Court Order or other process of law.
4. LBMMC agrees that it will install the equipment and it will provide reasonable
maintenance of same, but only upon request of Subscriber. The maintenance will be
performed within a reasonable time after receipt of a request from the Subscriber, and
will be performed at the expense of LBMMC, except that any maintenance necessitated
by the negligence of the Subscriber, or by the negligence by anyone at the place of
installation of the equipment, will be performed at the sale expense of the Subscriber and
Subscriber agrees to promptly pay for such maintenance. LBMMC will provide
instructions on the use of the equipment Subscriber shall be responsible for replacing lost
or damaged PHS (Personal Help Button).
5. The Subscriber will provide at Subscriber's sole expense suitable electric and telephone
service to allow installation and for the operation of equipment, and will pay all of the
charges for such telephone and electric service, including taxes, if applicable. The
Subscriber will make no alterations or repairs to the equipment and will not move the
equipment without the written authorization of LBMMC.
6. The Subscriber is advised that if there is more than one (1) telephone in the residence
where the equipment is installed, that it would be to his/her advantage to have an RJ31 X
jack that will enable the Lifeline unit to obtain access to the phone line should any phone
in the house other than the one (1) Lifeline is attached to, be off the hook. LBMMC will
install the Lifeline unit upon request, even if the Subscriber does not wish to have a
special jack installed. However, as provided herein, LBMMC will not be responsible for
any equipment failure.
Page 8 of 1 I
0100710M 1/68439 01
EXHIBIT "B"
7. The Subscriber understands that the purpose of the equipment is to transmit to the
Response Center signals which may indicate the presence of an emergency at the location
of the equipment. The Response Center is Lifeline Central. The Lifeline Central
Monitoring Service Agreement must be signed separately and is attached to this packet.
8. The Subscriber acknowledges consent for any of the "Responders" or any law
enforcement or emergency medical personnel contacted by ERC personnel to enter the
Subscriber's residence at the address shown above, with force, if necessary, and relieves
and releases Responders, LBMMC, and any members, personnel or employees thereof
from any and all liability for injury or damages done to the premises in making such an
entry.
9. Subscriber will be liable and responsible for the payment of any expenses or costs
incurred by any person responding to a call from the ERC occasioned by an incoming
signal from the equipment. As an example: Subscriber will be responsible for the cost of
any ambulance services provided if dispatched to an incoming call.
10. LBMMC shall not be liable nor responsible for the failure of the equipment nor for the
failure of the equipment nor for the promptness, sufficiency or adequacy of the actions of
any response personnel which LBMMC may notify in the exercise of its discretion. The
Subscriber understands and acknowledges that the operation of the Voice Communicator
equipment bay be interrupted by radio, television or airplane noises and other outside
interferences. Subscribers using the voice communicator also understand and
acknowledge that the effectiveness of the voice communicator depends upon adequate
vocal projection by, and the hearing ability of, the Subscriber.
It. The Subscriber acknowledges that by entering into this Agreement that LBMMC is
undertaking to perform a service in the public interest at a minimal charge to the
Subscriber and that in view of the small charge being made for the equipment and
services to be provided by LBMMC hereunder, LBMMC cannot assume any liability or
responsibility for any damage, injury or death, which may be caused by any failure of the
equipment or any failure in the performance of any services hereunder, and the
Subscriber hereby agrees to indemnify, hold harmless and defend LBMMC and its
officers, employees, members, trustees, agents and servants against all claims, suits,
losses, damages and costs, including, but not limited to, court costs, attorney's fees, on
account of any injury or damage, including death, incurred by Subscribers or anyone else
as a result of the failure of any equipment or any failure in the performance of service
under this Agreement.
12. This Agreement shall constitute the entire agreement between Subscriber and LBMMC
with respect to the equipment regardless of inconsistent or additional terms and
conditions in Subscriber's purchase order or other documents submitted by Subscriber to
LBMMC.
Page 9 of 11
01007/0001/68439.01
EXHIBIT "B"
13. This Agreement is not assignable by Subscriber, but may be assigned by LBMMC. Any
attempt by Subscriber to transfer by any means of the rights, duties or obligations of this
Agreement shall be of no force or effect.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement this day and year
first above written.
