From Backlogged to Backpacks: ArSHA Webinar hopes to close the service gap for AAC users

Photo shows Elijah White, a black teenage male student, wearing a backpack and a mask and standing next to a car on the first day of school. In his backpack is his new AAC device, nicknamed “Ryan.” The author encourages all of her clients to nickname their devices and consider them as part of their family- because as their voice, they should go everywhere and do everything with their owner! Other clients have nicknamed their devices “Big Words,” and “Buttons.” Is there a new AAC device in your student’s backpacks this school year? Or do you need to know how to help your student get one? Tune in to the ArSHA AAC Webinar on August 21st to find out more.
Elijah, a teenage student, has his AAC device (nicknamed Ryan) in his backpack as he stands by a car on the first day of school.

Back-to-school looks different for everyone this year. Yes, there are fresh haircuts, new school uniforms, and bright white sneakers. But there are temperature checks, masks, and hand sanitizer bottles, too. School itself looks different; some are online, in-person, others follow a hybrid model or homeschool. Everyone is a little anxious. But for some nonverbal students in Arizona, there is something new in their backpack this year: a long-awaited personal AAC device. For the first time, some children will get to take their voices to school.


The Department of Developmental Disabilities (DDD) has been working with contracted AAC agencies and vendors to fulfill a backlog that began in 2019, right before the pandemic hit. At one time, approximately 200 nonverbal individuals were waiting to receive their voices.  The long wait for AAC and the fight for individuals who were at one point denied AAC services was dubbed the ‘Quiet Crisis’ in previous ArSHA articles.  (You can read more about the “Quiet Crisis’ here.)

Despite supply chain disruptions caused by the pandemic and other obstacles, DDD has now processed the majority of long-waited AAC claims. That means more AAC devices in backpacks this year as nonverbal students take their voices to school with them.  But for speech-language pathologists, teachers, and other special needs providers who know a nonverbal individual in need of a speech-generating device, there is still confusion over how to help a student receive DDD funding for a personal device. And what about students who need AAC, but do not qualify for DDD services? The ArSHA webinar has answers to all of these questions, including how to properly document the need for a device.

Documentation Demands in the New Medical Model

The webinar specifically outlines how speech-language pathologists can meet new documentation demands in the managed care model. Without proper documentation for medical necessity, clients face delays and possible denials. Documentation collected from clinics, home health, and school therapists can all contribute towards a big picture that supports the need for AAC.

What is the new process for acquiring AAC?

On January 1, 2021, the state of Arizona shifted management of AAC benefits and services from DDD to its contracted managed care organizations, Mercy Care and United Health Care. The switch to the managed care organization model, or MCO model, has been relatively smooth, and both United Health Care and Mercy Care can boast improved processing time over the previous state-run model, which means a more efficient service delivery and reduced waiting for those applying for AAC benefits.  But the total volume of AAC referrals in 2021 appears significantly reduced over previous years.

Why the reduction in referrals?

Until 2021, speech-language pathologists began the AAC referral process by submitting a packet known as 1151-A, or the Communication Skills Questionnaire (CSQ). But in a medical or MCO model, the request for AAC services has to originate from the family, not the provider.  This simple shift in origin is quite complex, given the fact that AAC is not widely understood by the general public. For this shift to be successful, service providers in schools, home health, and other settings like clinics need to educate their families on AAC and make them aware of their AAC benefits.

Educate about AAC

The ArSHA AAC webinar provides tools and resources SLP’s need to educate families. Speech-language pathologists need to ask themselves:

Do families on their caseload–

  • Know what AAC is? Understand why it is considered a research-based intervention?
  • Understand the top five myths of AAC?
  • Understand their insurance plan’s AAC benefits?
  • Know where to start the process to help their child get an AAC device?

ArSHA: Breaking down barriers for AAC

ArSHA’s AAC committee has been working directly with both managed care organizations (United Health Care and Mercy Care) to plan a series of presentations that will break down barriers for families who need access to augmentative and alternative communication services and the providers who serve them.  Educating speech-language pathologists on the new process can help close the AAC service gap. With informed service providers to counsel and guide families through the AAC acquisition process, and a new easy-to-use referral form in English and Spanish, the professional organization hopes to reduce barriers to AAC and increase access to services for those who need it.

ArSHA is providing a FREE live webinar titled, AAC in AZ: Navigating the New Managed Care System on August 21, 2021. It will be recorded and available for one year. You can find the registration link here.

The new ArSHA AAC referral forms in English and in Spanish are on the ArSHA website. Just click on the link!