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Assistive Technology Funding and Systems Change Project

Outline

Social Security as a Source of Assistive Technology Funding

• Introduction
• Program Structure
• Procedure
• Appeals
• Sample A
• Sample B

What Types of Assistive Technology can be Deducted as IRWE?

"But, We Don't Have the Money..." (Or as it should be "The Check's in the Mail...")

• Introduction
• I Wish I Had Said...
• What Can I Do?
• Funding
• Is There Anything Else I Can Do?
• So Much for Kids, But What if I'm Out of School and Need Technology?
• Finally

Social Security as a Source of Assistive Technology Funding

Introduction

Many people with disabilities receive benefits through programs operating under the Social Security Act. Older, retired workers and people who are unable to work because of illness or injury, receive payments through the Old Age Survivors Disability Insurance (OASDI). The disability insurance through this program is known as Social Security Disability Insurance (SSDI). Another important program for people with disabilities is the Supplementary Security Income (SSI) program. This program currently covers children and adults with disabilities who have become eligible because of "their inability to engage in substantial gainful activity (SGA)."

SSDI and SSI provide important benefits, including health insurance (e.g., Medicare for SSDI, Medicaid with SSI, usually). However, many recipients feel frustrated by what are considered work disincentives in the rules of these programs. People fear that ,if they work or try to work -they will lose benefits. And they worry that, if they lose health insurance coverage, they probably will get no private insurance to take its place.

People who receive SSDI or SSI benefits need to be informed about "work incentives" in the law. Work incentives are sections in the law that allow you to earn income and keep benefits for expenses related to employment. If used well, work incentives give you the opportunity to use benefits to get necessary training and other supports that you need to get established in work. They also ensure that benefit loss will not occur until you have worked for a specified period. For this discussion, remembering that assistive technology devices are a major expense covered under work incentives, is important.

To use work incentives as a source of funds for assistive technology devices or services, you need to understand: The 1) structure of the two programs; 2) the range of work incentive sections in the law; and 3) some administrative complexities and procedures involved in the Social Security Administration's handling of the process. An individual, or someone on their behalf, needs to be able to do planning and record keeping. None of this is difficult or mysterious.

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Program Structure

People often confuse SSDI and SSI, but they are really very different. The programs serve different people, based on differing eligibility criteria, and with different procedures for their operation.

Social Security Disability Insurance (SSDI)

SSDI is an insurance program. Workers who have paid Social Security taxes (including self employment taxes paid by people who are self employed), are entitled to monthly benefits - before and until they reach the age of 65 if they cannot work because of a disability. The law is strict, requiring that you be medically unable to work because of an illness or injury that has lasted, or is expected to last, for at least one year, or expected to result in death. This definition of disability is a very different one than would apply under a law like the Americans with Disabilities Act (ADA), where the assumption is that people with disabilities can and should be given the opportunity to work.

The fact that SSDI is an insurance not an "income maintenance" program, is critical to its understanding. You do not lose SSDI for having income. You could win the lottery or inherit money and still remain eligible for SSDI. You lose SSDI benefits only if the government determines that you no longer have a disability, or if it decides that, although you have a disability, you can work.

Supplemental Security Income

SSI is a strictly "means tested" program. This means that your income and assets must be below a certain level to receive benefits. Eligibility for SSI is also based the severity of your disability, and its impact on your ability to engage in "Substantial Gainful Activity (SGA)." Substantial gainful activity is earnings from work of $500 per month ($940 per month if you are blind). To receive SSI, your income has to fall below a figure specified by the government (the Federal Benefit Rate), and you may not have more than $2,000 in resources (e.g., a savings account, stocks, bonds, etc.). You may remain eligible for SSI while working; however, for income exceeding $85 per month, you will lose $1 of SSI for every $2 earned.

If you give the government back $1 in SSI for every $2 in earnings, it is the same as having 50% tax rate. In addition, the $1 will be taxed (at a low rate of 15% for someone who works long enough to be responsible for income taxes). In addition, there may be Social Security and Medicare tax deducted from the wages (at a rate of 7.65%). The state tax on the income is probably around 2%.

This means that you are looking at a tax rate of about 75%. For every dollar that you earn, you keep only a quarter. If you have work related expenses, such as transportation, clothes, lunches, or child care, those costs have to be taken into account. Until an individual's income rises to a high level, going to work can be a money losing proposition, even if work is available.

Let's be clear SSDI is all or nothing; if you cannot work, you receive the payments; if you can, they stop. If you are an SSI beneficiary and receive income, your SSI will be reduced by the income you receive, but payment may continue. This is where work incentives come directly into play.

Work Incentives

In SSDI, the test of your eligibility is based partly on your medical condition and your ability to work. If you make an average of over $500 a month ($940 if you are blind), you are considered capable of "Substantial Gainful Activity (SGA)." Exceptions now exist that prevent benefits loss, even following an income based determination that you are capable of SGA.

