From Disability Scoop:
“Remote Monitoring Offering
Adults With Disabilities More Independence”
If his support worker isn’t on
the way out the door by 9 p.m., John Mogan might encourage the exit. That’s
when his alone time starts. The 50-year-old gets to sleep, watch television or
listen to music without someone watching over him. No one in his home, anyway. Ali
Rahimi monitors Mogan remotely, by way of video cameras, sensors and other
devices. Rahimi can dim lights, lock doors, play relaxing songs and, most
importantly, see when Mogan needs in-person help. Mogan has developmental
disabilities and mental illness. Those conditions make it all but impossible
for him, and for thousands of other Ohioans, to safely manage day-to-day life
without assistance. “John used to have staff with him 24/7,” said Rahimi,
founder and CEO of Medforall, a company based in Grandview Heights. “We’ve been
able to cut that in half.” Although its use is still far from widespread,
“supportive technology” is emerging as an answer to some of the disability community’s
most pressing issues. Advocates see it as a means to help people gain greater
independence and reduce reliance on the direct-support workforce, which is
struggling under low wages, a shortage of employees and alarmingly high
turnover rates. “I truly believe that what we’re doing will save the industry,”
Ken Smith of Rest Assured, a telecare and remote support company out of
Lafayette, Ind., said during a recent meeting with Ohio officials. “It can’t
continue this way. We don’t have the bodies.” As governor, John Kasich signed
an executive order last year that made Ohio the first state to formally
emphasize expanding access to technology for people with developmental
disabilities. “The kind of entrepreneurship, passion and commitment we have is
just phenomenal,” said Jeff Davis, director of the Ohio Department of
Developmental Disabilities. Rahimi, 37, is an Iranian immigrant and Ohio State
University graduate, a computer scientist and engineer who didn’t exactly dream
of being a trailblazer in the field of disability services. The seed grew after
a chance meeting 16 years ago, when he interviewed social worker Patti Ruble
for a college assignment. Ruble, who is now 76, lost almost all her mobility to
polio at age 12. Rahimi was astounded that she had gone on to earn two degrees
and establish a career. “I guess I had preconceived notions,” he said. “It was
a positive shock, really. It got my brain firing.” Rahimi couldn’t stop
pondering the frustrations and limitations of Ruble’s wheelchair, apartment and
unreliable support providers. He could barely contain all the ideas he had to
make things easier for her. And — this is the most important part, Rahimi said
— he quickly grew to care for Ruble. He considers Mogan a friend, too. “It’s
that human element that’s making this happen,” he said. “I’m an engineer, so as
much as I want to give credit to the technology, that’s not it. It’s wanting to
help make someone’s life better.”
Solving problems
Rahimi and his staff in the tiny
lab at Medforall mix off-the-shelf hardware such as smartphones and Amazon
Alexa with custom designs, programs and even 3-D-printed devices. Offerings
range from relatively simple smart-home features — Ruble’s University District
apartment has several — to specialized video that protects privacy in bedrooms
and bathrooms. There are sensors that notify workers when a client gets out of
bed, gaze-activated screens, and visual and voice prompts when medications are
due. “Pretty much everything we do, we just start from solving one problem,”
Rahimi said. One cutting-edge development underway uses augmented reality to
create a calming, interactive model that looks like a young client’s father,
for example. “Imagine that there is an invisible person on the couch, but only
the phone can see it,” said Medforall animator Jesse Cutrell. The pace of
advances is breathtaking, Ruble said. “Ali doesn’t even know where a lot of
this stuff is going to lead him.” She remains most impressed, however, with his
compassion. “He’s a son to me,” she said. Even before Medforall took off,
Rahimi sought to help Ruble obtain more responsive support staff members. In
2011, he started Ohio At Home, a health-care agency now connected to the
supportive-technology business he founded in late 2015. “I was fearful,” Rahimi
said. “I remember the first person we hired. I said, ‘Patti, what are we
doing?’ And now we have 64.” Rahimi hires Ohio State students, most of whom are
majoring in health- and social-service fields. “They’re pre-conditioned,” he
said. “I don’t have to teach them why this work matters.”
Increasing numbers
According to the state, about 420
people in Ohio have remote support as part of their disability services, and
approximately 480 are using assistive-technology devices. Some opt for both. Disabilities
officials have a plan to increase the total to 2,150 this year, which still
would be just a fraction of the 44,000 Ohioans whose Medicaid funding can be
used to pay for support workers, tech-based care and other community services. “Getting
the manpower out there to talk about it is a challenge,” said Adam Shoemaker of
THS Remote Support Services in the Cincinnati area. “There’s a lot of education
to be had.” Incorporating technology typically requires cooperation with paid
support providers, and that can raise questions about expectations and billing,
risk and liability. Ohio’s county disability boards need to become more aware
of the technology so that case coordinators can explain options, advocates
said. But families shouldn’t be made to feel as if they are being pushed to
agree to technological support as a means of saving money. “It’s not a good fit
for everybody,” Shoemaker said. Costs vary widely, depending on the service or
device. But Shoemaker said a client who switches from in-person support to
remote monitoring for even a few hours each week could easily reduce spending
by thousands each year. He’d like to see some of the savings go toward boosting
wages for support workers, few of whom earn more than $12 an hour. John Mogan’s
father, Pat, admits to “some trepidation” about the family’s decision more than
a year ago to trust that technology could help his son regain time on his own
in his West Side apartment. The Franklin County Board of Developmental
Disabilities had recommended around-the-clock support a few years ago after
Mogan suffered a series of injuries. That change raised expenses and, at times,
Mogan’s stress level. A case coordinator told his father that while it was obvious
that Mogan couldn’t be on his own, “he can still be independent, and this is
how we can do it.” Mogan, whose speech is severely affected, said he likes his
home and doesn’t mind the cameras. He’s clearly fond of Rahimi. “Ali comes to
John’s at all hours of the night,” Pat Mogan said. “If they notice something,
or if John is restless, he’ll be right there.” Rahimi is among a handful of
technology vendors communicating with the state about progress and problems. He
can’t help but laugh when he considers where he started. When he first built a
technology “hub” for Ruble, he didn’t even know he could get paid for providing
such services. “We had no idea,” Rahimi said. He just figured that, based on
his skills and her needs, it was the right thing to do. “The home health-care
model is not going to be the same,” Rahimi said. “Everything is changing. But
what technology is not going to be able to take over is love and compassion.”
^ This seems too good to be true,
but I really hope that it is true and that it can help millions more disabled
people around the world to gain more independence. ^
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