April 17, 2013

PA Premise Alert FAQ

What is the Premise Alert System?

The Premise Alert System provides families with a uniform method to alert first responders about special needs individuals. It also provides first responders with advance knowledge, allowing for quick and educated responses during crises, evacuations, and disasters. The form is provided free of charge to families through DPW and MH/MR Case Managers and can be found at www.papremisealert.com

Police Chief Kevin McCarthy, Sr. along with Susan F. Rzucidlo, advocate, created this program. It was implemented as a Chester County program in Nov. 2004. The Premise Alert System became a statewide program in 2008 and is available in every county and city in Pennsylvania.


Who can use it?

 Anyone who has a special need, health challenge or disability such as, but not limited to, Alzheimer’s Disease, Autism, Mental Health Challenges, Mental Retardation, a complex or rare medical condition, who would like first responders such as police, ambulance and fire department to know of their special needs. HIV/AIDS IS NOT CONSIDERED A RELEVANT MEDICAL CONDITION FOR THE PURPOSES OF THIS FORM, THE PREMISE ALERT SYSTEM AND PROGRAM. UNDER NO CIRCUMSTANCES SHOULD INFORMATION RELATED TO AN INDIVIDUALS   HIV/AIDS STATUS BE DISCLOSED ON THIS FORM BY ANYONE.

Do I have to give my Foster Care Child’s name on the form? 

No, it can be processed without a name but someone with authorization needs to sign the form.


Who can fill out this form?

*Individuals with special needs can fill it out for themselves.

*Parents of minor children

*Guardians of minor children

*Current Foster Care Parents (child’s name isn’t required)

*Those with LEGAL guardianship for another

*Those with the Power of Attorney for another      

If you do not have, a legal right to provide this information you should NOT fill out this form or provide this information


Do I have to fill it out? 

 No, it is VOLUNTARY. You do not have to provide any information you do not want First Responders to know or use.


How do I use the form?

Fill out the form with as much information as you would want put into the 911 database, sign it, and then take a copy to your local police department.  They will review it and send a copy to the County 911 center. The information will be put into the system for future use. 


What if I live in an area that uses both a municipal police department and a State Police Department?

If you are in an area that is served my both municipal and state departments then you need to make two copies and take one to each department. Take time to talk to an officer about your form.


The form asks for a recent photograph, what kind of picture is best?

A close up picture, like a passport picture or school picture, if the background is plain, will be easiest for police departments to use.  The pictures used on the “smile safe picture cards” from school will work or you can make an appointment at your police department and an officer will take a digital picture to attach free of charge.


Will I receive preferential treatment by using this form?  NO

*Providing this information does not entitle anyone in a household to preferential treatment. It is simply an attempt to provide emergency response personnel with information that may be helpful when providing service to residents or occupants if it can be utilized by responders.


*Providing information in advance may allow first responders to react and treat in a way that can reduce the possibility of poor outcomes.


How often do I need to fill out a Premise Alert Form?

This form is good for 1 to 2 years depending on the system it is filed in. If you move or need to make changes in the information just fill out another form and submit it.  Any of the systems will automatically use the new information.


How can I get more copies?

MH/MR Case Mangers can mail a copy to you or additional copies can be found on-line at www.papremisealert.com


What if I need help filling out the form?

Your case manager, school social worker, guidance counselor, or local advocacy group would be happy to help you fill out the form.