Trial Work Period (TWP)

The intent of the TWP is to decide if an individual with disability can engage in SGA. During the trial work period, individuals are making more than $75 per month. Each beneficiary is allowed to work for up to 9 months, and keep their benefits. If, after 9 months it is determined that you can work, your benefits will stop three months later. If you are determined unable to engage in SGA during this 9 month period, there will be no interruption of benefits.

However, for each period of disability, the 9 months are totaled. For example, you may have been receiving SSDI benefits for 10 years, working "on and off." Let's say that you have worked nine months total. Therefore, you no longer have an opportunity to use the TWP. It is important, if you are going to use Social Security the TWP option, and you have been working once in awhile, that you ask whether the whole nine months are available to you.

For example:

Hilda is on SSDI because she suffered a serious head injury that left her unable to work. Her injuries included some short term memory loss, migraine headaches, and partial paralysis of her left arm and leg. She had been working for 10 years prior to the injury.

Hilda applied for and is receiving SSDI since her injury. After several years of rehabilitation, Hilda and her physicians feel that she can probably return to work. However, Hilda is afraid that if she takes a job, she will not be successful. She is even more afraid that she will lose her SSDI and Medicare when she starts working. The employer told her that she cannot take part in the company insurance plan because of her pre existing condition.

Fortunately, Hilda learns, through a Social Security claims representative, that she can use SSDI Work Incentives to stabilize herself in a job (work for 9 months without losing her benefits) and keep her Medicare.

Impairment Related Work Expenses (IRWE) and Blind Work Expenses (BWE)

Impairment Related Work Expenses (IRWE) are costs of certain items and services that a person with disabilities needs in order to work, that can be deducted from your earnings as SSA decides whether you are capable of substantial gainful activity. This means that, if you deduct the cost of certain impairment related items, your SSI benefit will not be remain at a higher level. Similarity, Blind Work Expenses (BWE) is income earned by a person who is blind, used to meet expenses that are needed for that person to work, and is not counted in determining SSI eligibility and the payment amount.

When the Social Security Administration calculates your average monthly income for SGA, they are supposed to subtract amounts spent on IRWEs and BWEs. If your gross income averaged $501 a month, you might lose your benefits. If the amount was reduced to $499 after taken IRWEs (or $939 for someone who is receiving benefits as a blind person), you would not lose benefits.

The law clearly describes the kinds of expenses that qualify as IRWEs, including equipment that you may need to work. So, if your gross income were $600 a month, but you paid $150 a month for AT devices or other IRWEs, your income for SGA purposes would fall below the $500 threshold.

The TWP does not apply to SSI because, in that program, income over the allowed amount will automatically trigger a reduction in benefits. Yet the IRWE and BWE provisions play an important role. As with SSDI, the object is to use IRWEs/BWEs to lower your income and keep benefits.

To make this clear, we should note that the technical term is "countable" income. People pay taxes on their "taxable" incomes, not their "gross" incomes (taxable income is what remains after deductions and exemptions have been taken into account). Social Security is interested only in your "countable" income, not the total amount you have earned. That includes what is left after all exclusions, including IRWEs/BWEs, are factored. To say that something qualifies as an IRWE or BWE is to say that it is "excludable income," income that is excluded from countability.

After 48 months, Clyda intends to count the monthly payments on the equipment as IRWE, and it would be not be considered "countable income."

Anybody can write their own PASS request, but it often helps to get help from someone who is skilled in their preparation. Many Independent Living Centers have staff or volunteers who are skilled in dealing with Social Security. Some Vocational Rehabilitation agencies have staff with this knowledge. As we will see in the next section, networking with people who know the Social Security work incentives programs may be helpful for you.

There are some people who write PASSs for a fee. Some of these people can be helpful, but the issue is whether the same service, if needed, is available at no cost, and how well the for profit service provider actually knows the system. Expertise is important, but beware of people who say that they have special knowledge of the law shared by no one else, or who claim to have influence over the decision. Two sample PASSs are attached to this document. One is for the purchase of equipment and the other is for the purchase of training services.

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Procedure

Knowing that work incentives exist, and what they are, is not a guarantee of benefiting from them. As discussed in the next section, careful planning may be required to make full use of work incentives. Social Security Administration procedures play an important part in the outcome. Understanding these procedures will help you to get the full benefits that the law allows.

Every Social Security office should have at least one "Work Incentive Specialist." The "Work Incentive Specialist" is a staff member who knows about the work incentive sections of the law. However, Social Security and the laws that guide it are very complicated. You cannot assume that SSA's employees are experts in, or even familiar with, the work incentive provisions in Social Security. In the day to day work of SSA, work incentives play a very small part.

