Finding funding for assistive technology.
New technological developments have raised the expectation that people with disabilities can employ assistive devices to function more independently in their homes and communities and pursue vocational goals not dreamed of before. Every day people act on this expectation and do gain more independence.
But expectations are often dashed or delayed when people seek financial assistance to purchase devices and are faced with a maze of funding sources, eligibility restrictions, paperwork requirements and rules and regulations governing the funding of such equipment.
Selecting Funding Resources
Sources of financial assistance for purchasing assistive technology are many and varied. Each has a different eligibility criteria. Most require that an application for services or financial assistance be completed. All have specific rules regarding what equipment can be purchased.
Most primary sources of financial assistance are programs authorized and funded by the federal government. Programs such as Social Security are operated by federal agencies. Others, such as vocational rehabilitation programs, are federal/ state partnerships and are operated by state agencies.
The Supported Employment (Title VI programs) and Independent Living Services (Title VIIA & VIIC programs) are federal/state rehabilitation programs that also provide funding for assistive technology. Independent living programs are noteworthy because they can provide funds to purchase assistive technology for individuals neither working nor preparing to work, and who are therefore ineligible for vocational rehabilitation. Title VII monies can pay for assistive devices that enhance an individual's ability to function more independently at home and in the community.
In addition to government agencies, some private organizations can be sources of funding. Foundations, corporations and trust funds are potential sources of direct financial assistance. Some research at a local library will help identify an appropriate source of funding. Usually, the person seeking the funds must write a funding proposal or justification statement indicating the nature of the need and how the monies will be spent. The proposal may be simply a letter or may require more formal correspondence.
Civic organizations and service dubs are another resource. They often raise funds on behalf of individuals needing financial assistance to purchase of assistive devices. Lions Clubs, Kiwanis, Rotary and Pilot International are examples of organizations that have a history of assisting people with disabilities.
Finally, there are several organizations that have established low-interest revolving loan programs. These programs are particularly valuable to individuals and families whose incomes make them ineligible for programs based on financial need. The low-interest loan program administered by the National Easter Seals Society was established specifically to aid people with the purchase of assistive technology. The American Foundation for the Blind, in cooperation with the Xerox Corporation and the Bank of Boston, established a low-interest loan program to help people who are blind to purchase personal readers.
A few manufacturers of assistive technologies provide financing or other forms of time payments, but this is a rare practice. However, often manufacturers and vendors are sensitive to the difficulties consumers face when trying to find funding sources. Prentke Romich, Co. of Wooster, Ohio, is one example of a vendor attempting to aid its current and potential customers by educating them about the funding process.
Once you have identified a primary source of funding, you should develop a specific strategy that is tailored to your unique requirements.
Developing a Funding Strategy
When deciding on the best approach for funding the purchase of assistive technology, it may be appropriate to choose one primary source. However, funding sources often like to share the cost with one or more other providers. The key to success is selecting the appropriate funding strategy.
The Arkansas Research and Training Center offers the following questions which might help to narrow down the choices:
* What is the most promising funding source?
* Has this source been dealt with before?
a. Was it successful?
b. What problems were encountered?
c. Who was the contact person?
* Is there a possibility of more than one funding source?
* Will the vendor be an advocate and provide preapproval and billing services?
* Are there persons with disabilities using these devices, and can they be contacted for suggestions on their proper use?
* Will the device enable the consumer to enter or continue employment, live more independently or improve overall health? Can the funding source be convinced of this advantage?
* Are written policies of the primary source available?
* If a person has a disability as a result of a job-related accident, is the device the responsibility of workers' compensation insurance?
* Will a civic or charitable organization, foundation or association help raise the necessary funds?
The Arkansas RTC publication notes that the answers to these questions will be unique for each individual and may depend on factors such as severity of disability, age, education, employment status, insurance coverage, and geographical location.
Preparing a Justification Statement
Some funding sources require the applicant to prepare a justification statement. This is particularly true for government programs. When the funding source is a public or private insurance policy, a statement must be submitted by the expected beneficiary, a physician or a therapist indicating the medical necessity of the purchase.
When applying for funds from a state vocational rehabilitation agency, the applicant must demonstrate that the device will assist in preparing for, getting or keeping a job. If work is not an expected outcome, then the justification must indicate the device will enhance the individual's ability to function independently.
Local school districts will often pay for devices and auxiliary aids used in the classroom. Families requesting that the school pay for assistive technology should be prepared to demonstrate how the device will enhance the child's ability to obtain an appropriate education in the least restrictive environment.
Other funding sources will have their own specific requirements. Success in securing funding is often dependent on the applicant's ability to address each agency's unique requirements in a funding request.
