Funding of
Assistive Technology
Resources in Pennsylvania
IM4Q Annual Statewide
Training Conference
Harrisburg, PA
July 24, 2012
Thinking Green!
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support an
environmentally friendly
atmosphere.
If you would like an
electronic or alternate
format copy of this
presentation, please
email us at
ATinfo@temple.edu
YOUR PRESENTERS TODAY
Jamie A. Prioli
RESNA ATP
Pennsylvania’s Initiative on
Assistive Technology,
Institute on Disabilities
Phone: 1-800-204-7428
Email: Jamie.Prioli@temple.edu
Susan Tachau
Executive Director
Pennsylvania Assistive
Technology Foundation
Phone: 1-888-744-1938
Email: stachau@patf.us
About PIAT
At School  At Work  At Home  In The
Community
Device Demonstrations
Device Loans
Reused and Exchanged Equipment Partnership (REEP)
Public Awareness Activities
Telecommunication Device Distribution Program (TDDP)
Information and Assistance
AT Training and Technical Assistance
Website: disabilities.temple.edu
Phone: 1-800-204-7428
About PATF
Non-profit, statewide, organization that provides:
 No-interest, mini-loans for the purchase of assistive technology
[$100 to $1,000]
 Low-interest loans for the purchase of assistive technology: traditional
and guaranteed (“backed” by PATF)
[$1,000 and above at 4% interest rate]
 Information & Assistance about assistive technology (AT) funding
resources
 Financial education
 Website: www.patf.us
 Phone: 1-888-744-1938 (toll-free)
PATF Independence is priceless...
we help make it affordable
GETTING ASSISTIVE
TECHNOLOGY FUNDED
IN PENNSYLVANIA
Getting Assistive Technology
Funded in Pennsylvania
ASSISTIVE TECHNOLOGY DEVICES,
INCLUDING REPAIRS OF ASSISTIVE TECHNOLOGY,
MAY BE FUNDED BY THE FOLLOWING:
 Medicaid Home and Community Based Waivers
 Medical Assistance (Medicaid)
 Medicare
 Tricare
 Private health insurance
 Office of Vocational Rehabilitation
Getting Assistive Technology
Funded in Pennsylvania
ASSISTIVE TECHNOLOGY DEVICES,
INCLUDING REPAIRS OF ASSISTIVE TECHNOLOGY,
MAY BE FUNDED BY THE FOLLOWING:
Area Agency on Aging
Telecommunication Device Distribution Program
Individuals with Disabilities Education Improvement
Act (IDEA 2004)
Getting Assistive Technology
Funded in Pennsylvania
MEDICAID HOME AND COMMUNITY BASED WAIVERS
 Help persons with disabilities to live in the community rather than in
institutions.
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Aging (persons age 60 or older)
COMMCARE (adult with traumatic brain injury)
Consolidated (person with intellectual disability age 3 or older)
Independence (adult with physical disability)
OBRA Waiver (adult with developmental disability)
Infants, Toddlers and Families (child birth to age 3)
Person/Family Directed Support (person with intellectual disability age 3
or older)
Assistive Technology (AT) For
People Who Have an Intellectual Disability
Home and Community-Based Waivers and Base Dollars
(county):
Person/Family Directed Support Waiver
Consolidated Waiver
Limited County Dollars (FY 2012 – 2013 pilot
program with up to 20 counties)
What’s New in the Waiver World
For AT?
The Person/Family Directed Support Waiver and the
Consolidated Waiver were renewed with changes
(including to service definitions & reimbursement rates),
effective July 1, 2012.
AT devices and services are provided in 4 distinct areas:
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Assistive technology
Home accessibility adaptations
Vehicle accessibility adaptations
Durable medical equipment
Participant Services Within the Waivers
Assistive Technology
Service
Examples
Limits
Assistive Technology
switches, computer
software, seat lift chair
$10,000 per lifetime*
Home Accessibility
Adaptations
ramps, stair glides, roll-in $20,000 per 10 years
showers, porch lifts
Vehicle Accessibility
Adaptations
ramp, lowered floor, tiedowns
Durable Medical
Equipment
grab bars, wheelchair,
scooter, Hoyer lift
$10,000 per 5 years
* with a possibility for an increase (the “exceptions policy”)
Durable medical equipment—”An item or device listed in the Medical Assistance program fee
schedule that can withstand repeated use; which are used primarily and customarily to serve a
medical purpose; which are customarily not useful to a person in the absence of illness or injury
and which are appropriate for home use.” 55 Pa code, chapter 1153
Services Are Allowable
Assistive technology “services” are an allowable
expense in the waivers. “Services” include direct
support to a participant in the selection, acquisition, or
use of an assistive technology device (including repair,
design, installation, training).
