Funding Guide
 

This manual is designed for easy use by consumers and their families. We have used larger type to make it more easily read. It is also available in alternative formats.

Before addressing funding sources in the manual, we provided information about ICAN, Increasing Capabilities Access Network, and its services. We also defined "tools for living, learning and working," which is the term we use for assistive technology and related services. The categories of equipment and services used throughout the manual are explained. Tips to help you in your search for funding are available in "Finding Your Way Through the Funding Maze."

Sections on Public and Private Funding Sources in Arkansas identify existing funding sources and provide information in an easy-to-read format so that the reader can quickly see if a particular source is applicable to an individual's needs. Charts have been provided identifying the types of disabilities, technology and services that may be funded with a star, based on information we have received from public and private funding sources. "Helpful Hints" are provided throughout the manual.

As you read through the sections on funding sources, keep in mind two important points: (1) Most funding sources approve technology on an individual-by-individual basis; and (2) The availability of funding often changes, sometimes very quickly. It is critical that you double check to make sure a particular funding source is still funding the technology and services designated in this manual. Unfortunately, our system is far from perfect and there are no guarantees specific needs for technology and related services.

Information about housing programs and work incentive programs of the Social Security Administration is separated from other funding sources. While these programs do not provide funds specifically for the purchase of technology, some do provide ways in which consumers can get assistance in modifying homes or in which funds spent on job-related tools can be excluded from income when determining if a person is eligible for financial assistance. Finally, in the section on "Where To Go For Help," we have provided a comprehensive listing of important programs and services that can provide assistance to readers in their search for funding for tools for living, learning and working.

It is our sincere hope that you will find this manual valuable in your search for funding. If we may be of further service to you, contact us at: ICAN, 2201 Brookwood, Suite 117, Little Rock, AR 72202, (501) 666-8868, or 1-800-828-2799 (Voice/TDD).

ICAN also established an Equipment Exchange, which provides a way for people with disabilities to sell, trade, or loan adaptive equipment that is new or no longer needed. Items that might be listed on the Exchange include, but are not limited to, the following: wheelchairs, reachers, computers, wheelchair lifts, accessible vans, walkers, hospital beds, Braille writers and TDDs. To list equipment on the exchange or to find out what equipment is listed, contact ICAN.

ICAN is also dedicated to training individuals with disabilities, families, employers, educators and professionals. Training is provided locally, regionally and statewide. Topics vary widely from modification of toys with switches to advocacy tips.

For more information about the services of ICAN and its Regional Centers, or information relating to technology, please contact:

Increasing Capabilities Access Network
26 Corporate Hill Dr.
Little Rock, AR 72205

(501) 666-8868 or

800-828-2799 (Voice/TTD)

What are Tools for

Living, Learning and Working?

"Tools for living, learning, and working" are types of equipment or devices that help people to live, learn and work more independently. There are many kinds of tools that exist or might be modified to meet the unique needs of a particular individual. Tools may be simple, like a long drinking straw, or very complicated, like computers that can track the movement of a person's eyes. There are so many types of tools that it would be impossible to discuss them all in this manual. For convenience, we divided these tools into the main categories described below.

Adaptive Exercise Aids -These tools help people to get the exercise they need to be healthy. Examples of these types of tools are hand weights with specially designed grippers, adapted exercise machines for people in wheelchairs, and mechanical devices that help keep injured joints mobile and build muscle strength.

Adaptive Sports and Leisure Aids -Tools in this category help people to participate in sports or leisure activities. Bicycles with hand pedals, portable handrails that enable people with visual impairments to bowl and specially designed equipment that enables people who use wheelchairs to water or snow ski fit into this category.

Alerting Devices - These tools alert people to emergencies or other types of concerns in ways other than just sight or sound. For instance, a person with deafness might use an alarm clock that flashes light or is connected to a vibrator. A signal at a street corner that announces "you may walk now," enables people with limited vision, or limited judgement, to know when to cross the street safely.

