Facebook-f Linkedin
Client Portal

Remote Support in New York: Every Service It Fits, and How It Is Paid

New York’s OPWDD waiver has covered Remote Supports since October 1, 2023. Any New York provider agency can get Vista Enterprise™, the remote support solution, the way it gets an EHR or payroll system, with no state approval. Billing is separate. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides.

Can any New York agency buy a remote support solution?

Yes. Any New York provider or agency can get Vista Enterprise™, the remote support solution, which includes VistaLink™, the technology. Like an EHR or payroll system, getting it needs no approval from the Office for People With Developmental Disabilities (OPWDD), New York Medicaid, or anyone else.

Billing is a separate question. It depends on the program, the service, your agency’s provider status, and each person’s plan. The rest of this page walks through every place remote support fits in New York.

Where does remote support fit in New York?

Setting or programHow technology is usually paidWhat to know
OPWDD HCBS Waiver, non-certified homesHome-Enabling Supports (HES), including Remote Supports, billed by an HES ProviderRemote Supports is for ages 15 and older
Self-DirectionHES costs must be accommodated within the person’s Personal Resource Account (PRA)Same HES rules apply
OPWDD certified residencesThe agency’s own budget; costs may be reflected in agency cost reporting for later cost-based ratesHES is for people in non-certified settings
ICF/IIDThe facility’s own costFederal staffing floor stays
Nursing homes and assisted livingThe facility’s own costResident privacy rules apply
Home care agenciesThe agency’s own costSupport between visits
Any agency, any settingThe agency’s own budgetNo approval needed to buy

What does Remote Supports under HES include in New York?

OPWDD’s ADM 2024-02 sets the HES rules. Effective October 1, 2023, OPWDD added HES to the Assistive Technology (AT) benefit of the OPWDD HCBS Waiver. Under the memorandum:

  • It builds independence. HES are meant to help a person be more independent and less reliant on physically present support staff, and they do not isolate the person from the community.
  • Two roles. The HES Provider, an OPWDD-certified AT provider chosen through a selective procurement, buys or leases the devices and is the provider of record for billing. Remote support itself is delivered by a Remote Support Vendor that subcontracts with the HES Provider.
  • Live support. Remote Support is delivered in real time, not through a recording, by awake staff at a Remote Support Base, using equipment with live, two-way communication. While providing Remote Support, those staff have no other duties.
  • The person controls it. The system has indicators that show the person when it is active. Use can be limited to certain hours by the person’s choice. The person is taught how to turn their devices on and off, or who to contact for help.
  • Training is included. The HES Provider or Vendor gives initial training to the person and to the informal or formal supports who help them use the service.
  • Backup is planned. Vendors keep emergency solutions in place if the Remote Support Base stops working, including an in-person backup plan based on the person’s needs, and a procedure for notifying emergency personnel.

What has to happen before remote support starts in New York?

  1. Goals in the Life Plan. The person’s Care Manager at their Care Coordination Organization (CCO) helps them set goals through person-centered planning, and the Life Plan names Home-Enabling Supports as the authorized service and the HES Provider.
  2. Prior authorization. The Care Manager requests HES from the Developmental Disabilities Regional Field Office (DDRFO), which issues a Notice of Decision. Purchases made before prior authorization are not reimbursed.
  3. An assessment and HES Plan. The HES Provider assesses the person’s needs with the Care Manager, the care planning team and the Vendor, and writes the HES Plan: the person’s valued outcomes, the technology, privacy, health and safety assurances, and informed consent. Based on the person’s preference, the in-home visit can happen remotely.
  4. A Remote Support Addendum. Because a Vendor delivers the Remote Support, the HES Plan includes a Remote Support Addendum that brings in the Vendor’s planning, including the backup plan.
  5. Written informed consent. Where HES affect privacy, the person gives written informed consent before HES are used, and so does anyone else in the home whose privacy is affected.

How does New York pay for remote support?

Your agency gets Vista Enterprise™ directly, as its own remote support solution. New York then has two ways to pay for the enabling technology a person uses:

From the agency’s own budget. Any agency can get Vista Enterprise™ as its own remote support solution, whether or not it bills a service. This is the route for ICFs, OPWDD certified residences, nursing homes, assisted living and home care agencies.

1. Home-Enabling Supports (HES). For a person enrolled in the OPWDD HCBS Waiver who lives in a non-certified residence, HES can pay for Remote Supports (age 15 or older) and AT devices. The HES Provider bills eMedNY and pays the Remote Support Vendor. HES has an annual limit on acquisitions, and internet service and cell phones are not paid through HES. HES alone is not sufficient to demonstrate the person’s reasonable indication of need, so the person also needs at least one monthly HCBS waiver service or monthly health and safety monitoring.

2. Self-Direction. For a person enrolled in Self-Direction, the cost of devices and of Remote Support or HACS Vendors must be accommodated within their Personal Resource Account (PRA).

Sources, checked October 25, 2026: OPWDD Administrative Directive Memorandum 2024-02, Home-Enabling Supports (HES), November 21, 2024; ADM 2024-02 Attachment 1, Glossary; OPWDD, Home-Enabling Supports for providers.

