Remote Support in Ohio: Every Service It Fits, and How It Is Paid
Ohio covers remote support in its Individual Options, Level One and SELF waivers under Ohio Adm.Code 5123-9-35. Any Ohio 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. The agency’s own trained team responds and decides.
Can any Ohio agency buy a remote support solution?
Yes. Any Ohio 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 Ohio Department of Developmental Disabilities (DODD), a county board, the Ohio Department of Medicaid, a managed care plan, 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 Ohio.
Where does remote support fit in Ohio?
| Setting or program | How technology is usually paid | What to know |
|---|---|---|
| IO, Level One and SELF waivers | Remote support, per person, at one of two rates set by backup type | Written consent and an ISP first; billed by a certified agency provider |
| Assistive technology service | Equipment, software and monthly fees, per person | Least costly option that meets the need |
| Shared living | Not remote support | Ohio’s rule excludes shared living |
| ICF/IID | The facility’s own cost | Federal staffing floor stays; Technology First policy applies |
| Nursing homes and assisted living | The facility’s own cost | Resident privacy rules apply |
| Home care agencies | The agency’s own cost, or the person’s waiver where it applies | Support between visits |
| Any agency, any setting | The agency’s own budget | No approval needed to buy |
What is remote support under Ohio’s rule?
Ohio Adm.Code 5123-9-35, effective July 1, 2026, covers remote support in the Individual Options (IO), Level One and SELF waivers. Under the rule:
- It comes first. Remote support is meant to meet assessed needs in a way that promotes autonomy and should be explored before more intrusive services, such as homemaker/personal care.
- It is live. Remote support is provided in real time, not via a recording, by awake staff at a monitoring base who have no duties other than to provide remote support at the time, and the monitoring base is located in a private area.
- Backup support is set in advance. Backup support can be an unpaid family member, friend or other person the individual chooses, or a paid homemaker/personal care provider.
- It is not for shared living. The rule says remote support will not be provided in a shared living setting.
What has to happen before remote support starts in Ohio?
- The person and their team explore remote support, including whether technology alone could meet the need.
- Written consent comes first. The person and each person who lives with them, or their guardians, give written consent through the service and support administrator (SSA). The consent form describes what remote support entails, such as whether the remote support staff will observe activities and/or listen to conversations in the residence, where specifically in the residence the remote support will take place, and whether recordings will be made.
- The Individual Service Plan (ISP) sets the details: the days and times, the need and the technology, the backup support with a contact and a reasonable time to arrive, and what happens if the person asks to turn the equipment off.
- The provider is ready. The billing provider is a DODD-certified agency provider with an Ohio Department of Medicaid provider agreement, with background investigations and training for remote support staff who monitor individuals from the monitoring base, a backup power system at every monitoring base, and a secure network system in place.
How does Ohio pay for remote support?
1. Remote support, per person. Ohio pays one rate when backup support is unpaid and another when it is paid. When several people in the same home receive remote support at the same time, the rate is divided equally among them. With paid backup support, the homemaker/personal care provider has the right of first refusal to bill for remote support, providing it directly or through a contract with a remote support provider that meets the rule.
2. The technology itself. Under Ohio Adm.Code 5123-9-12, the assistive technology service may include equipment used for remote support, software and monthly recurring fees. It pays for the least costly option that meets the need, and remote support equipment is designed so it can be turned off when someone designated in the ISP asks.
3. 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 how ICFs, nursing homes, assisted living and home care agencies use it.
Sources, checked October 25, 2026: Ohio Adm.Code 5123-9-35, remote support (effective July 1, 2026); Ohio Adm.Code 5123-9-12, assistive technology service (effective January 1, 2026); Ohio Revised Code 5123.025; Ohio Adm.Code 5123-2-01, Technology First.
What does Technology First mean in Ohio?
Ohio Revised Code 5123.025 makes it state policy that individuals with developmental disabilities have access to innovative technology solutions. Under Ohio Adm.Code 5123-2-01, each county board and each ICF/IID develops and carries out a written local Technology First policy, so technology solutions are explored and documented in person-centered planning.
How do consent and privacy work in Ohio?