Assistive Listening Devices - These tools would help a person with hearing loss to better hear and distinguish sounds. Examples of this kind of tool are amplified telephones and loop systems used in auditoriums to help people with hearing loss to hear meetings and productions.

Augmentative Communication Aids - Tools under this category help people to better communicate with others. A communication board is one example. With this tool, a person points to a letter, word or picture that communicates thoughts and needs to others. Other devices use synthesized speech to communicate the word or letter that is touched on a keyboard.

Bathroom Equipment - People can have greater independence in the bathroom with these tools. Some of these tools are in public restrooms that are accessible to people with disabilities, like higher toilet seats, handrails and modified handles on faucets. Tools used primarily at home include a modified toothbrush or a shower stall that is adapted for a wheelchair.

Braille & Tactile Aids - Braille is a language of raised dots that enables people with limited vision or blindness to read. The word tactile means tools that allow people to use their sense of touch in place of their sight. For instance, raised lettering in elevators tells a person with blindness which button to push for the 7th floor. Raised numbers on room doors enable hotel guests with visual impairments to find their rooms. Raised dots placed on an oven control let a person set the correct temperature for a holiday dinner.

Computer Hardware - Computer hardware refers to pieces of computer equipment such as hard disks, monitors, mice, keyboards, and printers. Hardware can be used off the store shelf or modified to meet the unique needs of an individual, such as an expanded keyboard.

Computer Input and Output Access Aids - These tools help people communicate with computers in different ways. For instance, instead of having to touch the keyboard, a person could communicate with a computer simply by talking to it. A computer might be made to give spoken instructions to the user, such as "You may turn off your computer, now." This helps people who have difficulty reading the screen to know what is written on it.

Computer Software - Software is the name given to programs that make computers work. In other words, software tells the computer what to do and how it should respond to the user's commands. There are hundreds of types of computer software that range from specialized teaching programs to programs that allow documents to be printed in sign language or braille.

Eating and Food Preparation - Any tool that helps a person to eat or prepare food is included in this category. The tools may be as simple as bent straws or silverware that is specially designed to make it easier to hold. They may be very complicated, like modified controls on a microwave oven, a specially designed can opener, or a machine that actually feeds a person without use of arms or hands.

Hearing Aids - These tools help people with loss of hearing to hear better by magnifying the tone and volume of sounds. Hearing aids are not all alike and should be selected or designed to meet the unique hearing needs of the person.

Low Vision Aids - These tools help people with limited vision to see better. Magnifying devices, large print books and large screen TVs are among the tools in this category.

Mobility Aids - This is a big category of tools that help people to have greater independence in getting from place to place. Wheelchairs, scooters, walkers, and motorized grocery carts are common mobility tools.

Orthotics and Prosthetics - These tools help people without functional limbs and other body parts. Artificial limbs, braces, splints, and crutches are some of the tools in this category.

Personal Care Aids - These tools help people to be more independent in their personal care, like dressing, personal hygiene and grooming. Tools in this category include tools like velcro closures on clothes in place of buttons or specially designed hairbrushes that can be more easily held.

TDD Equipment - The TDD (Telecommunication Device for the Deaf) is a tool that allows people with a hearing or language impairment to communicate by telephone. The TDD caller types a message on a keyboard which is relayed through the phone line. The message then appears on the screen of a TDD at the other end of the line. Both the sender and the receiver must have a TDD to make it work. TDD and TTY are also used to identify these types of devices.

Transfer Aids - Transfer aids help people to move from one place to another. For instance, a person who uses a wheelchair may use a cradle lift to get into the bathtub. Another person might use a trapeze above his bed to transfer into a chair.

Vehicle Modifications - These tools adapt regular vehicles so that people with disabilities can drive or ride in them. An electric lift might be needed to help a person in a wheelchair get into a car. Some adaptations enable the driver to control the brakes and acceleration with their hands, rather than their feet.

