Pathways To Funding: A Comprehensive Guide
Major Assistive Technology Funding Sources

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Medicaid

West Virginia's Medical Assistance Program, Medicaid, pays most of the cost of medical care for people who otherwise could not afford it. Medicaid is a state and federal assistance program, which covers medical costs for eligible individuals of all ages. Medicaid is administered by the Bureau for Medical Services, West Virginia Department of Health and Human Resources (DHHR).

Eligibility for Medicaid is determined by each local DHHR office. There are over fifty different ways to become eligible for Medicaid. If you think you might be eligible for Medicaid, you may file an application at the DHHR office in the county where you live. Individuals receiving Supplemental Security Income are also eligible for the Medicaid Program and automatically receive a medical card from the Department of Health and Human Resources.

Medicaid covers assistive technology that qualifies as durable medical equipment, prosthetic/orthotics, and medical supplies.

• is long lasting
• used to serve a medical purpose
• is not useful to a person who does not have an illness or injury
• can be used in the home

• wheelchairs
• hospital beds
• walkers
• oxygen equipment

• home healthcare
• speech, physical and occupational therapies
• surgical dressings
• splints and casts

Medicaid covers augmentative communication devices. Coverage of these devices will be for the purpose to assisting the beneficiary to communicate basic medical needs only. Devices intended to meet social, educational and vocational needs are not covered.

For more information about Medicaid please call 304-558-0684.

The Title XIX Medicaid Waiver Program provides in-home health care for eligible clients.

The West Virginia Bureau of Senior Services operates the Title XIX Medicaid Waiver Program. This is a Medicaid reimbursed Home and Community Based Waiver Program which functions as an alternative to institutionalized care. This program covers those elderly, blind and/or disabled individuals who are eligible for Medicaid or would be eligible for Medicaid if institutionalized. To be eligible:

• applicants must be 18 or older and a resident of West Virginia
• approved by the WV Medical Institute as medically eligible for nursing facility care
• require the level of care provided in a nursing facility as determined by comprehensive medical, nursing, and social services assessments
• meet the Medicaid financial eligibility criteria for the program
• require services which do not exceed the statewide average cost of nursing home care

Medicare

Medicare is a national health insurance program completely funded and run by the federal government. The Social Security Administration signs up people and gives them Medicare information.

Medicare helps pay health care costs for people sixty-five years of age or older, adults with permanent disabilities who receive Social Security Disability (SSDI), and people who have permanent kidney failure.

Centers for Medicare & Medicaid Services (formerly HCFA), which run the Medicare program, will mail Medicare cards to people with disabilities 24 months after their SSDI payments begin. Any person who qualifies for Medicare Part A will also be signed up for Part B. Part B has a monthly charge, but you may stop Part B if you do not choose to pay the monthly charge. Both parts A and B have deductibles, co-payments and co-insurance payments. Programs are available to help you pay Medicare premiums if you cannot afford them.

Part A - Hospital Insurance
Medicare Part A covers part of your stays in the hospital or stays in a skilled nursing facility, some home health care services and limited stays in hospice care. If you are admitted to a Medicare participating hospital, you should be given a copy of An Important Message From Medicare. It explains your rights as a hospital patient. If you are not given one, ask for it.

Part B - Medical Insurance Medicare Part B covers some medical care and outpatient costs, such as durable medical equipment and other medical services/supplies not covered under Part A, if prescribed by your doctor.

The key to assistive technology funding is found in Part B. Assistive Technology falls under the categories of durable medical equipment (DME) and/or prosthetics, such as augmentative communication devices, if you lose your speech through a stroke or other condition.

Any decision about Medicare services can be appealed. This is true whether an individual is in the Original Medicare Plan or a Medicare managed health plan. If Medicare does not pay for an item or service you have been given, or if you are not given an item or service you think you should get, you can appeal.

Call the Social Security Administration for more information at 800-772-1213 (English and Spanish or 800-325-0778 (TTY) or call the Medicare hotline at 800-638-6833.

Private Insurance

Private insurance is a contract between you and your insurance company. Your contract may or may not cover assistive technology. Look over your policy carefully. Even when your insurance does cover assistive technology, your policy may have a cap on how much is covered.

