Josie ... I can't speak either, and use a commercial service with a button you push. They are supposed to ask me only yes or no questions, but nobody can tell if I am saying yes or no either, so that doesn't really help. They first respond with their electronic system (they can communicate if I am lying on the floor away from the phone, etc.), then telephone me to confirm it, and if I don't answer or they can't understand, they call 911. I've pushed the button twice in the last couple of months, and it works great.
I think they all use basically the same system ... they outsource the calls to answering services. They put a lock box on my front door with a key in it, and they give the combination to the responders.
I went online and Googled a number of different comanies, then picked the cheapest one that had a local office.
I also have a TTY machine, which the deaf use. It's a regular phone with a keyboard, and all emergency services have TTY access where they can type answers back. It's an expensive device; ALSA loans it to me from their loaner closet. Other people can use it as a regular phone. You just push a button to use it for text messaging.