Voice/Audio Output Aids - These tools help people to speak to others or provide spoken information. For instance, a device that fits under this category is a sound magnifier that helps a person who has damaged vocal cords to be heard by others. A personal reader that translates the written word into the spoken word is also in this category.

Types of Technology Services

Information and Referral - These services describe efforts to provide information about types of tools and services that are available as well as resources to help you to get the services you need.

Assessment/Evaluation - In these services, a team, which would likely include the individual, family and one or more professionals, evaluates a person's need for technology. The assessment should also identify the specific types of tools or adaptations that might be appropriate for the individual.

Training - Many tools require special training in order for a person to use them properly. This training may include how to keep them in good working order.

Maintenance and Repair - Maintenance and repair are services that are necessary to ensure proper performance of tools for living, learning and working. Some devices, like electric wheelchairs, require periodic maintenance and specialized repair services.

Finding Your Way Through the

Funding Maze

Ironically, most children and adults with disabilities who need assistive technology are the least able to afford these tools. They must then look to other funding sources. Unfortunately, finding the right source(s) of funding is often a most difficult task for several reasons. The simple fact that there are many potential funding sources makes it hard to even begin the hunt, particularly in light of fluctuating funding cuts. Many times there is a lack of coordination among the funding sources that do exist, and it isn't always clear who really makes the funding decisions. Furthermore, because the whole field of technology is relatively new in human services, many agencies don't have specific guidelines for funding technology. When guidelines do exist, they vary drastically from one funding source to another. The fact that each person's abilities, needs and situation are different and distinct makes the process even more confusing.

This funding guide was developed to help people needing technology and their families to get the tools and services they need to live, learn and work more independently. The information in the following pages is provided to simplify your journey through the funding maze in Arkansas. Information presented will facilitate your use of the sections on public and private funding sources.

Important Questions to Ask

In every situation, the unique abilities, needs and circumstances of the individual define the kind of tools that will help that person achieve greater independence in living, learning or working. They also determine the most likely funding sources. So, it is important to ask these questions early in the search. A written record of this information will help in your search.

• What is the person's age?

• If under 21, is the child receiving special education?

• What was the person's age at the onset of the disability?

• Is the tool necessary for a child to benefit from education?

• What label/disability does the person have, i.e. cerebral palsy, neurological impairment, spinal cord injury, etc.?

• Is the disability short term or long term?

• Was the person's disability related to employment or military service?

• What is the living situation of the person?

• What is the individual's (or family's) financial situation?

• Is the person covered by private health insurance?

• Is the person eligible for Medicare or Medicaid coverage?

• Is the person receiving SSI or SSDI?

• What type of tools does the person need to live, learn or work more independently?

• Will the tool(s) help the person get or continue employment?

• Will the tool(s) help the person to live more independently or to improve their overall health?

• Can the tool(s) needed be rented?

• Is training necessary to use the tool?

• What services are needed to follow-up, i.e. training, repair, etc.?

Once these questions are answered, there should be enough information to begin the search for funding. There are many possible funding sources which have been listed in this manual in an easy to use format. It is important to remember that while there is no one specific method that will assure funding for tools or services, your search will be easier if there is a basic understanding of the service system for people with disabilities in Arkansas.

An Overview of the Service System in Arkansas

Most human services in Arkansas are provided by, or through, state agencies, including, but not limited to, the Department of Education and the Department of Human Services, which serves as an umbrella agency for divisions that address specific human needs. The following brief descriptions of state services that are of particular interest to Arkansans with disabilities will give you an idea of the complexity of the system. Information more specifically related to technology is provided later in this guide. Agencies having a home page on the world wide web can be located from www.state.ar.us/directory/