You should always ask to speak to the individual in the SSA office who is responsible for the work incentives program. If there is no work incentives staff person in the office, consider going to another office. You should also be prepared to remind the person about, and to refer all doubtful issues to, the SSA Program Operations Manual System (POMS). The POMS is the instruction manual used by all Social Security personnel to guide them in all procedures, computations, requests for documentation, and decisions. The rules for applying the work incentives are clearly explained in the POMS, and every Social Security employee should have an up to date copy, or be able to get one easily.

The POMS are not written for use by the public. However, they should always be consulted by SSA employees when a question comes up. If you want to see them, they are available in some libraries, in legal services offices, at some Independent Living Centers, and even from the Social Security Administration headquarters in Baltimore, Maryland. In addition, SSA publishes several booklets informing the public about the work incentive programs. You may wish to get these before talking to the SSA about work incentives.

It is important to remember that appropriate documentation is required for all income and expense information. You must also be able to provide information about how and why expenses were made if they are to be excluded from "countability" for work incentive purposes. You should also have pay stubs, sales receipts, and information/explanations on what specialized devices or services you need in your files. Getting all of the necessary information and documents together may not be easy. If you do not have Social Security

Some of the needed documentation (e.g., verification of wages by an employer, background information on an assistive device from a vendor), every effort must be made to retrieve the information.

Once you have the information, calculations still have to be made in order to determine what amount of income will not be counted toward your total income. These are important calculations because they determine how much extra income you will have, by using the work incentive "Impairment Related Work Expenses" formula. As stated earlier, you can earn $85 per month without losing any of your SSI payment. Countable income above that figure results in a $1 benefit reduction for each $2 earned.

Suppose that you earn $185 next month. Since this is $100 more than $85, it would result in a $50 decrease in your SSI check for the month ($1 less for every $2 extra dollars earned). Suppose you needed a van lift in order to get to and from work. The lift qualifies as an IRWE, and you have arranged to pay for it at a rate of $50 per month, starting next month. By treating this $50 expense as an IRWE, it becomes excluded from "countable" income. This means it is taken off the top, leaving your countable income for the month at only $135, which is $50 above the permissible $85. This results in only a $25 cut in your payment for the month.

Because many separate calculations are involved in arriving at the final figures, you need to have an accurate income figure, accurate IRWE accounts, and correct calculations.

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Appeals

You have the right to appeal any decision made by an SSA employee. In SSA, the responsibility for making decisions is distributed to different units and to different people. An initial decision of any kind can be made by the unit, or by the staff members responsible for it. The only way of getting that decision changed may be through an appeal. It is not a question of whether the original decision maker would or would not reconsider the decision if you gave them new information the decision is out of their hands once it has been made.

Several appeals opportunities are available in dealing with Social Security Administration decisions. The notice you receive about decisions will describe these. It is important to act right away, because often there are strict timelines guiding when you can appeal. You have two possibilities for the first appeal: (1 ) you can request "reconsideration" or (2) you can request a more formal appeal and seek a hearing. At the "reconsideration level," you request that the record be reviewed, and you explain in writing why you believe the original decision was wrong.

The next level of appeal is to ask for a hearing. This involves a hearing in which an administrative law judge hears evidence presented by both sides. Often, the person appealing the decision has an attorney to present his/her side of the case. The hearing officer then issues a decision. If you disagree with the decision, your attorney may file a lawsuit in federal court.

Remember these items when you are dealing with the Social Security Administration about work incentives or any other issue:

• When calling Social Security, always write down the date you called, who you spoke with, what questions you asked, and what answers were given. Be sure to keep this information with your records.
• Always make copies of any document you send to Social Security. This includes things that you send to them, and things that they send to you.

Social Security

• All paperwork sent to you by Social Security should be kept. If you do not understand any of this paperwork, ask a friend, family member, or advocate to help you. It is important to act quickly when you receive information, because you have only a certain amount of time to answer.
• Ensure that you report any address or job changes immediately. You can call the SSA 800 number to report these changes.
• Ensure that all of your bank accounts, in total, are under $1200.
• Pay stubs must be sent to the Social Security field office once each month.
• If you are unsure of what to do, ask for help from a friend, family member, counselor, or advocate.

For information on in an individual case, contact your local Social Security office and ask for the Work Incentive Specialist. The number of your local office may be found in the phone book Ask for information on the particular work incentive you are inquiring about (e.g., PASS, IWRP).

For additional information about Social Security (in easy to understand language, or in foreign languages, or alternate formats), contact the SSA in your area or call the SSA national hotline at 1 800 772 1213.

The opinions expressed herein do not necessarily reflect the position or the policy of the U.S. Department of Education. and no official endorsement by the U.S. Department of Education of the opinions expressed herein should be inferred.

