10 Colo. Code Regs. § 2505-10-8.7519

Current through Register Vol. 47, No. 8, April 25, 2024

Section 10 CCR 2505-10-8.7519 - Electronic Monitoring

8.7519.AElectronic Monitoring Eligibility

1. Electronic Monitoring is a covered benefit available to Members enrolled in one of the following HCBS waivers:

a. Brain Injury Waiver

b. Community Mental Health Supports Waiver

c. Complementary and Integrative Health Waiver

d. Elderly, Blind, and Disabled Waiver

8.7519.BElectronic Monitoring Definitions

1. Electronic monitoring services means electronic equipment, or adaptations, that are related to an eligible person's disability and/or that enable the Member to remain at home, and includes the installation, purchase, or rental of electronic monitoring devices which:

a. Enable the Member to secure help in the event of an emergency;

b. May be used to provide reminders to the Member of medical appointments, treatments, or medication schedules;

c. Are required because of the Member's illness, impairment or disability as identified and documented in the Person-Centered Support Plan; and

d. Are essential to prevent institutionalization of the Member.

2. Electronic monitoring provider means a Provider Agency as defined in Section 8.7400 and Section 25.5-6-303. C.R.S., that has met the Provider Agency requirements for electronic monitoring services specified in Section 8.7519.E.

3. Medication Reminders means devices, controls, or appliances that remind or signal the participant to take actions related to medications

4. Personal Emergency Response System (PERS) means ongoing remote monitoring through a device designed to signal trained alarm monitoring personnel in an emergency situation.

8.7519.CElectronic Monitoring Inclusions

1. Electronic monitoring services shall include personal emergency response systems, medication reminder systems, or other devices which comply with the definition above and are not included in the non-benefit items below at Section 8.7519.D.

8.7519.DElectronic Monitoring Exclusions and Limitations

1. Electronic Monitoring services shall be authorized only for Members who live alone or who are alone for significant parts of the day, or whose only companion for significant parts of the day is too impaired to assist in an emergency, and who would otherwise require extensive supervision.

2. Electronic Monitoring services shall be authorized only for Members who have the physical and mental capacity to utilize the particular system requested for that Member.

3. Electronic Monitoring services shall not be authorized as an HCBS benefit if the service or device is available as a state plan Medicaid benefit.

4. The following are not benefits of electronic monitoring services:

a. Augmentative communication devices and communication boards;

b. Hearing aids and accessories;

c. Phonic ears;

d. Environmental control units, unless required for the medical safety of a Member living alone unattended; or as part of Remote Supports;

e. Computers and computer software unrelated to the provision of Remote Supports;

f. Wheelchair lifts for automobiles or vans

g. Exercise equipment, such as exercise cycles; or

h. Hot tubs, Jacuzzis, or similar items.

8.7519.EElectronic Monitoring Provider Agency Requirements

1. Electronic monitoring providers shall conform to the following standards for electronic monitoring services:

a. All equipment, materials or appliances used as part of the electronic monitoring service shall carry a UL (Underwriter's Laboratory) number or an equivalent standard. All telecommunications equipment shall be Federal Communications Commission (FCC) registered.

b. All equipment, materials or appliances shall be installed by properly trained individuals, and the installer and/or provider of electronic monitoring shall train the Member in the use of the device.

c. All equipment, materials or appliances shall be tested for proper functioning at the time of installation, and at periodic intervals thereafter, and be maintained based on the manufacturer's recommendations. Any malfunction shall be promptly repaired, and equipment shall be replaced when necessary, including buttons and batteries.

d. All telephone calls generated by monitoring equipment shall be toll-free, and all Members shall be allowed to run unrestricted tests on their equipment.

e. Electronic monitoring providers shall send written information to each Member's Case Manager about the system, how it works, and how it will be maintained.

8.7519.FElectronic Monitoring Reimbursement

1. Payment for Electronic Monitoring services shall be the lower of the billed charges or the prior authorized amount.

2. For Electronic Monitoring the unit of reimbursement shall be one unit per service for non-recurring services, or one unit per month for services recurring monthly.

3. No reimbursement is available under this Section for Electronic Monitoring in Provider-owned, -Controlled, or Congregate Facilities.

10 CCR 2505-10-8.7519

47 CR 03, February 10, 2024, effective 3/16/2024