Arkansas Department of Education (ADE). The Department of Education is responsible for ensuring that quality education is provided for all students in Arkansas public schools. Under Federal law, the Department also has the primary responsibility for ensuring that all children with disabilities have the right to receive a free appropriate public education, regardless of the nature or degree of their disabilities, through local school districts. ADE's Educational Equity Assistance Center provides technical assistance to local districts and monitors compliance with federal civil rights mandates including Title IX, VI, Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act of 1991. Contact: Your local school district to receive special or regular education services. http://arkedu.state.ar.us

Department of Workforce Education (DWE). This Department's mission is to provide the leadership to develop an educated, trained and retrainable workforce. DWE provides many services geared toward this end and the Special Needs Section of DWE helps to ensure successful training and job placement for students with disabilities.

For more information contact:

Special Needs Program

Three Capitol Mall, Luther S. Harding Building, Room 305

Little Rock, AR 72201-1083,

(501) 682-1800

www.work-ed.state.ar.us

Arkansas Rehabilitation Services (ARS). Arkansas Rehabilitation Services (part of DWE) is responsible for providing vocational and other rehabilitative services to individuals with physical and/or mental disabilities. Services to eligible persons may include the following: medical diagnosis; counseling and guidance; comprehensive evaluation; medical and surgical treatment; job placement; assistance with self-employment; vocational training; adaptive technology; housing and transportation assistance; and information and referral. Any Arkansas resident who has a physical or mental disabilities resulting in a vocational handicap and has a reasonable chance of becoming gainfully employed or returning to a gainful occupation after receiving rehabilitation services may be eligible. Individuals whose disabilities are so severe that they are unable to work without long-term support may be eligible for supported employment. Any individual who has a severe physical or mental disability and has a reasonable chance of becoming more independent following the provision of services through the Independent Living Program may be eligible. Contact your local county office.

 www.state.ar.us/ars/

ARS Housing Office. Also under Arkansas Rehabilitation Services is the ARS Housing Office. This office provides assistance in helping people secure affordable housing and supported living opportunities.

For more information contact:

ARS Housing Office

Hot Springs Rehabilitation Center, 8th floor

Hot Springs, AR 71902

 (501) 624-4411, extension #380

Arkansas Department of Health (ADH). The mission of the Arkansas Department of Health is to promote and protect the public health and well being of the citizens of Arkansas. Through county offices, the ADH provides a wide range of preventive and protective health care services which are accessible to all Arkansans.

 For more information contact:

Bureau of Community Health Services,

4815 W. Markham, Slot 2,

Little Rock, AR 72205

(501) 661-2167

http://health.state.ar.us

Arkansas Department of Human Services (DHS). The Arkansas Department of Human Services exists to provide quality services, within available resources, which enable people to maximize their potential and to increase their abilities; preserve and enhance human dignity and worth; and prevent or reduce the need for services. The department has separate divisions that address specific needs. In addition to those described in detail below, DHS includes Divisions of Volunteerism, Finance and Management Services.

For more information contact:

Department of Human Services

325 Donaghey Bldg

P. O. Box 1437, 7th & Main,

Little Rock, AR 72203-1437

(501) 682-8650

www.state.ar.us/dhs

DHS-Division of Aging and Adult Services (DAAS). The Division of Aging and Adult Services is responsible for planning, coordinating, funding and evaluating programs for older persons. The Area Agency on Aging (AAA) in each planning/service area is the community-based agency which delivers local services.

For more information contact:

Division of Aging and Adult Services

1417 Donaghey Plaza South

P. O. Box 1437

Little Rock, AR. 72203

(501) 682-2441

DHS-Division of Children and Family Services (DCFS). The mission of the Division of Children & Family Services is to improve the quality of life for Arkansas' children and their families by creating and maintaining an integrated system of effective service delivery adhering to the principles of prevention, permanency planning and least restrictive environment. Services are provided for abused/neglected children and youth, juveniles in need of supervision, juvenile delinquents and emotionally disturbed children and youth.

