Building An Initial Information Base: Assistive
Technology Funding Resources
for School-Aged Students with Disabilities
Crystal E. Kemp
The University of Texas at Austin
Jack J. Hourcade
Boise State University
Howard P. Parette
Southeast Missouri State University
Perhaps more than ever before, teams developing
IEPs for students with disabilities are being asked to consider what assistive
technology (AT) devices and services a student with a disability may require in
order to benefit from special education (Chambers, 1997). An AT device is
defined legally as: " ... any item, piece of equipment, or product system ...
that is used to increase, maintain, or improve the functional capabilities of
children with disabilities" (Individuals with Disabilities Education Act
Amendments of 1997, P.L. 105-17, 20 U.S.C. §1401, 1997). An AT service is
defined as "...any service that directly assists an individual with a disability
in the selection, acquisition, or use of an assistive technology device." "
(Individuals with Disabilities Education Act Amendments of 1997, P.L. 105-17, 20
U.S.C. §1401, 1997). Under the Individuals with Disabilities Education Act
(IDEA) of 1997, IEP teams must consider AT when developing programs for students
with disabilities. Therefore, if a student needs technology-related assistance
and that need is documented in the IEP, the student is entitled to AT devices
and services through the local education agency or any existing statewide AT
delivery system (Turnbull & Turnbull, 1998).
Assistive technology has the potential to enhance many aspects of a student's school life. For example, augmentative and alternative communication (AAC) systems ranging from simple communication boards and wallets to sophisticated electronic communication devices enable students to communicate more effectively with teachers and peers. Mobility aids can vary from long white canes for students with visual impairments to powered wheelchairs. Devices to enhance greater computer access include expanded or adapted keyboards, touch windows, and speech recognition systems. Visual aids include magnification devices and computer screen-reading adaptations. These and similar AT devices all contribute to the ultimate goal of helping students with disabilities succeed in inclusive environments. If school professionals are not aware of these and other potential contributions AT can make in the lives of their students with disabilities, then those students with disabilities are unlikely to realize their full potentials.
Even when IEP team members recognize the tremendous potential of AT to benefit students with disabilities, they may not pursue the issue further because they may not know how to access or pay for AT devices and services (DeWitt, 1991; Wallace, 1995; Wallace, Flippo, Barcus, & Behrmann, 1995). Securing the funding necessary for these often-expensive resources is a common frustration. In fact, funding is often the biggest barrier to acquiring AT devices and services (DeWitt, 1991; Galvan, 1998; Judge, 1998; Judge & Parette, 1998; Margolis & Goodman, 1998; Wallace et al., 1995). While one might wish otherwise, the practical reality is that cost issues often influence whether team members consider AT during the development of an IEP (Judge & Parette, 1998; Todis, 1996; Wallace, 1995).
Despite the potentially high cost of AT devices,
this difficulty cannot be used as a reason not to purchase AT that the IEP team
has decided is necessary for a student. Recent policy rulings by the Office of
Special Education Programs (OSEP) clarify the school district's responsibility
to provide assistive technology at no cost to the student and his/her family
when the IEP team determines that the child requires the device (e.g., a
computer) in order to receive a FAPE (RESNA, 1992; 1994). Thus, during
development of an IEP for a student with disabilities, the team must determine
if assistive technology is necessary for a student to achieve educational or
social goals, benefit from education, make reasonable progress in the least
restrictive educational setting, or be included in the general education
classroom (RESNA, 1994). If so determined, the school district must (a) identify
those AT devices and accompanying services that will facilitate the student's
education in the inclusive environment, (b) list the devices and services in the
IEP, and (c) then provide the devices and services to the student.
School professionals and parents should be aware that AT funding is available through a variety of sources, including IDEA, Medicaid programs, Developmental Disabilities initiatives, the Department of Vocational Rehabilitation, and private insurance. In general, for school-aged students, schools (through IDEA) are responsible for any assistive technology that is used primarily for educational purposes. Funding for AT that is being used to help gain meaningful employment for students aged 16 and over might be obtained through the local Department of Vocational Rehabilitation. Funding for any AT that is proposed as a medical necessity should be accessed through private insurance or Medicaid (Assistive Technology, Inc., 1998).
