Medforall · Stark County Board of DD
Privacy-First Thermal Sensing Program
Rollback Decision Tree
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Rollback Decision Tree

Stark County Privacy-First Thermal Sensing — April 2026
Important: This system supports the people keeping your loved one safe — it does not replace them. Every change made during this program is designed to be reversible. Rollback is not failure — it is the system working as intended.

This document guides the decision process for reversing support reductions. A rollback conversation is appropriate whenever data, consent, or clinical judgment indicates that current support levels should be restored.

Decision Flowchart

Is the system missing events that staff observe directly, or are alert response times consistently above threshold?
YES
▶ Initiate rollback conversation
NO
Has the participant or family withdrawn consent, or expressed discomfort that education has not resolved?
YES
▶ Initiate rollback conversation
NO
Has the care team identified concerns about current support levels, or has there been a change in clinical status?
YES
▶ Initiate rollback conversation
NO
✓ Continue current plan.
Review at next scheduled interval.

When Rollback Is Appropriate

TriggerAction
Missed safety event — the system failed to detect an event that required interventionImmediately restore previous support level; investigate root cause; do not re-attempt reduction until issue is resolved
Increase in adverse outcomes — falls, injuries, emergency calls, or hospitalizations increase compared to baselineRestore previous support level; review whether the reduction was premature or the system configuration needs adjustment
System reliability drop — uptime falls below 90% or connectivity gaps in monitoringRestore previous support level until system reliability is restored above 95%
Loss of confidence — participant, family, or team no longer feels safe with reduced supportRestore previous support level; reassess through team conversation
Change in clinical status — seizure frequency increases, new medication, new diagnosisRestore previous support level; reassess CtLC scorecard with updated clinical information
Consent withdrawal — participant or guardian withdraws consent for monitoringRestore all prior supports immediately; follow data deletion procedures per DGSP

When Rollback Is NOT Needed (but Review Is)

SituationRecommended Response
Single missed alertInvestigate root cause (sensor placement, threshold, connectivity). One event is not a pattern — document and monitor.
Temporary spike in false positivesSystem may be recalibrating after an environment change (new furniture, pet, heating). Adjust thresholds; review after 7 days.
Family questions about privacyAddress with education — refer to playbook sections on thermal visibility and the two-layer privacy model. Privacy concerns alone do not require rollback.
Staff turnoverRetrain new staff on alert response protocol. Do not reduce supports further until new staff are fully onboarded.

Rollback Process

When any trigger above is met, follow these steps:

1

Convene Team Meeting

SSA, family/guardian, provider staff, Medforall representative, and clinical team (if seizure-related). Schedule within 5 business days of trigger event.

2

Review the Data

What triggered the concern? Present alert logs, staff response times, pattern changes, and any incident reports. Compare current data against the baseline established during the parallel operation period.

3

Determine Scope

Full rollback: Restore all prior supports to pre-reduction levels.
Partial adjustment: Restore supports for specific time windows or specific concerns only.

4

Document the Decision

Record in the ISP: date, participants, data reviewed, decision made, rationale, and next review date. This becomes part of the participant’s implementation record.

5

Restore Supports First

Implement restored human supports before reducing or removing technology monitoring. The safety net must be in place before any changes take effect.

6

Schedule Follow-Up Review

Review within 30 days of rollback. Assess whether the underlying issue has been resolved and whether a new graduated reduction attempt is appropriate.

Key Principles

Every change is designed to be reversible. No existing supports are removed until the team has real data showing the system is reliable for this person. This is a gradual shift, not an overnight switch.
Rollback is not failure. It is evidence that the safety framework is working as intended — data is driving decisions, and the team is responding to what the data shows.
The safety net works both ways. Technology augments human support; human support backstops technology. Neither replaces the other.
Seizure monitoring is a proxy. The HEARO system detects movement consequences of seizures (falls, thrashing, prolonged immobility) — not seizure electrical activity itself. This is a moderate confidence proxy for tonic-clonic seizures. It cannot detect absence or focal seizures. Rollback decisions for seizure-monitored participants should involve the clinical team.