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HomeMy WebLinkAboutAGENDA REPORT 1991 0306 CC REG ITEM 08CPAUL W. LAWRASON JR. Mayor BERNARDO M. PEREZ Mayor Pro Tem SCOTT MONTGOMERY Councilmember JOHN E. WOZNIAK Councilmember LILLIAN KELLERMAN City Clerk ME FROM: DATE: MOORPARK G;, :cundl Mooling of ACTON: [n�mzl7,li M E M O R A N D U M The Honorable City Council ITEM S. C . STEVEN KUENY City Manager CHERYL J.KANE City Attorney PATRICK RICHARDS, A.I.C.P. Director of Community Development JOHN F. KNIPE City Engineer JOHN V. GILLESPIE Chief of Police RICHARD T. HARE City Treasurer Donald P. Reynolds, Jr., Management Analyst February 25, 1991 P�-� SUBJECT: Consider City Administration of the CDBG Senior Lifeline Program and Expenditure of City Funds to Support Program The following report will review the development of the Moorpark Senior Lifeline program, as sponsored by the Community Development Block Grant, ($5,480 of 1989/90 CDBG funds). Staff proposes that the City Council consider City administration of this program, (in place of the Rotary Club of Moorpark). In order to purchase and install ten devices, staff is also proposing an appropriation of $1,200 to pay for incidental costs and to compensate for the increase in the price of the device. Background During the 1989/90 CDBG public hearings, a representative from the Rotary Club of Moorpark and the Simi Valley Senior Citizen's Lifeline program (Dr. Wayne Templeton) presented the Senior Lifeline program to the Council for consideration of beginning a program for Moorpark residents. Lifeline devices are telecommunication systems which allow a person who is unable to reach a telephone in times of an emergency, to place a call with a remote control to the nearest emergency health care facility in the vicinity. The device provides an important health security system for those persons who may find themselves alone during an emergency, and cannot call for help. Simi Valley CDBG funds have sponsored the majority of the Simi program, (108 devices), in conjunction with emergency support services from Simi Adventist Hospital (a complete and detailed description of this program is provided for the Council in Attachment "A"). The Council appropriated $5,480 of 1988/89 CDBG funds for the purchase of ten devices and authorized Rotary to administer the program. A CDBG proposal was presented to the County of Ventura 799 Moorpark Avenue Moorpark, California 93021 (805) 529 -6864 which reflects this action. In order to administer the program, a system has to be developed to include the following; procure devices, select participants, receive support documentation regarding each beneficiary, execute an agreement between each applicant and the administrative body, install devices in people's homes, monitor the performance of the device, and make repairs as needed. Many of the support functions are performed by volunteer services which are coordinated by Dr. Templeton. In July of 1990, staff learned that the Rotary Club could not make • long term commitment to the program as originally proposed. As • result, staff has been working with the Moorpark Senior Citizen's Club and Dr. Templeton in order to establish an administrative system for the Moorpark program. Staff and Dr. Templeton have met with representatives of the Moorpark Senior Club to discuss the potential for the Senior's involvement in this program. It was determined that the Seniors could provide volunteer services and outreach assistance, but that the administration of the program and the funds required to install and maintain the devices would have to be provided by the City. The Senior Club has endorsed the City's efforts, as shown in their letter of support, Attachment "B." Staff determined that creating an administration with Rotary or the Seniors, would be a duplication of City administration which already exists, and add additional complexities to a relatively simple CDBG program. Discussion Dr. Templeton expressed a willingness to accept responsibility for coordinating volunteers to install and monitor the ten additional Lifeline devices provided by the Moorpark CDBG program. Moorpark devices would be included in the existing Simi Valley program, and no formal arrangements would be required between the City and the Hospital. With this support, the City's role would consist of a small addition to existing administrative programs, (such as eligibility reviews for mobile home rent subsidies, and the assessment district rebate program). Proposed Role of City The role of the City would be limited to coordinating the placement of devices, establishing an agreement with each beneficiary (an example is provided in Attachment "C "), and requesting that the devices be installed. The City would pay for the maintenance of the devices, and incidental expenses for installation, but volunteers would provide these services through Dr. Templeton. Placement of a device involves an eligibility review of each applicant. Only Moorpark residents will be eligible for the service. Seniors are considered as "special clientele" according the CDBG regulations, therefore, eligibility reviews will only 2 serve to determine which applicant can afford to lease a device directly from the Hospital, ($15 per month), and which applicants would qualify for a donated device from the City, (CDBG funds should not be considered for leasing devices, because this will create "program income," and add to the cost of administering a program which is already available to Moorpark residents). Staff is currently receiving requests for the devices, and these requests may indicate that there is a greater need for Lifeline than the current CDBG appropriation will provide. Eligibility reviews will also help to establish which applicant has the greatest need, in case more than ten applications are received that qualify for a free device. Once eligibility has been determined, follow up information is requested from the applicant which describes health needs, and local friends and relatives who can act as "responders," (samples of these forms are included at the end of Attachment "A"). When a situation occurs where the Hospital determines that an emergency may exist, a "responder" in the neighborhood is asked to check on the applicant before emergency personnel are deployed to the site. The final step is to execute the "lease agreement." Staff will make modifications to the example provided in Attachment "C," and create a non - financial agreement between the City and beneficiary. This arrangement will help to protect the City's liability, and clarify the responsibilities between recipients, the manufacturer of the devices and the City. Once the agreement is executed, the device is installed by a trained volunteer. Once installed, the City will monitor the program pursuant to CDBG regulations, receive additional requests for the device and establish a waiting list if needed. Once a device becomes available, the placement procedure is re- initiated. Devices have a two year warranty, and an expected life of ten years. Financial Considerations Providing additional funds for minor expenses will need to be considered by Council before initiating the Lifeline program. Since July, 1990, improvements to the device increased the cost to approximately $610 each. The cost of ten devices will exceed Council's original appropriation of $5,480 by about $1,000 (including sales tax, but not including any small additional expenses such as delivery or shipping). Although the installer works for free, the Simi Valley program donates $5 per installation to pay for gasoline and incidental expenses. This would add $50 dollars to the initial cost of the program for an approximate total cost of $6,516. Maintenance of the devices is minimal, and would not require City support for two years. Eventually, based on the history of the Simi Valley program, the City could spend between $150 