West Virginia Assistive Technology System

Section 4 - How to Organize Your Funding Request

Get an evaluation by a person with professional experience.

a photo of a girl with pigtails drawing at a desk

Health insurance, government or private, has to have a health care provider make the decision on whether a person needs assistive technology. Other professionals, including speech/language pathologists, and physical or occupational therapists (PTs or OTs) may evaluate the person, but you must still get an assistive technology prescription from a health care provider.

The Evaluation/Diagnosis will drive the entire funding process. You must have a good evaluation that is clear about the person's assistive technology needs.

You can start by collecting the information below. You may need to get more specific information once you speak with the funding source. To get a good start, you should gather the following:

  • Child's background and history. You should include the child's level of ability and how assistive technology will improve his or her condition. Include age, disability or medical diagnosis and goals for the future.
  • Whether the child is covered by private insurance
  • Information about other money sources or programs the child may be using or has used
  • The name, maker or vendor of the assistive technology and its cost

Choosing the right assistive technology is hard. Many kinds of assistive technology are available at different prices. Here are a few questions that will help.

  • What type of assistive technology will increase the child's level of independence?
  • Who sells the assistive technology?
  • How much does the assistive technology cost? Can it be loaned or rented to try out?
  • Is there a professional person, such as a case manager, who can help you and your child write a funding request?

What other services are needed to train you, the child and others in how to use the assistive technology, to follow up to see if it works right, and to teach you and your child how to take care of the assistive technology?

  • Is there a professional person such as a speech pathologist or occupational therapist who can help with training and follow-up?
  • Can the assistive technology vendor provide follow-up help?

   

Once all of the above information is collected, it's time to write a justification for funding. The justification should not be based on why the assistive technology is needed but on what the assistive technology does for the person.

A good funding justification should include the following:

  • Details about what type of help the assistive technology will provide for the child
  • Evidence that the assistive technology is useful to the child
  • Why this assistive technology was chosen. Include other assistive technology choices that you tried that did not work. Explain why the assistive technology is the ONLY real answer to the child's problems and why other assistive technology did not work.
  • Pictures or videotapes of the child with and without the assistive technology.

Step 2: Find out what funding is available

two children playing in a play castle

Several funding sources are available, so finding the best one may take time. You can start by answering the questions below.

  • Can you pay for the assistive technology? Do you have private insurance? If so, will it pay for the assistive technology? Does the private insurance have limits or caps on what it will pay?
  • Does your child qualify for help from government agencies?
  • Are there private funding sources or grants? What are the requirements of each? How can I apply? How long is the wait? Are funds easily available?
  • Can I get a loan? Do local banks give assistive technology loans? Do I qualify for the Revolving Loan Program?
  • Does the assistive technology vendor have a special way to finance the assistive technology?

You don't have to find the funding source on your own. This would be a perfect time to get professional advice from a case manager, an advocate, a health care professional or a social worker. They can help you tackle the following questions based on their experiences.

  • Will the assistive technology vendor order the assistive technology knowing funding is not approved yet, and then submit billing to the funding source?
  • Will the assistive technology vendor be able to help with any financing? For example, will the supplier accept a lesser payment and finance the remainder or write it off as payment in full?
  • Have you reviewed what information the funding source needs and what assistive technology they will cover? (Medicare, Medicaid, private insurance, etc.)
  • Is it possible to combine two funding sources that will equal 80% or more of the total cost? Private insurance funding sources may only pay up to 80% or less. For example, if your private insurance paid less than 80%, Medicaid could pay the difference up to 80%.
  • Are there charitable groups in your area that can help raise the necessary funds? (Lions Club, Kiwanis, etc.)

Step 3: Funding approval

What happens when your request is approved?

a photo of a baby looking at sign language symbols

The amount of funding that was approved from your request will be stated in writing. Hopefully, your request was approved for the full amount requested. If this is the case the vendor will order the assistive technology.

