Transcript
HOST: Thank you so much for joining us today for December's Tech Accelerator Webinar. Our topic this month is funding for alternative and augmentative communication, or AAC devices. And this session is being recorded. The video will include picture in picture ASL translation, as well as a full transcript. You can access that video on our website at disabilities.temple.edu. I will put that link in the chat as well.
That website is also where you can register for future webinars. So TechOWL has a wonderful series of 18 topics running from July 2024 to December 2025. Each is held on the third Thursday of the month, and is offered at two times, 12:00, noon, and 4:00 PM.
The series is part of the Tech Accelerator program, which is an initiative funded by the Office of Developmental Programs, and the Office of Long-Term Living here in the Commonwealth of Pennsylvania. And this is made possible through funding from the American Rescue Act. The Pennsylvania Tech Accelerator project includes five major focus areas, training and resources to build capacity for stakeholders, readiness evaluation, to develop tools for successful adaptation of remote supports and assistive technology, statewide assessment to plan and benchmark a technology first system change, a provider survey to assess technology awareness and resources among providers, and finally, two technology summits, which will be live events hosted in Philadelphia, and in Pittsburgh this coming March to enhance awareness of tech solutions. You can learn more about all of those fantastic projects at our website at disabilities.temple.edu using the link in the chat.
All right, I'm going to turn it over to our speaker this month, Hali, for finding and funding AAC. Thank you, Hali.
HALI STRICKLER: I'll introduce myself in the meantime. So, like Caitlin said, I am one of the speech language pathologists and AAC services coordinators at the Institute on Disabilities at TechOWL program at Temple University. We are a part of Temple's college of Education and Human Development. And so today, we're going to be talking about finding and funding AAC. If you have any questions, feel free to put those in the chat, and I'm going to try to keep an eye on that while I'm talking at you for the next hour or so.
Just some disclaimers that we like to give before we do any presentation, so I am speaking from the perspective of a speech language pathologist. I consider myself someone who specializes in AAC, but I am not a person who I identify as someone with a disability, and I am not an AAC user. So kind of that being said, it's good to seek out the perspectives of disabled folks and AAC users for a more comprehensive and holistic viewpoint about these types of topics and information as well.
So a lot of the information I'm going to be giving today is based on my experience as a professional in this field, not as a person with lived experience. So just keep that in mind. And then we-- and I'm going to be using a variety of identity first and person first language throughout the presentation.
I do this to accommodate both preferences for each type of language. So you might hear me say AAC user. And you might also then hear me say person who uses AAC. A few other examples, autistic person, person with autism, disabled person, person with disability. So again, we do that to include and accommodate both preferences for each type of language.
So just to break down the terms that I've already probably been using a little bit, and that you've probably heard, we're going to be focusing on AAC. So you're going to hear that phrase, or that acronym a lot. AAC stands for augmentative and alternative communication. We'll go more into that definition, and what AAC is briefly on the next few slides.
We are also going to look at AT, and talk about AT, that's assistive technology, so any of those tools that a person with disabilities might use to complete a task, or participate in an activity that they want to. You might also hear me use things like DD or ID to refer to developmental mental disability or intellectual disability. And then one of the big ones we're going to be talking about today is SGD, so speech-generating device.
We're going to be using that kind of as an umbrella blanket term to refer to the physical AAC type devices, but you might also hear me say AAC device to refer to a speech-generating device. So I might use those types of terms interchangeably, but just know that not every form of AAC is a speech-generating device. And then also, SLP, that stands for speech language pathologist, or speech therapist like myself.
So just to go in a little bit more about what is AAC. Again, AAC stands for augmentative and alternative communication. So we kind of have two points there. So it's augmentative, meaning, that it can add to someone's speech, or it can also be alternative. So it's used instead of someone's speech.
And some folks might use their AAC in a combination of those types of ways. It's not just an either/or type of thing for every person. Some people may be able to use their oral speech some of the time, but then they might not be able to use it other parts of the time. So that might be when they use a device to supplement their existing speech.
So AAC does include any other type of communication method beyond oral speaking, oral speech or talking. So this can include things like gestures, facial expressions, pictures, symbols, sending an email, giving a thumbs up, or sending an emoji over a text. Those are all forms of AAC. And we all use AAC in our daily lives, but some of us just use AAC a little bit more than others.
On the slide we also have some visual examples of different types of systems. When we talk about AT and AAC specifically, we tend to use a hierarchy ranging from low and light tech, to mid tech, and then up to high tech. That being said, a person doesn't have to work their way through the hierarchy before they graduate, or move on to the next level. So somebody doesn't have to start at a low tech device or system, and then move up to that high tech.