Getting Assistive Technology
Funded in Pennsylvania
MEDICAL ASSISTANCE (MEDICAID)
 Government-funded health insurance for eligible
children and adults, including many persons with
disabilities.
 Many – but not all – forms of assistive technology are
covered by MA
 Apply for Medical Assistance at the local County
Assistance Office
Getting Assistive Technology
Funded in Pennsylvania
MEDICAL ASSISTANCE (MEDICAID)
 Depending on the level of eligibility or age, the types of
assistive technology that may be covered include:
 Medical supplies
 Durable medical equipment
 Prostheses
 Orthotics
 Surgical supplies
 Wheelchairs
 Augmentative communication devices
Getting Assistive Technology
Funded in Pennsylvania
MEDICAL ASSISTANCE (MEDICAID)
 Depending on the level of eligibility or age, the types of assistive
technology that may be covered include:
 Eyeglasses
 Hearing aids
 Other medical supplies for children under age 21 through
Early and Periodic Screening, Diagnosis, and Treatment
(EPSDT)
 If MA pays for the individual to be in a nursing facility or ICF, the
facility MUST provide the necessary AT devices and services,
including repairs
Getting Assistive Technology
Funded in Pennsylvania
MEDICAL ASSISTANCE (MEDICAID)
 Always talk with the Primary Care Physician to discuss needs and
to know what documentation is required to seek AT coverage
through MA.
 Devices and services must be medically necessary
 Certain documentation must be provided to the health plan
 The PCP should ask the individual’s health plan for any coverage
rules regarding the specific AT device or service that is being
prescribed
Getting Assistive Technology
Funded in Pennsylvania
MEDICAL ASSISTANCE (MEDICAID)
 For information and assistance, contact the MA managed care
health plan’s Special Needs Unit
 NOT the same as Member Services!!!
 Ensures that the individual has information about and access to
physicians, specialists, and services they need
Getting Assistive Technology
Funded in Pennsylvania
AAC AND MEDICAID
 Medicaid pays for a range of speech generating devices (SGDs) as
prosthetics and/or durable medical equipment
 AAC services covered under speech therapy and/or rehabilitation
 Getting AT and/or AAC through Medical Assistance (MA) - - - must be
medically necessary and not “experimental”.
 Payer of last resort
Getting Assistive Technology
Funded in Pennsylvania
PRIOR APPROVAL REQUEST PROCESS FOR MA
 Speech-language pathologist (SLP) and family assist provider
(vendor) in gathering needed documentation.
 Provider (vendor) submits prior approval request for device to MA
(fee for service or MA MCO)
 Documentation should demonstrate medical necessity (doctor’s
prescription for specific devices, SLP report, letter of medical
necessity, etc.)
Getting Assistive Technology
Funded in Pennsylvania
MEDICARE
 Government-funded health insurance for persons:
 Aged 65 or older
 Receiving Social Security Disability payments
(and their dependent adults with DD)
 Receiving railroad retirement payments based on
a disability
 Persons with named diseases (end stage renal
disease; ALS)
 AT may be funded through Medicare Part A and Part B
Getting Assistive Technology
Funded in Pennsylvania
MEDICARE
 Medicare Part A is generally provided at no cost
 AT that may be funded under Part A includes medical
appliances and equipment, or durable medical equipment
 Medicare Part B is provided at a monthly cost, or premium
 AT that may be funded under Part B includes durable
medical equipment (power wheelchairs and augmentative
communication devices), prosthetic devices, and orthotic
devices
 Services are usually funded under other categories
Getting Assistive Technology
Funded in Pennsylvania
MEDICARE
 Requires a doctor’s written prescription for the AT device
or service
 Item must be medically necessary
 May be required to submit a Letter of Medical Necessity
 For SGDs: SLP provider must have CCC (and license)
Getting Assistive Technology
Funded in Pennsylvania
TRICARE
 Health insurance for active and retired military personnel
and their dependents
 Benefits include durable medical equipment
 Pays for prosthetics, including augmentative
communication devices
 For a list of covered devices and services, visit
http://www.tricare.mil/
Getting Assistive Technology
Funded in Pennsylvania
PRIVATE HEALTH INSURANCE
 May pay for assistive devices and services
 Check with the insurance to see if AT is covered and if prior
authorization is required
 Requires a prescription from the doctor ordering the AT
device or services
 Letter of Medical Necessity may be required
Getting Assistive Technology
Funded in Pennsylvania
OFFICE OF VOCATIONAL REHABILITATION
 Provides services to help individuals with disabilities prepare for,
start, and maintain employment
 OVR offices may arrange for a free evaluation of AT needs
 Local OVR offices, including the Bureau of Blind and Visual
Services, can help “customers” choose and get AT recommended
by the evaluation
 Based upon the individual’s financial resources, they may have to
pay for part of the cost of AT devices and services
Getting Assistive Technology
Funded in Pennsylvania
AREA AGENCY ON AGING
 Local Agency may pay for home modifications and durable
medical equipment, medical supplies, and assistive devices
 Must be age 60 or older to qualify
 All other resources must be exhausted before the Area
Agency on Aging will pay for the AT
Getting Assistive Technology
Funded in Pennsylvania
INDIVIDUALS WITH DISABILITIES EDUCATION
IMPROVEMENT ACT (IDEA 2004)
 Requires a school district to provide special education and
related services to a child with a disability
 States that the school district must provide services,
including AT, to a child if necessary to provide a free
appropriate public education (FAPE)
 Child with a disability (3 or older) may receive AT devices
and services as part of the IEP
Examples of How PATF and PIAT Can Help
• A young man (24 years old) wants an iPad to help access
the Internet to look for jobs and keep in touch with friends,
as well as to begin a journal (with pictures), play games
and read books. He also needs voice-recognition and
voice-output software.
