Medforall’s Formal Public Comment on Proposed Audio & Video Monitoring Rule Submitted April 2026
1. Introduction & Position Summary
Medforall respectfully submits this public comment on the Ohio Department of Developmental Disabilities’ proposed rule 5123-2-XX governing audio and video monitoring devices in HCBS residences.
Core Position: Thermal sensing is fundamentally different from audio and video monitoring. It provides meaningful safety monitoring while preserving inherent privacy — no faces, no identity, no audio. We urge DODD to recognize thermal as a distinct modality category with its own governance framework, rather than regulating it under the same rules designed for cameras and microphones.
This comment is informed by Medforall’s active deployment under DODD Contract #2558727 (Stark County Innovative Technology Solutions Grant), serving 60 participants with developmental disabilities and seizure disorders.
2. Thermal Is Not a Camera
The proposed rule addresses “audio and video devices” — technologies that capture identifiable images and sound. Thermal sensing operates on a fundamentally different principle: it detects infrared heat radiation, not visible light.
What Thermal Can See
Body shape, posture, and limb positions
Whether someone is dressed (body features that indicate gender are visible)
Multiple people in a room (distinguishable by heat signature)
Head movement, liquid on bed, CPAP mask displacement
Activity patterns: in-bed, out-of-bed, floor presence, movement vs. stillness
What Thermal Cannot See
Faces or identity — a person cannot be identified from thermal data
Text, clothing color, or room contents at ambient temperature
Emotional state, pain, or subjective experience
The privacy argument is not that thermal can’t see detail — it can. The argument is that thermal cannot identify who someone is, plus software filters further reduce what the human viewer sees. This is a two-layer privacy model: inherent modality privacy plus algorithmic protection.
3. Why Consumer Cameras Do Not Meet the Residential Care Standard
Ohio Admin Code Rule 5122-30-22.1 establishes resident rights regarding monitoring in sleeping areas. Consumer cameras (Ring, Wyze, Nest, baby monitors) create fundamental conflicts with these rights:
Shift-based access with MFA, audit logging, role-based permissions
Consent granularity
Binary: camera on or off
Privacy Mode, ROI cropping, condition-bound viewing windows, manual shutter
Dignity in sleeping areas
Full visual recording of a person sleeping, dressing, or in intimate moments
Heat patterns only — no identifying visual detail
4. Technology First Alignment
Ohio’s Technology First mandate directs that technology should be considered first as a way to support people with disabilities in living independently and safely. Thermal monitoring directly supports this mandate:
Least restrictive alternative: Thermal provides safety monitoring without the privacy intrusion of video or the physical presence of awake staff in the bedroom
Supports independence: Enables people to live in their own homes with remote monitoring rather than congregate settings
Gradual shift model: Technology augments human support — no existing supports are removed until data demonstrates reliability for that individual
Person-centered: The individual and their team choose this technology; every change is reversible
This system supports the people keeping your loved one safe — it does not replace them.
5. Governance Framework Already in Place
Medforall’s deployment under the Stark County grant operates under a comprehensive Data Governance & Security Policy (DGSP) that addresses the spirit of the proposed rule:
Informed consent: 14-section consent form signed before deployment
Shift-based access: Staff view data only during scheduled hours; emergency access requires supervisor approval and is reviewed within 1 business day
Encryption: TLS in transit, AES-256 at rest; Medforall holds keys
Retention limits: 30–365 days based on risk level; MUI recordings retained 7 years per legal requirement
Audit trail: Immutable logs of every access — who, when, why, what, outcome
Right to withdraw: Monitoring stops and data is deleted within 7 business days
No data sale: Data is never sold, used for advertising, or shared with third parties without consent
6. Recommendations to DODD
Create a distinct “thermal/non-identifying” category in the rule, separate from audio/video. Thermal does not capture identity and should not carry the same regulatory burden as a camera.
Recognize the two-layer privacy model (inherent modality privacy + software filters) as a governance framework that meets or exceeds the intent of the proposed rule.
Require a DGSP or equivalent for any monitoring technology used in residential care, regardless of modality. Governance standards should apply to cameras too — not just thermal.
Encourage Technology First innovation by creating a pathway for new sensing modalities (thermal, radar, mmWave) that support independence while maintaining privacy.
Mandate shift-based access control for all residential monitoring — the single most effective privacy protection regardless of modality.
7. Conclusion
Thermal sensing represents a meaningful advance in the balance between safety and privacy for people with developmental disabilities. It is not a camera. It does not record audio. It cannot identify the people it monitors. Regulating it as if it were a camera would discourage the very innovation Ohio’s Technology First mandate is designed to promote.
Medforall is committed to transparent, person-centered, and evidence-based deployment. We welcome further dialogue with DODD as the rule is finalized.
Submitted by: Medforall Contact: ra.6@medforall.com Deployment: Stark County Board of DD, DODD Contract #2558727 Date: April 2026