Some people might start with a high tech system, and some people might decide to just stick with a light tech, paper based AAC, and that's OK. One's not inherently better than the other. One's just better for the individual. And so that's all on an individual basis.
So here on the slide, we do have an example of a light tech paper based system. So that is the little flip book that you see. On the bottom row towards the left and in the center are two examples of mid tech devices. So the one with the red button is called a BIGmack. And then the green device with the four images, including the cat and the ball, this is an example of a GoTalk device.
So both of these require somebody else to record their voice, their speech. And then when the person using the device activates the button, or presses the picture, then that recording will be voiced. So those are examples of mid tech devices.
And then on the right, in the top corner and in the bottom corner are two examples of high tech systems. So the one on the top right is a Tobii eye gaze device, so eye gaze meaning that somebody is using their eyes basically as a mouse. So a camera picks up and tracks their eye movements, and then they're able to use their eye gaze and eye movements to control that screen and make their selections on the device. And then the bottom one is an iPad based system with an AAC app.
So kind of moving on to the next phase, we're going to be talking about finding AAC. So how do we get devices? And how do we identify which ones are a good fit? So some more terms to know. Keep in mind that as we're talking throughout this presentation, there is going to be a large focus on the insurance funding process, so using medical insurance to pay for an AAC device. That's not the only way to pay for an AAC device, but a lot of the other types of forms, and a lot of the language we use to talk about funding kind of comes from the more insurancey world of things.
So here's just some more terms to know while we're talking today. So DME, that stands for durable medical equipment. Durable medical equipment can be really any type of medical device that somebody might use. And in this case, a piece of DME for communication, that would be one of our AAC systems. A bundled iPad, that is going to be an-- we're going to use that term to refer to iPads that are funded through a specific AAC vendor.
Different vendors are going to sell iPad products. Basically, their bundled iPads are an iPad in a case with a communication app on it, but they're going to have a specific name. So the examples we have here on the slide say the TalkPad Wego edition, that's from the company Talk To Me Technologies and Smartbox. The Quick Talker Freestyle is from the company Ablenet. And then Choice Communicator is from the company ACCI.
Even though they have different names, at the end of the day, they're still an iPad in a case with an app, but insurance doesn't outright like to pay for a kind of consumer grade iPad. You can't just go to Target, or Walmart, or Amazon, and buy an iPad and pay for it yourself out of pocket, and then have insurance reimburse you. That's not really an option. You have to go through one of these special vendors to purchase the iPad preloaded with the AAC software.
Next, we have dedicated communication device. So this is another one of those umbrella terms. A dedicated communication device is a device that is funded through insurance, and it's dedicated only for communication. That means that it's locked down to the communication software.
If you look at the bottom of the screen, there's images of all kinds of different AAC devices from different companies. And you'll notice that they're all kind of computerized fancy tablets. At the end of the day, they're computers, they have access to the internet. You can do other types of things besides just communicating on most of these products.
It's just that when insurance pays for them, they are locked down, meaning, you can't get to the internet. You can't get to those external features. A lot of times, that's offered behind a paywall. So you can pay out of pocket, then maybe like a small fee, sometimes, it ranges from $20 to $50. Some companies, it's free. You just have to ask. But you can then get your AAC device unlocked and then be able to use it as basically a functioning computer.
You can go on the internet, you can watch Netflix on a lot of these systems. You can send emails, get text messages depending on what type of device you have. So especially for someone with a complex body and complex access needs, they can do a lot more than just communicate using their device. It can be integrated for home environmental controls, all kinds of different things. But in a lot of those cases, insurance doesn't want to pay for those other things, those environmental controls, or the leisure access that you can have on one of these devices.
And then we already said speech-generating device, dedicated communication devices can come as speech-generating devices. And those bundled iPads are dedicated communication devices. And they are also speech generating devices. So a lot of these terms kind of blend together.
So the next part, what is an AAC evaluation? In my practice, we tend to look at AAC evaluations as either formal or informal. So when I talk about them being formal, that's usually for evaluations that are needed for insurance funding purposes.
So that being said, there's a lot of steps and information that needs to be collected if you're going down the insurance funding route. Sometimes, if you're going to pay for a device out of pocket, or through a grant program, or other avenues, you don't necessarily need to go through all those bells and whistles to find the right choice. But when we're talking about the evaluations, we're going to be looking at that from more of that insurance focused perspective.