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SAMPLE A

PLAN FOR ACHIEVING SELF SUPPORT

Name: John Jones

SSN: 999 99 9999

1. My work goal is data entry clerk

2. I want my plan to begin in December. 1995 (month and year)
I expect to reach my goal in November. 1996 (month and year)

3. I will have the following expenses in order to reach my goal:

Item - large screen reader

Connection to Goal - read materials on computer screen

Months Paid - 10/95 - 3/96

Cost - $150 per month

Total - $950

4. I already have the following money or property that I will use to reach the goal: none

5. I expect to receive the following income that I will use to reach the goal: SSI check

6. I will keep the money I set aside in the following bank account: None--I will make a payment each month

7. I am/am not already working or saving toward the goal.

8. Signature
Date

9. Individual(s) who helped me with the plan:

Mary Smith, Department of Vocational Rehabilitation

Excerpted from Project Inform training materials, United Cerebral Palsy Associations, Inc., December, 1990

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SAMPLE B

PLAN FOR ACHIEVING SELF SUPPORT

Name: John Jones

SSN: 999 99 9999

1. My work goal is data entry clerk

2. I want my plan to begin in December. 1995 (month and year)
I expect to reach my goal in November. 1996 (month and year)

3. I will have the following expenses in order to reach my goal:

Item - large screen reader

Connection to Goal - read materials on computer

Months Paid - 10/95 - 3/96

Cost - $150 per month

Total - $950

4. I already have the following money or property that I will use to reach the goal: none

5. I expect to receive the following income that I will use to reach the goal: SSI check

6. I will keep the money I set aside in the following bank account: None--I will pay each month's tuition

7. I am/am not already working or saving toward the goal.

8. Signature
Date

9. Individual(s) who helped me with the plan:

Mary Smith, Department of Vocational Rehabilitation

Excerpted from Project Inform training materials, United Cerebral Palsy Associations, Inc., December, 1990

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What Types of Assistive Technology can be Deducted as IRWE?

Allowable expenses that may be deducted as IRWE include payment for the purchase, installation, maintenance, and repair of an impairment-related item or payment for an impairment-related service that is needed for work. There is no separate deduction for the repair or maintenance of vehicles used for transportation to and from work, since these costs are already included in a separate deduction for mileage.

Expenses that are made in the work setting, transportation expenses for travel to and from work, and community residence expenses are all deductible as IRWE. Medicare or Medicaid may provide many of the items that are listed below. Any assistive technology that is obtained through those programs is NOT deductible as IRWE.

Assistive technology that is deductible is separated into several categories, as follows:

Medical Devices

• Durable medical equipment that can withstand repeated use, are primarily used to serve a medical purpose, and are generally not useful to a person in the absence of an illness or injury. They include wheelchairs, hemodialysis equipment, respirators, intermittent positive pressure breathing machines, pacemakers, inhalators, nebulizers, suction machines, traction equipment, braces (leg, arm, back and neck), and similar items (20 C.F.R.Section 416.976(c)(2), 404.1576(c)(2)).
• Prostheses include devices that replace internal body organs or external body parts. They include artificial hips and artificial replacements of arms, legs, or other parts of the body. Payments for prosthetic devices that are used for primarily cosmetic, rather than functional, purposes are usually not deductible.
• Work Related Equipment means equipment, other than medical devices and prostheses that an individual with a disability may need to perform his/her job, or transportation to move from home to work, or to control the disabling condition at home or in the work setting, so as to be able to function in a work activity. Costs for these expenses are deductible only when paid for by the individual, and not by the employer. Examples include one handed typewriters, typing aids such as page turning devices, measuring instruments, vision and sensory aids for people who are blind, telecommunications devices for people who are deaf, and special tools which have been specifically designed to accommodate the individual's employment. Training to use the equipment is also deductible.

If these expenses are deducted as a business expense by a self employed individual, they are not deductible as IRWE in determining SGA or SSI countable earned income (20 C.F.R. Section 41 6.976(c)(4), 404.1 576(c)(4)).

Residential modifications for individuals employed outside the home may be deducted as IRWE if they are necessary for the individual to get to work. For example, exterior ramps, railings, or pathways are considered part of the total process of enabling a person to get to and from work. Generally, interior modifications are not deductible, since they are primarily intended to facilitate functioning in the home (20 C.F.R. && 416.976(c)(4)(ii), 404.1576(c)(4)(ii)).

Residential modifications for individuals who work at home may be deducted to the extent that the modifications pertain specifically to the work space in the home. These may include enlarged doorways into an office or work space, or modifications to the work area to accommodate problems in dexterity. Any tax deductions taken as self employment expenses are not deductible as IRWE (20 C.F.R. && 41 6.976(c)(4)(ii), 404.1 576(c)(4)(ii)).

