The AT Messenger ....bringing technology to you Published by the Delaware Assistive Technology Initiative Vol. 1, Issue 1, Jul/Aug 1993 DATI Annual Conference Set for October 4 & 5 The Second Annual DATI Conference will be held on October 4 and 5 at Clayton Hall on the University of Delaware campus in Newark. Like last year’s conference, sessions will address a variety of assistive technology applications across the lifespan. Nationally-recognized experts will talk about AT opportunities available through early intervention, school and vocational rehabilitation programs, Medicaid, and SSI. Several sessions will address leisure and recreational activities supported by assistive technology. A Washington insider will update attendees on the latest developments in health care reform and the implications for AT service delivery. A large exhibit of products and services will accompany the conference sessions. The registration fee of $15 for consumers and $25 for all others permits access to all conference activities, including continental breakfast, lunch, and breaks both days. A limited number of consumer scholarships are available. For more information, or to receive the conference brochure/registration kit, contact Sonja in the DATI Central Site Office at 651-6790 (voice) or 651-6794 (TDD). DATI Throughout the State... The DATI is funded by a grant to the University of Delaware from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. The statewide program is operated out of four primary sites. The Central Site, at the Applied Science & Engineering Laboratories at the A.I. duPont Institute in Wilmington, is the administrative and programmatic hub of the DATI network. The program also supports Technology Resource Centers in each of Delaware’s counties. Central Site The Central Site coordinates statewide activities including the annual conference and other types of training, the equipping of the TRCs, the equipment recycling program, funding advocacy, and the peer network. We also handle telephone and written inquiries and work collaboratively with other agencies to increase technology-related assistance in DE. Give us a call and get in on the action!! The Central Site staff includes Beth Mineo, Director; Bob Piech, Project Coordinator; Ron Sibert, Funding Specialist; Donna Bacon, Education & Training Coordinator; Gregg Stum, Research Programmer; and Sonja Simowitz, Staff Assistant. New Castle County Delaware Elwyn 321 E. 11th St. Wilmington, DE 19801-3499 (302)657-5647; (302)658-8860 (TDD) It has been almost a year since we started making the Technology Resource Centers an operational reality, and we are enthused about sharing the excitement of helping people obtain assistive technology. We would like to introduce the staff that will be helping you when you call the New Castle County Center, located at Delaware Elwyn. We are delighted to have Amy McEvoy as Administrative Assistant. Amy is a recent honors graduate in English and French from the University of Delaware. Amy is extremely knowledgeable about computer software and worked as a student part time at the DLRS Center for Technology at the University of Delaware. When Amy is not working at the center, she is busy getting ready for her wedding in October! Linda Heller, Director of the center, is an audiologist and speech therapist by clinical training. Linda has worked in schools, hospitals, and rehabilitation centers both as a clinician and in senior management positions in health care. In addition, she was born with a moderate to severe hearing loss and has worn two hearing aids since the age of 17. Linda brings a unique perspective to the Center with experience as a clinician, administrator, and consumer. The NCC Center also has several consumer volunteers and a wonderful, active advisory board that guides and supports the services of the center. But we at the center look forward most of all to hearing from you! TOGETHER we can reach the goal of getting assistive technology into the hands of all who need it! Kent County Easter Seal of Del-Mar Kent County Orthopedic School Carver Rd. Dover, DE 19901-2716 (302)739-6885; (302)739-6886 (TDD) The Easter Seal Technology Resource Center operates under the philosophy that technology is nothing without the human factor. We believe that the technology available through the TRC will allow individuals with disabilities to break some of the barriers that restrict their educational, social-recreational, and vocational goals and achievements. We believe that “for most people technology makes things easier. For people with disabilities, however, technology makes things possible”. (Mary Pat Radabaugh) Maureen Schweitzer is the Coordinator of the TRC. She has extensive experience in providing augmentative communication services and using computer technology in intervention with children and adults. Ed Salisbury is the Assistive Technology Specialist who has a background in electro-mechanical engineering. Ed has experience in fabricating equipment and devices specifically to meet the needs of individuals with disabilities. Patty Hove and Justine Gray are Occupational Therapists who share the responsibilities of the Assistive Technology