So an AAC evaluation can be a lot of different things. But really, overall, we're going to use this as an opportunity to identify the person's best communication modalities, and also, those areas of communication where they might need some additional support. We're going to also explore what types of systems, and devices, and strategies are out there and available for that individual.
And then we're going to find the solutions that are going to work for that person. So we do that really by one, identifying all the things that a person can do, what they want to do, and what they need, and then taking the devices that are available on the market, and matching them to the individual. So there's a phrase, or a term that they use that's called feature matching. We want to match the person to the features that exist within a device.
And then we're going to determine which one is appropriate for the individual. Sometimes, in a lot of cases, that's through device trials. We might try out one, and it's great. Yay, perfect. But then other times, we might get some feedback and say, hey, we need to go and revisit, and try some other options out there to find a better fit, or a better solution. Whenever you are going through medical insurance, that's when you're going to need that big, fancy formal evaluation. And that evaluation is going to need to be conducted by a licensed and certified speech language pathologist, especially in the state of Pennsylvania, if you're looking for insurance funding purposes.
So here's just a visual to go over that evaluation process. We're going to gather that information. Then we're going to take that information about the person, about what they want to do, what tools exist. And then we're going to look into device and system trials.
So sometimes, the devices, a lot of companies are going to offer similar systems. Some are going to offer more specialized systems. And so we might have to determine how many trials, or where we're doing our trials based on the products that the company sells, or the different companies sell. So, for example, if we're looking for one particular app, we might have a lot of options and can pick from different companies that have different cases, and different size devices.
But if we're looking for a very specific type of language software, or a very specific app, not every company might offer that one. Some companies might only offer their proprietary language and AAC software, so that might narrow down some of our choices. That's kind of the same thing too, with some of our access methods.
So if somebody needs eye gaze, that's not necessarily available on every single system. Or every single eye gaze camera is not compatible with every single AAC device. So we have to narrow down and find the best combination, the best pros and cons, to get a person closest to their ultimate solution. And then we're going to look at funding sources after we decide what product is the best fit. And then hopefully, we go through the funding process, and then we obtain that AAC device for the person to own.
So some information, when we are doing any type of evaluation, but especially one with the goal for insurance funding purposes, the SLP on the case, or that the person is working with, they're going to collect information like case history and background, and that's going to include things like medical diagnosis. All that information is needed to submit in these reports. We're going to look at the person from a holistic perspective as well, so we're going to get information about their sensory needs, cognition, fine, and gross motor abilities, hearing, and vision. We're going to need to know if that person is using a wheelchair or a power chair, that they might need some additional accessories, whether they're going to be able to use their finger to interact with the screen of a device, or if they need other accessories to be able to access and navigate their system.
And then we're going to again, look at their communication overall. So how do they communicate? And then also, where are they communicating? Who are they communicating with? We want to look at all of those things.
And then we take a peek at your speech and language skills overall. So a person might be able to use some of their speech. But when we're writing up this big, fancy report as an SLP, we don't really want to focus on all the things that the person can do. In a lot of cases, we really want to highlight the things that are hard, or that a person can't do. And that's because we have to really battle the insurance company, and we need to unfortunately, come from a more deficit and impairment based approach when we're getting funding for these types of devices.
We don't want the insurance to come back and say, oh, well, they can use their speech sometimes, so they don't need this device. Sometimes isn't good enough when it comes to communication. We need to be able to have an effective and efficient way to communicate all the time, not just sometimes.
And then we're also going to need to look at that access method, that again, either if it's eye gaze, is it switch? Do they need something to help them with their fine motor to physically touch the device with a finger, or a toe, or a different body part? We might need additional accessories to be successful with navigating and using our system.
So if we're a powerchair or a wheelchair user, we might need a mounting system to attach our communication device. We might need a key guard. So that's a screen overlay that can act like a bumper on the surface of a device to help somebody with making more accurate selections.
We might need those switches. We might need an eye gaze camera accessory. So all of those things we're going to need to identify as having a need for that person to be successful with their device. And we're going to need to be able to justify why they need that and why is it medically necessary.
So device trials, after we've kind of done that evaluation, and narrowed down, and talked about some options, in a lot of cases, it's probably really good to do a device trial. Sometimes, your insurance is also going to require a device trial. And what that trial looks like the length of that, how many devices it needs to be, is dependent on the type of insurance and plan that the person has. But a overall like, very similar idea is that most insurance companies do require about three options were considered, or actually trialed. Some get a little more specific with those requirements, but it's always good to at least in the report, include information about three things that were considered, including the device that was selected.