and $200 per year repairing devices. Eight devices could be purchased without an additional expense to the City, (for a total 3 approximate cost of $5,225). Recommendation: That the City Council: 1) Authorize staff to administer the Senior Lifeline program based on a similar criteria to the Simi Valley program as presented in Attachment "A," and make a minor modification to the 1989 CDBG proposal which exchanges the City for the Rotary Club, as the administrative body; 2) Authorize staff to prepare an agreement for project beneficiaries; 3) Appropriate funds to support the program from the Social Services Account, (01.117.642), not to exceed $1,200, (to pay for costs above the original CDBG appropriation to purchase ten devices, and to pay for incidental expenses related to installation for the balance of 1990/91 fiscal year). Attachments: A) Description of the Current Lifeline Program in Simi Valley, Including Related Various Forms B) Letter of Endorsement from the Moorpark Senior Club C) Sample "Lease Agreement" 4 ATTACHMENT A SIMI VALLEY LIFELINE PROGRAM TABLE OF CONTENTS SECTION A: ORGANIZATION Names, addresses and phone numbers of the Lifeline Program's staff members. SECTION B: HISTORY Chronological history of the Simi Valley Lifeline Program. SECTION C: EMERGENCY ROOM NURSES' INSTRUCTIONS Instructions for the emergency room nurses. SECTION D: TECHNICIANS' HANDBOOK Installing a home unit, pick up or replace a home unit, cleaning home unit, evaluating problems by telephone, and general problems and possible solutions, etc. SECTION E: INSTALLATION GUIDE AND CHECKLIST Check sheet with step by step instructions for installing home units. SECTION F: MONITORS' INSTRUCTIONS How to make a home unit check. SECTION G: APPLICATION PROCEDURE Step by Step instr,.:ct ions to complete the necessary paperwork from initial applicat,on to installation. ` Application forms are at the end of Section "G." t Hospital Staff: Director: Timothy R. Patten Assistants: Yolanda Hernandez Sherri Dart City Staff: SIMI VALLEY ADVENTIST HOSPITAL AND CITY OF S114I VALLEY, CA LIFELINE PROGRAM SECTICIN A ORGANIZATION 805- 527 -2462 X7435 805 - 527 - 2462 X7276 Senior Services Coordinator: Judith Collins 805- 526 -9237 Lifeline Systems, Inc Simi Valley Code Number CA76 1 -800- 451 -0525 Volunteer Staff: Director: Wayne Templeton 805- 527 -2481 Technicians: Charles Petty Sr. 805- 526 -7823 Martin Morocco 805 - 527 -3878 Jim Coleman 805 - 526 -3289 Alfred Bersbach 805 - 523 -7341 Subscriber Coordinator: Claudell Spoonemore 805 -526 -2376 Subscriber Monitors: r Pauline Naylor Bennie Brown June Nason Dr'CapFS�'qQ/GN lz _ Subscriber Helpers: Dott -ie- Bowling -- Orma Herren Revised: March 29, 1990 Senior Center 3900 Avenida Simi Simi Valley, CA 93063 One Arsenal Marketplace Watertown, Mass. 02172 545 Mark Dr., SV, CA 93065 PO Box 1553 SV, 93062 (4908 Leeds) 3192 N.Divernon Ave., SV, CA 93063 891 Anson, SV, CA 93065 8305 Fruitvale, Moorpark, CA 93021 2190 Magnolia, SV, CA 93065 805 - 526 -1626 1687 Deodora, SV, CA 93065 805- 581 -4509 3177 N. Peoria, SV, CA 93063 805 - 527 -1587 1360 Sawyer, SV, CA 93065. yv' - J'a�_1/565 X385- s�,* j 54; e--4 q 3oG3 805 - 527 - 4365 -- 4491 - Hempstead;- --SV; CA793063 805 -583 -5285 49.6 Alamo, SV, CA 93063 SIMI VALLEY ADVENTIST HOSPITAL AND CITY OF SIMI VALLEY, CA LIcELINE PROGRAM SECTION B HISTORY Revised: March 28, 1990 Lifeline is a community -based program designed to care for elderly or disabled people who may be living alone or who spend periods of time alone and are at risk. 'It consists of the following: a. A Personal Help Button is a small transmitter that is worn on a person. When help is needed, a press of the button sends a call to the hospital through the Home Communicator. b. A Home Communicator is a small unit connected C to the telephone line. It picks up the signal from the Personal Help Button and calls for help to the hospital Emergencv Response Center. C. An Emergencv Response Center (ERC) is a large unit located at the hospital that receives the Help Needed call from the Home Communicator. When a Help Needed signal is received at the ERC, the following steps occur: a. The Home Communicator's unit number and HELP NEEDED appears on the ERC screen and tape. An audible alarm warns the Trained Hospital Personnel. b. Trained Hospital Personnel (emergency room nurses) attempt to call the home. If there is no answer, they call a Responder. C. A Responder (usually a relative or friend) who lives nearby and has access to the home is sent to check on the person. d. Communications are established, if needed, Cbetween the Responder and the Trained Hospital Personnel. Regardless, what ever action to be SIMI VALLEY LIFELINE PROGRAM - Revised: March 28, 1990 History - Continued Section B Page 2 taken is then determined and accomplished by the responder. This, basically, is how Lifeline works. It provides security for those who are subscribers and peace of mind to their families. It can save considerable money by allowing earlier release from the hospital. For example, some patients could be released earlier, provided there was constant supervision and care at home, but the cost of such supervision and care would be a hardship. Lifeline can provide this supervision, and care would be close by, thereby Providing independence from the costly services. This 24 hour care is an excellent program for Simi Valley. By 1990, the Lifeline Program in Simi Valley consisted of 100 Home Communicator Units connected through phone lines to the Simi Valley Adventist Hospital. The nurses in the Emergency Room monitor each one of these units through the Emergency Response Center Unit. They are the trained personnel who provide the expertise that makes the program successful. In addition, the program in Simi Valley has many volunteers. Some call the subscribers on a monthly basis to test the home units, others install and repair the home units and some help coordinate the program. These services help free the hospital staff for other responsibilities. It keeps the cost to the subscribers at a minimum. The Simi Valley Lifeline Program was started in 1983 by Bob Stotz who was responsible for the health services at the Adventist Hospital. The Emergency Response Center Unit (over $8,000) was purchased for the hospital by the Hospital's Volunteer Guild. Twenty home units were purchased, some by the hospital and some donated by such civic service organizations as the Simi Valley Womens' Club, Rancho Simi Rotary Club, Simi Valley American Association of Retired Persons and the FiLlmore Trinity Church. About this same time, the Simi Valley Council on Aging was looking for some way to provide security for older persons who were in need. Katherine Flock called attention to this new Lifeline Program that was just starting and suggested that it could be a solution. Wayne Templeton, who was then chairperson of the Council on Aging (COA), with the help of the City Council and many others, managed to obtain 77 units in the next three years through the Community Development Block Grant monies of the federal government. These units were to be used for the needy who qualified as low income persons and could not afford the rental cost of the home SIMI VALLEY LIFELINE PROGRAM - Revised: March 28, 1990 l History - Continued Section B Page 3 units. The COA has lent great support to the Lifeline Program through the years. Lionel Flock, who was an early volunteer in the program, installed almost all of the earlier units. By the end of 1988 all the COA units were all in use. Because of this demonstrated need, the Simi Valley City Council, in October 1988, authorized an additional 13 units to be purchased through the Community Development Block Grant Program. The Simi Valley Adventist Hospital, anticipating reimbursement, ordered two more units. By purchasing 15 units, the hospital qualified for the Lifeline October Incentive Program and received two