Essential non-medical appliances and equipment, such as portable room heaters, air conditioners, humidifiers, dehumidifiers, electric air cleaners and posture chairs, which are ordinarily not used for medical purposes, are not deductible as IRWE. However, if an individual can establish an impairment related and medically verified need for such an item, it may be deductible and may be for use in the home or workplace. To be essential, the item must be of such a nature that the lack of it would result in an immediate adverse impact on the individual's ability to function in a work activity. For example, an air cleaner for someone with a severe respiratory condition may be deductible as IRWE. Items typically used for physical fitness, such as exercise bicycles, are not deductible unless prescribed by the treating physician and necessary to enable the individual to work (20 C.F.R. Section 416.976(c)(4)(ii), 404. 1 576(c)(4)(ii)).

Routine drugs and medical services are deductible if they are necessary to control the disability and allow an individual to work, if the individual pays for them. It is unclear, however, if drugs and medications can be considered assistive technology for most purposes (20 C.F.R. Section 416.976(c)(5), 404.1576(c)(5)).

Other items and services that may be deductible include eyeglasses (if related to a disabling visual impairment), expendable medical supplies such as bandages, face masks, incontinence pads, etc., and the purchase of and expenses associated with dog guides (20 C.F.R. Section 416.976(c)(6)(ii), 404. 1 ~76(c)(6)(ii)).

Vehicle modification costs may be deducted if an individual requires a specially modified vehicle in order to work. The cost of the modification (but not the cost of the vehicle) Is deductible as an IRWE if the individual pays for the modification. Any modifications paid for by the rehabilitation funds (e.g., Vocational Rehabilitation) may not be deducted. Individuals may also deduct the operating costs of a modified vehicle which are directly related to work. For persons who wish to secure the full document Accessing Assistive Technology contact: Protection and Advocacy, Inc., 100 Howe Avenue, Suite 185 N, Sacramento, CA 95825, Phone, 800-776-5746 (VTTY)

The opinions expressed herein do not necessarily reflect the position or the policy of the U.S. Department of Education and no official endorsement by the U.S. Department of Education of the opinions expressed herein should be inferred.

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"But, We Don't Have the Money..."
(Or as it should be "The Check's in the Mail ...")

Introduction

Assistive technology is machinery or equipment that helps people with disabilities do things more quickly, easily, or independently. It can be elaborate and expensive or simple and low cost. Examples of assistive technology devices include wheelchairs, computers, toys that are adapted for easy use, and machines that read aloud, speak for people, or translate speech to print. Other examples include grab bars, railings, ramps, or equipment used for eating or daily activities. Assistive technology services are supports to using such devices, such as evaluations, maintenance, demonstration, or training.

When individuals and families become aware of the benefits of assistive technology, they may ask for such devices or services through their service delivery agency, school, or other professionals with whom they work. For each person who gets what s/he needs, there are others who are told:

"We don't have the money."
"We don't pay for things like that."
"We've never funded equipment before "
"If we paid for that for you, we'd have to pay for everyone."
"With the funding cutbacks this year, we can't do that."

Given one of these answers, the person with a disability or parent turns to friends and family and says, It doesn' t seem right, but what could I say? What could I do?"

When financial reasons are used to refuse requests for assistive technology equipment or services, there are many ways that parents and adults with disabilities can answer. To accept a "NO" often means giving up choices that can open doors to independence, communication, interaction, and inclusion in the community. By not accepting the "NO," many people have been successful in getting the equipment and services that they need.

It is possible to use the system's rules and regulations to answer the statement 'We don't have the funds." Individuals and parents can point out rules that make the "lack of funds" answer an unacceptable excuse. It may, however, take long, hard work to change the attitudes and priorities behind such remarks.

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I Wish I Had Said...

If parents ask for assistive technology devices or services for their child, and are turned down with the answer "We don't have the money," they should point out that:

Federal laws such as the Individuals with Disabilities Education Act (IDEA), P.L.102 119, guarantee a student's right to full educational opportunity and to a free appropriate public education (FAPE), including special education and related services through age 21. Related services help a student benefit from special education, and include: transportation, speech pathology and audiology, psychological services, physical and occupational therapies, recreation, social work services, counseling services (including rehabilitation counseling), and medical services. Remember . . . Assistive technology CAN qualify as a related service.

Federal law and court decisions state that lack of funds is not an excuse for a school system's failure to provide a free appropriate public education (FAPE). Since assistive technology devices and services may be an important part of FAPE, this excuse should not be given to parents.

The Individuals with Disabilities Education Act, IDEA, defines assistive technology devices and services in Section 602(a). In addition to evaluation, selection, maintenance, coordination, training, and technical assistance related to devices, the definition of assistive technology service includes:

"(B) purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by individuals with disabilities."