IDEA as a Funding Source for Assistive Technology
The primary source of federal support for AT for school-aged children when the
AT is found to be educationally required should be IDEA (Sheldon & Hager, 1997;
Galvan, 1998; Golden, 1998). Under IDEA, special education and related services
needs, including AT needs, of students between the ages of 5 and 21 are
specifically addressed (Advocacy, Inc., 1994; RESNA Technical Assistance
Project, 1992; Galvan, 1998).
The role of AT devices and services in the education of students with disabilities became even more important with the passage of the Individuals with Disabilities Education Act Amendments of 1997 (P.L. 105-17) (Huefner, 2000). This legislation specifically required the IEP team to evaluate a student's need for AT devices and services in developing a student's IEP. There are three sections in the IEP where the role and contributions of AT may appear. These include: (a) the proposed annual goals and benchmarks or short-term objectives, (b) required supplementary aids and services, and (c) related services necessary for the student to benefit from FAPE (Advocacy Inc., 1994; RESNA Technical Assistance Project, 1992; Todis & Walker, 1993).
Given both the newness and rapidity of change in the field of AT, many IEP teams struggle in determining a student's needs in AT. To assist these teams, some school districts are developing support systems to assist school professionals. For example, a listserv titled "Quality Indicators in Assistive Technology (QIAT)" (available through QIAT@LSV.UKY.EDU) currently serves as a popular mechanism for sharing AT checklists and approaches. Additional support frameworks to assist teams in identifying and meeting the needs of students have been identified by Bowser and Reed (1998), The Institute for Matching Person & Technology (1999), Reed and Bowser (2000), and Zabala (1995).
While IDEA should be the primary funding source that school districts use to secure AT devices and related services for students with disabilities, too often IEP teams discover that the resources available through the legislation are inadequate to fund fully a program that will ensure a FAPE in the least restrictive environment (LRE). Many times parents are informed that there are no school funds available to purchase AT devices and services (Kemp, 1998). In spite of this claim by the schools, the legal reality is that funding cannot be used as a reason to avoid purchasing AT devices and services that are documented in the IEP. In order to provide a comprehensive and effective AT program, additional resource streams must be accessed. Information related to a variety of funding options is readily available on the Internet (Ohio Legal Rights Service, 2000; Sheldon & Hager, 1997; Washington Assistive Technology Alliance, 1999).
Assistive technology funding alternatives and/or
supplements to IDEA include several Medicaid programs (Advocacy Inc., 1994;
Golden, 1998; Hager, 1999; Sheldon & Hager, 1977; Margolis & Goodman, 1998;
Wallace, 1995), the Department of Vocational Rehabilitation, Developmental
Disabilities initiatives, and private insurance (Judge & Parette, 1998; RESNA
Technical Assistance Project, 1992; Wallace, 1995). Each of these programs is
described in greater detail below.
Medicaid Programs as a Funding Source for Assistive Technology
Initially authorized through the Social Security Act Amendments of 1965 (1965),
Medicaid is designed to provide medical assistance for certain individuals and
families with low incomes and resources. The program is a jointly funded
cooperative venture between the federal and state governments to ensure the
provision of adequate medical care to eligible persons who are in need. As such,
it is the largest program providing medical and health-related services to
America's poorest citizens (Health Care Financing Administration, 2000). In
fact, over the past 30 years Medicaid has grown to become one of the largest
programs in the federal budget and one of the largest components of every state
budget (Advocacy, Inc., 1994; Menlove, 1996; RESNA Technical Assistance Project,
1992; Wallace, 1995).