additional free units. With these 17 units, the total in the program grew to 117. Application was made early in 1990 by the Council on Aging for 20 additional units to be purchased again through the Community Development Block Grant Funds. In anticipatation of the time when no longer will there be federal monies available for such projects, the Simi Valley Lifeline Program staff and the Simi Valley Council on Aging (specifically, Mr. Cliff Snowden and the Board of Directors) have developed a program to meet this continuing community need. The Simi Valley Council on Aging's major function is to support the-Meals on Wheels Program. This program is and will be its first priority. In addition, it has assumed Lifeline as a second and subservient program. The major direction of this new responsibility is in three areas as follows: (1) Volunteer Help. There is a continual need for volunteers to check the home units on a monthly basis. Technicians are needed to install the units and to investigate problems in the field. As observed in the attached Lifeline Organizational Chart, this major task has been completed. The Council on Aging continues to provide superior volunteers. Currently, there are over 12 who have specific responsibilities to keep the program running smoothly. (2) New and Replacement Equipment Except as granted through Federal monies, there had been no provisions for Purchasing new units as the need escalates; nor had there been provisions to replace the units as they become old and obsolete. Now, the Council on Aging has encompassed The Lifeline Program in its fund raising activities. SIMI VAL=Y LIFELINE PROGRAM - Revised: March 28, 1990 History - Continued Section B Page 4 Monies directed to a Discretionary Account which are nct needed for Meals on Wheels or Lifeline can be, at the discretion of the COA, set aside for new units or deposited into a replacement account. This major task is well on it way to being solved. (3) Equipment Repairs. At the discretion of the Council on Aging, monies in the Lifeline Account may be donated to the hospital to help pay for the expenses of maintaining and repairing the COA Home Units. Money from the Lifeline and Discretionary Funds are currently being used to repair the COA Units. This major task is also well on its way to being solved. Persons, other than those named above or those on the current Organizational Chart, who have been instrumental in serving the Lifeline Program are: Carolyn Agee, Jerry Albritton, Robin Shadduck, Mary Allred, Dorothea Smith and Michelle Bietz all of the hospital staff; and these retired program volunteers: Dorothy Serene and Marjorie Budecki. SIMI VALLEY ADVENTIST HOSPITAL AND CITY OF SIMI VALLEY, CA LIFELINE PROGRAM SECTION C EMERGENCY NURSES' INSTRUCTIONS September 25, 1989 A. GENERAL: The Emergency Room Nurses are the heart of the Lifeline Program. They are the ones who must deal with the subscribers on a daily basis. Many times there are false alarms but the nurses handle these as well as the real emergencies with efficiency and compassion. The subscribers, and especially all of us who work in the program, really appreciate the dedicated work of our Emergency Room Nurses. B. OPERATING INSTRUCTIONS: When an emergency signal (HELP NEEDED or INACTIVITY ALARM) is received at the Emergency Response Center (ERC), determine if the subscriber has a STANDARD or a VOICE home unit. All voice units will have a red dot Placed on the upper ri hone number. ht hand corner of the Subscriber Information Card just under the Proceed with the following instructions: 1. Push the CLEAR button on the ERC front panel. Pull the Subscriber Information Card corresponding to the Subscriber Number appearing on the ERC display board. 2. Identify the subscriber's phone number, and call the home immediately. It is possible that someone could have called subscriber between emergency signal and your call. Keep trying. 3. STANDARD or VOICE unit procedures: a) If the Subscriber's Home Unit is a standard unit, the subscriber will answer the phone if at all possible. * ** If the problem can be resolved with Out further action required, SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 I Emergency Nurses' Instructions - Continued \. Section C Page: 2 have the subscriber reset the home unit (Press the RESET [yellow] button until it stops blinking). After the HOME UNIT RESET has been received on the ERC, press the CLEAR button on the front panel. * ** If help is needed, whether you get an answer or not, proceed with the standard emergency protocol (call responders, or call 911, ambulance etc.). * ** If everythin subscriber press button. * ** Document the back side of the Information Card g is OK, have the RESET (yellow) information on the Responder's b) If the Subscriber's Home Unit is a voice unit, there will be a brief "ringing ". The voice home unit will automatically answer with a short tone. You may now talk directly with the subscriber. The subscriber may now talk without going to the phone if he \she is in direct visual range of the home unit. * ** Speaking slowly, clearly, and in a normal tone of voice, try to maintain contact with the subscriber. * ** If you can, verify that the message has been received and ask if the subscriber can tell you what happened in the home. * ** Regardless of whether or not you can maintain contact, reassure the subscriber that help is on the way and that you will now arrange for that help. * ** If help is needed, hang up and proceed with the standard emergency protocol (call the responders, call 911, etc.). SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Emergency Nurses' Instructions - Continued Section C Page: 3 4. If help has not arrived and \or the RESET (yellow) button has not been pushed within 30 minutes after you received the HELP NEEDED or INACTIVITY ALARM, you will receive a HELP STILL NEEDED message. Follow -up may be necessary at this point. 5. In a potential emergency, the HOME UNIT RESET indicates that the responder has arrived. a) Generally, the responder will take any action that is required, i.e. call 911, call ambulance, provide care help, etc. b) If the Responder need specific help, he may call the emergency room nurses. c) After the problem is taken care of, the responder should call the emergency room so the incident can be documented. d) In any event, the subscriber's information card should have the completed documentation. C. LOW BATTERY SIGNALS: Following are the Low Battery signals that may be received at the ERS. 1. LOW BATTERY - HOME UNIT: This is a non- life- threatening situation. All Lifeline Units will work for an additional 8 hours. 2. LOW BATTERY - BUTTON: This also is a non- life- threatening situation. a. Since neither of the above are life threatening situations, it is not necessary to call anyone between the hours of 10 PM and 6 AM. NOTE: But, be sure to call one of the following immediately after 6 AM. b. During office hours, call the Lifeline Staff: SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Emergency Nurses' Instructions - Continued Section C Page: 4 * ** Jerry Albritton 527 -2462 X276 * ** Yolanda Hernandez " It X436 C. At other times call the following in this order until you find someone at home: * ** Wayne Templeton 527 -2481 * ** Jim Coleman 526 -3289 * ** Charles Petty 526 -7823 * ** Martin Morocco 527 -3878 * ** Alfred Bersback 523 -7341 D. HOME UNIT TESTS: Monthly home unit tests are conducted by the volunteer Monitors. They are most appreciative of the tremendous work that the emergency nurses perform and will do everything possible not to interfere. The Technician, who installs and repairs the home units will occasionally call for a home unit check. Following is the procedure that will be used for these checks: 1. For the STANDARD units the Technician will call and ask if it is all right to conduct a test and that he will call back after it is completed to see if everything