On August 10, 1991, Director of the federal Office of Special Education Programs, Dr. Judy Schrag, issued an Office of Special Education and Rehabilitative Services Policy Letter. This letter made it clear that:

• Assistive technology can be listed in an IEP as either "special education" or a "related service."
• Assistive technology can be considered as a supplemental aid or service used to help with a student's education in a regular education setting.

Special education is defined as "specially designed instruction, at no cost to the parent, to meet the unique needs of a handicapped child. . ." Related services include "transportation and such developmental, corrective, and other supportive services as are required to assist a handicapped child to benefit from special education" (34 CFR 300.13(a)). Dr. Schrag stated in her Policy Letter that public agencies (including school districts) are not permitted "to presumptively deny assistive technology." The letter stated that students must be considered for assistive technology on a case by case basis, as the Individualized Education Plan (IEP) is developed.

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What Can I Do?

Parents who are told that their children cannot have assistive technology equipment or services because their school system does not have the money should also take these steps:

• Make sure that the device or service is included in your child's Individualized Education Plan (IEP) or Individualized Family Service Plan (IFSP). Need for the device or service should be described in the Needs and Present Level of Performance sections of the Plan. For example, "Johnny is nonverbal and has no way to express his needs or communicate with people around him. Although he communicates with his mother and other family members through body language, eye gaze, and crying, the success of these communication efforts depends on what the listener thinks he may be trying to say. His mother reports that he can visually focus on a preferred object. His physical therapist reports that he may be able to move his right arm to activate a switch." Such a description of Johnny's communication skills and needs sets the stage for asking for an augmentative communication device for Johnny.
• The IEP or IFSP should also contain specific recommendations as a result of an evaluation in this area. An example of a recommendation is: "Based on the evaluation by the interdisciplinary team and the observation of the Occupational Therapist, it is recommended that Jenny use a built-up fork and spoon for feeding herself. Also, a non-skid surface should be used to hold dishes, glasses, and utensils on the table or on her laptray." Evaluation recommendations should be as specific as possible, and should include any service supports that may be necessary (such as training family members or staff to use the equipment).
• The device or service should also be written into as many areas of the Goals and Objectives section on the IEP as possible. For example, objectives involving augmentative communication could be:

"Johnny will use his AAC device to initiate communication with peers in academic and non-academic settings, including lunch, physical education, language arts, math and science classes."

"Johnny will read aloud with his reading group, using sentences that he has pre-programmed into his AAC device, as a part of his homework assignment."

"Johnny will answer questions during science class, using complete sentences with his AAC device."

In order to be effective, the objectives should be as specific as possible, and include the used of the appropriate device.

• Make sure that requests for assistive devices are written into the IEP placement meeting minutes. These minutes should be a part of the record for each placement meeting. The district's answer to such a request should be recorded in the minutes, along with the request.
• Get documentation of denials: Two strategies for documenting denials are:
1. Ask the person who tells you that your child cannot have an assistive technology device or service because the school system lacks funds, to send you a letter or a written statement stating (a) that you are being turned down, and (b) listing the reasons.
2. If you do not have a refusal in writing, but the district continues to say that they will not pay for a device or service, then you should write to them. Write a letter to the person involved, repeating exactly what they have told you. Ask them to contact you within a week if the information in your letter is not correct.
• Send a copy of the school system's letter or your letter about the situation to the school board's attorney, and ask for a statement about whether such a position and reasoning are system policy or practice. A policy is a formal written statement, usually approved by the school board or superintendent, outlining how such situations should be handled. A practice is a "custom" or the usually way of handling a situation. A policy would have to be changed or approved by the "powers that be" such as the School Board, while a practice can be changed by an individual, such as an administrator or teacher.

Lawyers are often unaware of statements made by personnel in their system and they may quickly explain the position of the district on such matters. Again, ensure that you get a letter from the attorney, or that you send a letter to him/her, re stating what you were told. If the lawyer does not agree with the school's position, use this letter in pursuing your request. If the lawyer supports the "NO" answer that you have gotten from others in the system, send a copy of this letter to the State Director of Special Education. Ask whether this position is acceptable to the state, and in agreement with federal and state laws and regulations.

• Document your situation and file a complaint with the state's Director of Special Education, request mediation or a due process hearing, or file a 504 complaint with the Office for Civil Rights, if you are being denied access to appropriate programs or services. Other strategies such as those listed above should make it possible to avoid these procedures, but parents should know that they have the right to use these approaches if they need to.
• Ask whether the schools have looked into all possible sources of funds for technology devices and services. The parent should not feel responsible for finding such funds, since that is the job for which the school staff are paid, but they may wish to encourage administrators to pursue all avenues of funding.