Using broad Medicaid guidelines provided by the federal government, each state: (a) establishes its own eligibility standards; (b) determines the type, amount, duration, and scope of services; (c) sets the rate of payment for services; and (d) administers its own program. Given the level of authority states have in these matters, Medicaid programs vary considerably from state to state (Health Care Financing Administration, 2000). The Medicaid Amendments for Special Education Related Services of 1988 (1988) allow each state the option of including a variety of reimbursable services within that state's Medicaid plan, including special education and related services under Part B of IDEA. In essence, this law sought to provide a comprehensive range of services, including the provision of AT, without placing an unnecessary burden on state and local special education budgets (Wallace et al., 1995).
Schools wishing to take advantage of Medicaid funding to provide AT for students with disabilities should refer students and their families to their local Medicaid office as early as possible. This process may take up to 30-90 days to complete depending on state procedures. The time required to complete the application process also may vary depending on whether a family or a school district submits the application. In encouraging parents to apply for Medicaid assistance, schools must keep in mind that they cannot require parents to sign up for Medicaid in order to receive AT or other special education services for a child with a disability (Hager, 1999). Nor can a school deny services if parents refuse to authorize the use of Medicaid (Hager, 1999). Student and family eligibility for Medicaid will determine whether this resource is an option. Professionals should be cognizant of the fact that the paperwork involved is considered by many to be an unnecessary burden for families.
There is some disagreement concerning the role of Medicaid in securing AT for a child with a disability. For example, many professionals argue that all other funding sources, such as school funds, private insurance, personal funds, HMOs, and Medicare must be tried first before seeking resources through Medicaid (Assistive Technology, Inc., 1998). Parents are told that if their private insurance, HMO, or Medicare carrier denies a claim for AT for any reason, then a statement of denial is required for the claim to be processed through Medicaid (Assistive Technology, Inc., 1998).
However, other opinions exist. For example, instead of conceptualizing Medicaid as a payer of last resort, Golden (1998) suggested that the 1997 reauthorization of IDEA indicates that the financial responsibility of Medicaid and other public insurers precedes that of schools for devices and services that are both medically and educationally necessary. Golden (1998) suggested that Medicaid and other public insurers should be sought first instead of the school.
Assuming that Medicaid is
indeed the payer of last resort, the first consideration is to exhaust all other
funding sources for the desired AT. Once a private insurance carrier or other
funding source has rejected a claim, a Medicaid eligible client is able to
submit their claim to Medicaid. It is necessary to submit a copy of the Medicaid
ID and the letter(s) of rejection from the other funding source(s) in order to
initiate this process (Assistive Technology, Inc., 1998). School
professionals must be aware that, even when Medicaid is sought as a funding
resource, delays in accessing these benefits cannot delay the provision of the
AT to the student. The school can purchase the technology and seek reimbursement
later (Margolis & Goodman, 1998).
A second key consideration for determining whether or not AT devices and services can be provided by a state's Medicaid program is whether the devices and services are deemed to be medically necessary for a child as required in Medicaid legislation. Meeting the criterion of medical necessity can be established by noting, for example, how the absence of an augmentative and alternative communication (AAC) system poses a substantial risk to the child's health or safety. It might be stated that such a device is the child's only way of indicating that he or she is hungry, hot or cold, not feeling well, or needs to use the bathroom (Assistive Technology, 2000). Usually Medicaid services identified as medically necessary fall under the categories of rehabilitative services, home health services and prosthetic devices (Advocacy, Inc., 1994).
The provisions authorizing states to establish a medical-necessity standard emerge from the statutory and regulatory language governing Medicaid. The federal legislation provides funding for medical care, rehabilitation and other services for eligible individuals "to meet the costs of necessary medical services" (Social Security Act Amendments of 1984, P. L. 98-369 [42 U. S. C. 1396]). Sheldon and Hager (1997) noted that a state may place appropriate limits on a service based on such criteria as medical necessity or on utilization control procedures (Early and Periodic Screenin, Diagnostic, and Treatment Services Final Rule, 1993[42 C.F.R. 440.230(d)]). Since each state provides interpretive language that provides the framework for evaluation of medical necessity, the terminology used to describe AT devices and services when reimbursement is sought is critical, and should be consistent with the language in federal and state guidelines (Galvan, 1998; Parette, Hofmann, & VanBiervliet, 1994).
