Funding AT Beyond Educational Purposes

Private insurance refers to a contract between the individual/family and an insurance company. The policy coverage, enrollment requirements, and co-payment requirements vary among insurance companies. Medical insurance is based on the “medical necessity” of services and equipment. Private medical insurance may provide certain types of AT and AT services under three categories of funding: prosthesis, durable medical equipment, and therapy services. An LEA may request but cannot require families to use private insurance to pay for a student’s required services or devices. In many cases, families are willing to pursue this avenue for a communication device or other AT since that will allow them to retain ownership. Private insurance funding can be pursued for AT in collaboration with the student’s family but cannot delay provision.

When an AT device is funded by a third party such as private insurance the family generally owns it, and it can be used for purposes other than educational goals at the families’ discretion. If the device is used at school to meet the goals of the IEP, the LEA is responsible for the repair and maintenance of the device or replacement of the AT that is specified in the IEP.

AEM Tie-In:

Whether materials are used on an LEA's or a child's own device, SEAs and LEAs are responsible for developing digital rights policies and procedures for the legal distribution and use of accessible formats.

Several government programs are available to support funding of AT. Each has its own stipulations and nuances of the type and dollar amount of AT it may cover. This section will provide a brief overview of the options available in Ohio but will require further investigation if the IEP team is considering utilizing one of these options.

Department of Developmental Disabilities (DODD)

DODD offers funding for AT through Medicaid Waivers. DODD Rule 5123-9-12 “Home and Community-Based Services Waivers – Assistive Technology Under the Individual Options, Level One, and Self-Empowered Life Funding Waivers” defines assistive technology; sets forth provider qualifications, requirements for service delivery, and documentation of services; and describes payment standards for AT through the various waiver programs. For more information regarding other AT opportunities in Ohio, please check in with your County Board.

Ohio Department of Medicaid

Medicaid is a federal program of medical assistance for low-income individuals including persons with disabilities. Although the federal government establishes certain parameters for all states to follow, each state administers its Medicaid program differently, resulting in variations in Medicaid coverage across the country. The Ohio Department of Medicaid provides funding to many different types of medical equipment, including AAC devices or "speech generating devices," orthotics and wheelchairs, etc.

Medicare

Medicare is a federal health insurance program that serves individuals over 65 years of age plus those with severe disabilities who are under 65. Medicare covers certain medically necessary assistive technologies under its statutory benefits for durable medical equipment, prosthetic devices, and orthotic devices (42 U.S.C. 1395(k), (m), and (x)). Effective January 1, 2001, speech generating devices were considered to fall within the durable medical equipment (DME) benefit category defined in section 1861(n) of the Social Security Act. Speech generating devices are covered if the patient suffers from severe speech impairment and the medical condition warrants the use of a device. Speech generating devices are defined for Medicare coverage purposes to include dedicated speech devices used solely by the individual who has severe speech impairment. The national coverage determination (NCD) is available in section 50.1 of the Medicare NCD Manual (Pub. No. 100-3, Ch. 1, Part 1).

Ohio Department of Health

The Ohio Department of Health administers several programs including the Children with Medical Handicaps (CMH) and the Ohio Hearing Aid Assistance Program (OHAAP).

• The Complex Medical Help Program (CMH) is a health care program in the Ohio Department of Health (ODH). CMH links families of children with special health care needs to a network of quality providers and helps families obtain payment for the services their children need. CMH receives funding for services from the federal Maternal and Child Health Block Grant, state general revenue funds, county tax funds, third-party reimbursements, and donations.
• The Ohio Hearing Aid Assistance Program (OHAAP) provides assistance to families with children, birth to 21 years of age, with hearing impairments to purchase hearing aids, earmolds, assistive listening devices, external cochlear implant processor replacements, and/or hearing aid batteries. Families with incomes at or below 400 percent of the federal poverty guidelines are eligible for the program. Children enrolled or who can qualify for Medicaid or the Children with Medical Handicaps Program (CMH) are not eligible for OHAAP (unless documentation can be provided that Medicaid or CMH will not pay).