If you receive private insurance from your employer there is a federal law known as the Employee Retirement Income Security Act (ERISA) that controls employee benefits plans. This law gives employees the chance to find out what the policy covers. Coverage guidelines will be written into a contract that private insurance companies by law have to follow. Every insurance policy is different. Make sure you understand what your insurance policy covers.

You may not have health insurance through your employer but you can get insurance on your own. If you have questions about what your policy covers or would like to get insurance on your own, call the West Virginia Insurance Commission at 800-642-9004.

Rehabilitation Services, Division of

The West Virginia Division of Rehabilitation Services (DRS) is a program of state government that helps West Virginians who are disabled achieve independence within the workplace, family, and local community. DRS is funded through the state and federal government. For more information on rehabilitation services or any of their programs (listed below) call 800-642-8207 or your local office.

What are rehabilitation services?
The West Virginia Division of Rehabilitation Services (DRS) is a program of the state government that helps West Virginians who are disabled achieve independence within the workplace, family and local community. DRS is funded through the state and federal government.

Who can get rehabilitation services?
A person who has a physical or mental disability that keeps them from getting a job and being independent. There is no age limit, but you may not be able to get services unless you are 16 years old. For more information on Rehabilitation Services call 800-642-8207 or call your local state office.

Rehabilitation Technology Unit Services
The West Virginia Division of Rehabilitation Services Rehabilitation Technology Unit provides services statewide including assessment, drawing up plans, training, equipment setup and follow-up for persons with disabilities.

Centers for Independent Living
There are three Centers for Independent Living in West Virginia covering 44 counties. West Virginia Centers for Independent Living (CILS) have grants from the United State Department of Education/Rehabilitation Services Administration to provide services at no cost to people of all ages who have physical, mental, or sensory disabilities. The goal of this program is to give support to people with disabilities to help them become independent in their homes and other non-work settings.

The Ron Yost Personal Assistance Services Program
In 1999, the West Virginia Legislature passed the Ron Yost Personal Assistance Act, (RYPAS) which created a new program, controlled by consumers, to help individuals with severe disabilities live in their own homes and be active in their communities. The RYPAS program provides individuals with severe disabilities the needed resources to help them get a personal assistant and the necessary support to participate in daily living activities.

• your disability will last at least 12 months
• you or a designee can meet your responsibilities as an employer
• you or a designee can manage your own financial and legal affairs
• you need assistance with daily living activities
• you are not receiving assistance through any other program
• you meet income guidelines

West Virginia's Technology-Related Assistance Revolving Loan Fund for Individuals with Disabilities
The West Virginia Legislature set aside $100,000 for a revolving loan fund to allow people with disabilities to get the assistive technology they need. Loans may range from a minimum of $500 or a maximum or $5,000. A person may borrow up to 90% of the cost of the technology-related device or service. The current interest rate is 4%.

Cooperative School Program (CSP)
The Cooperative School Program is an agreement between DRS and the Board of Education to see that students with disabilities are provided all the rights they are entitled to by law. It enables DRS and the schools to work together to provide the best services available to eligible students. The DRS counselor will assist you in your transition from school to adult life.

For additional information on any of the above Rehabilitation Services please call 800-642-8207.

The Family Support Program

What is the family support program?
The family support program helps West Virginia families that have someone living in their home with a developmental disability. This program offers services to help you and/or your family meet your basic needs and maintain your quality of life.

• Families who have a member with a developmental disability
• Families who have been turned down by other funding sources
• Families who have no insurance
• Family Support is "funding of last resort"

• Respite care
• Special equipment
• Transportation
• Home modifications
• Service coordination
• Assistance in getting benefits from Children with Special Health Care Needs, SSI, Vocational Rehabilitation
• Other supports that a family requests

CHIP (WV Children's Health Insurance Program)

WV Children's Health Insurance Program (CHIP) is a community outreach program. WV CHIP gives health coverage to uninsured children whose family income is less than 200% of the federal poverty level. The child's family income can be as much as $25,575 a year for a family of four, which makes this insurance program available to working families.

CHIP's goal is to help each child to be in good health and to stay in good health. Good health allows children to learn and grow so they can be at their educational and personal best.

