Apps help the disabled communicate. So why won’t Medicaid pay for them?

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Technology gets more amazing every day. Satellites guide us from our driveways all the way to a grocery store in Ohio. A webcam enables a soldier in Afghanistan to talk face-to-face with his wife in Nebraska. And a new wave of iPhone apps allows individuals with disabilities to communicate with others — some, for the very first time.

At 235 megabytes, Proloquo2Go turns a standard iPhone into a fully functional augmentative and alternative communication (AAC) device. Co-designed by Penn State doctoral student Samuel Sennott and carried by iPhone app developer AssistiveWare, Proloquo2Go “provides a full-featured communication solution for people who have difficulty speaking,” such as individuals with autism, Lou-Gehrig’s Disease, Down syndrome or cerebral palsy. Like any other AAC device, it combines symbols, words, sounds and technology (source) to guide its user through an intuitive, hierarchical system of sentence-building software. Added to that, it hosts a minimum vocabulary of 7,000 words and life-like voices — and, at approximately $150 (not including the iPhone), costs a fraction of the $8,000- $10,000 families pay for cumbersome text-to-speech machines.

Co-created by the parents of a boy with autism and a certified speech-language pathologist, HandHold Adaptive’s slightly-less-publicized iPrompts® uses AAC technology to assist parents, teachers and therapists in scheduling and sequencing events for developmentally challenged and language-impaired individuals, such as those with Down syndrome, autism, speech-language disorders or otherwise cognitive disabilities. Unlike Proloquo2Go, iPrompts does not offer text-to-speech technology; however, it does offer a number of other useful tools, such as a visual countdown timer and picture scheduling. Users can access stock photos to create schedules and choice prompts, upload their own, or take pictures with the iPhone camera to add to their image library. It’s also significantly cheaper than Proloquo2Go, at only $49.99.

Sounds great, right? Many parents agree. So do the 76 professional centers in 31 states already using Proloquo2Go within a mere six months of its creation, including the FAAST Central Regional Demonstration Center, right here in Tampa. So why won’t Medicare or Medicaid pay for it?

According to the New York Times and other sources, “governmental insurance” requires the maker of assistive technology, regardless of its effectiveness, to block any “non-speech” software, such as text messaging or browsing the web. That means that, even if an individual makes measurable progress while using multipurpose technology, Medicare and Medicaid will not cover it — because it is multipurpose. This has created a frenzy across innumerable media sources, including USA Today and the New York Times, http://www.autismpodcast.com and parent message boards across the web.

One such article, found on tuaw.com, a website reporting on iphone news, reads, “Once again it seems that technology has outstripped law, and I hope that this inexcusable coverage hole will be repaired.”

Inexcusable coverage hole, indeed. Why are we (and I do mean “we”) willing to cover an $8,000 PC — hardly even transportable, and embarrassing for any kid to have to use — but not a hand-held, proven-effective device that, hardware and software included, barely totals $500? Why, because an on-the-go mom can email her kid’s doctor while simultaneously finding out what kind of juice he wants? How does that make sense?

Get with it, U.S. government. It’s the 21st century. Even you must act accordingly.

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