RESNA Technical Assistance Project REPORTS ON Progress and Outcomes A Report on the State Assistive Technology Act Projects 2000 - 2001 March 2003 "My New Freedom Initiative will help Americans with disabilities by increasing access to assistive technologies, expanding educational opportunities, increasing the ability of Americans with disabilities to integrate into the workforce, and promoting increased access into daily community life." President George W. Bush, February 1, 2001 INTRODUCTION The Assistive Technology Act of 1998 is the centerpiece of federal efforts to provide people with disabilities access to appropriate, affordable assistive technology (AT) devices and services that enable them to maintain and improve their self-sufficiency and independence. The Act's purpose is to "provide financial assistance to states to undertake activities that assist each state in maintaining and strengthening a permanent comprehensive statewide program of technology-related assistance, for individuals with disabilities of all ages." (footnote #1) This is achieved in part by: * Increasing funding for and access to assistive technology devices and services for people with disabilities. * Increasing outreach efforts to underrepresented and rural populations who need AT. * Increasing and promoting coordination among state and local agencies and private organizations involved in activities covered by the Act. * Facilitating changes in laws, policies, and regulations to promote access and use of AT. * Increasing awareness about AT among people with disabilities. Indeed, the AT Act and the President's New Freedom Initiative strive toward similar goals. Title I of the AT Act supports efforts to increase access to AT devices and services in states and territories. It supports state AT project efforts to (1) increase public awareness of and outreach to people with disabilities, (2) improve interagency coordination, and (3) provide technical assistance and training to meet the needs of people with disabilities. This report demonstrates the work state AT projects have accomplished to meet AT Act goals. It explains the information, training, technical assistance, and coordination services they provide, using methods they have determined best meet the needs of people with disabilities who reside within their borders. It also shows the important role state AT projects play in coordinating and improving services to people with disabilities in diverse areas that include identifying financial assistance, creating equipment distribution services, offering hands-on AT demonstrations, and assisting with developing appropriate state policies. State AT projects routinely encounter many complexities as they work with and for consumers of AT devices and services. Examples include: * Increased demands for AT from a rapidly aging population with growing and varied needs. * Decreases in government funding and limited project resources. * Insufficient medical assistance and insurance coverage for AT devices and services. * Nominal AT resources, particularly in rural areas. The legacy of the AT Act is that AT is more accessible, available, and affordable to people with disabilities than ever before. State AT projects have created useful and appropriate services and resources for AT consumers, while recognizing significant cost savings. Most important, people with disabilities have been given the AT tools they need to obtain or improve their prospects for employment, pursue higher or vocational education, and enjoy the benefits of becoming truly integrated into the greater community. This report details how state AT projects meet AT Act goals. Data come primarily from the 2000 - 2001 annual reports submitted by 34 state AT projects that completed a data collection form developed by the National Institute on Disability and Rehabilitation Research (NIDRR); data from other sources are noted as appropriate. A. CONSUMER BENCHMARKS Last year, 60 percent of respondents told a national survey of people with disabilities that information and advice about obtaining AT increased their educational, independence, productivity, and community integration levels. (footnote # 2) Clearly, people with disabilities appreciate the benefits of AT. Proper use of AT, however, requires consumer training, education, and other appropriate support services to ensure that these benefits are maximized. All consumers served by state AT projects are guided through a series of steps as they learn how to integrate AT into their lives. Each step represents a benchmark that measures the progress of each state AT project in meeting AT Act goals and its success in serving AT consumers. Following is a description of state AT project benchmarks that illustrate progress in delivering services to AT consumers. 