Under the AT Act, the state-level activities to which a state must dedicate most of its funds include device demonstrations and short-term loans of assistive technology.

Device Demonstrations

“The AT Act states: State shall directly, or in collaboration with public and private entities, such as one-stop partners, as defined in section 101 of the Workforce Investment Act of 1998 (29 U.S.C. 2801), demonstrate a variety of assistive technology devices and assistive technology services (including assisting individuals in making informed choices regarding, and providing experiences with, the devices and services), using personnel who are familiar with such devices and services and their applications.”

A device demonstration enables an individual to make an informed choice, even if that choice is to not purchase any device. To create this outcome, a viable device demonstration meets a number of criteria. A demonstration provides individual, guided experience with the device(s), is interactive, and is conducted in real-time. It allows comparison of the features and benefits of a particular device or category of devices and is led by an individual with technical expertise related to the device(s).

Though preferably conducted hands-on, there are ways that demonstrations can be done through distance learning or video conferencing if they meet the above criteria. A demonstration is NOT a training that includes showing a variety of devices, a public training activity, or an archived presentation of devices. For example, a pre-programmed tutorial would not constitute a demonstration.

Demonstrations are conducted in a variety of settings, depending on a program’s structure. Some states have regional demonstration centers, some have a central demonstration location, others have mobile demonstrations, and still more have combinations of these options.

Device Loans

A second state-level activity is device loan. “The AT Act states: the State shall directly, or in collaboration with public or private entities, carry out device loan programs that provide short-term loans of assistive technology devices to individuals, employers, public agencies, or others seeking to meet the needs of targeted individuals and entities, including others seeking to comply with the Individuals with Disabilities Education Act (20 U.S.C. 1400 et seq.), the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), and section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794).”

Like device demonstrations, loans are primarily intended to assist individuals make informed choices about devices, though loans may serve other purposes as well, such as fill in the gap for a consumer waiting for repair or funding for their own device or to provide a short-term accommodation. Devices can be borrowed for self-education for a consumer or professional, and for training. Depending on a state’s policies, only one device may be loaned at a time or several devices may be borrowed at once.

By definition, device loans are short-term, though each program may determine the length of the loan. An open-ended loan in which the consumer can keep the device as long as he or she needs it is considered a form of device reutilization, not device loan.

Loans are made in a number of ways: sometimes the devices are shipped from either a central location or regional location to a consumer; sometimes a consumer is responsible for picking up and dropping off a device from a central or regional location. Programs have established their own methods and their own policies regarding device loans based on their structure.

II. Considerations for Program Implementation

When determining the design of your program, there are three primary considerations that will determine your operations:

Program scope
Administrative structure
Cost

A. Considerations for Program Scope

Program scope takes into account the depth, complexity, and diversity of your equipment inventory, expertise of staff, and the overall reach of your program.

A basic inventory of low tech equipment requires less staff expertise to demonstrate, presents fewer complications with maintenance and repair, and is generally of lower cost. Providing higher-end AT is generally more complicated, requires greater staff expertise and often takes more time to work with the consumers.

If you have the appropriate level of staff expertise to match the complexity of your inventory, you can properly represent the equipment, its potential application(s), and optimize the setup for the best client demonstration or trial. This requires on-going training opportunities as well as initial qualifications, and these are addressed in greater detail in the staff development section of this document.

Your overall reach is defined not only by the quantity of items in your inventory but also the type of equipment you demonstrate or loan and the consumers you serve. Inventory to meet the needs of children for early intervention will differ greatly from tools used by seniors for assistance with daily living activities. People with neuromuscular disease have progressive conditions that may require low tech devices to complex powered mobility, computer access, and augmentative and alternative communication devices. Consumers with visual impairments require a highly specialized inventory. Though you want to be comprehensive and statewide, you have to determine what populations you can reach initially and in what parts of the state. Once that is achieved, you need a strategy for building capacity by leveraging resources and establishing partnerships to reach additional locations and populations.

B. Considerations for Administrative Structure: Centralized vs. Regional Model

The first decision concerning administrative structure is to determine whether to use a centralized or decentralized model for your device demonstration or loan program, meaning that you either cover your state from one central location, or you have centers regionally (either run by you or operated through sub-contracts or with partners and collaborators).

There are advantages and disadvantages to each model, whether for device demonstration or device loan programs. Table 1 summarizes the advantages of the two models. Table 2 delineates the disadvantages of the models.

Table 1. Advantages of Program Models

Model

Advantages

Centralized

Model

1. All information, data, and staff are in one place, so there is direct oversight of these areas. This makes data collection, program evaluation, training, and other activities easier to coordinate. It is easier to leverage state dollars when it is easier to define

the scope of your program.

2. You can set up greater volume purchasing discounts because all inventory is

purchased and maintained at the same center rather than divided among regional

centers.

3. You can develop very good communication with vendors because of the single point of entry with the program. Vendors are able to build stronger relationships with a core group of staff members for referrals and sharing of data.

4. It may be easier to get more high level expertise housed in a central location because the centralized location will often be chosen by population density, urban vs. rural location, better access to professionals from higher education.

5. It is easier to manage inventory from a central location.

6. There is better consistency of data because you don’t have to mix and match data from several sources.

De-centralized

Model

1. It is easier to leverage money for support from the community, as many philanthropic organizations are regionally based.

2. It is easier to use existing equipment pools at a local level, whether it is focused on some specific type of technology or disability.

3. You can realize some operational savings because of less travel required from staff or by the consumers you want to reach.