Ohio’s Technology First initiative, established by Executive Order 2016-11K and codified in Ohio Revised Code §5123.025, directs that technology be considered first as a way to support people with developmental disabilities in living independently, safely, and with dignity.
Technology First does not mean “technology only.” It means technology is the starting point in every conversation about supports — and that traditional staffing models should not be the default when a person-centered technology solution exists.
Under DODD Contract #2558727 (“Tech Matters: Advancing Safety and Independence”), Stark County Board of DD is deploying Medforall’s HEARO thermal sensing system to monitor 60 participants with developmental disabilities and documented seizure disorders.
The program uses a gradual shift model: technology augments existing human support. No existing supports are removed until the team has real data showing the system is reliable for each individual person. This is not an overnight switch.
| Technology First Principle | How HEARO Delivers |
|---|---|
| Least restrictive alternative | Thermal provides safety monitoring without video surveillance, audio recording, or physical staff presence in the bedroom. No faces, no identifying features. Privacy is inherent to the modality. |
| Supports community living | Enables people to stay in their own homes with remote monitoring rather than moving to settings with higher staffing ratios. Supports independent and family living arrangements. |
| Person-centered choice | The individual and their team choose this technology. Every configuration is tailored using the Charting the LifeCourse (CtLC) framework. Every change is reversible. |
| Reduces restrictive practices | Replaces more intrusive monitoring (baby monitors, cameras, awake staff in bedroom) with a privacy-first alternative. Shifts from surveillance to safety support. |
| Data-driven decisions | Monthly reports and baseline comparison drive all support-level changes. No reductions happen without documented team consensus and real data. |
| Cost-effective | HEARO equipment at $850–$2,000 per site + $25/mo cloud subscription vs. $9.48/hr for in-person overnight support. Technology investment pays for itself within months while improving safety data. |
The program follows a three-phase model for each participant:
| Phase | Duration | What Happens |
|---|---|---|
| Phase A: Parallel Operation |
30–90 days | HEARO is installed and begins learning baselines. All existing supports remain unchanged. Monthly reports compare system observations against existing caregiver logs. The team builds trust in the system’s accuracy. |
| Phase B: Graduated Reduction |
Ongoing | Based on Phase A data, the team proposes small, targeted, reversible reductions in support hours. Each reduction requires documented team consensus. If outcomes worsen, the reduction is reversed. |
| Steady State | Ongoing | Support levels match actual need as demonstrated by data. Monitoring continues. Monthly reporting continues. The gradual shift can be reversed at any time. |
Every participant is assessed using the Charting the LifeCourse (CtLC) framework — a validated assessment tool developed by Dr. Sheli Reynolds at UMKC. The CtLC scorecard evaluates each proposed configuration across 6 dimensions:
Configurations scoring below 55 (Tier D) are not recommended. Configurations with life-safety risk where the primary risk signal is not covered (the Safety-Critical Modality Gate) cannot exceed Tier C until the configuration is strengthened.
Thermal sensing is a moderate confidence proxy for tonic-clonic seizure monitoring. It detects movement consequences — falls, thrashing, prolonged immobility — not seizure electrical activity itself.
This honest framing is central to Medforall’s approach. Overclaiming what thermal can do would put participants at risk. The CtLC scorecard enforces this honesty by capping Technology Fit scores for thermal-only seizure configurations.
The Stark County program is a model for how Technology First can be implemented with integrity — person-centered, data-driven, privacy-first, and honest about limitations. As Ohio continues to develop its Technology First infrastructure, programs like this demonstrate that safety and privacy are not in conflict.