So some options for device trials you can borrow. If you are a person in Pennsylvania, you can borrow equipment from the TechOWL Lending Library. We have lots of iPads that can come with multiple AAC apps on them. And that's a free service.
We do also have some more dedicated systems as well, like, some gaze devices. We have switch accessories. But I will say that sometimes, we can't necessarily keep up with the companies in terms of staying with the latest and greatest tech that's available on the market. So if somebody really wants to try out the features of the latest model, it might be a good option to go and look to the vendor directly to trial their specific products.
Another thing too, about the device vendors is, there's usually folks that worked for those companies that can come out and provide more hands-on support to individuals, families, teams with getting some of those more specific setups of devices set correctly for the person. Like I said, I consider myself an AAC specialist, but there are so many products out there on the market. It's hard for me to know the ins and outs of every single device from every single company out there.
So I tend to rely a lot on the device vendors to assist with especially like, access modes, and some of those more nitty-gritty type programming things that were computer functions of these communication devices, so that we're giving the individual and their family the best chance at trying it out in a more successful way than maybe me doing some trial and error and guess and check. That might not be the best solution. So definitely, reach out to vendors. I highly recommend that.
Other options for device loans would be through PaTTAN, and that is for school districts. So that is another option that exists for folks in Pennsylvania. So some things to think about when you're doing the device trials, and then after device trials, during it, especially initially, we want to make sure that we're providing access to this AAC in all settings. A lot of insurances are going to require examples of how this device was used, how it was successful for the person. And they're going to want to hear where the person used the device, and especially if they used it out in the community, and what that looked like.
We want to make sure too that support persons are modeling language throughout the day, especially for emerging communicators, where this might be the first AAC system that they've actually tried. It's not just fair to hand the person the device and go, here you go. Try it out, see if you like it. In some cases, this is brand new information, and the person needs to see it be used. Caregivers and support persons should use it together with the individual to give them the best chance of learning how to use that system, and the best chance of being successful.
We also want the trials to be realistic, so we don't want to make this an unpleasant experience for a person, or for it to feel like work. So if it's being used with rather than at a person, that can be a lot easier to introduce, and give it a fair chance. We also want team members to take relevant data. For a lot of the teams that I work with, I usually ask for like, anecdotal information, or qualitative information.
I want to know how was the device used? Did he like it? Why did she like the device? Like, what worked? What didn't work?
And I want to hear examples of what was said on the device. If you can tell me that we used it to order at a restaurant, or he brought it to his doctor's appointment and asked a question, that's great information. We want to be able to include that in the person's report when we submit to insurance.
And then all throughout the device trial, we want to make sure, again, we're using it, we're sharing data, we're celebrating victories, we're setting the person up for easy wins. But we also want to make sure too, that we're customizing that device, so that it has vocabulary that's useful and familiar to the individual. A lot of devices kind of come out of the box with lots of things pre-programmed, but some of that might not be what the person wants or needs to say.
Now, when I say this, you don't want to spend so much time customizing during a trial, especially if you only have a couple weeks with the device, that you're actually doing more editing and programming than actually using the device. But you do want to make sure that there are choices and options there that are relevant and meaningful to the person. And then after trials, I really do encourage teams to meet and discuss how it went.
And then that discussion can help provide the direction for next steps, whether that's saying, yes, this worked, we're going to move right into our device funding, or hey, this didn't work so well. Let's go back and look at some other options. Maybe we need to revisit the trials. Maybe we need to tweak some things, or try it again.
So all that information is super useful. And even if you do have to do another trial, or do try a completely different device, or go in a different direction, that's not time wasted. That's information that's going to be useful down the road for when you do find the solution that you want to get funded.
So more on our funding, so I already mentioned medical necessity a little bit. But just to focus a little bit more, here on the slide are just some definitions. Every company, insurance company is going to have their specific definition of what medical necessity means. But overall, it's kind of a way to say that this device is needed for the person's medical functioning, their day to day.
Medical necessity is different than educational needs. So when I write a report, meaning, that we're going to look for insurance funding, I can say that this person needs this communication device to participate in school. But the medical insurance, they don't really care that the device is needed for academic purposes.
They care more about that this device is needed for the person to get their wants, their needs, and like, to talk about their health, to request care, those types of self-concepts. So that's kind of a little bit of the difference when we're writing reports, and we're trying to justify why a person needs a device, we really focus more on that kind of medical talking about our health care, talking with doctors, with emergency personnel. Those types of things tend to be like, good key phrases that insurance seems to like.
So here is just a visual to break down what these insurance funded devices look like. So we have the starting point is that AAC device. And then we kind of have funding broken down. So the items that are dedicated AAC devices, and then branch off from there, those are our insurance ones.