Keys to Funding
In sum, the keys to opening the agency doors and breaking down funding barriers are knowledge, determination and preparation. First, identify specific needs, then identify assistive technology that addresses the need. Become familiar with potential funding sources, their eligibility criteria, paperwork requirements and payment policies. Learn to select appropriate funding sources to match the need and to justify the funding request in terms that meet the agency's goals. (See the chart on page 26 for a list of agencies and organizations that can be of assistance in your search for funds.)
In seeking funding, parents (in conjunction with their child's clinical and educational teams and an adaptive medical equipment professional) may need to use more than one source in order to obtain the necessary device. As illustrated in the article Insurance Claim Appeal (on page 30 of this issue), applying to any of these funding sources can be a frustrating process. The following list of sources also includes eligibility requirements:
* Credit financing. Eligibility is based upon the applicant's credit history. Collateral is usually used to secure the loan along with other assurance of likelihood that the loan will be repaid. Because some equipment can be difficult for a bank to resell in the event of a default, the loan may need to be secured in other ways.
* Medicaid. Based on Title XIX of the Social Security Act, Medicaid covers needy persons who are eligible for AFDC or Supplemental Security Income (SSI) programs. Some states cover medically needy persons whose incomes, after deducting medical expenses, fall below the income threshold.
Medicaid equipment payment policies vary from state to state, generally following Medicare policies. Most states pay for home medical equipment; many pay for prosthetics and orthotics. Augmentative communication equipment is paid for by a growing number of states. "Medical necessity" is the critical factor for payment.
* Medicare, Part B. Based on Title XVIII of the Social Security Act, persons under 65 years of age who are disabled severely enough qualify for Social Security Disability Insurance (SSDI) for at least 25 months are eligible. Payments are made for so-called durable medical equipment (DME) which:
(a) can withstand repeated use;
(b) is primarily and customarily used to serve a medical purpose;
(c) generally is not useful to a person in the absence of illness or injury;
(d) is appropriate for use in the home.
Examples of equipment covered include internal prosthetic devices, external braces and artificial limbs or eyes.
* TEFRA. Based on the Tax Equity and Fiscal Responsibility Act of 1982, children (infants through age six) are eligible. TEFRA provides coverage for children deemed diagnostically eligible (as established by SSI definition), but who would be financially ineligible for SSI due to parental income. Children must meet medical necessity requirements for institutional care; however, the intent of this legislation is to provide the necessary services, including equipment, for the child to remain at home.
* Private Insurance. Eligibility depends on specific terms of the insurance policy. Often equipment is not explicitly specified in the contract. Payment then depends upon the insurer's legal obligations as well as the role of the desired equipment in meeting the child's needs.
* Special Education. Children with disabilities through age 21 are eligible based on the Education for All Handicapped Persons Act (P.L. 94-142) and Amendments and Chapter I (Elementary and Special Education Act). Payment for equipment is justified as expediting educational goals of students. This source is also now responsible for meeting the family support needs of families with preschool-aged children. In many states, equipment is owned by and remains at the student's school.
Information about special education funding is sometimes available from your Local Education Agency (LEA), usually your school district's special education coordinator or your state Board of Education, within the office of the state Director of Special Education Programs. Contacting a local parent advocacy group may also be helpful in this process.
This article has been adapted from ABLEDATA Fact Sheet, number 14, July 1992, entitled Funding Assistive Technology. ABLEDATA is located at the National Rehabilitation Information Center (NARIC). NARIC is a library and information center on disability and rehabilitation. NARIC collects and disseminates the results of federally-funded research projects. The NARIC collection also includes commercially published books, journal articles and audiovisuals. NARIC manages the REHAB-DATA bibliographic database, which contains citations and descriptions of the material in the collection.
For copies of the fact sheet (single copies are free) or more information, contact ABLEDATA, 8455 Colesville Rd., Suite 935, Silver Spring, MD 20910-3319, (800)227-0216 or (301) 588-9284 or call ABLE INFORM, an electronic BBS, at (301)589-3563 with the modern settings 2400 baud, 8-N-1.
Both ABLEDATA and NARIC are funded by the National Institute on Disability and Rehabilitation Research (NIDRR), with contracts number HN92026001 and HN90028001, respectively. Both are operated by Macro International, Inc. The Provision of Assistive Technology Services in Rehabilitation by Barry Brandt is the publication of the Arkansas Research & Training Institute referred to in the article. Copies are available for $12.50 plus $3 postage and handling from Arkansas Research & Training Center in Vocational Rehabilitation, University of Arkansas at Fayetteville, P.O. Box 1358, Hot Springs, AR 71902, (501) 624-4411, (501) 624-3515 (fax).