The person supported decides whether remote support is used and where devices go, with help from the team they choose. The Individual Service Plan is person-centered and led by the person with their service and support administrator (SSA). Ohio’s rule requires written consent, obtained by the SSA, from the person and each person who lives with them, or their guardians. The consent form includes a description of what remote support entails, such as whether the remote support staff will observe activities and/or listen to conversations in the residence, where specifically in the residence the remote support will take place, and whether recordings will be made. The person can withdraw consent, and the provider must have a plan for turning the equipment off if the person asks. The team also revisits consent whenever the plan changes. The agency’s own trained team responds and decides, following the plan.
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 Ohio can keep every in-person shift and still use remote support, because technology raises 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 fills 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, and 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.
- In Ohio, remote support is a waiver service, so an ICF does not bill it. Each ICF/IID still keeps a written Technology First policy under Ohio Adm.Code 5123-2-01.
- 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 Ohio 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 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. 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. Residents live in their own units, with their own rights to privacy and choice. Technology placed with each resident’s consent gives staff better information between scheduled visits.
- In Ohio, 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 Ohio?
Home care agencies send aides into people’s homes for set hours. Between visits, no one is there. Remote support fills that gap: the person keeps their privacy, and the agency’s own trained team can see 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 Ohio, a homemaker/personal care agency that provides paid backup support has the right of first refusal to bill for remote support for that person.
Who else can remote support help in Ohio?
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 Ohio’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. The agency’s own trained team responds and decides, following each person’s plan.
Your agency stays the provider. It confirms that its full setup meets Ohio’s rules for the service it bills, or the rules for its license if it bills nothing. For waiver remote support, that includes Ohio’s consent, ISP, staffing, backup power and network security requirements.
For states and government agencies
Vista can also work with the Ohio Department of Developmental Disabilities (DODD), county boards, and with other state and government agencies, for example through a procurement or a contract. Any single agency can already get Vista Enterprise™ with no state approval.
Remote support for states and government agencies
What does remote support look like for a Ohio agency? (composite example)
This is a composite example built from common situations. It is not a real person.
A man in the Level One Waiver lives in his own apartment and wants fewer staff hours in his home. He, his guardian and his SSA explore remote support first, and his guardian signs the written consent form with him, which says where the non-wearable sensors go. His ISP names his sister as unpaid backup support. On the hours in his plan, an awake staff member at his certified agency provider can reach him the way his plan describes, and calls his sister when he needs someone in person.
Questions and answers
Can any Ohio agency buy a remote support solution?
Yes. Any Ohio provider or agency can get Vista Enterprise™, which includes VistaLink™. Like an EHR, it needs no DODD, county board or managed care approval. Billing follows each program’s rules.
Which Ohio waivers cover remote support?
Remote support is a service in the Individual Options (IO), Level One and SELF waivers run by the Ohio Department of Developmental Disabilities (DODD), under Ohio Adm.Code 5123-9-35.
Who can bill remote support in Ohio?
An agency provider certified by DODD that has a Medicaid provider agreement with the Ohio Department of Medicaid. With paid backup support, the homemaker/personal care provider has the right of first refusal to bill.
What has to be in the plan before remote support starts in Ohio?
Written consent through the service and support administrator, and an ISP that sets the days and times, the need and the technology, the backup support, and what happens if the person asks to turn the equipment off.
Can remote support be used in Ohio shared living?
No. Ohio’s rule says remote support will not be provided in a shared living setting.
How is equipment paid for in Ohio?
Through the assistive technology service under Ohio Adm.Code 5123-9-12, which can include equipment used for remote support, software and monthly recurring fees.
Can a Ohio 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, no cameras are required in bedrooms or bathrooms, and the facility pays for Vista Enterprise™ as its own cost.
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 Ohio 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 Ohio agency could run its own remote support with Vista Enterprise™ and VistaLink™.
Related pages
- Enabling technology for human services: a remote support solution for any agency
- How states pay for remote support
- Vista Enterprise™
- VistaLink™
- Remote support in the District of Columbia
- Remote support in Maryland
- Remote support in Pennsylvania
- Remote support in Tennessee
- Remote support in Minnesota
- Remote support in Missouri
- Remote support in Indiana
- Remote support in Wisconsin
- Remote support in New York
- Remote support in Colorado
- Remote support in Kentucky
- Remote support in Washington
- Remote support in Virginia
- Remote support in New Jersey
- Remote support in Delaware
- How to start remote support
- Family guide to choice and consent
- Remote supports FAQ
- Enabling technology: terms, states and settings