We can have our dedicated systems. And technically, somebody could pay for them outright, out of pocket if they want, but a lot of these devices are really expensive. Then you also have your iPad based systems, which tend to be a little easier, or more consumer market friendly to be able to have purchased.
You don't need a prescription to be able to go and buy an iPad from Target, and then download an AAC app. Anybody can do that, but some of these apps are pretty costly. Some are free, and that's great. Others can be over $400, including tax.
So when a person does want to make an out of pocket payment for an app, it's always good to maybe have tried it, unless you're 100% sure this is the app for me, or the person I'm working with. So that's kind of when we might encourage you to borrow from the TechOWL Lending Library, or another resource. So that you're making sure that you've tried out the app, you know what it is before you invest your own money into that system.
And that's good too, with of course, insurance funding as well. Usually, in the insurance world, you can get a device funded once every five or so years, unless there's some sort of big problem or big issue. But a lot of times, if it's just like, oh, we made a mistake, I actually don't like this app, I like this other one better, that's not often going to be the easiest fix. So when we look at our AAC devices, we have our more specialized speech-generating devices, and then we have our bundled iPads. Those are the two big ones that we'll talk about in terms of getting funded.
So here on this slide, are just a few more examples of different types of dedicated speech-generating devices. This is not the end-all-be-all list of devices. There's a lot more out there, and we're constantly seeing new ones come out on the market, but these are just some examples to make you familiar with some names.
So we have the PRC Accent, the Grid Pad, that's from SmartBox. Then we have the Tobii I-Series. So these are eye gaze devices from the company Tobii Dynavox. And then last, we have the NeuroNode Trilogy, which is from the company Control Bionics.
And here are some more examples of those bundled iPads. I talked about a couple of them earlier, but now, here's some pictures to go along with that view. So we have the QuickTalker Freestyle. That's from the company Ablenet. We have the PRC Via, the Tobii SC Tablet. That's another one from Tobii Dynavox, and then the TalkPad Wego edition. That's from Talk To Me Technologies and Smartbox, now that those two companies have merged.
One thing to reiterate here is that with the bundled iPads, some companies are going to offer a whole list of apps that you can choose from. Other companies are going to be limited in that they're only going to sell you an iPad, or have iPads available with their proprietary apps and software. So that can be a deal breaker depending on which company you might want to go with.
So you might really like the case, and the options that you have with company A, but the app that you need is only available from company B. So you might then have to make a choice with which is more important. And sometimes, too, that if you have specific accessories, a lot of companies might be able to work with you to get you a different case and things like that. So stuff's not necessarily always a deal breaker. There's always workarounds and other creative solutions, but those are things that you might have to determine. Sometimes, we do have to make choices and weigh our options.
So cost estimates, when we're looking at an iPad and creating a speech-generating device just from consumer products, so meaning, I went to the Apple store, I picked up an iPad, and then I downloaded an app, we're looking anywhere between probably 500 to $800, depending on the accessories, or if we're getting different gigabytes, and memory, and things like that, they might be more expensive. But in most of those cases, you can get an iPad with an app and all the bells and whistles for about under $1,000 out of pocket.
When we're looking at our dedicated devices, those are usually going to be over $1,000 plus. Our eye gaze devices are going to cost as much as a car, in a lot of cases, out of pocket. So that's really where insurance is going to come into play, because most people don't have an extra 16,000-$20,000 to pay for a eye gaze communication system.
And then anytime we're adding accessories, so things like mounting equipment, key guards, anything like that, those additional accessories are also going to have additional costs that go into them. And any time there's an additional cost, or an additional request, we have to then be able to justify that request, especially when we're looking at funding sources where we're asking other people to purchase the equipment. So think insurance, grants, waiver funding, those types of things. We're always going to need to be able to justify and argue for what we need.
So an overview of some of those different funding options, there's a variety depending on what the person is involved in, maybe their age, things like that. So one doesn't have to be the end-all-be-all for your funding, but these are just some options to get you started. So we have waivers. We have your insurance, whether that's your private or supplemental, Medicaid and Medicare. Sometimes, OVR, or an employer can pay for devices. Also, if a student is still school age, and they have an IEP, that device can possibly be funded through their IEP.
There's also things like, grants available, or the Pennsylvania Assistive Technology Foundation, PATF. They also offer low and no interest loans for assistive technology. Keep in mind, that's not just limited to AAC, but other forms of AT as well. And then you also have the out of pocket, private pay, or crowdsourcing options as well.
