Obtaining Assistive Technology and Transitioning Out of Nursing Facilities

1. Obtaining Assistive Technology and Transitioning Out of Nursing Facilities Naomi Walker, J.D. PAAT Program Director Georgia Advocacy Office 404 885-1234

2. Introduction • The PAAT program in Georgia has as the following first priority/objective: Priority: “to protect individuals with disabilities in need of assistive technology devices and services in Georgia from abuse and neglect. Objective 1: Advocate on behalf of people unnecessarily institutionalized for the provision of appropriate assistive technology.”

3. Past Successes • Augmentative communication devices are available to people who live in nursing facilities. Settlement agreement in William T. ex rel. Gigi T. v. Taylor, 465 F.Supp.2d 1267 (N.D.G.A. 2000)

4. Past Successes • Evaluations for people who live in nursing facilities can generate recommendations for customized wheelchairs or augmentative communication devices. • “Clinic Services” Part II Policies and Procedures for Nursing Facility Services Section 908

5. Current Work • Nursing Facility/Customized Wheelchair Project • Checklist • Increasing the number of advocates

6. Current Work • Nursing Facility Transition Team • “Nursing Facilities” are not homes. • Medicaid Home and Community based waivers • Assistive Technology

7. Barriers • Lack of awareness • Medicaid policies • Medicaid waiver slots; caps on care

8. Lack of Awareness • Lack of awareness—and skill level—of facility staff • Lack of awareness of people who live in nursing facilities and family members

9. Medicaid policies • Nursing Facility Provider Manual (2001) 901 Covered Services 2) Nursing Facility Covered Services   Durable Medical Equipment (such as but not limited to beds, bedrails, walkers, wheelchairs) excluding specialized equipment for individual use (e.g. appropriate for use by only one person and could not be used by anyone else; such as specially fitted braces, etc.) . . . .

10. Medicaid policies • Nursing Facility Provider Manual (2009) 901 Covered Services 3) Nursing and routine services: Durable medical equipment such as but not limited to beds, bedrails, walkers, wheelchairs, oxygen equipment, oxygen, and related supplies.

11. Medicaid policies • Durable Medical Equipment policies • limited to people who do not live in institutional settings (including nursing facilities)

12. Medicaid Waivers • Limited number of available slots • Caps on care