For more information contact:

DCFS

626 Donaghey Plaza South

P. O. Box 1437

Little Rock, AR 72203-1437

(501) 682-8008

DHS-Division of Developmental Disabilities Services (DDS). The Division of DDS is responsible for the provision of services to people with developmental disabilities including those with autism, cerebral palsy, epilepsy, mental retardation, and other conditions that cause a person to function as if he/she were mentally retarded. DDS operates six institutions, or Human Development Centers (HDCs), which are licensed as Intermediate Care Facilities for the Mentally Retarded (ICFs/MR). DDS also provides services through a Medicaid waiver and oversight for private nonprofit community based programs. Field counselors provide case management services to individuals with disabilities and their families throughout the state. DDS also serves as the lead agency for early intervention services for children with disabilities aged 0-2.

For more information contact:

DDS

P. O. Box 1437

Little Rock, AR 72203-1437

(501) 682-8703

DHS-Division of Medical Services (DMS). This Division manages Arkansas' federal and state Medicaid program, including Children's Medical Services, Home Care for Children (TEFRA), Early and Periodic Screening, Diagnosis and Treatment (EPSDT), determination of eligibility for ICF/MR level and other nursing home services.

For more information contact:

Division of Medical Services

P. O. Box 1437, Slot 111

Little Rock, AR 72203-1437

(501) 682-8732

( 800)-482-5431

DHS Division of Mental Health Services (DMHS). The Division of Mental Health Services provides, or contracts for, mental health services in Arkansas. There are fifteen (15) community mental health centers throughout the state where services are provided. Services include but are not limited to: assessment, therapy, consultation, and referral.

For more information contact:

DMHS

4313 W. Markham

Little Rock, AR 72205

(501) 686-9000

(501)686-9176 (TDD)\

DHS Division of Services for the Blind (DSB). Division of Services for the Blind is responsible for providing or purchasing the following services: referral and counseling; independent travel skills training; rehabilitation teaching in the consumer's home and community for independent living; remedial education; pre-vocational evaluation; career and skill counseling; occupational skill development; vocational training; job retraining; sheltered workshops; vocational placement; follow-up services; and training in food service management.

For more information contact:

DSB

522 Main, Suite 100

Little Rock, AR 72201

(501) 682-5463

(800) 960-9270

Housing and Urban Development (HUD). The U.S. Department of Housing and Urban Development is responsible for providing direct loans for persons who are elderly or handicapped. Through the Section 8 Housing Program, HUD provides rental assistance to eligible residents by reimbursing housing owners for all or a portion of rent. Through Section 202 Housing Program, HUD provides direct federal loans to assist private, non-profit corporations in the development of housing for adults who are elderly, physically disabled, developmentally disabled or chronically mentally ill.

For more information contact:

HUD

Little Rock Office, Region VI

425 West Capitol, Suite 900

Little Rock, AR 72201

(501) 378-5961

www.hud.gov

Arkansas Spinal Cord Commission (ASCC). The Arkansas Spinal Cord Commission was established to provide a coordinated approach to early recognition, emergency care, definitive treatment and rehabilitation services to individuals with spinal cord injuries. ASCC provides statewide comprehensive case management to all eligible persons with spinal cord disabilities. Case manager's roles include assisting individuals in obtaining needed adapted equipment, making referrals for vocational rehabilitation services, Medicaid and state supplemental income, finding accessible housing, counseling, advocacy, assistance in purchasing medically prescribed equipment and supplies, and lifelong follow-up services.

For more information contact:

ASCC

1501 N. University, Suite 470

Little Rock, AR 72207

(501) 296-1788 (Voice)

(501)-296-1794 (TDD)

Social Security Administration (SSA). Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) are federal programs that provide monthly benefits to people who are aged, blind and/or disabled and who have little resources and income. SSA determines eligibility, makes basic payments, and maintains a master record of recipients.