The language in the federal legislation indicates that the primary goal of Medicaid is to provide medical assistance to persons in need and to furnish them with rehabilitation and other services to help them "attain or retain capability for independence or self-care." (Social Security Act Amendments of 1984, P. L. 98-369 [42 U. S. C. 1396]). The courts have found that persons with disabilities were entitled to Medicaid funding for augmentative and alternative communication (AAC) devices by reasoning that obtaining or retaining the capability for independence is the "primary goal of Medicaid" (see Meyers v. Reagan, 1985).
As noted earlier, each state generates its unique language and requirements consistent with federal guidelines. For example, New York state law provides that Medicaid will pay for services and supplies "necessary to ... correct or cure conditions in the person that ... interfere with his capacity for normal activity ..." (New York Social Services Law 365-a, 1999). In Washington state, individuals must show that the AT service or device is needed to prevent, alleviate or correct a condition, or to minimize or alleviate suffering (Washington Assistive Technology Alliance, 1999). Thus, to be successful in securing AT resources, the request in these states might provide evidence that the requested AT: (a) prevents further injury or pain, (b) prevents secondary complications, (c) is necessary for communicating symptoms, (d) is needed for safety reasons, (e) prevents deterioration in mental health, (f) decreases dependence on other services and devices, (g) serves as a prosthetic bridge of lost functional capacity, or (h) is required as part of a physical therapy, occupational therapy, or speech therapy program.
Continuing with the state of
Washington as a useful example, the definition of medical necessity in that
state also requires Medicaid recipients to establish that there is no other
equally effective, more conservative, substantially less costly course of
treatment available to meet the consumer's needs (Washington Assistive
Technology Alliance, 1999). Thus, if a school district requests a wheelchair
that is more expensive than others considered, the request for coverage should
explain why a less costly wheelchair does not meet the person's medical needs.
To satisfy the least costly requirement, the school district must prove three
things: (a) that the features of the specific AT are medically necessary, (b)
that the features are not included in the less costly alternative AT, and (c)
that the features are included in the AT requested. In short, for school
professionals to be successful in providing AT, they must be aware of the
state-specific eligibility criteria and appropriate terminology (Galvan, 1998).
Medicaid can also be used to provide AT equipment if that device is identifiable as durable medical equipment (DME). As is the case with the term medically necessary, definitions of DME vary from state to state and program to program. However, typical guideline questions to determine whether a device qualifies as DME include the following:
1. Is the piece of equipment able to withstand repeated use?
2. Is the piece of equipment primarily used for medical purposes?
3. Is the piece of equipment generally not useful to a person in the absence of illness or injury?
4. Is the piece of equipment appropriate for home use? (Assistive Technology, Inc., 1998).
Although the focus of this article is on school-age students with disabilities, the preceding information addresses the needs of adults with disabilities. However, students with disabilities become adults with disabilities; therefore, this information is crucial for those students as they transition from students receiving Medicaid eligible services to adults receiving Medicaid eligible services. Under the Medicaid guidelines, school districts may access two especially useful funding streams to provide AT devices and/or services to students with disabilities. These are the School Health and Related Services (SHARS), and the Early Periodic, Screening, Diagnosis and Treatment (EPSDT) program.
School Health and Related Services (SHARS) Program
The SHARS program allows school districts to obtain Medicaid reimbursement for
specific services provided to students who are Medicaid-eligible and are
receiving special education and related services (Texas Health and Human
Services Commission, 1997). In order for school districts to apply for Medicaid
reimbursement under the SHARS program, a student must be eligible for Medicaid
services. Additionally, AT devices and services must be deemed medically
necessary and related to a child's IEP (National Heritage Insurance Company,
1996; Texas Department of Health, 1997).
In order to participate in SHARS, school districts must meet any state licensing, certification, and registration requirements that apply to medical and educational services. Additionally, the school district must be registered as a Medicaid provider, and be enrolled in the state's Medicaid program. A school district participating in the SHARS program must agree to: (a) provide school health and related services as listed in the IEP, (b) provide the program in the LRE, and (c) maintain and submit all records and reports required by the school district to ensure compliance with the IEP (National Heritage Insurance Company, 1996; Texas Department of Health, 1997).
