Fee for Service Tele-Conference Call Tammy Koger Director North Carolina Assistive Technology Program October 29, 2009

Fee for Service History in NC: Support Request for Other Services: 1. Device demo and loan: - No professional evaluation as part of decision making. -More in depth evaluation requested: -VR/IL wanted reports with specific recommendations -Schools requested reports outlining specific needs and recommendations -Follow up training once device was purchased 2. Need to increase funds for program, specifically equipment funds

Fee for Service History in NC: Need to Supplement Federal Dollars: AT Act: Section 4, item 6B(ii): “funds received … will be used to supplement, and not supplant, funds available from other sources for technology-related assistance, including the provision of assistive technology devices and assistive technology services” Replenishment of Equipment in Centers: All funds obtained through “fee for service” are used to support the federal AT requirements. (Purchase of equipment)

Fee for Service History in NC: Support at the Division Level (Division of Vocational Rehabilitation - DVRS) Support at the Department Level (Dept. of Health and Human Services Secretary submitted request for updated Administrative Code for DVRS April 1,1999: New NC ADMINISTRATIVE CODE 10A NCAC 89C.0109: RATES AND FEES FOR PURCHASERS OF SERVICES: The Division shall establish fees it charges for any services by determining the amount necessary to recoup all direct and indirect costs associated with the respective service. Direct costs are those that can be identified specifically with a particular service. Indirect costs are those that have been incurred for common or multiple services and cannot be readily identified with a specific service. Any fees assessed shall not be in conflict with the provisions regarding comparable benefits in 34 C.F.R

Commonly Asked Q:You are a state agency, can you charge for your services? A:Yes, we can charge for services. On April 1, 1999 NCDVRS received approval through the Legislative Rules committee to establish and charge fees for services. It is written into the NC administrative code, Title 10a, Chapter 89, subchapter 89C section.0109 "Rates and fees for purchasers of services". Q:Why do you charge a fee since you get federal funding? A:NCATP receives funds under the federal Assistive Technology Act (P.L ). This law stipulates that State AT Projects cannot supplant (replace) the responsibilities of other programs such as special education, vocational rehabilitation, independent living, veterans administration, etc. If programs require evaluations or assessments to determine whether to provide specific services (such as purchase of equipment), then that entity must pay for the service. NCATP cannot supplant the other program’s responsibility by using AT Act federal funds & staff to do this for free.

Fee for Service Activities: Assistive Technology Evaluations (Performed at NCATP Centers or in community)…..$ 475 Training on Specific Devices/Software…..$75.00/hr Consultation Services…..$75.00/hr Job Site Evaluations.…$ Workshops/Seminars….Negotiated prior to training Group Training/Train the Trainer…..Negotiated Travel Time –To/From evaluation site/training, etc (billable in 30 minute increments)…$37.50 per hour Notes: Fees were set in A report is generated for any individual fee for service activity

Customers: Vocational Rehabilitation Independent Living Services Schools Workers Compensation Companies Office of the Courts Veterans Administration Medicaid (Augmentative Communication Assessments) Non-profits (grants for AT services)

Budgeting Information: All Fee For Service funds are maintained in a separated line item budget (2324) All expenses under budget 2324 are used to support the AT program to include: Device Demo, Device Loan, AT Expo, and Marketing All remaining funds in 2324 carry over into next state fiscal year