For more information contact:

SSA,

700 W. Capitol

Little Rock, AR 72201

1-800-772-1213

www.ssa.gov

Many other disability-related services and organizations that provide advocacy, services and other assistance for individuals with disabilities and families are listed in the "Where To Go For Help" section of this manual. You might also look in the "Social Service Organizations" section of your local yellow pages for other organizations that might be of help locally.

Planning a Funding Strategy

The funding strategy below provides ten steps that will help you decide where to begin your search for funding.

• Step 1: Recognize and identify the problem.

• Step 2: Document what needs exist.

• Step 3: Identify the equipment and/or services needed. Some of the potential funding sources noted in this manual also provide assessments and evaluations to determine the type of technology or tools that a particular person needs.

• Step 4: Secure the necessary prescriptions and other justification (records, support letters and evaluations).

Helpful Hints

For Medicare and many other sources of funding, a tool must be determined to be medically necessary in order to be funded. Medical necessity exists when the item is a part of the physician's course of treatment and when a physician is supervising its use directly. Although a therapist may be providing the treatment, the prescription must be from and signed by a doctor. Your doctor may also be willing to write a letter substantiating this item is a medical necessity--a very helpful item. Letters from other professionals involved in the case, such as therapists, counselors, teachers, direct care workers and others are recommended and make the case stronger.

In addition, the following information may prove helpful: a general discussion of medical diagnosis that may further provide specific medical information and needs; a photograph of the individual; a discussion of the tools and services needed with specific reasons as to why they pertain to the individual; explanation of the individual's functional skills without the equipment and how they will be improved with the tools and services; and specifications of the equipment including cost and a photograph or catalog picture and description.

• Step 5: Determine if there's an alternate way to get the equipment needed rather than to purchase it. For instance, can the equipment be rented instead of purchased? Is it available via ICAN's Equipment Exchange for loan or for a reduced price?

• Step 6: Determine if the particular tool desired is really cost-effective. Questions like these will help: Is the expense reasonable when compared to the therapeutic benefit? Is the equipment or service more costly than another option or alternative that would serve the same purpose? Does the item serve the same purpose as equipment that is already available to the consumer? Many funding sources may want to ensure the cost-effectiveness of a tool or device before considering purchase and whether the cost is reasonable and at the customary rate. This is particularly true for insurance companies.

• Step 7: Determine potential funding sources. You may find that many funding sources require a refusal from an insurance carrier before considering funding equipment (tools) or services, if private health insurance is carried.

• Step 8: Get, complete and submit an application for funding.

• Step 9: Search for co-payment options, if necessary.

• Step 10: Follow the appeals process, if you believe you have been denied fair treatment in decisions relating to your application for services. At the end of every funding source description is a notation about the appeals process for that source. A list of organizations and agencies that may be helpful to you in obtaining funding for tools and services for living, learning and working is provided in the section on "Where To Go For Help" in this manual.

Advocacy Tips

The following tips on how to be a good advocate will be helpful to you in contacting various funding sources.

Hopefully, all will go smoothly in your search for funding for tools for living, learning and working. However, if you should be denied funding or services from public agencies, you have the right to appeal. Appeals processes vary from one funding source to another. Therefore, you should be sure to request a written copy of the particular agency's appeal procedures.

Some appeals procedures are "informal". This means that the process offers the possibility of resolving problems without following strict rules. For instance, an initial step might be a meeting with the person providing the service to see if a resolution to the disagreement can be reached. A more "formal" procedure would be one in which a hearing would be held before a third party, like an impartial hearing officer or professional mediator. Often agencies have policies that include both informal and formal procedures.

Because policies of appeals are sometimes complicated and vary so widely, it would be difficult to provide a detailed description of each agency's appeals process in this manual. Where possible, the appeals procedures for various funding sources have been summarized under the "What if services are denied" question in the description of each funding source. The advocacy tips listed below should help you no matter what specific guidelines define a particular appeals process:

Pursue your concerns quickly. Some appeals procedures have very short timelines in which to appeal decisions that are made.