What do you do if the request was approved but for less money?

If the approval was for less than the amount you asked for, then you must think about some other things to do. Go to your records on all the possible funding sources that you have found and look over this information before moving on to Step 4.

What do you do if the request was turned down?

If the funding source called to say the request was turned down, you have the right to ask for that information in writing. The funding source must also tell you in writing why the request was turned down. Go to Step 5.

Step 4: Seek funds to make up the difference

If you are not happy with the amount of funding that was approved, there are other options that you can try before paying for the assistive technology on your own. You may choose either option or both.

  • Look for other funding sources
  • File an appeal to try and increase the amount of funding

After you have looked into the two options above without success, it is possible that you may have to pay for the amount of the funding that was not approved.

a photo of a family helping their girl who uses a wheelchair board a bus

  • Can you get a bank loan or possibly a home equity loan?
  • Are there any other funding sources, for example, community agencies or local clubs that can help in covering the difference?

Step 5: Attacking the appeals process

If your request for funding was turned down or not fully funded, it is time to ask for an appeal. Look over your funding request package and ask the following questions.

  • Was my request clear?
  • Did I include all the necessary information? Was it organized?

If you answer "no" to either of the above questions you should take care of any problems and resubmit the funding request.

If you answer "yes" to either of the above questions you have the right to file an appeal.

This is your opportunity to ask for the decision to be reviewed. Many times, funding sources say no to funding for assistive technology due to lack of understanding by whomever is making the decision or a lack of evidence that the assistive technology meets your child's needs.

All funding sources have an appeals process. You have the right to request an appeal to have your request looked at. This is why it is important to keep all your records on file. The appeal will be much easier if you have already collected evidence of how the assistive technology will help your child.

Find out what is most important to the funding source. If possible, find out why the request was denied. Does the funding source need more information? Were they out of funds until a certain date in the future? It will be helpful if you have built a good relationship with the funding source staff people, since these same people can discuss why the request was denied and help you appeal the decision.

Try to find evidence of whether the funding source has funded this type of assistive technology request in the past. If so, it will be more difficult for the agency to turn your appeal down.

Key elements in successful funding are:

  • Determination...Never Give Up
  • Self-advocacy
  • Educating funding sources about the advantages of the assistive technology chosen
  • Looking for other funding sources, if necessary

Remember that knowledge is power. By educating funding sources you are paving the way for other people in the future. Other individuals may benefit from your efforts.

Fundraising for Assistive Technology

On occasion it is necessary for an individual or family to consider fundraising as a means of purchasing needed assistive technology.

How do you start a fundraising effort?

If you are an individual or have a family member needing assistive technology, it may be helpful to approach a church, fraternal or civic organization within your community to sponsor the fundraising effort. They may be willing to sponsor a bake sale, bazaar, pancake breakfast or similar activity that can help raise funds for your cause. Usually organizations are already familiar with this type of fundraising.

If you have a willing sponsor that has no experience in fundraising but is willing to assist, here are some general guidelines that can help take some of the mystery out of fundraising.

  • What is the funding need? Be specific.
  • Work with your supporter on a plan to achieve the goal.
  • Include a timeline on when things should be accomplished.
  • Be available to answer questions and make appearances at events on your behalf.

If your sponsor wishes to create a donor letter campaign, these are a few things to keep in mind when creating the letter:

  • Think about why you are writing the letter.
  • Who is the audience you are writing to?
  • Write the letter so it reads well out loud.
  • Include why the donation is needed and what it will be used for.
  • Let donors know what an impact their donation will have.
  • Use short paragraphs and simple concise descriptions.
  • If your sponsor is a nonprofit entity that can accept charitable contributions, check if the donor can get a tax exemption for their gift.

It is often necessary to combine several types of resources. It can often be difficult to go to the community for assistance. But it is important to remember that asking for assistance is not admitting defeat, but realizing that there are people willing to help donate time and money to your cause.

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