In addition, a licensed therapist or other medical personnel, as appropriate, must provide the services. Under the SHARS program, students who are Medicaid-eligible can receive a range of services for which schools may be reimbursed (National Heritage Insurance Company, 1996; Texas Department of Health, 1997).
A requirement of the SHARS
program is that meticulous records be maintained regarding children served.
While such record keeping is time-consuming, an often-overlooked benefit is that
school districts may also bill Medicaid for the time spent in the administrative
process required to provide these services (Texas Department of Health, 1997).
Reimbursement for administrative aspects of Medicaid was provided with the
original law authorizing Medicaid in the late 1960's. However, this provision
was not effectively accessed on a wide-scale basis until recently. The specific
formula for eligibility for this reimbursement is based on the school district's
overall Medicaid-eligibility. In addition, school districts receive more
reimbursement if individuals identified as Skilled Professional Medical
Personnel (SPMP) provide the services. In general, physicians, dentists, nurses,
and other specialized medical professionals would be included in this group
(Texas Department of Health, 1997).
A list of services typically covered under SHARS is provided in Table 1.
The Early Periodic, Screening, Diagnosis and Treatment (EPSDT) Program
In addition to SHARS, students with disabilities may receive AT devices and services through a second Medicaid program known as the Early Periodic, Screening, Diagnosis and Treatment (EPSDT). Many service providers have found the EPSDT program to be an excellent third-party funding source for AT services and devices for children who are Medicaid-eligible (Texas Assistive Technology Partnership, 1996). EPSDT was established under the Medicaid Early and Periodic Screening, Diagnosis, and Treatment Amendments of 1989 (P.L. 101-238), and targets children from birth to age 21 who are eligible for, or who are presently receiving, Medicaid services (Advocacy, Inc. 1994; Assistive Technology, Inc. 1998; Galvan, 1998; RESNA Technical Assistance Project, 1992; Wallace et al., 1995).
Under EPSDT, states must provide medically necessary diagnostic and treatment services for any physical or mental disability identified during a screening or assessment up to age 21(Galvan, 1998; RESNA Technical Assistance Project, 1992; Sheldon & Hager, 1997; Wallace et al., 1995). The law provides broad funding for AT devices and services, especially those that are health-related (Parette et al., 1994). In addition to DME, other potential services include rehabilitation, physical therapy, and occupational therapy (RESNA, 1992); medical supplies; hearing, language, and speech therapies; and private duty nursing (Advocacy, Inc., 1994; Galvan, 1998). Many of these services (e.g., rehabilitation, physical therapy) can be structured as AT services. Examples of AT that may be medically necessary include AAC devices, customized eating devices, and mobility aids. Under EPSDT, schools can purchase AT and then seek reimbursement for the cost of those resources (Margolis & Goodman, 1998).
The Developmental Disabilities Assistance and Bill of Rights Act
Amendments of 1987 as a Funding Source for Assistive Technology
While IDEA and Medicaid remain the two major providers of assistive technology
for students who have disabilities, there are several other options available
for parents and schools. Federal funds for AT support are available to states
through The Developmental Disabilities Assistance and Bill of Rights Act
Amendments of 1987 (P.L. 100-146). Through this legislation, states are assisted
in the provision of direct services to persons who incur a chronic or severe
disability prior to age 18 or, in some states, age 22. Each state has its own
plan for service delivery. Persons eligible to receive services are individuals
with developmental disabilities that: (a) arose prior to age 22 (18 in some
states), (b) have continued or can be expected to continue indefinitely, and (c)
constitute a severe handicap to such individual's ability to function in society
(Galvan, 1998). Services provided through this program are usually broad-based
and on an individualized basis. Most services are provided to children from age
5 (Galvan, 1998).