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Funding

Funding sources include, for example:

Public Law 89 313, the Elementary and Secondary Education Act Amendments of 1965, set up grants for state agencies to educate students with disabilities in state operated or supported schools and institutions. If a student has been served in a state school or institution, and is now served in a public school, PL. 89 313 funds should follow him/her to the local school. Although this usually amounts to no more than $400 per student, some schools have used it to buy "low tech devices" such as tape recorders and tapes, toys, or switches, or to buy lower cost augmentative communication devices. Parents can call their state Department of Education offices to get information on 89 313 funds.

The EPSDT (Early Periodic Screening Diagnosis and Treatment) Program was expanded in 1990, making it an excellent third party funding source for services and devices for children who are eligible for Medicaid. Education laws do not require that a school system pay for each and every service or device only that they make sure that the student has the equipment, services, or programs outlined in the IEP. Medicaid eligible students are entitled to diagnosis and treatment services under EPSDT. This means that they may be evaluated for technology needs and get services or devices through EPSDT (Medicaid) funds.

Private Insurance is another option. Parents should know that school systems can ask them whether they would be willing to use their private insurance to cover the cost of special education and related services, but that use of their insurance is strictly voluntary. Parents do not have to use their insurance unless they choose to do so. The schools may not require the parents to file an insurance claim. If costs result from a claim, the state or local agency must cover such costs. For example, if Jennifer's IEP says that she needs a screen magnification device to enlarge the print on the computer screen so that she can read better, the school may ask Ms. Jones if she would use her insurance for this device. Ms. Jones' insurance company may pay 80% of the cost. Any remaining cost should be paid by the school, not the parent, since services in the IEP are at no cost to the parent. Parents may not wish to file their private insurance for services listed in the IEP, because there is a possibility of insurance premiums being raised. The insurance company may have limits on the total amount that they will pay over time for an individual or family's claims (the amount available for payout may be reduced as the result of lifetime limits in individual or family coverage).

Whether filing claims initiated by the family or for school needs, families should remember that insurance companies are very likely to say NO the first time around, and the success of a claim may depend on the parent's willingness to re apply and/or appeal a claim determination.

Equipment loan programs may be available to students, through education, libraries, private sources, manufacturers, or banks.

The Technology Related Assistance Act, PL 100407, has funded states to expand and coordinate technology services. Through the Tech Act grant, there may be additional resources available to you or to agencies that serve families and people with disabilities. For example, some states have set up low interest loans and equipment lending programs. Every state receiving these funds is required to expand technology services in local communities. These funds are earmarked for statewide activities and should not be restricted to a particular age or disability group. I

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Is There Anything Else I Can Do?

When your school system uses funding as an excuse for denying services, parents may want to take a more general approach to problem solving for the total system. For example:

• Become involved in the budget and planning process for education services. . .
• As a part of your local Special Education Advisory Panel,
• An the School Board,
• As an individual citizen, or
• As a part of a special interest support group.

The budgeting process results in setting aside money for those areas that are considered important. Parent involvement can ensure that budget priorities are likely to meet the needs of their children.

Survey local schools to find out how many computers are available to students, when they are used, and how students get to use them. Compare the information that you have about where, when, and how computers are used in the different programs. Remember:

• Computers are equally valuable if not MORE important to the education of children and youth with disabilities and special learning needs, as compared to students without disabilities.
• Computers do not always have to be bought with special education funds.
• Computers need not be used by one group or another, but can be jointly used by students with and without disabilities.
• Network with other parents. Find out how other families have gotten services and devices. Share successful strategies with other family members.
• Educate administrators, School Board members, and legislators about the effectiveness of assistive technology, and encourage them to support funding in these areas. Write letters, send them copies of newspaper articles, provide them with examples of successful technology use in other systems, and have them get to know your child personally.
• Identify model programs and success stories from other school systems, or other states, if necessary, and promote adoption of best practices in your child's program. When parents give examples of "promising educational practices" related to their child's situation, they can also ask for training and continuing education for parents and staff related to these practices.

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So Much for Kids, But What if I'm Out of School and Need Technology?

Most programs provided to people after the age of 21 are not entitlement programs. Students with disabilities are guaranteed a free appropriate public education; they have a right to those entitlement programs. Adults over age 21, however, often deal with programs from which they could be excluded because of requirements such as meeting income levels, the person's potential for employment, or type and severity of disability. Perhaps because of the possibility of not "fitting" certain programs, an adult with a disability often feels at a disadvantage and may be more likely to accept the excuse, "We don't have the money," or 'we don't have the money to provide assistive technology services." Instead of accepting such excuses, self advocates and others working with them should know:

• Rehabilitation Services Administration Commissioner Nell Camey has written a Policy Directive (November 16,1990) on rehabilitation engineering services. Rehabilitation engineering services include technology methods, approaches, or devices that help individuals with disabilities overcome barriers to education, rehabilitation, employment, transportation, independent living, and recreation. Commissioner Camey's Policy Directive said that State Vocational Rehabilitation agencies had to:
1. Look at whether technology supports would affect their potential for employment;
2. Make rehabilitation engineering supports available during evaluation, annual review, and as a part of post employment services; and
3. Provide rehabilitation engineering services regardless of whether similar services and benefits are available under any other programs.