For more information on the CHIP program, call your local Department of Health and Human Resources (DHHR) office, or call 877-982-2447, or access the CHIP website at www.wvdhhr.org/wvchip

Children with Disabilities Community Service Program (CDCSP, formerly TEFRA)

The Children with Disabilities Community Service Program allows states to provide Medicaid to children with disabilities who live at home and are under 18 years of age. States that have this program must provide Medicaid coverage to all children who qualify. Services are not based on family income.

For more information on Children with Disabilities Community Service Program please call 304 558 1711.

Children's Specialty Care

Children's Specialty Care provides specialized medical care for children who have or might have chronic disabling medical conditions. Any child living in WV who is under 21 years of age and has a medical problem that needs specialized care may be eligible for this program.

• medical visits
• laboratory tests
• x rays
• medications
• limited physical and/or speech therapy
• referral for medical services
• equipment and supplies, including AT
• surgery
• hospitalization

For more information on Children's Specialty Care, please call 800 642 9704 or 800 642 8522 or visit www.wvdhhr.org/mcfh

Health Check (EPSDT)

Early Periodic Screening, Diagnosis, and Treatment (EPSDT), known in West Virginia as Health Check, is a mandated Medicaid program enacted in 1967 to ensure that Medicaid eligible children ages 0 through 20 years, receive a comprehensive range of preventive and primary health services before conditions become serious enough to impair growth and development. Thus, the program's central purpose is preventative. While a broad array of medical benefits are covered, the program's mission is to get care to children before they become ill and disabled.

Who can get Health Check?

• Children under the age of 21 who receive Medicaid can participate in the Early and Periodic Screening. Diagnosis and Treatment (EPSDT) Program.
• A child may receive Medicaid and EPSDT even if the family does not qualify for Medicaid.

What Services does Health Check offer?

• Physician's services
• Hospital inpatient care
• Outpatient hospital services
• Emergency room services
• X ray and laboratory services prescribed by an authorized practitioner
• Prescribed drugs
• Prescribed drugs for AIDS patients
• Transportation by ambulance or other appropriate means
• Artificial limbs, braces, orthopedic shoes, crutches, walkers, wheelchairs and breathing machines, when prescribed by a doctor
• Eye care services
• Medical supplies
• Care in nursing facilities
• Family planning services
• Speech and hearing services, physical therapy and occupational therapy
• Outpatient mental health services

West Virginia Birth to Three

Who can get services from Birth to Three?

Eligibility:

• Age eligibility includes children up to 36 months
• There are no financial requirements
• Eligibility is based only on a child meeting one of the following definitions:

1. Is experiencing a developmental delay: An infant or toddler who has been diagnosed by a multidisciplinary team as having a significant delay in one or more of the following areas of development:

• cognitive development
• physical development including vision and hearing
• communication development
• social and emotional development
• adaptive development

2. Has a diagnosed physical or mental condition which has a high probability of resulting in developmental delay - includes infants/toddlers who have a diagnosed condition but may not be demonstrating delays at the time of evaluation. Examples of such conditions include, but are not limited to:

• Down Syndrome and other chromosomal abnormalities associated with delay;
• Congenital syndromes or genetic disorders associated with developmental delays;
• Inborn errors of metabolism.

3. Is at significant risk of having substantial developmental delays if early intervention (EI) services are not provided. Risk may be established when children are experiencing a combination of multiple biological and/or environmental risk factors in accordance with the state definition.

Assessment/Plan:
Children who are suspected of having or being at significant risk of developmental delay receive a multi disciplinary evaluation to determine eligibility for the WV Birth to Three Program under Part C (formerly Part H) of the Individuals with Disabilities Education Act. The multi disciplinary assessment also helps to identify the needs of the child and family. With participation of the family, an Individualized Family Service Plan (IFSP) is developed for each child's family based upon the strengths and abilities of the child and shaped by the concerns and priorities of the family. Services and supports listed on the plan are targeted to promote the child's development as well as to support the ability of the family and other caregivers to address the special needs of their child.

Services:
According to federal law, entitled services identified on a child's/family IFSP are delivered in natural environments. Families determine the environment in which the child would be if he/she was not in need of early intervention services. Services may support the family's participation in community activities and everyday routines. It is important that services and strategies are designed to work across all of the child's and family's natural environments.

Assistive Technology is one of several services that may be identified as needed on an eligible child's Individual Family Service Plan (IFSP). Part C services identified on the IFSP are provided at no charge to the family.