Specialist. They offer information about access as it relates to the use of different parts of the body and body movements. This expertise has been invaluable as it has encouraged individuals to try various access methods that they may not have considered otherwise. Lori Zimmerman is the Center’s Administrative Assistant who schedules all appointments and equipment demonstrations. Sue Ellen Powell is a consumer demonstrator who works part-time during the school year. She uses the Center’s database to research information requested about different pieces of technology. The TRC is set up to represent 9 different areas of technology. A series of work stations display different groupings of equipment representing low technology and high technology for individuals of all ages. We are located behind the William Henry Middle School in the Kent Orthopedic School, with a satellite site at the Delaware Division of Libraries in the Edgehill Shopping Center, Dover. Call us for more information or a tour at 739-6885. Sussex County Easter Seal of Del-Mar Easter Seal Rehabilitation Center 600 N. DuPont Highway, Suite 100 Georgetown, DE 19947 (302)856-7946 (voice or TDD) It’s summer, hot and humid, and the beaches are crowded. When you feel the need to get away, please accept this invitation to come visit the Sussex Technology Resource Center. Go to Georgetown and get on Highway 113, and turn into the professional plaza across from 84 Lumber. This will bring you to the Easter Seal complex which houses the Sussex TRC. The Sussex center, although small, has a lot to offer, especially in the area of daily living devices. Don’t let the size fool you! It’s packed with computers, communicators, walkers, and cushions. Also available is a computer/video room and resource library where you can try out computer programs, preview videos, or browse through reference materials and catalogs. Our staff of Linett Fleetwood, Director, and Dee Huffman, Administrative Assistant, is happy to answer any questions or help find equipment. And if you can’t make it to us, we’ll make housecalls! Call at 856-7946 between 8:30 and 4:30 weekdays to arrange for an individual consultation. Assistive Technology Funding for Children with Disabilities Ron Sibert, DATI Funding Specialist These are exciting times for children with disabilities. Assistive technology (AT) can enable many to learn and participate more fully in activities with their nondisabled peers. While not all AT is expensive, paying for devices and services is still a common concern. Resources are out there. Getting to them is just a matter of understanding and working within the appropriate system. Described here are two major AT funding streams for children and adolescents with disabilities: Medicaid and the School System. Medicaid/ EPSDT The Medicaid program was created under Title XIX of the Social Security Act “to provide assistance to states to furnish medical assistance on behalf of families with dependent children and of aged, blind or disabled individuals whose income and resources are insufficient to meet the cost of necessary medical services”. People who know that Medicaid exists also know that it is a “means [or income] tested” program; that is, eligibility depends on one’s limited income and inability to pay for medical care. Many families with disabled children will actually forego the program’s medical benefits because they don’t want to be regarded as poor. The fact is that some families whose incomes may qualify them for Medical Assistance do not apply for it because it seems like “welfare”. Also, families whose incomes fall above the poverty level believe that their children with disabilities do not qualify for Medicaid benefits. Many children with disabilities can qualify for Medicaid regardless of the family’s income level. Once it has been established that a child is disabled, the child may qualify for Medicaid either because of that disability or due to lack of personal income. In such instances the child’s income, which is usually modest or nonexistent, is considered independent of the family’s income. This, is called the MEDICAID OPTION FOR DISABLED CHILDREN. Use this term when inquiring about eligibility. Every state that participates in the Medicaid program receives matching funds from the federal government. In Delaware, the match is 50 cents on the dollar. That is, the Federal Government reimburses the State for 50% of the funds spent on providing Medicaid services. Each state must file a state plan detailing the services covered under its Medical Assistance (Medicaid) program. Some of these services are mandatory and others are optional. That is, participating states are required to provide some Medicaid services, and can choose whether or not to provide others. The durable medical equipment (DME) funding component of the program (the part that would pay for assistive technology devices) is an optional service. However, that distinction need not be a concern for younger age groups because Medicaid eligible children with disabilities are not bound by state plan service restrictions under the Medicaid’s Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. EPSDT is a mandatory