Remote Support Frequently Asked Questions for Professionals
Cost & Billing Questions
Remote Support Provider Questions
Remote Support Vendor Questions
Remote Support Implementation Questions
Privacy Questions
Consumers Who Use Remote Support Questions



How does the billing for remote support work?

Remote support vendors can either be a Homemaker personal care (HPC) provider agency or hired by a HPC provider agency. When the remote support vendor is hired by a HPC provider, the HPC provider purchases the services of the remote support vendor. When this is the case, the remote support vendor will send the HPC provider a bill for their services. Then the HPC provider bills the state so that they can pay the remote support vendor. Some of the money billed to the state goes to the HPC provider who hired the remote support vendor, the rest of the money goes to the remote support vendor. Though each remote support vendor has the same billable cost, the amount a vendor keeps for each billable unit is different for each provider agency.

The following are questions that were generated for a session titled “Technology First and Remote Support” held at the 2017 Spring OACB conference*:

What codes are used for billing backup support?                                                                                                                                                                                                                   

Paid Backup Support I/O AMR
Level One FMR
Self-Empowered SMR
Unpaid Backup Support I/O AMS
Level One FMS
Self-Empowered SMS



What codes are used for billing remote support equipment?

Equipment codes/limits I/O AML $5,000/Span (Equipment only)
  Level One FML $7,500/3 years (Equipment & Service)
  Self-Directed SML $25,000/Span (Equipment & Service)

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.

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.

How is the technology paid for?
All Ohio DD waivers covers the cost for both remote support services and remote support equipment. However, technology is often expensive. While the rule does not include any specific language about how equipment must be paid, the remote support equipment is often leased. This means that rather than paying a one time fee each time equipment is purchased, the cost is distributed across the life-span of the technology making the service more affordable for those using it. This also means that when individuals who use remote support cancel the service, they will not have purchased the equipment and it may be removed to possibly be installed at a different house if it’s still within it’s use life.


 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 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.

Who reports Unusual Incidents (UI) and Major Unusual Incidents (MUI)? 
During times that a remote support vendor is supporting an individual, it is the responsibility of the remote support vendor to create incident reports. During times that the remote support backup worker (provided by the provider agency) is called into a home the responsibility to report UIs and MUIs transitions to the backup provider. The remote support vendor will not be monitoring during times that the backup worker is present. 

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.”

How many homes/individuals does one remote support vendor serve at one time?
This varies from provider to provider for various reasons.  revised rule.

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 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.

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.

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.

 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.


How do I know who is 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.