So looking at some of our public and private funding sources, so here on this slide, it's just breaking it down into some public options that might be available for a person. Some other ones that weren't on the slide previously, was early intervention, the CHIP program, and then other special programs that people might be eligible for, and then our private funding sources. You can also look at things like private foundations or charities.
A lot of them might have special grant programs, or they might offer kind of like, a one off thing that they might be able to fund a device for a person. There's also options to get reused equipment. So at TechOWL we do run a reuse program, where if people donate their AAC device, or other types of AT that they no longer need or use, that it can then find a new home for somebody that does need it.
And sometimes, you can get equipment made depending on what it is. I would say, it might be really difficult to make a fancy, eye gaze communication device out of nothing. But you might be able to get a light tech AAC system made for you, or an accessory made for you, maybe like a keyguard through 3D printing. And we do have a slide later that does look at the 3D printed key cards that TechOWL does make.
So to go over more information about our general funding process, this slide is just a visual about starting that funding process. So we want to really know what that person needs, and what they want. So looking at, again, the person holistically, all their features that they're looking for in a device, what's going to work best for them. That helps us narrow down what our options are.
We want to also know what potential funding sources are out there and available to that person. Sometimes, for example, some insurance companies don't have a co-pay, and they'll cover a device all the way. We've also seen some companies charge a $1,000 co-pay for an iPad based system, which at that point, you might as well just go and buy the device out of pocket yourself. But even that can be really hard for some individuals and families. So they might need to find another funding option to go along with their insurance to cover that copay fee. So being able to think ahead, and looking at all the different possible avenues is usually a good plan to start.
And then you need to apply to those funding sources. So each funding source is going to have maybe some different rules and steps. Some grant programs might only run on a certain time frame of the year, like, for example, a quarterly basis. And then other funding sources might be a pair of last resort, meaning that you've tried other options, and you need to have proof that you've tried, say, insurance, and were denied before that they will jump in and cover something.
And a lot of times, too, you're going to have a wait, especially with insurance. I've had devices get funded after all the paperwork is in within a week, and they're shipped out the next week. And then I've had other ones where it's taken almost over a year for a device to be funded, and be in the hands of the individual. So it really just depends on the funding source, and honestly, whose desk I think it gets on. So there's a lot that goes into funding, and it can be a timely process in a lot of cases.
And especially with the insurance world, we might get a denial, and then we have to fight the insurance company to get that person a device. Just because we get a denial letter doesn't mean it's over. Usually, in a lot of cases, we can just write a letter further justifying why they need it, and there's a good chance then it'll get approved.
But then sometimes, you have to do what we call a peer-to-peer. So in that case, the SLP will need to meet-- most likely, it's a phone call-- with a doctor from the insurance company, and then kind of further justify to them in a conversation about why the person needs this device funded. And then hopefully, after all that, then the device will be approved, and the person will get the equipment that they needed.
So the next couple of slides are just going to show some different considerations for some of the funding source options. And this isn't-- you have to do this. This is just to help teams navigate some of these funding solutions. So one thing to mention when we're looking at schools is, what kind of school does the person go to, if they're a student in their school age.
So if they're in a private school, there might be a chance that there is some sort of discretionary funds to pay for some sort of equipment like this. There might be charitable contributions that can go towards students. Also, if the student has an IEP, whether they're in the private or the public school, if the device is in the IEP, then the school district does need to provide that device for them.
When an AAC device is purchased with school funds, however, that device does not necessarily belong to the student. If it's purchased with medical insurance funds, like the school SLP uses, or writes a report, and uses the student's medical insurance to pay for it, or their access funds, then the device belongs to the student. But if the school district just pays for it outright, then that's where that question of ownership comes into play.
And if the student, for whatever reason, moves in the middle of the year, or maybe they graduate, they might not be able to take that device with them, because it doesn't belong to them. And that's something to consider. Just because you graduated doesn't mean you no longer have to communicate. So we want to think about those things before making decisions of how we're obtaining devices.
Other things too that you might see is when a school district pays for a device, there might be the question of whether the student is allowed to bring it home on the weekends, or over holiday, or summer breaks. Just because you go home, again, doesn't mean you stop communicating. You still need to be able to communicate, and do your homework, talk about school, those types of things. But sometimes, then that becomes up to debate with the IEP team and the school district. So those are things-- I don't have a magic answer-- but those are things that individuals, and their teams, and families should consider when maybe working with schools for funding.