How do consent and privacy work in New York?

The person supported decides whether remote support is used and where devices go, with help from the people they choose. The Life Plan is built through person-centered planning with the person and their Care Manager, and the HES Plan is written by the HES Provider with the person, the care planning team and the Vendor. Devices are explained to the person and/or a representative who assists them with informed decision making. Consent is informed, voluntary and written down: the person is told about the Remote Supports staff’s ability to observe the person’s activities and/or listen to their conversations, where devices go, and whether recordings are made, before HES are used. Anyone else in the home whose privacy is affected also gives written consent. The person can revoke consent at any time, and consent is updated when a new device or service is added. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides, following the plan.

Under OPWDD’s HES rules, Remote Silent Monitoring Video Devices and remote audio devices with a continuous feed are not permitted in bedrooms or bathrooms, and audio or video devices facing into the home must have two-way communication. No cameras are required in bedrooms, bathrooms or other personal spaces.

What if our staffing stays the same, as in an ICF or a fully staffed group home?

An agency in New York can keep every in-person shift and still use remote support, because technology can raise quality even with full staff.

Even a fully staffed overnight shift cannot be in every room at once, stay fully alert through every hour of the night, or carry every detail from one shift to the next. When nothing answers those human limits, they quietly become limits on the outcomes people supported can reach. That is a limit of people, not a failing of staff.

Enabling technology for human services helps with those gaps without replacing anyone. It gives trained people better information and more of their time for the moments that need a person in the room.

  • Fewer night checks that wake people up. For people whose plans do not call for hands-on checks through the night, a door opening on a schedule interrupts sleep and privacy. Non-wearable sensors the person agreed to can let overnight staff know when something may need a person. Whether a plan moves away from scheduled checks is decided through the person’s plan, by the person and their team, with input from the agency’s own nurse or clinician.
  • Better information. Plain-language daily reports on sleep, activity and safety events give nurses and the team a fuller picture than a shift note alone.
  • Closing gaps in data and judgment. A steady record across shifts means handoffs rest on more than memory, and a change that is hard to read in the middle of the night comes to a trained person with the facts in front of them.

Know the limits.

  • Federal ICF rules set the staffing floor. In an intermediate care facility for individuals with intellectual disabilities (ICF/IID), federal rules require responsible direct care staff on duty around the clock when people are present, awake in some living units, plus minimum direct care staff ratios. Remote support adds to on-site staff. It does not replace them.
  • Privacy comes first. Federal rules require ICFs to give each person the opportunity for personal privacy. CMS guidance for surveyors says video or audio never takes the place of staff. No cameras are required in bedrooms, bathrooms or other personal spaces. Non-wearable sensors fit that approach.
  • The facility pays. An ICF/IID is paid as a facility, not through a person’s waiver plan, so an ICF that uses Vista Enterprise™ pays for it as its own operating cost.
  • ICF terms apply. In an ICF/IID, the person’s plan is the Individual Program Plan (IPP), developed by an interdisciplinary team that includes the person and the qualified intellectual disability professional (QIDP). A move away from scheduled night checks is decided by that team, including the person and their legal guardian where they have one, with input from the facility’s own nurse, and written into the IPP. If the change could affect the person’s protection or rights, the facility’s specially constituted committee reviews it, and it goes ahead only with written informed consent from the client, their legal guardian, or a parent if the client is a minor.
  • In New York, HES is a service in the OPWDD HCBS Waiver for people who live in non-certified settings, so an ICF does not bill it.
  • Group homes and privacy. Federal home and community-based settings rules give each person privacy in their sleeping or living unit. Any limit on that must be based on a specific assessed need, written into the person’s plan, and agreed to with informed consent.

Can nursing homes and assisted living in New York use remote support?

Yes. Nursing homes and assisted living communities get Vista Enterprise™ the same way any agency does, and the facility’s own trained team responds and decides.

  • Nursing homes. Federal rules give each resident a right to personal privacy and to be free from restraints that are not needed to treat medical symptoms, and require the facility to give each resident adequate supervision and assistance devices to prevent accidents. Better information can help staff see who needs them without waking everyone. Each resident decides whether devices go in and can say no, and a resident representative decides for the resident only as far as the resident, a court or state law gives them that role. CMS guidance for surveyors treats devices that alert staff when a resident moves as position change alarms, so the facility’s care team checks, in each care plan, that a device does not keep a resident from moving freely or disturb their sleep. Remote support does not prevent falls, and it is not a promise that every fall will be noticed. A trained person on the facility’s own team decides each step. Nursing homes are paid as facilities, so Vista Enterprise™ is the facility’s own purchase. In-person staffing rules do not change.
  • Assisted living. Assisted living is licensed by each state, not under the federal nursing home rules, so each community follows its own state’s licensing rules for resident rights, privacy and consent. Where Medicaid home and community-based services (HCBS) pay for a resident’s services there, the federal HCBS settings rules also apply, including privacy in the person’s sleeping or living unit, a door they can lock, and a say in choosing any roommate. Technology placed with each resident’s consent gives staff better information between scheduled visits.
  • In New York, nursing homes and assisted living communities follow the state’s own licensing rules alongside the federal ones.