1. Learning About AT. State AT projects target their information resources to meet local needs, reflecting diversities such as language and other specific needs for both AT users and their caregivers. Accordingly, the services they provide include: * Information and referral services. * Specialized database searches that provide a full range of AT options. * Materials in languages other than English. * Training and resource manuals for AT users and their caregivers. State AT projects provide information about AT through several avenues: * Nineteen report that more than one million people visited their websites. * Twenty-three directly responded to more than 76,700 requests for information. * Twenty-five produced and disseminated over 103,000 newsletters. Individuals can contact state AT projects via toll-free telephone, TTY, the Internet, e-mail, and the U.S. Postal Service. 2. Receiving AT Technical Training and Advice. Training provides opportunities for state AT projects to present information to consumers and stakeholders-policymakers, educators, healthcare providers, and employers-on topics ranging from instruction for using specific AT devices and services to identifying funding sources to discussing legal issues such as Section 508 (footnote #3) standards and voting accessibility issues. * Thirty state AT projects made a total of 1,325 informational presentations at meetings, conferences, and workshops to more than 70,000 individuals. * Thirty-two state AT projects held more than 5,200 in-depth skills training and technical assistance sessions for nearly 58,500 individuals. * Nearly 35,000 professionals received AT training from 27 state AT projects. 3. Identifying Funding Assistance. State AT projects connect AT consumers to funding sources to help them acquire the AT they need. Primary funding sources include special education and vocational rehabilitation services, Medicare, Medicaid, and private insurers. In addition to guiding consumers to federal, state, private, and leveraged funds, more than half the state AT projects also collaborate with AT financial loan programs. State AT projects continuously develop new funding sources for people with disabilities such as low-interest loan programs and special AT loan funds. The AT Act Alternative Financing Program, funded under Title III of the AT Act, loaned over $2.3 million. The median loan amount was $5,000 (RESNA Alternative Financing Technical Assistance Project, 2002). 4. Attending Demonstrations of AT Devices and Services. State AT projects operate demonstration centers that provide key opportunities for people with disabilities to personally gather information about AT, view and test devices, and interact directly with AT professionals. * Thirty-four state AT projects operate or support 109 demonstration centers. * More than 80,800 individuals visited state AT project demonstration centers. 5. Assessing, Acquiring or Borrowing AT Devices. Consumers access AT in a variety of ways. State AT projects test creative approaches such as AT equipment loan clearinghouses and equipment exchanges that match buyers to second-hand AT vendors. Some state AT projects operate AT refurbishment and recycling centers, which have been particularly beneficial in states with large rural areas and underrepresented consumers. State AT projects have also established buying cooperatives to help consumers acquire equipment ranging from scooters to communication devices to computer adaptive devices. The chart below shows the different ways state AT projects assist consumers with assessing, acquiring, or borrowing AT equipment. Figure - Bar Graph Title: State AT Projects: Center Based Activities N=34 State AT Projects Activities Demonstration Centers =109 Centers Equipment Lending Programs =98 Centers Equipment Recycling Programs =39 Centers Equipment Exchange Programs =18 Centers Source: NIDRR Annual Performance Reports for AT Act Grantees, 2000-2001 Reporting Period B. STATE AT PROJECT BENCHMARKS Examining the methods state AT projects employ to meet their benchmarks provides an effective tool for measuring overall program outcomes as well as the progress of individual state AT projects, where positive outcomes, or results, may be gradual, incremental, and indirect. State AT projects have worked assiduously and on multiple fronts to meet a wide range of benchmarks. 1. Leveraging funds and providing cost savings to states. Federal funding for state AT projects have been reduced and cannot satisfy the growing need for AT devices and services. State AT projects have tapped into other financial resources to continue existing services, allowing them to provide access to AT by people with disabilities while providing substantial savings to state governments. State AT projects leverage funds from a wide range of sources, including: * State Departments of Education, Health, and Justice. * Public service commissions. * State-run schools for the deaf and blind. * Tobacco settlement programs. * Private banks. * Workshop fees. * State legislative appropriation. By leveraging funds, state AT projects have maintained and even expanded the services they provide to people with disabilities. Twenty-three state AT projects collectively leveraged more than $8.4 million, almost matching the $10.6 million federal disbursement and nearly doubling the amount of overall funding. However, the sources for leveraged funding generally cannot be counted upon for regular support, and their donations are usually a one-time event. Figure - Bar