Signature of Subscriber
Page 10 of 11
1) 1007l000116843Q-01
EXHIBIT "C"
SUBSCRIBER INFORMATION CHANT GE FORM
Page It of 11
01((}71000 1168434 01
PHILIPS
Lifeline Philips Lifeline Care Plan Agreement Page 1 oft
❑ This Is a PARTIAL Install
❑ This Is a FOLLOW-UP Install
Program Name
Program Phone Number
Installation Date
Program Code Household Phone # Model Type
( )
Unit #
Accessories
Salutation
Subscriber Last Name
First Name
Middle
Suffix
Preferred Name Last Name Sounds Like
Language Need?
❑ Spanish ❑ Other
Gender Date Of Birth
❑ Male ❑ Female
Household Information.
Emergency Phone Numbers (Do not list 911 or 8GG Ws)
Residential Street Address/Apt.#
CENTRAL DISPATCH ( )
POLICE ( }
City
State Zip Code
FIRE ( )
Towns hlplMunlcipality
County
AMBULANCE ❑ Chick H Private
ALTERNATE AMBULANCJE
Household Hidden Key Location
Directions To Home (Must Be Provided It PO Box Listed)PIE31Healthcare
tional Services
Directives
vit Alarm Service
ialInstructions
Funded
e Smoke Detector
Drug Allergies
Medical Conditions and/or Diseases;
Household Warning
Responder
One
Res onder Two.
_R�f' 0nlier Three.
Name (First/Last)
Name (FirstlLast)
Name (First/Last)
Language Need?
❑ Spanish ❑ Other
Language Need?
❑ Spanish ❑ Other
Language Need?
❑ Spanish ❑ Other
Street Address
Street Address
Street Address
City, State, Zip Code
City, State, Zip Code
City, State, Zip Code
Family Relation ❑ Have Key
❑ Family Caregiver
❑ Notify
❑ Reminder Contact
Family Relation ❑ Have Key
❑ Family Caregiver
❑ Notify
❑ Reminder Contact
Family Relation ❑ Have Key
❑ Family Caregiver
❑ Notify
❑ Reminder Contact
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
{ )
All information contained in this report is considered private and confidential, and is intended solely for use by authorized Philips Lifeline representatives.
L 0930338 Rev. 05 (LMS)
p111ups
Lifeline Philips Lifeline Care Plan Agreement Page 2of2
Program Code
Subscriber Last Name
First Name
Household Phone #
Program Name
Notify'
Notify
Name (First/Last)
Family Relation
Name (First/Last)
Family Relation
❑ Family Caregiver
❑ Family Caregiver
Reminder Contact
0 Reminder Contact
Phone ❑ Home ❑ Werk ❑ Cell
Phone ❑ Home ❑ Work ❑ Call
Phone ❑ Home ❑ Work ❑ Cell
Phone ❑ Home ❑ Work ❑ Cell
Primary Physician
Third Party
Notify.
Name (First/Last)
Name (First/Last)
Fax Number
Phone
Name (First/Last)
Fax Number
Preferred Hospital~ -
Referral Source
Hospital Name
Name (First/Last)
Phone
City, State
Phone (REQUIRED)
Organization/Agency Name
Position/Title
❑ Multiple Subscriber Household
Street Address City, State, Zip Code
(You must complete a separate Care Plan Agreement for each
Subscriber)
Coupon
Name of Additional Subscriber
Code
A B C
Subscriber Notes
Pa er.Information
First Name (it applicable organization name)
Last Name
Home Phone #
( }
Street Address
Work phone #
( }
City
State
Zip Code
Social Security Number
Medicaid Number
Monthly Fee(s)
One Time Fee(s)
Payment Frequency
Payment Method
Monitoring Service $
Enrollment Fee $
❑ Monthly
❑ Invoice
Inactivity Service $
$
❑ Quarterly
❑ Credit Card
$
Shipping & Handling $
❑ Yearly
❑ Debit Card
Card Type
Name (as it appears on Card) Card
Number
Expiration Dale
❑ Visa
❑ Master Card
❑ American Express
❑ Discover
For Program Use Only (Not to be Entered by Data Entry)
Signature Of Subscriber Date
Signature Of Payer (If Different) Dale
All information contained in this report is considered private and confidential, and is intended solely for use by authorized Philips Lifeline representatives.
PN0930338 Rev. 05 (LMS)
LIFELINE COPY