 iPad demonstration from PIAT
 Financial loan (Mini-Loan) for the iPad from PATF ($25/mo for 2
years)
 Waiver funds for the software applications
PATF and PIAT Can Help Put
Together a Package
• A woman (36 years old) lives in SE PA and has an intellectual
disability and cerebral palsy. She needs a telephone with large
buttons, a ramp, a roll-in shower, a raised toilet seat and grab bars.
 Investigate the Telecommunications Device Distribution Program (TDDP) for
possible telephones. Before applying for a particular phone, it can be
demonstrated or borrowed (from PIAT’s equipment Lending Library) to make
sure it will work.
 Use the case manager/supports coordinator to coordinate the home
accessibility adaptations (ramp and roll-in shower). NOTE: If the cost of the
shower and ramp exceeds $20,000, it may be possible to get a small grant
from a disability-specific organization (i.e., UCP Philadelphia) to help cover
the funding gap. If some of the expenses remain unpaid, a PATF loan may
be able to pay for the balance!
 Submit to Medical Assistance for payment for the raised toilet seat and the
grab bars (Durable Medical Equipment).
OTHER
RESOURCES
Assistive Technology
Financial Loans
PATF provides no-interest or low-interest loans to people with
disabilities for the purchase of assistive technology devices and
services. PATF also provides Information and Assistance about
other possible funding resources.
Who does PATF serve?
 Pennsylvanians of all income levels, disability diagnoses, ages
PATF Independence is priceless...
we help make it affordable
Pennsylvania’s Initiative on Assistive
Technology (PIAT)
Reused and Exchanged Equipment Partnership (REEP)
Telecommunication Device Distribution Program (TDDP)
Device Demonstrations
Assistive Technology Lending Library
ASSISTIVE TECHNOLOGY
RESOURCES
• RESNA Catalyst Project
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56 statewide AT Act Programs
33 Alternative Financing Programs
57 Protection and Advocacy for AT Programs
19 Access to Telework programs
• http://www.resnaprojects.org/
• Note: AT Act Programs in every state as well as Puerto Rico, US Virgin
Islands, Northern Mariana Islands, District of Columbia, American Samoa, &
Guam.
PENNSYLVANIA TRAINING AND
TECHNICAL ASSISTANCE NETWORK (PATTAN)
• Short Term Loan (STL) Program (www.pattan.net)
• Library of AT materials available to Local
Educational Agencies (LEAs) for trial and evaluation
• STL kits contain devices for:
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Augmentative communication
Computer access
Written communications
Environmental controls
Technology for sensory impairment (hearing and vision)
ASSISTIVE TECHNOLOGY
AND LEGAL ASSISTANCE
• Disability Rights Network of Pennsylvania
(DRN PA)
• Legal and “systems” issues around access to and
acquisition of AT
• Offices in Harrisburg, Philadelphia and Pittsburgh
• Website:
• Email:
http://drnpa.org
intake@drnpa.org
DISABILITY-RELATED ORGANIZATIONS
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National MS Society
Multiple Sclerosis Association of America (MSAA)
ALS Association
JEVS Human Services – Supports for Independence
Disabled Children’s Relief Fund
QUESTIONS?
FEEL FREE TO CONTACT US
Jamie A. Prioli
RESNA ATP
Pennsylvania’s Initiative on
Assistive Technology,
Institute on Disabilities
Phone: 1-800-204-7428
Email: Jamie.Prioli@temple.edu
Web: disabilities.temple.edu
Susan Tachau
Executive Director
Pennsylvania Assistive
Technology Foundation
Phone: 1-888-744-1938
Email: stachau@patf.us
Web: www.patf.us