Vocational Rehabilitation as a Funding Source for Assistive Technology
Consideration of the role and potential contributions of assistive technology can be especially vital when administrators and parents are preparing for a student's passage into the world of work. Any student, age 16 or older and enrolled in special education, requires an Individualized Transition Plan (ITP) as part of the IEP. Assistive technology services for transition-age students may include items necessary to prepare the student for job training, independent living, employment, social/recreational activities, and further education. The agency legally responsible for providing the services identified in the ITP will remain financially responsible for providing any associated AT services that the student requires (Advocacy, Inc., 1994). In addition, if the AT is being used to gain meaningful employment, the local Department of Vocational Rehabilitation can help fund the device (Assistive Technology, Inc., 2000). Requests made for assistive technology through a state's Department of Vocational Rehabilitation might especially highlight the contributions that the technology will make towards the student's potential for vocational independence and/or productivity.
Private Insurance as a Funding Source for
In addition to federal and state funding sources, parents can access AT through
private insurance (Craddock, McNeal, Somerville, & Wilson, 1995; Galvan, 1998;
Parette et al., 1994; Todis & Walker, 1993; Wallace, 1995). The IDEA regulations
also authorize the use of a parent's private insurance (Golden, 1998; Hager,
1999). However, school districts cannot require parents to use this funding
source. Thus, its use must be strictly voluntary on the part of the parents
(Chambers, 1997; Golden, 1998; Inge & Shepherd, 1995; RESNA, 1992).
Private insurance may dictate the type and degree of AT equipment covered (Wallace, 1995).
Private insurance often includes coverage of durable medical equipment (DME), and thus will pay for AT if it can be classified as DME (Menlove, 1996). It is not unusual for parents to feel compelled to use private insurance due to delays and funding barriers imposed by systemic barriers in Medicaid and school funded programs. Private insurance will always be an option available to parents. However, accessing private insurance can cause a variety of problems for families, as its use can cost the parents in terms of out-of-pocket deductible charges, decreases in lifetime coverage, and subsequent increases in premiums.
Even when parents are aware beforehand of the financial ramifications of using private insurance to purchase AT devices, the school can later be held accountable for the loss (Golden, 1998). The use of private insurance benefits for third party reimbursement to the school system may also be seen as a violation of the requirement that students receive a FAPE; that is, an appropriate public education provided at no cost to the parents (Golden, 1998; Margolis & Goodman, 1998). The use of private insurance should not pose a threat of financial loss to the parent of a child with disabilities (Chambers, 1997).
Documenting Claims for Reimbursement
Decision-making by funding sources regarding the provision of funds for AT often
plays a crucial role in service delivery. Most funding streams require that
eligibility be established prior to the submission of a claim. The following
sections outline typical procedures for submitting a claim for Medicaid or
The federal Medicaid regulations require that "each service must be sufficient in
amount, duration, and scope to reasonably achieve its purpose" (Early and Periodic Screening, Diagnostic, and Treatment Services Final Rule, 1993 [42 C.F.R. 440.230(b)]). Individual state legislation may also provide supplementary provisions that offer further direction (Sheldon & Hager, 1997). General guideline questions in most state Medicaid programs include the following:
1. Is the proposed AT device and/or service medically appropriate for the symptoms, diagnosis, or treatment provided for the symptom, condition, illness, disease, or injury?
2. Is the proposed AT device and/or service the most cost-effective means that can safely be provided?
3. Is the proposed AT device and/or service accepted medical practice and state of the art?
4. Is the proposed AT device and/or service not primarily for the convenience of the person insured, provider, or professional? (Assistive Technology, Inc., 1998).
When submitting a claim to Medicaid or private insurance, families and school personnel should include all information necessary to facilitate a favorable decision by the reviewer of the claim. The following documents often are required:
1. A prescription from the child's primary care physician outlining the exact equipment required.
2. A letter or certificate of medical necessity from the physician or speech language therapist
3. A written evaluation from the speech language therapist describing the student's diagnosis, prognosis, communication capabilities, educational ability, and need for device
4. Student's date of birth, complete address, and phone number
In general, the more documentation that is provided, the better the opportunity for funding. Some Medicaid and insurance offices may require a trial rental period, a comparison between the requested device and other devices, and/or photos or videos of the child using the device (Assistive Technology, Inc., 2000). Information regarding Medicaid/SHARS and related AT recommendations are noted in Table 2.
