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8.11- Open Door Remote Support and Assistive Technology Services

Purpose

Remote Supports and Assistive Technology services are available for people using Individual Options, Level One, and SELF waivers.

Remote Support allows an off-site direct service provider to monitor and respond to a person’s health, safety, and other needs using live communication, while offering the person more independence in their home.

Equipment used to meet this requirement shall include one or more of the following components:

(a) Motion sensing system;

(b) Radio frequency identification;

(c) Live video feed;

(d) Live audio feed;

(e) Web-based monitoring system; or

(f) Another device that facilitates live two-way communication.

Remote Support service is always combined with Assistive Technology.

Assistive Technology is equipment used by a person to improve functional ability and overall independence (typically an item, hardware, equipment, software, and/or product system which must meet standards for DODD AT approval. AT can be authorized with or without remote supports.

Requirements For Remote Support

Consistent with 5123-9-35: CCHS dba Open Door is committed to inspiring life journeys through provision of remote supports and assistive technology services. Our agency will maintain compliance with the provider qualifications which require the following:

  • A Medicaid provider agreement in good standing with Ohio Department of Medicaid.
  • All staff responsible for providing remote services at monitoring base shall comply with training specified in Appendix C to rule 5123-2-08.
  • Requirements for service delivery outlined below.
  • Documentation requirements contained in this policy.

Requirements for service delivery

Remote support is intended to address an individual’s assessed needs in a manner that promotes autonomy and minimizes dependence on paid support staff and should be explored prior to authorizing services that may be more intrusive, including homemaker/personal care or participant-directed homemaker/personal care, as applicable.

  • An individual’s service and support administrator, in consultation with the individual and the individual’s team, shall assess whether remote support is sufficient to ensure the individual’s health and welfare.
  • Open Door’s Remote support service shall will be provided pursuant to an individual service plan that conforms to the requirements of rule 5123-4-02 of the Administrative Code.
  • Remote support shall will be provided in real time, not via a recording, by awake staff at a monitoring base using the appropriate connection. Open Door remote support response time will be determined by individual needs through the remote supports care plan. While remote support is being provided, the remote support staff shall will not have duties other than remote support.
  • Remote support will not be provided in shared living or non-residential settings.
  • When remote support involves the use of audio and/or video equipment that permits remote support staff to view activities and/or listen to conversations in the residence, the individual who receives the service and each person who lives with the individual shall will consent in writing after being fully informed of what remote support entails including, but not limited to, that the remote support staff will observe their activities and/or listen to their conversations in the residence, where in the residence the remote support will take place, and whether or not recordings will be made. If the individual or a person who lives with the individual has a guardian, the guardian shall will consent in writing. The individual’s service and support administrator shall will keep a copy of each signed consent form with the individual service plan.
  • Open Door shall will provide initial and ongoing training to all staff to ensure they know how to use the monitoring base system.
  • Open Door will ensure that a backup power system is in place at the monitoring base in the event of electrical outages. Additionally, Open Door will secure alternate cellular fail over backup systems and ensure safeguards in place which shall include, but are including but not limited to, contacting the backup support person in the event the monitoring base system stops working for any reason.
  • Open Door will comply with all federal, state, and local regulations that apply to the operation of its business or trade, including but not limited to, 18 U.S.C. section 2510 to section 2522 as in effect on the effective date of this rule and section 2933.52 of the Revised Code.
  • Open Door will notify emergency personnel such as police, fire, emergency medical services, and psychiatric crisis response entities as determined necessary by the individual’s remote supports care plan.
  • Open Door will provide an individual who receives remote support with initial and ongoing training on how to use the remote support system as specified in the individual service plan/remotes care plan.
  • If a known or reported emergency involving an individual arises, the remote support staff will immediately assess the situation and call emergency personnel first, if that is deemed necessary, and then contact the backup support person. The remote support staff shall will stay engaged with the individual during an emergency until emergency personnel or the backup support person arrives. The back up support person shall verbally acknowledge receipt of a request for assistance from the remote support staff.
  • The back up support person shall arrive at the individual’s location within a reasonable amount of time (to be specified in individual’s service plan/remotes care plan) when a request for in-person assistance is made.
  • When an individual needs assistance but the situation is not an emergency, the remote support staff will address the situation as specified in the individual service plan for an individual who receives remote support with unpaid backup support or contact the paid backup support for an individual who receives remote support with paid backup support.
  • Open Door remote support staff shall will have detailed and current written protocols for responding to an individual’s needs as specified in the individual service plan, including contact information for the backup support person to provide assistance when necessary. The individual service plan shall will set forth the protocol to be followed should the individual request that the equipment used for delivery of remote support be turned off.
  • A monitoring base shall will not be located at the residence of an individual who receives remote support.
  • A secure network system requiring authentication, authorization, and encryption of data that complies with 45 C.F.R. section 164.102 to section 164.534 as in effect on the effective date of this rule shall will be in place to ensure that access to computer, video, audio, sensor, and written information is limited to authorized persons.
  • If an unusual incident or a major unusual incident as defined in rule 5123-17-02 of the Administrative Code occurs while an individual is being monitored, the remote support provider shall will retain or ensure the retention of any video and/or audio recordings and any sensor and written information pertaining to the incident for at least seven years from the date of the incident.
  • When an event is triggered from assistive tech device or another sensor or device during times when remote support is not being provided, this will be considered an Ad-Hoc response from Open Door remote supports. The remote support staff will respond to the event, document the event and response. A copy of this will be forwarded to service team if additional follow-up is needed.

Documentation of services

Open Door’s service documentation for remote support shall will include each of the following to validate payment for Medicaid services:

(1) Type of service.

(2) Date of service.

(3) Place of service.

(4) Name of individual receiving service.

(5) Medicaid identification number of individual receiving service.

(6) Name of provider.

(7) Provider identifier/contract number.

(8) Begin and end time of the remote support service when the backup support person

is needed on site.

(9) Written or electronic signature of the person delivering the service, or initials of the person delivering the service if a signature and corresponding initials are on file

(10) Number of units of the delivered service per calendar day.

(11) Group size in which the service was provided.

(12) 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. This will be entered using the remote supports portal with service plan notations.

Billing/Payment standards

The billing units, service codes, and payment rates for remote support are contained in Appendices attached to rule and available on DODD website. Open Door will utilize these appendices for billing and payment standards.

There are two payment rates for remote support, which differ depending on whether an individual is receiving remote support with unpaid backup support or with paid backup support.

When an individual receives remote support with unpaid backup support, Open Door will bill for the remote support. When an individual receives remote support with paid backup support, the Open Door remote support provider shall will bill for the remote support and provide the remote support directly or through a contract with a remote support vendor that meets the requirements of this rule.

In the event that the remote support staff contact the remote support provider to request emergency or in-person assistance, the paid backup support person’s time shall will be billed as homemaker/personal care or participant-directed homemaker/personal care, as applicable.

When remote support is provided to multiple individuals who live in the same residence, the payment rate for remote support shall be is divided equally among the individuals concurrently receiving remote support.

Signed by:

Rebecca Sharp Porter
Chief Executive Director

Last Revised: 3/11/2024

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