About Remote Supports
Remote support is the use of electronic equipment to support and assist people with developmental disabilities in their home. This service is provided from an off-site location, typically using home and community based waivers to fund the cost and maintenance of equipment and staff. It is an alternative to having the constant physical presence of staff in someone’s home.
As of January 2017, only 170 people of the more than 37,000 eligible Ohioans were taking advantage of remote monitoring services. A part of the Technology project is to identify out why that number is so low and expand these services to people throughout Ohio. This project is part of a collaborative enterprise between the Ohio Department of Developmental Disabilities and The Ohio State University Nisonger Center. The project aims to take an in-depth look at the role technology, including remote supports, plays in the lives of people with developmental disabilities and their families, create a vision for how the use of technology may be improved and expanded upon, and identify technological advances that might benefit people with developmental disabilities by increasing their independence and self-determination.
For more information contact:
Jordan B. Wagner
Coordinator, Technology Project
Remote Supports Frequently Asked Questions
How do I know if I’m eligible?
All Ohioans with a developmental disabilities waiver are eligible. The person’s support team should assess and discuss whether or not remote monitoring will meet the needs of the individual.
What are the duties of the remote support staff?
Remote monitoring is done in real time, not through a recording, by awake staff at another location. While remote support services are being provided, the remote support staff will not have other duties other than providing remote support services.
What happens if the power goes out?
The monitoring base is equipped with a backup power supply. In case this fails, direct-support staff will be notified and will respond accordingly. In the case of a power outage at the consumer’s residence, direct-support staff will be notified and will respond in a timely manner to ensure that the person is safe.
What happens if there is an emergency?
The provider of remote support services will notify first respondents. A direct support staff will also be contacted and respond accordingly. While the individual awaits emergency services, remote support staff will remain engaged with the individual until the first respondents and direct-support person arrive.
Who has access to shut down the equipment?
Remote monitoring equipment will be designed so that it can be turned off only by the authorized people and those specified in the Individual support Plan.
How are people prevented from hacking into the live feeds?
The system uses a secure network system that requires authentications, authorization, and encryption of data to ensure that access to computer, video, audio, sensor, and communication is fully protected and access is limited to authorized persons only.
The following are questions that were generated for a session titled “Technology First and Remote Supports” held at the 2017 Spring OACB conference*:
What codes are used for billing backup support?
|Paid Backup Support
|| Level One
|Unpaid Backup Support
The remote monitoring equipment vendor is required to calculate the amount to be billed for remote monitoring equipment and to provide a monthly “lease” amount to be billed to the waiver. This amount is the vendors’ cost to procure the equipment plus a setup and maintenance fee divided by the useful life (i.e. 36 months). No other equipment costs are required and lump sum payments are permitted.
What codes are used for billing remote monitoring equipment?
||$5,000/Span (Equipment only)
||$7,500/3 years (Equipment & Service)
||$25,000/Span (Equipment & Service)
Is it acceptable to authorize both HPC and remote monitoring for a short time to transition an individual/team/guardian into the new service?
HPC services and remote monitoring services cannot be billed at the same time. While an individual may use HPC services and remote monitoring at different times of day, they do not occur simultaneously. However, in a situation in which an individual has 2:1 staffing, remote monitoring may be used to reduce the ratio to 1:1 in addition to remote monitoring. Therefore, while there may only be one staff physically present within the home, the other staff is assisting from a distance.
What happens when the remote monitoring provider is responding to one individual while another individual requires assistance?
Multiple remote monitoring caregivers are available to respond to requests from any individual for whom services are being provided
Who is doing the monitoring?
Remote monitoring services are being provided by people who are familiar with the individuals ISP. In many cases, those providing services are Direct Support Professionals or have received the same training. Remote monitoring providers must fill out paperwork in the same way a direct support professional would. The rule specifically states: “Service documentation for remote monitoring shall include… [the] Description and details of the services delivered that directly relate to the services specified in the approved individual service plan as the services to be provided.”
What happens to the information?
While the rule does not guarantee recordings, it does say that IF recordings are made then they must be retained in the case of an UI or MUI. When there is not an MUI the recordings can be discarded.
How do you know they are not monitoring during other hours?
Remote monitoring equipment includes an indicator to the individual being monitored that the equipment is on and operating. The indicator shall be appropriate to meet the individual’s needs. Sometimes this is as simple as having a light on the device.
How long/where is the information stored?
In the case of an UI or MUI, documentation is stored for seven years within a secure network system.
Who has access to the information?
The system uses a secure network system that requires authentications, authorization, and encryption of data to ensure that access to computer, video, audio, sensor, and communication is fully protected and access is limited to authorized persons only; those permitted by the ISP.
What kind of certification is required for providers?
Remote monitoring equipment shall be provided by an independent provider or an agency provider that has a medicaid provider agreement with the Ohio department of medicaid.
How many homes/individuals does one remote monitoring provider serve at one time?
This varies from provider to provider for various reasons. The rule requires that during the provider selection process the provider must disclose the ratio of monitoring staff to individuals receiving remote monitoring to the individual and the individual’s team. However, this specific rule is scheduled to be removed in July. You may read the new rule here: revised rule.
How are other counties providing actual backup staff if someone needs to actually go to the location? Are there provider agencies willing to be the “on-call” person or is it generally family or county board staff?
The rule leaves room for many options. If it is in the individuals best interest to have a family member provide the backup support, then that is a possibility. Alternatively, if it is in the individual best interest they ought to receive backup support from a HPC provider. Normally this is not an additional expense because the provider agency already has someone on-call.
*Answers based off of a presentation from Ken Smith and Dustin Wright*