is OK. 2. For the VOICE units the following procedure will be used: a) The Technician will call and ask if it is alright to conduct a Voice Unit check and will request the Nurse to call back as soon as the HELP NEEDED signal arrives on the ERC. b) When the Nurse returns the call and it is determined that the unit is working OK, the Technician will ask the Nurse to call back only if the HOME UNIT RESET signal does not appear on the ERC. E. HOME UNIT BREAKDOWN: 1. If it seems that the home unit is not functioning properly, Call any one of the SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Emergency Nurses, Instructions - Continued Section C Page: 5 technicians listed in C.2-c) above. If none of them can be reached, call Jerry or Yolanda (X276 or X436) . SIMMI VALLEY ADVENTIST HOSPITAL AND CITY OF SIMI VALLEY, CA LIFELINE PROGRAM SECTION D TECHNICIANS' HANDBOOK Revised: September 25, 1989 A. GENERAL: It is the responsibility of the technicians to install the lifeline units and to investigate any problems that the subscriber has with the unit itself. In addition to helping the subscriber understand and work the unit, this responsibility also includes such things as checking on malfunctions, repairing or replacing units, changing batteries, and other maintenance chores. B. INSTALLING A HOME UNIT: 1. The unit will be assigned to the subscriber by the Lifeline Office Staff. Assignments will be made in this order: a) the unit that is being maintained at the technician's residence, b) a unit that is being maintained at the hospital office, and c) a unit that is in storage. _ 2. If a unit is assigned that has been in storage, maintain it at home for a day or two to charge the battery and insure that it is working properly. 3. Pick up the installation packet that has been prepared by the Lifeline Office Staff. The information packet contains the following: a. Subscriber Information Card b. Installation Guide and Checklist C. Important Notice to Lifeline Subscribers d. Lifeline Subscriber Lease Form e. Instructions For Using Lifeline SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Technician's Handbook - Continued Section D Page: 2 f. Coupon Book (For SVAH Units) 4. At sometime before the installation, make sure the Subscriber Information Card is completed and filed, in numerical sequence, at the Emergency Response Center (ERC) located in the emergency room at the main hospital. 5. Follow and complete the Installation Guide and Checklist as you proceed with the installation. C. PICK UP OR REPLACE HOME UNIT: 1. Pick up an empty carton or exchange unit (if exchanging) from the Lifeline Office. 2. a) If picking up home unit, get the Subscribers Information Card from the ERC and give it to the Lifeline Office Staff for closing the subscriber's records. b) If exchanging, make sure the unit number is changed on both the Subscriber Information Card in the ERC and the Master List at the Lifeline Office. 3. Make an appointment with the subscriber or person responsible for the subscriber's welfare. 4. To pick up the old unit follow these instructions: a) Unplug the J102 and place in the styrofoam container. b) Plug telephone directly to line. c) Place help call button in styrofoam container. SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Technician's Handbook - Continued Section D Page: 3 d) Place home unit in styrofoam container so that on /off switch is in hole and is off. e) Check phone before leaving to make sure it is working. f) Clean unit and help button before final storing. g) Put unit's name, number and condition information on the yellow paper located on the lid of the styrofoam container. 5. If replacing a unit, follow the installation instructions in the Installation Guide and Checklist. Instruct the subscriber in the use of the voice unit (if applicable). 6. If the replaced or picked up unit is not working properly, check it out at home or give it to the Volunteer Staff Coordinator who will arrange to have it repaired. 7. If the replaced or picked up unit is working properly, it should be cleaned and stored for future use. D. CLEANING HOME UNIT: 1. Rubbing alcohol seems to work well. A good non - abrasive disinfectant cleaner also does a good job. 2. It may be necessary to use a sharp object, such as a knife point, to clean the corners of the help button. Use caution not to scratch or damage it. 3. Use extreme care in cleaning the front of the home unit. The red and yellow buttons break very easily. E. EVALUATING PROBLEMS BY TELEPHONE: t SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Technician's Handbook - Continued Section D Page: 4 1. Can the subscriber get a dial tone from the unit phone? If no: a) Is the telephone plugged into the J201 jack properly? b) Are all the phones hung up properly? c) Have subscriber unplug the home unit and plug the telephone directly to the phone line: * ** If there is a dial tone then trouble is in the unit or the J201 plug. * ** If still no dial tone, trouble could be in the phone or the line. A home call will be necessary. 2. Trouble with the home unit: a) Pick up unit and replace on a flat hard surface (should beep). b) Check to see if hone unit cord is Plugged into the J201. c) Is the green power indicator light on? If not: * ** Place the home -away switch to home. * ** Check to see if the power transformer is plugged in securely. * ** Make sure the unit is on a hard flat surface and the white plunger switch on the bottom is fully depressed. * ** If green light is still off, a home visit will be necessary. SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Technician's Handbook - Continued Section D Page: 5 3. Trouble with the "Personal Help" button: a. If the red "Help" button does not light, flash and beep when the "Personal Help" button is fully depressed, check the antenna, it should be straight and not wadded up or cut off. (The newer units do not have an outside antenna.) b. Is there a possibility that the frequency could be different from that of the home unit? C. If still not working, the "Personal Help" button may need replacing. F. GENERAL PROBLEMS AND POSSIBLE SOLUTIONS: 1. Button not activating home unit: a. Check for correct coding of help button to home unit. b. If possible, locate another button of same frequency as home unit and see if it activates unit. NOTE: If you have a spare help button, the HC102E (or later) series home unit frequency can be changed by PROM - line. * ** If it does, order new help button. * ** If it doesn't, the unit needs repair. 2. Button has a short activating range or is intermittent: a. Check antenna - Should be extended straight. NOTE: Newer units have a built -in antenna. t b. Follow steps in lb above. SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 ( Technician's Handbook - Continued Section D Page: 6 3. No audio - Unit dead: a. Charge home unit for 24 hours. b. If the power is up, check the timer switch on older units and make sure it is on the 24 hour position. C. If it still does not work, unit needs to be repaired. 4. No message is sent to the ERC. a. Make sure there is a dial tone in the phone line: * ** If none, check for phones off hook, check J201 connection, plug phone directly into line plug. If still no dial tone, it could be in the phone or the line. * ** If there is, try a new J201. * ** If there still is, try another home unit. * ** If replacement solves the problem, send unit in for repairs. 