service for Medicaid eligible children from birth through age 21. Because of its comprehensiveness, it has been referred to by some as the “gold card” of medical service coverage for children with disabilities. Under the “treatment” part of EPSDT, Medicaid will pay for medically necessary equipment (DME) and services that are covered under Title XIX, even if the equipment and services are not specifically listed in the state plan. The only catch is, like with most other insurances, equipment purchased by Medicaid must be “medically necessary” and prescribed by a physician. Now exactly what does medical necessity mean? Let’s say a child who is both deaf and blind needs an Arkenstone reader - a device that can scan written materials and translate those materials into braille. The child needs this device in order to read and communicate. Are reading and communicating medically necessary? Think about it. If you were unable to communicate would you be able to make your doctor understand your illness well enough to obtain adequate medical care? Not likely. Does an augmentative communication device replace a function which is absent due to a disability? Of course it does. That communication device is just as medically necessary as a wheelchair is for a person who is paralyzed from the waist down. Both types of devices replace a function that is diminished due to a diagnosed disability. Of utmost importance is the language that is used to document medical necessity. The prescribing physician should explain how the patient’s impairment/illness affects the ability to function, and how the prescribed device would improve the situation. Delaware Medicaid requires a complete description of the prescribed device (i.e., price, brand, and model number) and the specific features that make that particular item the most appropriate to meet the individual’s needs. Comparing it to similar, less expensive products is also advisable. It will speed up the processing of the claim. If there is other insurance coverage, all claims should be submitted at the same time to avoid delays. Medicaid is the “payor of last resort” and will therefore require written denials from other insurers before purchasing any equipment or services. Schools Besides Medicaid, schools are another major funding source for assistive technology for children and adolescents with disabilities. According to Public Law 101-476, the Individuals with Disabilities Education Act (IDEA), every child with a disability is entitled to a Free Appropriate Public Education (FAPE) in the Least Restrictive Environment (LRE). FAPE includes Special Education Services for children with disabilities. Because AT can accommodate functional needs that impact learning and education of children with disabilities, it must be considered a component of Least Restrictive Environment and Free Appropriate Public Education. In order for a school district to pay for equipment, it must be deemed a part of Special Education, Related Services, or Supplementary Aids and Services. Above all, the equipment must be EDUCATIONALLY NECESSARY. Here again, note the importance of wording in the equipment justification. It should always be tailored to the funding source. So how are assistive technology needs documented in Special Education? According to IDEA, every child who receives special education or early intervention services must also have its amount, duration and scope documented in an Individualized Education Program (IEP) for Special Education or an Individualized Family Services Plan (IFSP) for Early Intervention. If a child needs assistive technology devices or services to compensate for an educational deficit, and that need is documented on the IEP, the school district must provide that device or service. The law requires it. Parents have the right to participate in the IEP’s development at a meeting convened for that purpose. Children with disabilities have the right to assessments in which AT is considered. At the IEP meeting the parent and child also have the right to be represented or accompanied by any advocate, clinician, or technology expert they choose. Parents may also appeal any decision made at the IEP meeting through due process; but schools and parents need not be adversaries. A great deal can be accomplished with cooperation. The incorporation of technology into educational programs is a challenge that must be shared by consumers, schools, and service providers. For example, assistive technology device recommendations should always be based on thorough professional evaluations and assessments of individual needs. No device should be selected solely because of its price, attractiveness or prevalence in the marketplace. The usefulness of a device is not a function of cost or popularity; it is a question of the individual’s unique needs. Finally, school districts in Delaware are approved Medicaid/EPSDT providers. Recall that assistive technology devices, as well as necessary assessments and evaluations, may be charged to the State’s medical assistance program - if they are shown to be medically necessary. This would significantly offset the cost of equipment and related services incurred by the schools. While