Same thing for early intervention, if a child is receiving early intervention services, we might identify that they need an AAC device, but the AAC device process might be taking a little bit of time. And when a child ages out of early intervention, especially in the Philadelphia and Pennsylvania area, there tends to be a little bit of a limbo for that child between when their early intervention services end, and when they enter in and get their next stages of services, whatever those look like for the child. So we might have started the AAC funding process, but now, they no longer have that SOP, they no longer have that provider.
And then it becomes a question of, well, how are we going to get a device? What if they need to do an appeal? What do we do next? That's another situation. I don't have a magic answer, but those are things that families and teams can consider when making decisions about whether they want to move forward now. Maybe they want to wait, try other things, or how they pursue funding.
Same thing with waivers. We want to look at what kind of waiver the individual has. Some waivers will have a cap for assistive technology in AAC, especially if equipment is over a certain cost, it might then require additional paperwork, additional justifications for a waiver funding monies to be used. So those are, again, things to consider.
Another thing as well is that some waivers might have a lifetime cap. And with a lifetime cap, that can be a little tricky, because a person might need that technology now, but especially if they're a younger individual, we don't know where they're going to be in, the later part of their life, what type of AT technology they're going to need down the road, and what that looks like. So we don't necessarily want to use a huge chunk of their money right away right now when they're younger, and then have nothing left over for later. Of course, there's always loopholes and exceptions to things, but these are conversations that individuals, families, teams need to be having with their supports coordinators before making official decisions.
So now, the next couple of slides are going to focus more in depth on that SLP, so that speech language pathologist funding process. I've kind of already mentioned some of this funding information, or this report information a little bit. But when we're-- especially if you're the SLP working with an individual and their family, you want to make sure that you really kind of know the process, and are familiar with those steps involved. We want to make sure that we've identified what the person needs and how we're going to move forward with that. Do we have backup plans if the first funding source we tried falls through?
Another thing, too, is that not every single device does need to go through medical insurance. Sometimes, maybe, we want to be creative and look at other options, whether that's because we know their insurance is going to take a long time, or maybe it's because we need to actually use the device for things like leisure or job supports. So we need it to be unlocked, and we need to navigate through a different avenue.
So when we're starting that insurance process, we want to make sure that we've completed device trials, especially if they're needed. Again, you can borrow from the TechOWL Lending Library directly through vendors, again, PATTAN for school students. We also want to make sure that we're gathering all the documents that are needed. So that being said, when we are anticipating using insurance funding, I tend to recommend to the families I work with that you don't call your insurance company directly and ask which devices and network, because nine times out of 10, the device that they're going to tell you, or the company that sells AAC that they're going to tell you is in network is not the right fit for the individual.
Sometimes, it is. But in my experience, it's usually not. And we don't want the insurance company to dictate what the person needs, or what they should have. We need to identify that based on an unbiased evaluation and trials, and then go to the insurance company, and tell them this is what we need, approved and funded.
Of course, that doesn't work in every single case. Sometimes, it's a long, drawn out battle. And sometimes, we have to pivot. But we want to make sure that we're at least fighting from the get go for what the person needs, rather than what the insurance company says they can have.
So we need to gather different materials, because we're going to create a packet that we're going to submit to that device vendor, the person selling the AAC device. They're going to take all those documents, and submit them, and deal with the insurance company. So they tend to act as a go between the SLP, the family, the individual and the medical insurance, which is kind of nice, because they'll tell you, they'll hold your hand, they'll tell you what to do throughout the process in most cases.
So typically, you're going to need copies of your insurance cards front and back. And that includes any and all insurance that you have. What can delay the process is if you know, oh, we also get it. We have our access insurance, but then we also get supplemental from a parent's work, but that was forgot to be mentioned. And now, when the company runs the insurance information, it gets flagged that there was another policy. And so what happens is, then that delays getting them that device, or getting that approval, and that submission. So it's good to get all that information up front.
What's also needed is a doctor's prescription, or a certificate of medical necessity. Most AAC vendors are going to have a special form that they use with the correct wording that's needed on that form, and they'll reach out to the doctor directly in most cases. The prescription is not like a traditional medication prescription. Other things, too, is that a lot of insurances might require a visit to the doctor within the last six months, so that's something that the family might need to get updated. They might also require face-to-face visit notes as well. So any paperwork from the doctor might need to be gathered as well.
There's a lot of forms, including the assignment of medical benefits form, that the family or the individual will need to sign. And then there's the SLP's super long and detailed insurance funding report. So all of that gets submitted to the device vendor, who then deals with the insurance company.
So here on this slide is just a list of information that's needed in most SLP report formats. A lot of vendors will have online forms or templates to fill out with the information that you need to get the devices approved. But here's just a list that goes over the basic information that you need. So it's a lot of background information, an overview of the person's communication. There's a really detailed, comprehensive assessment looking at the person from a holistic perspective.