Summary and Funding
Under IDEA, students with disabilities are to be provided a FAPE that maximizes
access to the general education curriculum. Any special education and related
services, including assistive technology that are required to achieve this goal,
must be made available at no cost to the student or the parent. However, funding
AT devices and related services remain problematic for school administrators,
parents, and IEP teams. If the IEP team determines that AT devices and services
are: (a) educationally necessary, (b) documented in the IEP, and (c) needed to
provide the student with a FAPE in the LRE, it is the responsibility of the
school district to provide the documented AT devices and services. If the
criteria above have been met, there should be no reason to seek other funding
sources. However, if these requirements have not been met, other funding
solutions such as Medicaid or private insurance should be explored.
In order for schools to receive reimbursement for AT and other related services through the Medicaid program, students who are served first must be eligible for Medicaid. Thus, helping parents obtain this eligibility should be the first step a school district takes. Next, the district should ensure that all professionals providing potentially reimbursable services have the appropriate licensure or certification, as well as the appropriate professional education and training to provide services to students. Assuming that Medicaid is the payer of last resort, all other funding resources must be exhausted prior to filing a claim through Medicaid.
A potential conflict for school districts may emerge between meeting the medical-necessity standard required of Medicaid and insurers, and the educational-benefit standard mandated by IDEA (Golden, 1998; Margolis & Goodman, 1998). One can easily envision situations wherein some AT might be reasonably seen as providing educational benefit under IDEA, but not qualifying as a medical necessity under Medicaid and private insurers, or vice versa. This conflict might best be resolved through an objective determination by the IEP team concerning the primary use and nature of the device and/or services. If it is a medical necessity, a claim should be filed through private insurance or Medicaid. If the device and/or services are used primarily for educational purposes, it might be most legitimately funded through IDEA and/or the local school system (Assistive Technology, Inc., 1998; Golden, 1998). Table 3 provides a summary of funding sources and strategies.
For the educational promises inherent in IDEA to be truly realized, schools have a legal and ethical obligation to provide access to those devices and services required for students with disabilities to (a) successfully interact with general educational curricula and materials, and just as importantly, (b) to successfully interact with their peers. Though often expensive, AT and related services offer the potential to allow this to occur. With the assistance of IDEA, Medicaid, The Developmental Disabilities Act, the Department of Vocational Rehabilitation, and private insurance, all students with disabilities increasingly can share these successes.
Due in large part to the 1997
amendments to the Individuals with Disabilities Education Act (IDEA),
individualized education program (IEP) teams increasingly are identifying
assistive technology (AT) for students with disabilities to ensure the provision
of free appropriate public education (FAPE) in the least restrictive environment
(LRE). Though this law requires that AT must be considered when developing the
IEP of a student with a disability, the high costs of AT devices and services
may lead some IEP teams to conclude that such technology is not accessible.
IDEA remains the primary funding source for assistive technology that is identified as an educational necessity. However, because funding of AT devices and services through IDEA remains limited, school administrators, parents, and IEP team members need information on other funding resources. Alternative options and guidelines for accessing these possible additional funding resources often are not well known by school professionals. This article provides an overview of several AT funding resources, notes basic requirements for eligibility, and offers suggestions for making successful claims.
Crystal Kemp is a Research Associate at the University of Texas at Austin. Jack Hourcade is Professor in the College of Education at Boise State University. Phil Parette is Interim Dean of Graduate Studies and Research at Southeast Missouri State University.
This manuscript is supported by Grant No. H029K50072 from the U. S. Department of Education. Opinions expressed herein are those of the authors alone and should not be interpreted to have agency endorsement.
Correspondence concerning this article should be addressed to Crystal Kemp, College of Education, University of Texas at Austin. Email to: email@example.com.