WV Birth to Three coordinates the Early Childhood Lending Library. Books and videos on a variety of topics, as well as switches and some other AT are available on a short term loan to try out with your child. Call 800 642 9704 for more information about WV Birth to Three or the library. You may also visit the Birth to Three website at www.wvdhhr.org/mcfh/birth23

Education and Assistive Technology

What educational services do schools offer?
The Individuals with Disabilities Act (IDEA) and West Virginia Board of Education Policy 2419: Regulations for the Education of Exceptional Students in West Virginia require school districts to ensure a free, appropriate public education for students with disabilities ages 3 21 in the least restrictive environment. It is the responsibility of the school district to provide assistive technology devices and services to students with disabilities if the IEP team determines that these devices and services are needed to meet the educational goals and objectives of the student.

Assessment

After the student has been referred for evaluation, a team of qualified individuals will conduct an assessment. The assessment will identify the child's individual needs.

The assessment may be conducted by the school district or by someone contracted by the school district. If parents do not agree with the results of the assessment, an independent assessment may be requested by the parents and paid for by the school district. If the assessment team and parent decide that the child is eligible for services based on the assessment and other information provided by the parent and teacher, an Individualized Education Plan (IEP) will be written for the student by the assessment team.

What do I need to bring to the assessment?

• Bring your child's medical information, family history and educational needs to the assessment. This information will give the assessment team a complete picture of your child.
• Bring your own concerns and do not be afraid to ask questions.
• Video or tape record the assessment so you do not have to write down all the information.

What is an Individual Education Plan?

The Individual Education Plan (IEP) for preschool and school aged children is a written plan for educating a child with a disability who needs specially designed instruction. The IEP describes the child's needs, goals and special services needed at school. The IEP is developed to help children reach goals and objectives in the least restrictive setting with their peers and to learn to be as independent as possible in their daily lives.

How do we get assistive technology in the IEP?

Family members, including the child (if old enough) need to be aware that they are equal partners on the team and have every right to help write the IEP. Parents may ask advocates, AT specialists or others to attend IEP meetings with them.

• Annual goal/short term objectives
• Supplementary aids and services
• Related services

A team of individuals including the parents, school personnel, and others who are aware of the child's needs will write the IEP. IDEA and Policy 2419 require that assistive technology services must be considered for ALL students involved in the IEP process. The IEP team must indicate on the IEP form that AT has been considered and describe the nature and amount of service. If AT is needed by the child after school to meet the educational goals and objectives, the IEP team must indicate that the AT may be used at home by the student. Training on the use of the AT for parents, teachers, aides, and other who interact with the student should also be addressed on the IEP.

The IEP is reviewed annually, generally at the end of the school year, and reevaluations are conducted every three years. However, IEP meetings may be requested at any time during the year by parents or teachers if the IEP needs to be revised or reviewed. Remember, AT must be written in the child's IEP for the child to get AT or AT services. The school district has to provide all services that are written into the IEP.

AT may be provided to students who are eligible as students with disabilities under IDEA. Students may also qualify for assistance under Section 504 of the Rehabilitation Act. Contact your school principal or county school board office for more information.

Who does the AT device belong to?

AT bought by the school district is owned by the school. If the child moves, the AT device is kept by the school. Parents should know that any AT paid for by private insurance or Medicaid belongs to the family, even if the school pays a portion of the cost of the AT.

What if the IEP teams turns down my request?

If parents do not agree with the IEP, they may ask for another assessment of their child's needs or they may request a hearing. The WV Parent Training and Information Center can help in appealing a decision, as well as by serving as an advocate during IEP meetings. You can contact the Parent Training and Information Center at 800-281-1436 or visit www.wvpti.org. The current IEP will be followed during the appeals process.

Will I be trained on how to use the AT?

The school system must provide training to all team members including the child and parents on how to use the AT.

Can a child take the device home?

The child can take the AT home, if the IEP team determines that the AT is needed to meet educational goals. An example of that is when the AT device is needed to complete homework assignments.

Who is responsible for repairs?

Most of the time the owner of the AT has to fix it. The United States Office of Special Education Programs says that schools must make sure they have similar AT for the child to use while the child's device is being fixed. If they do not own similar AT, they must borrow or rent it.

How does funding work?