Request a complete copy of the appeals process and your rights in that process. You should be able to get this information when you first apply for services, so that you will already have it should any problems occur.

Make sure your concerns are expressed and documented when you have conversations. Keep a phone log, noting the person with whom you spoke, the issue, what the person said, what was decided and any type of follow-up action. Such conversations should be followed-up with written confirmation.

Always make the request for review or appeals processes in writing. This is your only documentation that you did make such a request. Keep copies of all correspondence! Make a home file and keep everything! These can be very important in your case.

Be sure to date your letters and to note the date on letters that are provided to you in return. These dates may be important in meeting the timelines set out in the appeals process.

A general rule of thumb is to start with the easiest appeal alternative. Sometimes, problems can be worked out informally and with cooperation of service providers. This type of informal resolution to the problem helps to maintain good working relationships with providers and doesn't require as much time and effort on your part!

Get an advocate, if you feel that you need support. In many cases, another person, a family member or friends might be helpful to you in deciding what to do. In some formal procedures, you may even need representation of an attorney. The Disability Rights Center and your local Legal Services corporations have advocates and attorneys on staff that may be resources for individuals with disabilities. The Disability Rights Center's address and phone number are listed in the "Where To Go For Help" section of this manual. There are other resources listed in this section as well.

Don't be afraid to pursue a more formal procedure. Sometimes, procedures such as a formal hearing are necessary in order to reach a fair decision. While the more formal procedure usually takes more time and more precise information about the problem, these kinds of meetings are still simpler than pursuing court action.

Public Funding Sources in Arkansas

Children's Services

Child Health Services -- EPSDT

For more information contact:

Division of Medical Services

Department of Human Services

P. O. Box 1437, Slot 1101

Little Rock, AR 72203

(800)-482-1141

(501) 682-8297

or contact your county DHS office listed in the "Where To Go For Help" section of this manual.

What does the program do? Early and Periodic Screening, Diagnosis and Treatment (EPSDT) is not a program, but a category of Medicaid that funds health services to eligible children. It is funded through Federal Medicaid funding and matching state funds.

Who can receive services? Children can receive services through this funding category if they are under age 21 and eligible for Medicaid. There are several categories of Medicaid eligibility and each category has unique financial, disability and living arrangement requirements. Current guidelines are available from your county DHS office listed in the "Where To Go For Help" section of this manual.

People with the following disabilities may are served:

• Blind/Deaf

• Hearing Impairment

• Learning Disability

• Mental Retardation

• Neurological Impairment

• Other Health Impairment

• Physical/Movement Disability

• Psychological/Emotional Impairment

• Speech/Language Impairment

• Visual Impairment

Other:

DMS pays for ANY medically necessary treatment for children/youth with or without disabilities.

Following tools marked may be funded:

• Augmentative Communication Aids

• Bathroom Equipment

• Hearing Aids

• Low Vision Aids*

• Mobility Aids

• Orthotics and Prosthetics

• Personal Care Aids

Other:

Everything purchased through Medicaid is based upon a medical necessity. Many of the items noted above as "may be funded" are not automatically available, but subject to a review process. *Low vision aids include glasses only. Artificial larynxes are not covered.

• Following services may be offered:

• Assessment/Evaluation

• Information & Referral

• Maintenance/Repair

• Training

What if services are denied? If you are denied Medical/Medicaid Assistance, you may file a request for a hearing. A request for a hearing must be received in the DHS Office of Chief Counsel in the Appeals and Hearing Office no later no later than 30 days from the date of the written Notice of Action, which is provided to you if, and when, services are denied. A hearing will not be granted when Federal or State law requires automatic reductions in Medicaid Assistance.