school districts cannot require parents to apply for or divulge existing Medicaid coverage, it may be in the child’s best interest for them to do so. Why? Because if the school district pays for the equipment, it is the school district’s property; but if it is purchased by Medicaid, the device belongs to the child. New legislation and increased awareness is challenging parents, schools, state agencies and service providers to work together to meet the technology needs of children with disabilities. There is every indication that it can and will be done...with persistence, a little resourcefulness, and a lot of cooperation. DATI Network Enhanced Through Computer Technology The DATI has invested hundreds of thousands of dollars in the Technology Resource Centers, equipping them with the latest in assistive technology and staffing them with knowledgable individuals. The TRCs have become even more efficient with the installation of a computer system that connects all of the DATI sites and makes communication as easy as pressing a key. One of the most important features of the system is its inventory capability. All DATI locations have quick access to information about every information resource and every piece of assistive technology throughout the statewide network. Using the system, staff can find out in which center a particular item is housed, pricing and vendor information, and whether or not the device is currently on loan. Staff can use the system to reserve an item for someone who wishes to borrow it. The system also generates all of the paperwork necessary to complete the loan process. The computer system has other exciting capabilities. It provides a means of communication among all DATI sites with its electronic mail and bulletin board features. It generates other types of forms and documents needed by the sites, and collects and tabulates a variety of data. The system was designed exclusively for the DATI by Gregg Stum, a member of the Central Site staff. Gregg will be incorporating additional features into the system over the next several months. The DATI is very grateful to IBM for providing the hardware on which our communication software package operates. Recycling Craze Hits AT! Recycling is a common practice in these environmentally conscious times. This has carried over into the field of assistive technology. Recycling allows someone who sells a used device to recoup some of his/her purchase cost and enables the buyer to acquire technology at a reduced price. To address the interests of those with used equipment and those looking for it, DATI is pleased to announce the availability of a new service coordinated through our offices. The Assistive Technology Recycling Program will accept information from people with devices to sell or donate and from people looking to obtain used equipment. All of this information will be maintained in a computer database for efficient matching of those having devices with those needing devices. Once a match is made, DATI will inform the parties of the potential match and determine their willingness to pursue the sales/exchange of the equipment. If the parties concur, the project will provide them with each others’ names and phone numbers and they can then communicate directly with one another about the “deal.” People wishing to have one or more specific devices or needs listed in the database may call the DATI Central Site at (302)651-6790 or one of our three Technology Resource Centers. The number in New Castle Co. is 657-5647; in Kent Co. 739-6885; and in Sussex Co. 856-7946. The AT Messenger will feature new additions to this database list in each issue. Please note that this service is primarily for the matching of equipment with needs among private individuals. Commercial enterprises wishing to buy or sell used assistive technology devices should contact the DATI Central Site to discuss an appropriate means of information exchange. Also, be aware that the DATI accepts no responsibility for the working condition of any device passed on through this service. Any terms for product exchange are to be worked out privately between the supplier and recipient. The AT Messenger is published bi-monthly by the Delaware Assistive Technology Initiative. Delaware Assistive Technology Initiative Applied Science & Engineering Laboratories University of Delaware/A.I. duPont Institute P.O. Box 269, 1600 Rockland Rd. Wilmington, DE 19899 Phone: (302)651-6790 TDD: (302)651-6794 FAX: (302)651-6793 Beth Mineo, Director Ron Sibert, Funding Specialist Bob Piech, Consumer Activities Coordinator Donna Bacon, Education & Training Coordinator Sonja Simowitz, Staff Assistant Gregg Stum, Research Programmer DATI is funded by the National Institute on Disability and Rehabilitation Research of the U.S. Department of Education, Grant #H224A10005. This publication does not necessarily reflect the position or policy of NIDRR/ED, and no official endorsement of the materials should be inferred. The University of Delaware is an equal opportunity employer and prohibits discrimination on the basis of race, color, creed, age, national origin, marital status or disability in conformity with applicable laws.