Ohio STABLE Account

A STABLE account is an investment account available to eligible individuals with disabilities. STABLE accounts provide the option to save and invest money without losing eligibility for certain public benefits programs, like Medicaid or Supplemental Security Income (SSI). Earnings in a STABLE account are not subject to federal income tax, so long as funds are spent on qualified disability expenses which includes assistive technologies. The Office of the Ohio Treasurer administers the STABLE Account program.

STABLE accounts have some similar features to normal bank accounts, but they are not checking or savings accounts. STABLE accounts are investment accounts, similar to 529 college savings accounts or 401(k) retirement accounts. When money is deposited into a STABLE account, the money will be invested in different options that the owner of the account may choose. While money can be withdrawn and spent whenever it is needed, STABLE accounts also allow growth to save long-term for disability expenses.

Social Security Administration

The Social Security Administration offers disability benefits through the Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs. The SSDI program pays benefits to the person with a disability and certain family members if they are “insured.” This means that the employee worked long enough—and recently enough—and paid Social Security taxes on their earnings. The Supplemental Security Income (SSI) program pays benefits to adults and children with disabilities who have limited income and resources. While these two programs are different, the medical requirements are the same. Social Security does not fund AT directly but may provide a monthly payment and also may be a step in becoming eligible for other sources of AT funding such as Medicaid. Contact the local Social Security offices for more information.

Some individuals are not eligible for any of the funding sources mentioned thus far. In these cases, other sources of funding are sometimes utilized, such as disability-focused organizations, foundations, and service clubs. Typically, the disability-focused options are geared towards specific diagnoses, while service clubs may offer options for funding that can be used for any type of AT needed by the student. Seeking alternative funding can be a time-consuming process and is typically considered after all other funding options have been exhausted.

Grants

In general, there are very few grant sources for funding AT. However, one national example is through United Cerebral Palsy (UCP). The UCP Elsie S. Bellows fund is a national program operated by UCP that provides grants for purchasing or repairing AT equipment for individuals with cerebral palsy. Individuals and their families who are in financial need and do not have other funding resources are eligible.

For students with a diagnosis of autism, there is a unique resource named iTaalk Autism Foundation. The website includes a list of resources for obtaining iPads and other interactive technology. It also has grants for funding therapies, equipment, and services not covered by insurance. Finally, a blog named Tuesday Treasures features funding sources unique to individual states.

Foundations

There are thousands of foundations in the United States. The best way to begin to identify foundations that might be willing to fund an AT device is to review one or more foundation directories. These are usually available at larger public libraries, especially those affiliated with an organization known as Candid. Candid provides information and resources about grant funding, and they maintain the most comprehensive online database about grant makers and their grants. Their Funding Directory is a database of over 100,000 foundations. Candid also offers resources, training and basic information on proposal writing and how to approach a foundation.

In general, foundations are either “general purpose” or “special purpose.” Either type of foundation may provide funding directed to individuals with disabilities, technology, or education. Once several potential foundations have been selected, a letter of inquiry is the best way to begin. Find out if they accept unsolicited requests and, if so, when the deadlines are, how to apply, etc. That information can guide which foundations might be targeted first and which applications might be fruitful.

Disability-Focused Organizations

Disability-focused agencies such as the Muscular Dystrophy Association, United Cerebral Palsy, and the American Foundation for the Blind will sometimes provide funding resources for eligible individuals. These funding options require specific diagnoses for funding eligibility.

Service Clubs

Service clubs have for many years provided financial support for the purchase of many different types of AT. The club may take on a service project for one or more years to help raise funds for somebody who needs help with funding a specific AT device or for a parent group or school group that is seeking funding for several AT devices. In general, it is necessary to make contact with one or more officers of the club and arrange to make a presentation explaining the need. Personal contact within the group is most helpful. However, if no one on the team knows anyone personally, a team member can be assigned to approach the group to explain the specific AT funding needs. Often the relationship that develops between the service club and the student or family that received funding is one of the added benefits.

A comprehensive list of clubs is not possible here, but the most common include Elks, Kiwanis, Knights of Columbus, Lions, Moose, Optimists, Rotary, Easter Seals, United Way, Sertoma, March of Dimes, and Shriners. Locate a specific contact by searching for Fraternal Organizations.