5. Unit goes off by itself: a. Check for messages at ERC. If "Help Needed" is recorded or if subscriber says red light flashes: * ** Possible accidental; ring guard needed. * ** Check power outlet for tight connection. * ** Replace unit, if that solves SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 CTechnician's Handbook - Conti:uad Section D Page: 7 the problem, send unit in for repair. b. If ERC message is "Inactivity" or subscriber says that the yellow light flashes: * ** Possibility that unit was not reset. Reinforce the importance of resetting unit both morning and evening. * ** If this continues to be a problem, put home -away switch on away. (Remember, the inactivity feature is lost when switch is on away.) * ** Replace or check at another location. * ** If replacement works, send unit in for repair. C. If "no message" and subscriber says green light keeps flashing: * ** Check phone cord connection which should be tight. * ** Replace J -201. * ** Replace unit. If it persists, it may be in the phone line or connection box. * ** If replacement of unit solves the problem, send unit in for repair. 6• "Low Battery" Messages: a) Check the transformer to AC power outlet, it should be ticrht and making good contact. C SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Technician's Handbook - Continued Section D Page: 8 b) Check for interruption in electrical service, i.e power failure, switch on the circuit, unit unplugged, etc. c) Replace battery. If this does not solve problem, replace unit. 7. Check all batteries before discarding G. PROM LINE - SUBSCRIBER UNIT INTERNAL CHANGES: SIMI VALLEY ADVENTIST HOSPITAL AND CITY OF SIMI VALLEY, CA C LIFELINE PROGRAM SECTION E INSTALLATION GUIDE AND CHECKLIST Revised: September 25, '_989 Name: Phone Address ZIP Subscriber No. Communicator Serial No. Frequency A. HELP BUTTON FREQUENCY CHECK: 1. Make certain there is no home communicator unit with the same frequency located in the near vicinity. If SO., it is necessary to change to another unit that has a different frequency. (Use "Frequency Check By Map Grid" spreadsheet. B. SUBSCRIBER INFORMATION CARD: 1. Make certain this card is completed and filed at the ERC (Emergency Response Center - in hospital's emergency room) 2. Make sure the unit number is noted on all documents including the Subscriber Information Card C. INSTALLATION APPOINTMENT: , 1. Call Subscriber and make an appointment at both your convenience. Try to have a relative or responder present at the installation as it helps reinforce the instructions D. TELEPHONE SERVICE REQUIREMENTS: 1. Number of telephones in home? Desk? Wall? Cordless? — 2. Type of Service. Private Line Party Line ** (The Home Communicator Unit can not be installed on a party line without permission of the phone company.) 3. Location. Local 1 -Dial 1 -Area code -Dial Access Code SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Installation Guide and Checklist - Continued Section E Page: 2 4. Type of telephone connection used for Home Communicator Unit. Modular cator plug} Four prong Hard wire (no 5. Telephone company service required: No service required Jack installation. RJ31X Other Install or relocate interior phone'line Other 6. Service order date. Completion date_ E. ELECTRICAL POWER REQUIREMENTS: 1. Standard 110 Volt outlet within four feet of unit Or, heavy duty extension cord (If using an extension cord secure the transformer to the cord plug with electrician's tape) 2. Wall outlet not controlled by a wall switch wall switch deactivated Or, F. PHYSICAL INSTALLATION AND TEST: 1. Room location of Home Communicator Unit 2. Location. Flat solid surface Voice unit: the microphone should-be elocatedeinabest Possible room and position, with low noise level 3. Type of attachment for Remote Help Button. Chain Velcro clip Wrist band Other 4. Verify timer setting switch to 24 hours 5. Plug transformer (screw down if volt electrical outlet Possible) into a 110 6. Turn HOME \AWAY switch to HOME 7. Power Indicator Lamp is on - illuminated green 8. Make certain Home Communicator Unit is not on a wall switch activated outlet 9. Preliminary Unit Check: a) Yellow light (RESET Button) either flashes and /or SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Installation Guide and Checklist. - Continued Section E Page: 3 Cbeeps once when Home Communicator Unit is lifted and reset on its solid surface b) On newer units, if the unit "boops" instead of "beeps" on the above test, the timer is on the 12 hour Position and needs to be changed to the 24 hour Position c) With the Home Communicator Unit not plugged into telephone jack, press the Personal HELP Button. A four second DEDAH will occur, then the green light will flash Lift the unit to reset. d) Before plugging in the unit telephone line, check the Personal HELP Button from the furthest likely distance to determine that it activates the Home Communicator Unit 10. Telephone and Subscriber Unit Jack Adapters: a) Telephone and Home Communicator telephone lines. If an RJ31X is used, the Home Communicator telephone is plugged directly into it and no J201 Jack Adapter is required b) If a J201 Jack Adapter is used, plug the Home Communicator Unit telephone line into the larger hole of the jack and the telephone line into the smaller hole of the jack 11. Plug J201 Jack Adapter into the telephone company modular telephone jack 12. Check to see that both Personal HELP Button and the Red Help Button (on the unit) activates the Home Communicator Unit. The red button will flash and beep for a few seconds. Then it will stop beeping and flashing to dial the hospital. During the dialing the red light is on steady. Lift the Home Communicator Unit from its solid surface before it completes the dialing. This will reset the unit and abort the call 13. Check to see if the RESET Button (yellow button) blinks and beeps once when pressed 14. Check to see if (yellow) RESET Button beeps or flashes once when the telephone hooked to the J201 plug is off the hook for a few seconds 15. Explain the ON /OFF switch underneath the responder unit. It is most important whenever the unit is unplugged from the 110 volt electrical source, this ON /OFF switch is OFF.,This can be accomplished easily SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Installation Guide and Checklist - Continued Section E Page: 4 by turning the unit upside down (NOTE: It is important to make sure the switch is in the hole Provided when the unit is stored in its styrofoam case) . G. SUBSCRIBER /RESPONDER INSTRUCTIONS: 1. Calling For Help: a) Explain how Subscriber calls for help by using the Personal HELP Button ; and by using the Home Communicator (red) Button b) Explain how the emergency nurses at the ERC will respond to the help.call; i.e., they will call back to see what the problem is. If there is no answer, they will call one of the Subscriber's responders who will then check to see what the problem is 2. RESET Button Functions After Call For Help: a) If subscriber has pressed "HELP" button for an emergency, he \she should not press.the yellow blinking "RESET" button. Explain that when the (flashing yellow) RESET Button is pushed it dials the ERC to tell them the Home Communicator Unit has been reset b) Explain how the Responder will push the (flashing yellow) RESET Button to let the ERC nurse know that he /she has arrived at the home. This is why it is important that the subscriber not reset the unit. The ERC nurse will call an offer any assistance that may be necessary c) Explain how the Home Communicator Unit Will beep - and the (yellow) RESET Button will stop flashing when the phone call to the ERC has been completed H. OTHER INSTRUCTIONS: 1. Installation Test with ERS: a) Call the ERC nurse (Phone Number 527 -2727) and tell her /him that you will be testing the just installed Home Communicator Unit. Give the unit number and say that you will call back as soon as you have completed the test to verify that everything is working satisfactorily. (Remember, you must have previously filed the Subscriber Information Card at the ERC) b) Have Subscriber press the Personal HELP Button and explain exactly what is happening ds the unit calls the � ERC SIMI VALLEY LIFELINE PRGGRAM - Revised: September 25, 1989 Installation Guide and Checklist - Continued Section E Page: 5 c) If installing a voice unit, ask the ERC nurse to call back so Subscriber can talk to ERC without using the phone. Remember, he /she must be in visual range of the unit when talking d) Have Subscriber push (yellow) RESET Button and again, explain what is happening f) Call emergency back after yellow button flashes to verify that everything is ok. 2. Explain the monthly Home Communicator Unit test phone call (Same as the procedure in 1 above) 3. Explain timer operations: a) Demonstrate the manual reset (yellow RESET Button) morning and evening procedure and explain why it is necessary b) Explain five minute time out warning - flashing and booping of (yellow) RESET Button ** * *Emphasize that the unit could well go off at night and wake them up. c) Explain HOME /AWAY switch 4. Explain instruction booklet I. LIFELINE VS CALLING 911: If a subscriber is capable and is able to easily reach the phone, there would be a quicker response to dial 911. However it is important that you assess the ability of the subscriber to determine that he \she really does have the capability to relay the information properly to the 911 operator before giving this advise. J. FINAL PROCEDURES: 1. Does Subscriber understand the use of Lifeline ? 