And then we also want to talk about how things like vision, and hearing, and cognition does that, or does it not impact their ability to use an AAC device? We have to look at their daily communication needs, who, and where, and what they're talking about, and need to be able to communicate with and where. And then we also need to talk about how their needs cannot be met by other non AAC device options.
So for example, how does sign language might not fit their needs? How does using a writing utensil and paper not meet their needs? How does going to speech therapy, maybe that's not going to meet their needs? Or using a light tech paper based system, how that doesn't meet their needs. So we need to be able to justify and rule all those options out as alternatives that don't work for this person.
And then even more information, we're going to talk about all the devices we've trialed, and we're going to say why they weren't a good fit, why we're not considering them anymore. And then we're going to justify the one that we are recommending. We're going to say why this one was the best, that it has all the features that the person needs, and why we're recommending it.
We're then going to include things like treatment goals. We're going to say that the SLP is-- they're not biased. They don't work or have any financial stake with any of the AAC companies. And they're going to sign off on that report and send it, and hopefully, it gets the device funded.
So that is funding in a very general sense. A lot of more specific information can be shared. Each insurance company, each device vendor is a little different with their process. So if at any time anybody ever has questions, you can always reach out to us at TechOWL, and we're happy to help guide you through that process, or answer any of those questions you might have.
The next couple slides are just going to look at some general resources. So here are some additional programs that TechOWL offers. We have some programs that can help folks get other forms of assistive technology, for example, like, our free special phone program, where ICanConnect, which is to help folks who are deafblind get equipment.
Our Fabrication program, CreATe Together, can help 3D print a keyguard for your AAC device. And we have a slide with some examples of that coming up. Another program we have is a mini grant program. This one that we offer, as well as many others that are outside of our organization, a lot of times, grant programs are going to be what we consider a payer of last resort. So you will need to have tried other options as well.
And a lot of times too, with grants, it's good to mention and look into that sometimes, they will be like a one time use you. You apply, you've gotten accepted, you get the funds, you're not able to apply again. So those are things to just keep in mind when you're looking at some more creative or alternative funding options. And then we talked about reuse, TechOWL, if you're looking for equipment in your part of the state, sometimes, there might be AAC devices that come through our reuse partners.
Here's some examples of those 3D printed key guards. So if you need one of these for your AAC device, we can provide them for you for free through our 3D printing program at TechOWL. We just need the dimensions of your AAC device, and we can get that customized and sent to you if you are a Pennsylvania resident.
Here is some more specific information for PATF for low interest and zero interest loans for assistive technology. Some additional information about TechOWL's AAC services. We do have specific project contracts, for example, with Philadelphia Intellectual Disability Services and Early Intervention, as well as with Pennsylvania's Office of Developmental Programs. That specific program that we run is called JustSO Speech Services. There are specific requirements for eligibility with these programs.
So if you have any questions, or know somebody who might benefit from getting some more AAC supports, you can always reach out to us and we can see if that person may be eligible for one of these. And if they are, if they're not, we are still going to be going to answer questions. We can provide a free device demonstration. We can do informal video chats as well to talk about which AAC options are out there, or answer questions you might have.
We also have our ACES program. Show a slide for that in a minute. And then we also have more information at our website, AACCommunity.net. There are additional resources about funding and the insurance process on there as well.
ACES, so that is our Augmentative Communication, Empowerment, and Supports program. That's a program at Temple where young adult AAC users of at least 18 years and older can come to Temple for about a week, and get different types of training, and participate in communication class, learning new skills with their AAC, as well as participating in different leisure, listening to speakers, attending different sessions. And so we'll be offering it this July upcoming in 2025. If you are interested, or know someone who might be interested in attending, we encourage anyone to apply at our TechOWL website. Here on the slide is a link for the ACES program.
And then we also encourage you to follow us on social media. We have a pretty active Facebook, Instagram, and TikTok, so we're always sharing new information about new learning opportunities, trainings, as well as just sharing information about assistive technology. So please do follow us to stay up to date with all that exciting info.
Our general TechOWL contact information, our information for the Institute on Disabilities as well. And then I just ask if for attendees to please complete this survey to let us know how we're doing, and what information that you would like to see us cover in the future. This helps us also tell our funders that we're doing a hopefully, a great job, or an OK job, if that is what we're doing as well, so that we can continue to provide training opportunities like this, and making sure that we're sharing the information that the community wants and needs to hear and learn.
