WATA Bulletin: Summer 2003
Contents:
Video Relay Service offers new Web-based opportunities for telephone communication
Debbie Cook, Director, Washington Assistive Technology Alliance
Alan J. Knue, Program Manager, UW Center for Technology and Disability
Studies
Many people who are deaf or hard of hearing face a significant barrier
when using the telephone. When using a text telephone (TTY) or the
Telephone Relay Service (TRS) the deaf person must enter his or her
part of the conversation using a keyboard and must communicate in
English. With the advent of Video Relay Service (VRS), those deaf
and hard of hearing individuals for whom American Sign Language (ASL)
is their first and preferred language are now able to have real time
telephone conversations.
How does VRS work?
VRS uses video on the Web to provide two-way translation between individuals
who use spoken language and those who use ASL. Typically, the deaf
or hard of hearing person communicates in ASL. The hearing person
communicates by voice. A relay operator serves as a liaison, communicating
by video using ASL to the deaf party and by voice to the hearing party.
All domestic VRS calls, including long distance, are provided free
of charge.
Additional options include voice carryover (VCO) calls for individuals
who voice for themselves but cannot hear, and hearing carryover (HCO)
calls for individuals who can hear but are unable to speak.
VRS is only used for telephone communication. It is not the same as Video Remote Interpreting, which uses video conferencing to provide sign language interpreting of meetings or events.
How does a deaf person use this service?
The deaf person must have access to a computer with a high-speed internet
connection (DSL, cable, T-I or ISDN), a video camera or webcam, and
Microsoft NetMeeting for PC or VideoLink Pro for Macintosh.
To place a VRS call, a deaf person in Washington state loads the WA
VRS website: www. wavrs.com, or
if using ISDN, dials 1-877-660-7977 or 1-866-660-7977. The individual
enters the phone number to be called into the field provided and then
selects the button for login. The user is then prompted to enter a
username and password or create a profile if new to the system. When
the call is connected, the screen displays two windows—one showing
the deaf person who placed the call, and the other showing the Video
Interpreter (VI) who is located at one of 9 VRS centers across the
country.
How does a hearing person use VRS to call a deaf person?
A hearing person initiates a call by dialing 1-866-410-5787 to reach
a VRS operator. The hearing person must provide the IP address of
the deaf person so the operator can connect the call over the Internet.
In Net Meeting, for example, the IP address is displayed by selecting
Help on the Menu bar and then selecting About.
Many advocates of this service hope that soon there will be properly
configured computer workstations available to the public in centralized
locations so that individuals who do not have access to a computer
can also take advantage of this service.
For more information about how to use VRS, including technical support
and troubleshooting, visit the Washington State Video Relay Service
website at www.wavrs.com and follow
the link for Customer Service. Additional information on VRS and VRI
can also be found at SignOn, A Sign Language Interpreting Resource,
LLC located in Seattle, on the Web at www.signonasl.com.
At a glance: Medicaid and assistive technology
Pat Brown, Ed.D., UW Center for Technology and Disability Studies
Medicaid is a health care program for low-income families that is jointly funded by the state of Washington and the federal government. In Washington state, Medicaid is administered by the Medical Assistance Administration (see MAA at: fortress.wa.gov/dshs/maa).
To obtain assistive technology (AT) for children through Medicaid, you will need to establish that (a) the AT requested is included within the scope of covered benefits; (b) the item is medically necessary and (c) the proper procedures have been followed.
Scope of covered benefits:
Most AT is funded by Medicaid as durable medical equipment (DME).
Funding for AT for children may also be available in connection with
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services
(called Healthy Kids Now in Washington) at www.hipspokane. org/hkn,
or through the Children’s Health Insurance Program (CHIP) at:
www.hipspokane.org/FieldGuide/chip.htm
Under EPSDT, services may include AT that would ordinarily not be provided to an adult Medicaid recipient, including: coverage for eyeglasses and examinations, coverage for hearing aids and examinations, and physical therapy services.
Medical necessity:
Medicaid will authorize payment for a requested item only when the
individual establishes that the item is medically necessary or “reasonably
calculated to prevent, diagnose, correct, cure, alleviate or prevent
worsening of conditions in the client that endanger life, or cause
suffering or pain, or result in an illness or infirmity, or threaten
to cause or aggravate a handicap, or cause physical deformity or malfunction.”
Washington’s definition of medical necessity also requires Medicaid
recipients to establish that there is no other equally effective,
more conservative, substantially less costly course of treatment available
to meet the individual’s needs. Although EPSDT treatment may
be limited to the “most economic mode,” these limits do
not apply if there is an inadequate supply of the less expensive treatment
or provider, or if the less costly treatment is less effective.*
Advocates for children seeking AT from Medicaid may point to EPSDT as a basis for covering any medically necessary AT.
Prior authorization:
In most cases, you will need to work with a Medicaid-authorized vendor
and obtain pre-authorization (pre-approval) before the device is purchased.
Your physician or health care provider normally must submit a written
request (usually through the vendor) with documentation of your need
for the requested services or device. This documentation must explain
why the requested device is necessary to increase the recipient’s
independence, safety, functional abilities, or to alleviate the impact
of disability. It also should detail what other less costly alternatives
were considered and rejected and the reasons they were rejected.
* O’Connell, M. Esq. (2003). Introduction to Medicaid: Eligibility,
Federal Mandates, Hearings and Litigation. Southern Disability Law
Center: Austin.
Calendar of Events
Closing The Gap: 21th Annual Conference, Oct. 16-18, Minneapolis
(Pre-conference workshops Oct. 14-15.)
Topics cover a broad spectrum of technology applicable to all disabilities
and age groups on issues of education, rehabilitation, vocation and
independent living. More than 150 sessions will demonstrate successful
applications of computer technology. For information or registration,
go to www.closingthegap.com;
email info@closingthegap.com;
write to Closing The Gap, Inc., 526 Main Street, PO Box 68, Henderson,
MN 56044; call 507-248-3294; or fax 507-248-3810.
ASHA (American Speech-Language-Hearing Association) Annual Convention,
Nov. 13-15, Chicago
This year’s theme is “Exploring New Frontiers in Biology,”
recognizing the growing importance of biology in the field of communicative
disorders. Additionally, 2003 has been designated the “Year
of the Volunteer” with sessions related to biology and volunteerism
complementing programs on clinical and research topics across the
speech, language, and discipline-wide spectrum. Go to www.professional.asha.org/events/conv_slp.cfm;
email convention@asha. org;
write AHSA, 10801 Rockville Pike, Rockville, MD 20852. Professionals
and students call 800-498-2071; public, call 800-638-8255.
ATIA (Assistive Technology Industry Association) Conference and
Exhibition, Jan. 14-17, 2004, Lake Buena, Florida
Presentations, demonstrations and exhibits in augmentative and alternative
communication, low vision, blindness, computer access, electronic
aids to daily living and learning disabilities. Learn about various
assistive technology products while experimenting with and evaluating
the latest AT in computer and technology exploration labs. For more
information, go to www.ATIA.org;
email ATIA@northshore .net,
or write ATIA, 526 Davis St., Suite 217, Evanston, IL 60201. With
general questions call 877-687-2842; with questions about registration
call 847-869-1282; or fax 847-869-5689.
For calendar updates, visit the Web at:
http://wata.org/calendar.htm
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The WATA Bulletin is supported by grant number H224A020001 from the National Institute on Disability and Rehabilitation Research, U.S. Department of Education, to the University of Washington Center on Human Development and Disability, Seattle, WA. Kurt Johnson, Ph.D., is the principal investigator.