2. Explain, have Subscriber sign, and you witness the form "IMPORTANT NOTICE TO LIFELINE SUBSCRIBERS" concerning possible installation of RJ31X jack if there are multiple phones in the house 3. Explain, have Subscriber sign, and you sign the "LIFELINE SUBSCRIBER LEASE FORM" 4. List the names and relationship of those present who can help the Subscriber understand the system: SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, l929 Installation Guide and Checklist - Continued Section E Page: 6 5. Signature of the Subscriber indicates that she /he has been instructed on how to use the Personal HELP Button and understands the timer f•snction: Signature of Subscriber Signature of Installer Date SIMI VALLEY ADVENTIST HOSPITAL { AND CITY OF SIMI VALLEY, CA LIFELINE PROGRAM SECTION F RR L MONITOR'S INSTRUCTIONS Revised: September 25, 1989 A. GENERAL: It is the responsibility of the monitors to check the Home Communicator Units on a monthly basis. This is accomplished from the Emergency Response Center in the hospital Emergency Room). At least two calls should be made to reach each subscriber. If a subscriber is not reached, two more efforts will be made, on different days, by or Substitute Monitors. B. HOW TO CHECK THE HOME COMMUNICATOR UNIT: 1. Allow plenty of rings. 2. Keep the subscriber on the phone until you are ready for the test to begin. 3. Remember to use plenty of tender, love and care. 4. Following are the key words to use in explaining the test: REGULAR UNITS• AFTER WE HANG UP PRESS THE HELP BUTTON YOU HAVE AROUND YOUR NECK THEN GO TO YOUR MACHINE AND WAIT FOR THE YELLOW LITE TO FLASH WHEN IT FLASHES, PUSH THAT YELLOW BUTTON UNTIL IT STOPS BLINKING VOICE UNITS: (The subscriber number has a V in front of it. i.e. V1892 AFTER WE HANG UP, GO TO YOUR LIFELINE MACHINE PRESS THE HELP BUTTON YOU HAVE AROUND YOUR NECK SI241 VALLEY LI?ELrTZZ '-PROGRAM - Revised: September 25, 1989 Monitor's Instructions - Continued Section: F Page 2 AS SOON AS I RECEIVE YOUR SIGNAL, I'LL CALL YOU BACK (As soon as the "HELP NEEDED" signal comes in, call the subscriber back. You will talk to the subscriber through the home unit.) HELLO, CAN YOU HEAR ME I CAN HEAR YOU, or YOU NEED TO TALK A LITTLE LOUDER IT IS WORKING OK, AS SOON AS WE HANG UP, PRESS THE- YELLOW BLINKING BUTTON UNTIL IT STOPS BLINKING (The home voice unit will hang up by itsself after you hang up your phone.) (After you hang up, continue the procedure just as if it was a regular home unit) 5. When the subscriber presses the help button the ERC (Emergency Response Center) unit will print HELP ::CEDED and the Subscriber Number. 6. When the subscriber presses the Reset Button (yellow button), the ERC unit will print HOME UNIT RESET and the Subscriber Number. 7. After the Home Unit Reset is printed, call the subscriber and tell him /her that the machine is working perfectly and you will call again next month. 8. This completes the home unit check. Record it on your telephone list as OK in the left hand margin C: WHAT CAN GO WRONG: 1. The HELP NEEDED signal is not received: a) Allow plenty of time. At least 10 minutes. Some subscribers have an extremely difficult time moving to the phone. SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Monitor's Instructions - Continued Section: F Page 3 b) Call back and repeat the process. 2. The HELP NEEDED signal came in but the HOME UNIT RESET has not: a) Again, allow plenty of time. b) Call back, ask if they forgot to press the yellow blinking light button. If they forgot, have them press it until it stops blinking after you hang up. c) If they say they did press it, ask if they can see the machine. (remember, don't let them get away from the phone). Ask if the yellow light is still blinking? If so, have them push the yellow button after you hang up. If it is not blinking, it will probably be necessary to repeat the whole process again. 3. The ERC unit displays CALL - NO MESSAGE: a) Look up to the tape and see if there is a message. If not, don't worry about it. 4. The subscriber needs some special help: a) Get the bare essence of the need and tell the subscriber that you will get help. b) Call the Hospital Staff (yoli or Tim 527 -2462, x7276) and explain the problem together with the subscriber's name, phone number, unit number, etc. c) Call Wayne (527 -2481) and summarize the same information. This will insure that something will be done as he will check each problem. If you use Wayne's answe-ing machine, make sure he calls you back. If he dosen't, it means that he did SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Monitor's Instructions - Continued Section: r Page d not get the call properly. D: FINISHING PROCEDURES: 1• When you have finished making your calls, please make sure you complete each of the following steps: a) All units that checked OK must be recorded on your MONITORS' MONTHLY HOME UNIT CHECK RECORD form. b) C� C � J� e_)_ "In h so_ All units that were not checked OK must be called to the Follow -up Monitor so they can be checked at a later date. EXCEPTION If you find out that the subscriber will be away for the month or in the hospital etc., make a note of it on your worksheet, but do not forward this unit number to the Follow -up Monito Date hand initia our worksheet. . Staple the tape /from the ERC to your telephone worksheet. Fold the worksheet vertically three folds and staple closed. Address the worksheet to Albritton, Development Marra /— w�L Put the stapled out -going box on front of the ERC. worksheet in the the counter just in 4)1.14 SIMI VALLEY ADVENTIST HOSPITAL lAND CITY OF SIMI VALLEY, CA LIFELINE PROGRAM SECTION G APPLICATION PROCEDURES Revised: September 25, 1989 A. GENERAL: Application forms generally are sent to the potential Lifeline Subscriber by the Senior Services Coordinator. They are returned to the same person who will check them carefully for eligibility. If the potential subscriber meets the low income requirement, the application is processed through the Lifeline Committee and a priority is determined based on health and time alone. It is then approved. If the subscriber does not meet the low income requirement or can not reach a high enough priority, he /she may request a hospital unit which is rented at $15 per month. In either case, the application is sent to the Lifeline Hospital Staff for further processing as follows: B. ADDITIONAL INFORMATION REQUEST: 1. Set up a tentative file folder for the applicant. 