How does remote support help home care agencies in New York?

Home care agencies send aides into people’s homes for set hours. Between visits, no one from the agency is there. Remote support helps with that gap: the person keeps their privacy, and the agency’s own trained team can learn when something may need attention and decide who should go.

  • Better visits. Aides arrive knowing how the night went.
  • Earlier notice. Changes in routine can show up before they become a crisis.
  • In New York, home care agencies follow the state’s own licensing rules.

Who else can remote support help in New York?

It is not all about disability. Remote support is enabling technology for human services as a whole. It works for people with intellectual and developmental disabilities (IDD), older adults, people with physical disabilities, people recovering from an illness or injury, faith-based organizations that run health ministries, and the staff and families who support them.

How does VistaLink™ fit New York’s rules?

VistaLink™ uses non-wearable sensors and a display in the home to send events to your agency’s own trained team, and it never acts alone. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides, following each person’s plan.

HES Remote Supports is billed only by an OPWDD-certified HES Provider, chosen by selective procurement, through a subcontracted Remote Support Vendor. Any other agency runs its own remote support with Vista Enterprise™ from its own budget. An agency can take part as the selected HES Provider or as a Remote Support Vendor under contract with one. Source: OPWDD ADM 2024-02.

Vista is not the direct service provider. The agency or facility is. Vista Enterprise™ supports the people who plan and give support: the person, their family or guardian where they have one, the provider’s own team, and any case manager or coordinator. It helps them follow the rights, privacy and consent rules that apply in that setting and state, and build each person’s plan around their own wants and needs. When an agency runs its own remote support with Vista Enterprise™, its own trained team responds and decides.

For states and government agencies

Vista can also work with the Office for People With Developmental Disabilities (OPWDD), New York Medicaid, and with other state and government agencies, for example through a procurement or a contract. Any single agency, in any state or anywhere in the world, can already get Vista Enterprise™ with no state approval.

Remote support for states and government agencies

What does remote support look like for a New York agency? (composite example)

This is a composite example built from common situations. It is not a real person.

A man of 24 on the OPWDD HCBS Waiver lives in his own apartment. With his Care Manager he adds a goal to his Life Plan: cooking and getting ready for work with less in-person help. His Care Manager requests HES from the DDRFO, and after the Notice of Decision the HES Provider and its Remote Support Vendor write his HES Plan and Remote Support Addendum with him. He gives written consent and chooses non-wearable sensors and a display in the home, placed where he directs, and he limits remote support to the evening hours. When an event comes in, a trained staff member at the Vendor checks in the way his plan says, and contacts his backup person when he needs someone in person.

Questions and answers

Can any New York agency buy a remote support solution?

Yes. Any New York provider or agency can get Vista Enterprise™, which includes VistaLink™. Like an EHR, it needs no OPWDD approval. Billing follows each program’s rules.

What are Home-Enabling Supports in New York?

Home-Enabling Supports (HES) are part of the Assistive Technology (AT) category of the OPWDD HCBS Waiver, added on October 1, 2023. HES can include AT devices, Remote Supports, and Health Assessment and Coordination Services (HACS). They are meant to help a person live more independently and safely, with less reliance on physically present support staff.

Who can get Remote Supports through HES in New York?

A person enrolled in the OPWDD HCBS Waiver who lives in the community in a non-certified residence and is age 15 or older. HES devices and HACS have no age limit. HES do not apply to the Children’s Waiver or the Traumatic Brain Injury waiver run by the Department of Health.

Who bills for Remote Supports in New York?

The HES Provider. HES Providers are OPWDD-certified AT providers chosen through a selective procurement. They are the provider of record for billing, they bill eMedNY, and they subcontract with a Remote Support Vendor, which must have at least three years of operating experience.

Does Remote Supports need prior authorization in New York?

Yes. The person’s Care Manager requests it from the Developmental Disabilities Regional Field Office (DDRFO), and the DDRFO issues a Notice of Decision. Purchases made before prior authorization are not reimbursed and are not approved after the fact.

Can a person turn Remote Supports off in New York?

Yes. The person is taught how to turn their remote support devices on and off, or who to contact for help doing it. The system has indicators that show when it is active, and use can be limited to certain hours by the person’s choice.

Can a New York ICF, nursing home or assisted living facility use remote support?

Yes, as its own tool alongside on-site staff. Federal and state staffing rules still apply in full, and the facility pays for Vista Enterprise™ as its own cost. No cameras are required in bedrooms, bathrooms or other personal spaces.

Who responds when remote support is in place?

Your agency’s own trained team responds and decides, following each person’s plan. VistaLink™ never acts alone.

Is remote support in New York only for disability services?

No. It fits any human service where staff cannot be everywhere at once: disability services, older adults, assisted living, nursing homes, home care and faith-based health ministries.

Book a demo

See how your New York agency could run its own remote support with Vista Enterprise™ and VistaLink™.

Book a demo

Related pages