Ohio policymakers and stakeholders, including LeadingAge Ohio, are continuing discussions on yet-to-be-introduced legislation that would extend Esther’s Law — which allows residents to authorize electronic monitoring in long-term care settings — to assisted living communities.
During a January 21 stakeholder call hosted by the Office of the State Long-Term Care Ombudsman, providers, advocates, the bill sponsors and their legislative staff reviewed recent language revisions and raised additional implementation questions.
The bill would add residential care facilities (RCFs) to Ohio’s electronic monitoring statute, giving assisted living residents the same rights currently available in nursing facilities.
In response to stakeholder feedback, the latest draft removes a previously proposed $50 cap on installation costs. Instead, it allows facilities to charge residents only the actual cost of time and materials for installation, while clarifying that residents may not be charged for facility-wide internet or infrastructure upgrades.
The proposal also affirms that residents may select their own monitoring devices, so long as they are compatible with the facility’s internet infrastructure.
For Medicaid beneficiaries, the bill would cap monitoring-related charges — including installation and internet access — at 10% of the resident’s monthly personal needs allowance (PNA).
Providers raised questions about how the law would function in assisted living settings with high resident turnover. Some noted that a resident-by-resident installation model could require frequent device changes, creating staffing and IT challenges.
To address this, stakeholders discussed whether the bill should explicitly allow facilities to offer a standardized, facility-wide camera option as one way — but not the only way — to comply. Under this concept, residents could choose a facility-provided system or bring their own device under existing Esther’s Law protections.
Participants also flagged concerns related to cybersecurity and privacy. Providers expressed unease about connecting a wide range of third-party devices to facility Wi-Fi networks and the potential exposure to hacking or data breaches.
Related questions were raised about HIPAA and liability, particularly if facilities are required to provide internet connectivity for devices that transmit highly sensitive video footage. Stakeholders suggested additional legal review to clarify responsibilities and risk exposure.
While the bill includes cost protections for Medicaid residents, providers noted that connectivity and IT support costs would still be absorbed by facilities. Stakeholders suggested exploring whether CMP funds or other technology-related funding sources could help offset those expenses.
No final decisions were made during the January 21 call. Legislators and stakeholders agreed that the proposal reflects meaningful progress but may require further refinement. Additional legal review and continued stakeholder engagement are expected as the legislation moves forward.