School districts are responsible for funding AT devices and services if indicated on the IEP. If AT is needed for a medical condition, Medicaid or private insurance may pay for AT that is medically necessary.

Schools can ask parents to get funding through private insurance or Medicaid. Parents do not have to do this, but if they do so, the school should pay the co payment or deductible. Some insurance companies will set limits on how long or how much they will pay for AT. Check with your insurance company to find out what its limits are.

Call the special education director in your local school system for more information or call the West Virginia Department of Special Education at 800 642 8541.

Education, WV Department of

The application is for an individual child and must:

• identify the student;
• identify the student's specific AT needs;
• include a copy of the IEP that documents the need for the AT services and/or device;
• include a budget sheet that itemizes each AT device, service and unit cost; and
• ensure that each AT device is compatible with the district's technology system and purchased through state contracts, if available;
• be signed by the county superintendent.

Counties may apply for this supplemental funding as needed throughout the school year to meet the unique AT requirements of students who are IEP eligible. Within 10 business days after receipt and review of the request for funding, the department will notify the county regarding the status of the request. If the request for funding is denied, the county will be provided an opportunity to resubmit information for reconsideration and/or to request technical assistance.

For assistance with the technology specifications that must be included in the application, please contact Sarah Lyons, Office of Technology, at slyons@access.k12.wv.us or call 304 558 3538.

Other questions about the supplemental AT funding for students with disabilities should be addressed to Kathy Knighton or Kay Johnston, Coordinators, Office of Special Education, at 304 558 2696 (V/TTY).

Head Start/Early Head Start

What is Head Start?

What services do Head Start and Early Start offer?

Early Head Start/Head Start covers a wide range of child development services. These services include educational, health, social services and related services (parent involvement, medical, dental, mental health, occupational therapy, physical therapy, speech therapy, assistive technology).

Educational and related services must be written in to the Individual Family Service Plan (IFSP) or the Individual Education Plan (IEP) by the diagnostic team, parents and teachers.

There is no appeals process for this program; however, a parent can discuss concerns with their local Head Start/Early Start agency or the coordinator of the WV Head Start Collaboration at 304 558 0600.

Specifically for Older Adults

Social Security Programs

The Social Security Administration (SSA) administers the SSI and SSDI Programs that can provide benefits based on the disability or blindness of individuals. The SSA can determine if an individual is eligible for one or both programs. You can contact the SSA in your local area or by calling the toll free number 800 772 1213 or 800 325 0778 for the hearing impaired. You can also find more information on Social Security's website at www.ssa.gov

Supplemental Security Income (SSI)

• SSI is a needs based program that provides payments to individuals who are aged, blind, and/or disabled and who have limited income and resources.
• The amount of an SSI check can vary monthly due to earnings from work; unearned income (such as SSDI benefits; living arrangements and support that the individual may receive; the state the individual lives in; and any work incentives that may be used while that individual is working.
• When you are approved for SSI you will begin receiving payments because there is no waiting period.
• Report to Social Security any changes in your financial status, living arrangements, or supports that you may be receiving. These factors could change the amount of SSI that you receive and/or your eligibility.
• When you are approved for SSI in West Virginia you also become eligible to receive a Medicaid card.
• The SSA has developed Work Incentives that are available to individual with disabilities who receive SSI and are thinking of going to work. It is important for disability beneficiaries to understand that they can still receive benefits while they test their ability to work. To learn more about the work incentives that are available, you can contact the Social Security Administration or the Benefits Planning, Assistance, & Outreach Program at 304 293 4692.

Social Security Disability Insurance (SSDI)

• SSDI provides benefits to disabled or blind individuals who are insured by worker's contributions to the Social Security trust fund.
• To qualify you must be the worker, or the worker's widow(er), or the worker's disabled adult child. You must also meet Social Security's definition of "disability". Unlike the SSI Program, this is not a needs based program.
• The amount of an SSDI check is based on the worker's lifetime average earnings covered by Social Security.
• Usually there is a 5 month wait to receive SSDI cash payments, but in some situations it may be sooner.
• With SSDI a person will receive the health coverage, Medicare. There may be up to a 2 year wait for Medicare to begin, though it may be sooner.
• There are Work Incentives that are available to individuals with disabilities who receive SSDI and are thinking of going to work. These provide the person with the opportunity to maintain benefits while testing their ability to work and gradually becoming self supporting and independent. To learn more about the SSDI Work Incentives that are available you can contact the SSA or the Benefits Planning, Assistance, & Outreach Program at 304 293 4692.

