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LifeWorks

Pursuing better living for people with disabilities and their families. A pplied C linical S olutions. INTRODUCTION TO ASSISTIVE TECHNOLOGY FOR ADVOCATES PARTNERS IN POLICYMAKING CONFERENCE January 9 & 10, 2004 Mendel A. Uychutin, OTR/L, ATP. LifeWorks. Who are you?. Who are you?.

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LifeWorks

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  1. Pursuing better living for people with disabilities and their families Applied Clinical Solutions INTRODUCTION TO ASSISTIVE TECHNOLOGY FOR ADVOCATES PARTNERS IN POLICYMAKING CONFERENCE January 9 & 10, 2004 Mendel A. Uychutin, OTR/L, ATP LifeWorks

  2. Who are you? Who are you? LifeWorks~ACS

  3. What is the single, most important thing you wish to get at the end of this session? LifeWorks~ACS

  4. COURSE OBJECTIVESAt the end of the course, participants will be able to: 1. Describe examples of current assistive technology (AT) applications in various life situations, i.e. daily living, communication, work, recreation, education, travel, etc. 2. Define "assistive technology devices" and "assistive technology services." 3. Differentiate between "assistive technology device" versus "durable medical equipment." 4. Identify applicable legal basis and funding sources for AT services and devices given a specific case study. 5. Identify best practice features of an assistive technology service delivery model. 6. Articulate some effective advocacy strategies and leadership roles in helping consumers access AT services and devices. LifeWorks~ACS

  5. LifeWorks~ACS

  6. Assistive Technology Service(from Assistive Technology Act of 1998-PL 105-394) "Any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.“ This may include: the evaluation of the needs of an individual with a disability, including a functional evaluation of the individual in his/her customary environment (evaluating their needs in their usual surroundings) purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by individuals with disabilities purchasing, selecting, or borrowing AT devices selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing of assistive technology devices coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs providing training or technical assistance for an individual with a disability, or where appropriate, the family of an individual with a disability providing training or technical assistance for professionals (including individuals providing education and rehabilitation services), employers, or other individuals who provide services to, employ, or are otherwise substantially involved in the major life functions of individuals with disabilities. LifeWorks~ACS

  7. Assistive Technology Device(from Assistive Technology Act of 1998-PL 105-394) "Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities." LifeWorks~ACS

  8. Durable Medical Equipment(as defined by Medicare) • Can withstand use; • Primarily and customarily used to serve a medical purpose; • Generally is not useful to a person in the absence of an illness or injury; • Is appropriate for use in the home (42 C.F.R. '405.514a); • Is necessary and reasonable for the treatment of an illness or injury or to improve the functioning of a malformed body member (41 U.S.C. '1395a) *All aboveelements must be satisfied before Medicare will purchase an item as a durable medical equipment. LifeWorks~ACS

  9. Rehabilitation Technology(from Rehabilitation Act 29 U.S.C. '706(13) "The systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by individuals with disabilities in areas which include education, rehabilitation, employment, transportation, independent living and recreation. The term includes rehabilitation engineering, assistive technology devices and assistive technology services." LifeWorks~ACS

  10. What is Medicaid? It is: • a cooperative federal-state program authorized by Title XIX of the Social Security Act; • a health insurance program, designed to serve persons with limited income and resources • typically the only or primary health insurance plan for persons with disabilities who have limited income; • can pay for a wide range of health-related costs for both children and adults with disabilities including assistive technology LifeWorks~ACS

  11. Quotes About the Medicaid Statutes • ". . . almost unintelligible to the uninitiated." Friedman v. Berger, 547 F.2d 724, 727, n. (2nd. Cir. 1976) • ". . . an aggravated assault on the English language, resistant to attempts to understand it." Friedman v. Berger, 409 F. Supp. 1226, 1226 (S.D.N.Y., 1976) • "This is a world populated by Pickle People, Pseudo-Pickle, DACs and QMBs (Quimbies)." Accessing Assistive Technology, 1st ed. 1995, CA Protection and Advocacy, Inc LifeWorks~ACS

  12. What is Medicare? It is: • a federal health insurance program authorized by Title XVIII of the Social Security Act; • for a majority of persons with disabilities, an inferior health insurance plan compared to Medicaid; • can pay for assistive technology under Part A or Part B if you are in an institution ; LifeWorks~ACS

  13. What is IDEA? It is: • Individuals with Disabilities Education Act, enacted by Congress in 1975 to provide free and appropriate public education (FAPE); • authorizes provision of special education and related services; • authorizes assistive technology services/devices as part of related services LifeWorks~ACS

  14. What Changed in the Re-Authorization of IDEA?(20 U.S. C, 1401, Section 614 (3) (B)) (emphasis added) Every child’s IEP/IFSP must consider the following special factors: • in case of a child whose behavior impedes learning ... appropriate strategies, interventions, and supports; • in the case of a child with limited English proficiency… language needs • in the case of a child who is blind or visually impaired, provide for instruction in Braille and the use of Brailleunless the IEP Team determines that instruction in Braille is not appropriate; • consider the communication needs of the child, and in the case of a child who is deaf or hard of hearing, consider the child's language and communication needs, opportunities for direct communication with peers and personnel…; • consider whether the child requires assistive technology devices and services. LifeWorks~ACS

  15. An Overview of Legislative, Funding and Justification Matrix for Assistive Technology LifeWorks~ACS

  16. An Overview of Legislative, Funding and Justification Matrix for Assistive Technology LifeWorks~ACS

  17. For many instances, the difference between:(“assistive technology device and durable medical equipment”) “to-mah-to” and “to-mae-toe”… “flapjacks” and “pancakes” …

  18. Nada! Zip! None! • Except… You better use the right word and right way of asking for it, otherwise you get …

  19. Nada! Zip! None!

  20. Essential Features to Look For in Choosing Your AT Service Provider • Availability of multidisciplinary team (OT, PT, SLH, Rehab Engr., AT Specialist, etc.) experienced in various aspects of AT • Team approach and consumer driven • Outcomes-Based Service • Availability or access to a wide selection of AT devices and equipment for diagnostic or loan purposes • Competitive Response Time and Rates • Track Record of Successful Acquisition • Effective Case Management and Follow-up LifeWorks~ACS

  21. IDEA Keypoints 1 1. Do your homework! Know the rules! 2. Be clear about the results you want for Johnny. Do not confuse getting an AT device with Johnny’s improved ability to communicate as the pursued result. The AT device and service is only a means to an end. 3. Start your “diary”. Document events, dates, people, and transactions. 4. Despite the “system”, it’s a “people to people” transaction. Remember, in the long run, nice people always win. LifeWorks~ACS

  22. IDEA Key Points 2 • Know the appeal process and the timelines. • Avoid making accusations and personal insults. • Listen. • If you reach an agreement, make sure it has the “what, who, when” and, it is put in writing. LifeWorks ~ ACS

  23. Does anyone have a question? LifeWorks~ACS

  24. Trends in Mobility • The I bot

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