Given this new policy directive, many people with disabilities may wish to re apply for Vocational Rehabilitation services. Or, if they are receiving Vocational Rehabilitation services without any attention to their technology needs, they may want to ask for a change in the services they are getting.

• Your school, college, or university may be able to help you. If you are in a post secondary program such as college or vocational education, you may need assistive technology to participate in programs or classes on an equal basis with other students. It is possible that the school or university could provide assistive technology devices and services for you while you are a student in their program. For example, the library might provide computerized databases that could be read by a student with a visual impairment with the support of text enlarging software or programs that read text aloud. Students may have note takers or tutors, and all buildings, spaces, and programs should be physically accessible to all students. Rehabilitation Services (Vocational Rehabilitation) may also pay for technology devices and services if they are written into the Individualized Written Rehabilitation Plan (IWRP). >
• Even in non entitlement programs, there are appeals processes that individuals can follow. Each program, agency, or funding source may have a different appeal process, but these DO exist to protect the rights of the individual. It is worth finding out what the appeal process is for the program with which you are dealing, and becoming familiar with the rules governing such appeals.
• If you are employed, your employer may need to provide technology devices and supports as a Dart of their "reasonable accommodation" under the Americans with Disabilities Act (ADA). Reasonable accommodation means modifications or changes to the application process, to the work space, or to job situations. For example, an employer may have to make their building accessible to someone in a wheelchair, to change examinations for someone who has a visual impairment, to reorganize a job, or change work schedules.

The National Institute on Disability and Rehabilitation Research (NIDRR), under the U.S. Department of Education, has funded 10 Regional Disability and Business Technical Assistance Centers to help implement the Americans with Disabilities Act (ADA). These centers can answer questions and provide reliable information about ADA rights and responsibilities. In order to find out which Technical Assistance Center serves your region, contact the National Technical Assistance number at (800) 9494232. Your call will automatically be transferred to the DBTAC serving your particular state. (You can find an updated list of DBTAC contact points, included in the July, 1995 edition of Tech Express.)

• You may find assistance and technology resources through your state's Tech Act Grant Program. The resources available to parents and children through the Technology Related Assistance Act are also available to adults. Individuals may wish to contact their state's Tech Act program to get information on training, equipment loan programs, low interest loans, and other types of support. To find out who to call within your state, call the RESNA Technical Assistance Office at (703) 5246686. Alternatively, refer to the Sate Tech Act list included in the November 21, 1994 edition of Tech Express.
• Make sure that your program plans include technology. If you have an individual program plan in day service programs, Independent Living programs, or other facilities or services, make sure that this plan notes your need for assistive technology. . . regardless of whether the agency says it has money to pay for such devices or services. These plans include Individual Program Plans, Individual Education Plans, and Individual Written Rehabilitation Plans. If a person believes s/he is not eligible for technology services, their needs cannot be noted in their plans. Their reasoning is, "If the agency can't or won't pay for it, what difference does it make if it is written down?" The answer to that question is simple:

Agencies, as a rule, only deal with needs that are documented or written down. Once the need is documented, the agency may become creative in finding funds or resources to meet that need. Also, if many people receiving services from a particular agency write technology needs into their written plan, the agency may be able to use that information to convince their funding sources to provide additional funds or to find community resources to meet those needs.

Once the technology need is written, planning can begin to address those needs on a long term basis.

• Try talking to your legislators about your need. Although the agencies with which you are dealing may have limitations, your legislator may be willing to look into the budgeting of state or federal funds, or write your needs into the budget, or start the process of changing laws or regulations.
• Ask vendors--those companies that manufacture and sell technology products--to help you find funding AND other individuals who have been successful in finding funding for their products. Find out from your friends how their devices were paid for, and use the same resources.

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Finally...

Once parents and adults with disabilities are successful in finding funds for devices and services, they should share their successful techniques with as many people as possible within their community. The ideas and approaches that worked for one are likely to work for others. If you continue to be unsuccessful on your own, however, working with others interested in finding funding for technology may be the key to success. Many people working together to point out their needs for technology are likely to get results that will help the group AND the individual. If you are being refused assistive technology services or devices for financial reasons, the following resources can help you locate the available programs in your state: Parent Training and Information Projects
The TAPP Project (703) 684 6763

Protection and Advocacy Services
(202) 408 9514

National Information System for Vietnam Veterans and Their Children
(800) 922 9234

The opinions expressed herein do not necessarily reflect the position or the policy of the U.S. Department of Education and no official endorsement by the U.S. Department of Education of the opinions expressed herein should be inferred.

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