Traveling from Glen Burnie to Towson for her language program has been a struggle for 63-year-old veteran Alison Elinoff. A stroke 15 years ago left the right side of her body paralyzed and with aphasia that makes it a struggle to speak clearly.
While she likes being in class in person, it takes 45 minutes to get there, which is a hassle. She skipped the class several times — often for a doctor’s appointment at the Veterans Administration hospital or because she was too tired and her performance suffered. So, when the classes went virtual amid the coronavirus pandemic, she welcomed it.
“I really like virtual — virtual is great,” Ellinoff said.
But Elinoff will be forced to go back in person Sept. 30 to the Snyder Center for Aphasia Life Enhancement after the state ended a pandemic-related reimbursement policy for medical daycare, even though she’d prefer to remain virtual. The League for People with Disabilities, which runs the SCALE program, must bring people back to continue getting paid, a top official there said.
Elinoff is not the only disabled person who says they’re hesitant about going back in person and want to keep virtual services that began during the pandemic. But whether that’s possible remains uncertain. Other disabled people, meanwhile, say they’re eager to return to in-person activities.
During the coronavirus pandemic, many programs went virtual for the health of their participants and providers embraced telehealth enabling online appointments. Under the state’s emergency orders, providers were reimbursed at full price for virtual appointments, but Gov. Larry Hogan ended the state of emergency Aug. 15. That means some COVID-19 telehealth options expired on that date, Maryland Department of Health spokesman David McCallister wrote in an email.
Under the state’s Preserve Telehealth Act of 2021, insurers, such as Medicaid, are required to provide coverage for telehealth services, regardless of the patients’ location, he also wrote.
But David Greenberg, president and CEO of the League for People with Disabilities, said organizations offering medical day care for disabled people will be required to serve them in person if they want to get reimbursed starting Sept. 30. The League pays for its SCALE programming using the medical day care reimbursement.
The VA pays for Elinoff’s services as medical daycare and noted that it simply followed state policy.
Hogan “issued a state of emergency order and closed all adult daycare centers during the pandemic,” the VA wrote in a statement. “He lifted the emergency order ... and day centers were able to resume in person.”
Debbie Gnibus, of Middle River, whose son, Ricky, also uses services provided by the League, is not ready to go back to in-person activities. Ricky Gnibus, 41, has arthrogryposis, a muscle nerve disorder, and operates his wheelchair with his mouth or chin. He cannot operate the wheelchair with a mask on, she said.
Debbie Gnibus, 63, lives 40 minutes from the League and works full time. Before the pandemic, Ricky rode the bus to the League. Now he does virtual sessions.
“I’m concerned Ricky would be more susceptible to getting COVID. Even with the shot, people are still getting it,” she said. “There are so many unknowns. You just don’t know what to do, and I’m trying to do the best that I can for my son.”
Jacqueline Jones, 53, of West Baltimore, has had four strokes. Jones, who uses a wheelchair and is partially blind in one eye, took part in the League’s virtual programs, which she said kept her busy.
“This is a good place to be,” she said.
While she’s comfortable going to the League’s office in person, she said she’d like others to have access to virtual programming as the state reopens.
“For me personally, I would come back to the League. I love the League, but there are some people out there that are still hesitant to come back because of the COVID-19 virus and the variant,” Jones said. “I was concerned, but after getting vaccinated, I feel better about coming back to the League.”
Shifts in virtual services at local schools are impacting students with disabilities as well. Many disabled students lack the technology and Internet access to participate in virtual learning, since they’re often in households that have the lowest incomes, according to the Maryland Developmental Disability Council. A lack of closed captioning or interpreters also continues to be a problem, and screens are not typically useful for the visually impaired.
Despite such challenges, “virtual life is generally positive for people who have mobility issues because it alleviates the stress that can come with traveling,” said Rachel London, executive director of the MDDC.
She pointed to how the Maryland General Assembly embraced virtual meetings, which gave disabled people the ability to testify and attend public meetings from home instead of needing to find accessible transportation. The change lead to an increase in meeting attendance among individuals that the MDDC works with and their families, she said.
London said the organization raised $200,000 to provide technology for remote school access and other virtual services.
As schools resume in-person instruction, some parents have conflicting thoughts about what may be best for their kids. For some students who suffer from anxiety, virtual classes allowed them to comfortably communicate and participate in class.
Rene Averitt-Sanzone, executive director of the Parents Place of Maryland, a special education nonprofit, said several schools increased services, such as speech therapy and sign-language classes, to better accommodate students.
But others lost out on learning opportunities by not being in the classroom, particularly those who received specialized help with one-on-one educators or assistive technology. Younger students who spent little time in school before the pandemic have never had the opportunity to learn crucial social-emotional lessons.
Angie Auldridge, the mother of an 8-year-old with autism and cognitive impairments, was faced with the challenge of juggling care for him during the pandemic, working from home and looking after her two other children with her husband. Days were spent struggling to keep their son engaged with school for hours in front of a screen, Auldridge said.
Some days, Auldridge had to physically restrain her son in front of the computer; nevertheless, he was not able to stay on the same academic track, she said.
While the Auldridge family welcomes the return of in-person instruction, they would like to see telehealth carried over from the pandemic era.
Maryland Health Care Commission’s decision to expand telehealth services and reimburse providers for them at the same rates as in-person visits made attending medical appointments more convenient.
For families like the Auldridges, that meant they did not have to drive to Baltimore from their home in Western Maryland and their son was able to see a sought-after specialist in Kansas City.
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“I was glad to hear about it because having telehealth access made my son’s appointments so much easier,” said Auldridge. “It was more convenient especially because his appointments are usually more of a conversation between the doctor and parents than a physical examination, so I hope we can continue to have that option.”