U.S. Railroad Retirement Board Help Line

The RRB provides benefits for retired and disabled railroad employees. It has special considerations for individuals who have a medical recovery, permanent medical condition, are permanently disabled, or who have work expenses related to their disability.

The RRB Help Line is an automated telephone service. You will not be able to speak to an RRB representative by calling the RRB Help Line. Call the RRB field office if you want to speak to one of their representatives.

Call the RRB Help Line at 800-808-0772. To contact the WV field office call 304 529 5561. For more information visit the RRB website at www.rrb.gov/helpline.html

Veteran's Affairs, Division of

Veteran's Affairs (VA) provides health care for veterans and, in some cases, their families.

Who can get services from the Veteran's Administrations?
- veterans who have had 90 days of continuous active duty
- family members of veterans with disabilities

Tricare

Veterans Adapted Housing Program

Adapted Housing is part of the Department of Veterans Affairs (VA) program for the Paralyzed Veterans Administration. It provides qualified veterans financial help towards accessible housing. Veterans and family members of veterans who meet disability guidelines can get services. This program builds new homes, adapts existing homes and accommodates disability related needs.

The special housing adaptation grant for veterans who are blind or who have lost or no longer have the use of both hands is $10,000. Veterans may also use the grant to assist in acquiring a residence already adapted with special accessibility features. The one time adapted grant for disabled veterans with loss of one or both lower extremities is $50,000.

If you have any questions regarding your eligibility for any of the above housing grant programs or need assistance with applying for them, call the VARO in Huntington at 800-795-3577 or call the local Veterans Affairs office in your area (see Appendix E) or the regional office at 800-827-1000.

Veterans Hearing Aid Program

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

New rules will bring financial relief to CHAMPVA beneficiaries and extend benefits to older survivors and dependents of some disabled or deceased veterans who face medical expenses not paid by Medicare or other third party payers.

"CHAMPVA for Life" began in October 2001. It is designed for spouses or dependents who are 65 or older. They must be family members of veterans who have permanent and total service connected disabilities, who died of a service connection or who were totally disabled from a service connected condition at the time of death. Thy also must have Medicare coverage.

Veteran's Spina Bifida Program

This program provides monetary allowances, vocational training and rehabilitation to Vietnam veterans' birth children with Spina Bifida. It covers most healthcare services and supplies, including assistive technology that is medically or psychologically necessary for the treatment of conditions related to spina bifida.

Who can get services?
- Children of veterans born with Spina Bifida
- Natural child of an individual who served in Vietnam

Regardless of age or marital status, a child conceived after the date on which the parent first served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, without regard to the characterization of the individual's service is eligible for services. Prospective beneficiaries must call a regional office to initiate the application process.

For more information call the local Veteran Affairs office in your area (see appendix E) or the regional office at 800-827-1000.

Agent Orange Benefits Act

The Agent Orange Benefits Act of 1996 gives Vietnam veteran's children with all forms of spina bifida (except spina bifida occulta) health care benefits including home, hospital, outpatient, preventative and rehabilitative care. Assistive technology devices and services supplies, medicines and other equipment are covered if determined to be necessary.

The law provides a monthly allowance for any disability resulting from spina bifida. Monthly amounts, which range from $200 to $1,200, are based on the degree of disability. The Act also provides vocational training for Vietnam veteran's children with spina bifida.

For more information call the Spina Bifida Association of America at 800-621-3141.

VISIONS (Visually Impaired Seniors In Home Outreach and Networking Services)

VISIONS is a statewide program funded by the federal government to provide in home services to West Virginians 55 and older with visual impairments. The goal of VISIONS is to help these individuals achieve their desired level of personal independence.

• Outreach to community groups through presentations at workshops and meetings
• Exhibits and demonstrations of low vision assistive technology at conferences and other events

• In-home independent living assessments
• Development of independent living plans
• Low vision aide including: magnifiers, large print items like check registers, diabetic registers, address books and large button phones, adaptive equipment for the kitchen and other low vision aids
• Skills training