2. Send a questionnaire requesting the applicant's doctors, responders, health history, prescription drugs, etc. Send a copy of the letter to responders and a self addressed envelope with the questionnaire The questionnaire and enclosure letter are found in the IBM Computer in the WordPerfect 5 Program. The names and path are (a) questionnaire, C: \WP5 \LIFELINE \SUBINFOI.LTR and (b) enclosure letter, C: \WP5 \LIFELINE \SUBINF02.LTR. 3. File copies of the two SUBINFO with the application in the to the Pending File. 4. Follow up by phone call if the not received within a seven or period. letters together ztative folder in information is . ?ight day SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 ( Application Procedures - Continued Section G Page 2 C. SUBSCRIBER INFORMATION CARD: 1. From the information received, complete the Lifeline Subscriber Information Card. At this Point, do not assign a Subscriber Number. 2. Make two copies of the information card and file all three in the tentative folder. D. DOCTOR'S SUBSCRIBER INFORMATION LETTER: 1. Send the Doctor's Subscriber Information Letter to the doctors identified in the Subscriber Information Request Letter. The doctor's letter is located in the IBM Computer in the WordPerfect 5 Program. The name and path is: C: \WP5 \LIFELINE \PHYSICl.LTR 2. Enclose the following in the doctor's letter: a) A copy of the Subscriber Information Request Letter. b) A copy of the Instructions For Using Lifeline Brochure. E. RESPONDER'S INFORMATION LETTER: 1. Send the Responder's Information Letter to the responders identified in the Subscriber's Information Request Letter. The responders letter is located in the IBM Computer in the WordPerfect 5 Program. The name and path is: C \WP5 \LIFELINE \RESPONDI.LTR. 2. Enclose the following in the responder's letter: a) A completed Subscriber /Responder INFORMATION CARD. b) A copy of the Instructions For Using Lifeline. F. ACTIVE SUBSCRIBER FILE: SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Application Procedures - Continued Section G Page 3 G. l� H. 1. Make an active permaflex file folder for the subscriber. 2. Staple copi responders' Information Application Machine and folder. as of the doctors' letters, letters and the Subscriber's Request Letter to the subscriber's For Lifeline Home Communicator file in the active permaflex file 3. Retain the Lifeline Subscriber Information Card and the two copies in the tentative file folder. INSTALLER'S PACKET: 1. Type in the subscriber's name, address, and all available information on the following forms. a) Installation Guide and Checklist Form. b) Important Notice To Lifeline Subscribers. c) Lifeline Subscriber Lease Form. 2. Make a copy of the above b. and c. forms and place in the subscriber's tentative file folder. 3. Include in the tentative file folder a copy of the Instructions For Using Lifeline. Type the subscriber's name and the Lifeline Response Center's information i.e.: Emergency Room 527 -2727 Timothy Patten 527 -2462 x7435 CALL INSTALLER: 1. Call the Installer assigned to the area where the new subscriber resides. Have the tentative folder with all the information available for the installer to pick up. 2. At this time assign a unit. Make sure the proper unit t / SIMI VALLEY LIFELINE PROGRAM - Revised: September 25, 1989 Application Procedures - Continued Section G Page 4 goes to the proper persons or areas. We have four different type of units: (1) The Adventist Hospital Units; (2) The Council on Aging Units (two types); (3) The Moorpark Units; and, (4) The Filmore Units. Also, make sure that there are not two units in the area with the same HELP BUTTON frequency. I. CLOSURE: 1. After installer returns the tentative file folder, check to see that all information is recorded properly. 2. Check the two copies of the Lifeline Subscriber Information Cards to see that the Lifeline Unit Number has been added. 3. Place one copy of the Lifeline Subscriber Information Card in Wayne Templeton's file. 4. Attach all remaining forms etc. to the C information filed in the active permaflex file folder. NAME ADDRESS � COUNCIL ON AGING � CITY 2929 TaPo Canvon Road Simi Vallcv, California 93063 (805) X26 -9237 LIFELINE APPLICATION FORM STATE PHONE EXTENSION PHON:;S . YES NO IF SO, HOW MANY AND THEIR LOCATION DO YOU SEE OR SPEAK WITH SOMEONE EVERY DAY? YES WOULD SOMEONE CHECK IF YOU COULD NOT BE REACHED BY PHONE? DO YOU HAVE A RECENT HISTORY OF MEDICAL PROBLEMS? IF YES, PLEASE DESCRIBE: DO YOU HAVE ANY PHYSICAL HANDICAPS? YES IF YES, PLEASE DESCRIBE: ZIP NO YES YES NO NO con t inu(-. 1 f[i - DO YOU USE A WALKER OR CANE TO ASSIST WITH WALKING, EVEN ONCE IN A TWHILE? ` YES NO IS YOUR HOSE ONE OR T,O FLOORS? ARE YOU HEALTHY ENOUGH TO WALK UP AND DOWN STAIRS WITHOUT HELP? YES Np DO YOU RECEIVE HELP AT HOME FOR COOKING OR FOR HOUSEWORK? YES NO IF YES, HOW FREQUENTLY? c HAVE YOU SBEN A ICTOR WITHIN THE LAST SIX MONTHS? c NO WITHIN THECEAST MONTHS, DID YOU NEED HELP FOR AN EMERGENCY: YES NO GIVE DETAILS WHY DO YOU WANT LIFELII'E? ARE YOU 55 YEARS OR OLDER? YES NQ HOW MANY PEOPLE ARE IN YOUR HOUSEHOLD? WHAT WAS YOUR GROSS INCOME REPORTED ON LAST YEAR'S INCOME TAX FORM? PLEASE ATTACH A COPY OF LAST YEAR'S INCOME TAX FORM OR OTHER PROOF. WHAT DO YOU ESTIMATE TO BE THIS YEAR'S INCOME? I HEREBY CERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND ACCURATE TO THE BEST OF DIY KNOWLEDGE. SIGNATURE OF APPLICANT DATE ----- [continued] IF YOU DO NOT QUALIFY FOR A FREE LIFELINE HOME CO' IUNICATION UNIT, DO YOU WANT YOUR APPLICATION FORWARDED TO SIMI VALLEY ADVENTIST HOSPITAL FOR THEIR REPRE- SENTATIVE TO CONTACT YOU? YES NO PLEASE RETURN TO: SIMI VALLEY COUNCIL ON AGING ATTN: LIFELINE REVIEW COMMITTEE 2929 TAPO CANYON ROAD SIMI VALLEY, C? !,)63 INCOME LIMITS Household Size 1 2 3 4 5 6 7 8 50?" Very Low Income 15,250 17,450 19,600 21,800 23,550 25,300 27,050 28,800 8G% Lower Income 23,800 27,200 30,600 34,000 36,150 38,250 40,400 42,500 100% Low /Moderate Income 29,750 34,000 38,250 42,500 45,187 47,812 50,500 53,125 Rev.: 3 -06 -89 (Income) Rev.: 6 -28 -88 (Added 100 %) Rev.: 2 -19 -88 (Income) C i SI,� 11 `ALLEY ,AD\ f =,� IS T f- I()SPITL September 25, 1989 Alice L. Crater 1550 Rory Lane 115 Simi valley, CA 93063 Phone # 581-1585 Dear Ms. Crater, We are pleased to advise you that your application for a Lifeline Home Communicator Machine has been approved. We need some further information from You. Would you please fill in the blanks in the following questionnaire. We have a machine available and will install it soon after we receive this information. The monthly charge for the machine is $15. If you have any questions, you may call me. (527 -2481) First, you will need three responders who will be responsible to come to your house and help you if there is a need. The attached responder letter is for Your information. A copy of it will go to each of your responders. Remember, each responder will need a key to your house in case of an emergency or machine failure. RESPONDERS; RESPONDER # 1 NAME PHONE OFFICE ADDRESS (Street) RESPONDER # 2 NAME ADDRESS RESPONDER # 3 NAME ADDRESS (Street) (Ci ty) (Zip Code) PHONE OFFICE. (Ci ty) PHONE (Ci ty) (Zip Code) OFFICE (Zip Code) t, Lifeline Responder Letter - Continued September 25, 1989 Page: 2 NEAREST RELATIVE: RELATIONSHIP: NAME PHONE ADDRESS (Street) MEDICAL NOTES: ALLERGIES: MEDICATION: DISABILITIES: REMARKS: PHYSICIANS: NAME ADDRESS NAME ADDRESS Thank you. Wayne K. Templeton Lifeline Review Committee (Ci ty) Attachment: Sample Ietter to responders PHONE PHONE OFFICE (Zip. Code) 51,E 11 `ALLEY At-A I_\ -fly L I- 1O5P1 -F September 25, 1989 (This is a copy of the information that will be Your Responder's Name sent to your responders) Responder's Address Simi Valley, California 93065 Dear Responder, As an Emergency Responder for (Your name), you are an important part of the Lifeline network. Now people can live independently in their own homes because of you and Lifeline which provides 24 -hour monitoring and emergency assistance for our community. If a HELP signal is received, you may be asked by our Lifeline Emergency Response Center personnel to help in one or more of the following ways: ... To check to see what the problem is. ... To unlock the subscriber's door if the police, fire or ambulance service are called to help. .. To