You may request a hearing in one of three ways:

• (1) Complete an Appeal for a Hearing form;

• (2) Complete the back side of the Notice of Action; or

• (3) Take a written request for a hearing to your county DHS office (see "Where To Go For Help" section of this manual) or to the Appeals and Hearings Office of the Office of Chief Counsel of DHS located in the Donaghey Building at 7th Street and Main Street in Little Rock.

If you would like the hearing to be held in your home or at a location other than the county DHS office, you should make sure that you tell the Appeals and Hearing office this in writing.

You may withdraw an appeal at any time in the appeals process. If you do, you will be asked to sign either a statement to this effect or to sign a Withdrawal of Request for fair hearing form.

The county office is responsible for providing an office in which the hearing can be conducted in privacy. The county office will also appoint a county representative prior to the time of the hearing. This person should be familiar with the case and able to answer questions from you, your representative or advocate, and the hearing officer.

The county office may have legal assistance in preparing for the hearing and at the hearing. The hearing will be conducted by a Hearing Officer from the Appeals and Hearings Office of the DHS Office of Chief Counsel. No person who had any part in the decision being appealed can serve as the hearing officer. At the hearing, you may represent yourself or you may be represented by a friend, advocate or attorney.

The hearing officer may not review the case record or other material either prior to, or at the time of the hearing, unless such material is also made available to you or your representative.

The hearing should be conducted in an informal but orderly manner. The hearing officer should explain the hearing procedure and a county representative will read the county office's hearing statement aloud. The county office will present its case which may include presenting evidence and questioning witnesses. Then you or your representative can present your case, including presenting witnesses, offering arguments or providing additional evidence. The county office may cross-examine your witnesses and you may question the county office representative or cross-examine any of the county's witnesses. You may also question or disagree with any testimony/information presented. If you have trouble presenting information, the hearing officer is allowed to help you.

The hearing officer will prepare a final order based on a comprehensive report of the hearing. The final order will be mailed to you. The whole appeals process should not take longer than 90 days from the date of receipt of your request for an appeal.

If you are not satisfied with the decision, you have the right to a review of the decision by a county circuit court. If you wish to do this, a petition must be filed in the county circuit court within 30 days from the date that you receive the Final Order.

Child Health Services Through TEFRA

For more information contact:

Division of Medical Services

Department of Human Services

P. O. Box 1437, Slot 1101

Little Rock, AR 72203-1437

(800)-482-5850, ext. # 22277

(501) 682-8230

or contact your county DHS office listed in the "Where To Go For Help" section of this manual.

What does the program do? TEFRA is Medicaid demonstration waiver that provides funding for cost-effective services to keep children with severe disabilities out of nursing homes and other institutions when they are not financially eligible for SSI because of family income.  Children must meet the requirements noted below to be eligible. Funds under this category are through the Tax Equity and Fiscal Responsibility Act of 1982, TEFRA.  Premiums are charged for this program based on family income (sliding scale).  Services provided are the same as those provided for a child on Medicaid.

Who can receive services?

Children may be eligible for TEFRA if:

Following tools may be funded:

• Augmentative Communication Aids

• Bathroom Equipment

• Hearing Aids

• Low Vision Aids

• Mobility Aids

• Orthotics and Prosthetics

• Personal Care Aids

• Transfer Aids

• Vehicle Modification

• Voice-Audio Output Aids

• Following services are offered:

• Assessment/Evaluation

• Information & Referral

• Maintenance/Repair

• Training

What if services are denied?

 If there is a disagreement with a decision or the way in which services are provided, a person or family may contact the supervisor of their local county DHS office, noted in the "Where To Go For Help" section of this manual. A general description of the Medicaid appeals process is provided in this manual on page 27 under the "What if services are denied?" question. You have a right to receive a written copy of your rights as a recipient of services. Ask for a copy of these guidelines at your county DHS office.

Helpful Hint

Children's Medical Services can assist families in applying for services under this funding category.

For more information contact:

(800)-482-5850

(501) 682-2277.

Children's Medical Services