turn off, reset or switch the Lifeline home unit to the "AWAY" position if the subscriber has to be hospitalized or leave home. If you are asked 'To check to see what the problem is '," your response should be: • To respond quickly. • When you arrive, push the flashing yellow RESET button on the Communicator Unit. ... Help the subscriber; Call 911 if needed. ••• When things have settled down, call the Emergency Response Center (527 -2727) to update the situation. We have enclosed some information so that you may become familiar with the Lifeline Program and how the equipment works. We suggest that you look at the equipment. If you have any questions or would like to know more about our Lifeline Program, please call me. Thank you so much for caring. �'- ���.. t) �. .I:ili if <• L)rIAr II)li �. ,f ���. i'i if!11.t SIN 11 \ALLEI ,AIA r-x FI-q- HOSPITAL September 25, 1989 Otto Austel, M.D. 2876 N. Sycamore Simi Valley, CA 93065 Dear Dr. Austel, We are pleased to advise you that your patient has subscribed to the Simi Valley Adventist Hospital Lifeline Program. Your knowledge and su pport of the Lifeline program for this individual is important to its success. Lifeline is a personal emergency response system that helps elderl y or subscriber has a Lifeline n that can be worn on clothing disabled persons maintain their independence. The Communicator at home with a personal HELP butto or carried in a pocket. When help is needed, a push of the button signals the ERC in the emergency room. Staff then arrange appropriate help. The system does not provide standing orders or medical management or diagnosis. The equipment simply relays the message for help to the Emergency C Response Center; if personnel are unable to contact the subs identified previously by the subscriber (usually friends or relat.ivesewho nlive nearby) follow up to see that appropriate help is summoned. The information indicated on the attached xerox copy has been supplied by the subscriber and is on file at the Response Center. Please review it for accuracy and completeness. Any necessary revisions may be mailed to me or telephoned to 527 -2462, ext. 479. Thank you for your help. If you have any questions or would like further information about our Lifeline Program, please call me. My home phone is 527 -2481. Sincerely, Wayne X. Templeton Lifeline Coordinator JA/yh Enclosure - Noted W62 September 25, 1989 Mr. & Mrs. Gardiner 1125 Cadiz Dr. Simi Valley, California 93065 Dear John & Ginny, As an Emergency Responder for Nelle Kenison, you are an important part of our Lifeline network. Now people can live independently in their own homes because of you and Lifeline which provides 24 -hour monitoring and emergency assistance for our community. If a HELP signal is received, you may be asked by our Lifeline Emergency Response Center personnel to help in one or more of the following ways: ... To check to see what the problem is. ... To unlock the subscriber's door if the police, fire or ambulance service are called to help. To turn off, reset or switch the Lifeline home unit to the "AWAY" position if the subscriber has to be hospitalized or leave home. If you are asked "To check to see what the problem is," your response should be: ... To respond quickly. ... When you arrive, push the flashing yellow RESET button on the Communicator Unit. ... Help the subscriber; Call 911 if neededi ... When things have settled down, call the Emergency Response Center (527 -2727) to update the situation. We have enclosed some information so that you may become familiar with the Lifeline Program and how the equipment works. We suggest that you look at the equipment. If you have any questions or would like to know more about our Lifeline Program, please call me. (527 -2481) Thank you so much for caring. Sincerely, Wayne K. Templeton Lifeline Coordinator JA/yh Enclosures: Noted P.S. The enclosed wallet -sized card may be carried as a form of identification should it beccme necessary to enter the subscriber's home. suescaeER . NAME L/F8LINE rE► . ® SUBSCRIBER INFORMATION CARD •oars REMARKS TIMfR O O O ^e Il ?I R N ERS DATE NAME L MEDICAL NOTES A00 HOME DATE: OFF ALLERGIES: — NAME I KEY Y N ADD HOME MEDICATION: OFF NAME KEY Y N r ')D `\ HOME DISABILITIES: OFF KEY Y N NAME ADD HOME REMARKS: OFF NAME KEY Y N ADD I HOME OFF KEY Y N MED, RECORDS FILE NO 'TAME •00 HOME PHYSICIAN: - - OFF TELEPHONE: KfY T N i PHYSICIAN "'(r Ims TELEPHONE SueSC.IeER . TIRE HOS►IfA► ►REF NAME rE► . LIFELINE'S SUb*0,b..,R.*po„dW I INFORMATION CARD m o m m 0) U r) ... C ` Q o SUBSCRIBER: C 7 n m Q f0 U • V 6 c a ` C U _ = � C U 0 : � m m C L In m = w RESPONDER: ° � a) oQ o >, >D •- cl O N . r_ U Q) Lo LIFELINE N - Y PROGRAM a� o m e 3 °' C. Z z o MANAGER: m `�' a E >' °' m � m L c Q a m .� N N m Q m J PHONE °• L 3 s °' �, = Q ( E #� : a� cc Y INSTRUCTIONS FOR USING LIFELINE IN 2LN EMERGENCY 1. PUSH YOUR PERSONAL HELP BUTTON, OR PUSH THE HELP (SQUARE RED) BUTTON ON THE FRONT OF YOUR UNIT. (IF YOU ARE ABLE TO USE THE PHONE AND CAN GIVE CLEAR INSTRUCTIONS, IT PROBABLY WOULD BE BETTER TO CALL 911, OR YOUR RESPONDER YOURSELF FOR FASTER HELP.) 2. IF YOU CANNOT ANSWER THE PHONE WHEN IT RINGS, HELP WILL BE SENT. 3. WHEN HELP ARRIVES, HAVE SOMEONE PUSH THE RESET (ROUND YELLOW) BUTTON TO NOTIFY THE RESPONSE CENTER. IMPORTANT INSTRUCTIONS A. To provide extra protection for those who are living alone, when the HOME-AWAY switch is down on the HOME position, the TIMER will send a NO ACTIVITY message to the hospital if you do not push the RESET (ROUND YELLOW) button at least twice a day (morning and night) . B. If you leave home for more than a day, it is important to push the HOME -AWAY stitch up to the AWAY position. This will shut off the TIMER. For those who have someone checking on them each day, keep the HOME -AWAY switch up to the away position. C. If the electrical power goes off, your Lifeline will continue to work on its battery for several hours. D. You must not unplug the Lifeline Unit from the electrical outlet unless you turn the Unit over and place it upside down. The white (on -off) switch will spring off. Do not place anything on the lifeline in this position. If: you do not turn the unit off by turning it over, the battery will discharge and become dead. E. If the green light is off, check to make sure the Unit is plugged into the electrical outlet. You must never plug the Lifeline Unit into an electrical outlet that operates from a wall switch. TESTING YOUR LIFELINE HOME UNIT The Response Center will call you about once a month to make sure your Lifeline Unit is working satisfactorily. The procedure is easy but you must remember to do it right. The person conducting the test will give you the following instructions: AFTER WE HANG UP THE PHONE, PRESS THE HELP BUTTON YOU WEAR AROUND YOUR NECK NEXT GO TO YOUR LIFELINE UNIT AND WAIT UNTIL THE RESET (ROUND YELLOW) BUTTON BEGINS TO FLASH WHEN THE YELLOW BUTTON BEGINS TO FLASH, PUSH IT UNTIL IT STOPS FLASHING. The person conducting the test will call you back when it works properly or if there is a problem. That will complete the Lifeline Home Unit Test. OTHER INFORMATION 1. Call the Lifeline Response Center if there is any change in: (a) Your Responders; (b) Your address or telephone number; (c) Your doctor; or (d) If you plan to move the Lifeline Home Unit. 2. If you are having any problems with your Lifeline Home Unit, call the Response Center. Someone will be on hand during normal business hours to help you. If you have a problem during non business hours, call the Director or Assistants during the day and early evening hours. If you have an emergency problem during the night (9PM to 6AM), call the Emergency Room at the hospital., PHONE NUMBERS Response Center 527 -2462 X7276 During normal working hours Wayne Templeton 527 -2481 During day and early evening Charles Petty Sr. 526 -7823 Jim Coleman 526 -3289 Emergency Room 527 -2727 Emergencies only during night