Graph Title: State AT Projects' Leveraged Funds N=23 States Federal Funds =$10,697,218 Leveraged Funds =$8,400,144 Total Funds =$19,097,362 Source: NIDRR Annual Performance Reports for AT Act Grantees, 2000-2001 Reporting Period State AT projects have found creative and effective ways to leverage funds and stretch state dollars: * Several state AT projects assist with home modifications that enable people with disabilities to remain in their homes and out of institutions. * Several state AT projects provide home assessment services to initiate the process for people with disabilities to obtain funds to purchase various AT devices. One state has achieved 96 additional months of independent living for nine people with disabilities, saving the state $300,000 (at $34,000 per person per year) in nursing home expenses. * Another state AT project saves money through an AT bulk purchasing cooperative it established to serve students with disabilities. This cooperative produced more than $600,000 in discounts and savings, and increased AT use in schools. 2. Improving efficiency by coordinating interagency and interstate activities. All state AT projects collaborate with various departments and agencies within their states to improve and build upon services to people with disabilities. They coordinate interagency activities in areas such as community living, employment, healthcare, telecommunications, and information technology. * Staff at state AT projects are experienced in using and providing accessible information technologies. They work closely with other state agencies to ensure that all state public internet resources are fully accessible to people with disabilities. * Several states have collaborated with their Area Agencies on Aging to increase awareness of low-tech AT solutions-such as door levers, zipper pulls, and check-writing guides-that provide more independence to senior citizens with physical, sensory, and cognitive limitations. State AT projects also participate in interstate activities that build upon and improve regional capacities in areas such as information management. * Several state AT projects in the Rocky Mountain area jointly host an annual AT conference. Conference workshops address items such as using AT to improve employment opportunities for adults with disabilities, advance physical and social development in young children with disabilities, and expand opportunities for children and adults with disabilities to participate in leisure activities including music, art, sports, and games. * Six states in the mid-Atlantic region collaborate with their ADA technical assistance center by lending their expertise on accessible electronic and information technologies. 3. Providing technical assistance and information to policymakers. State AT project staff assume multiple roles as technical advisors and public information specialists for AT legislation and policy. This makes them useful resources for policy makers, who often call upon them to assist with formulating legislation and policies that satisfy mandates and provide practical, front-line advice. * Several state AT projects have facilitated agreements between their Departments of Education and Vocational Rehabilitation that allow students with disabilities who use AT to continue using AT as they transition from high school to jobs or higher education. * Many state AT projects actively participate in state efforts to de-institutionalize persons with disabilities. AT is a key component for increasing the independence of people with disabilities so that they can successfully live and thrive in their communities. * Most state AT projects have worked with their state information technology and procurement offices on implementing Section 508 standards to ensure the accessibility of IT in state governments. The following chart illustrates efforts by 47 state AT projects that resulted in legislative and policy changes to reduce barriers to AT faced by people with disabilities. Figure - Bar Graph Title: Systemic Changes in States N=47 State AT Projects Policy Change Areas Medical Assistance = 28 States Education = 22 States Section 508/Telecommunications = 21 States Vocational Rehabilitation = 19 States Private Insurance = 6 States Source: NIDRR Annual Performance Reports for AT Act Grantees, 2000-2001 Reporting Period 4. Providing Satisfactory Services to Consumers. Consumer satisfaction is a vital measure of project success. Twenty-five state AT projects distributed 16,305 surveys to consumers to measure this benchmark and identify areas that need improvement. The response rate was 22 percent. Results show high satisfaction levels with state AT projects: * Seventeen received overall satisfaction ratings over 90 percent. * Twenty-one received satisfaction ratings over 80 percent. Comments from AT state project clients have reinforced these ratings: * "We never dreamed it would be possible to build an accessible addition for our daughter." * "Your agency has been a wonderful resource." * "Thanks to you, our paperwork went in correctly and our client received approval for the Delta Talker." A state AT project director commented that "we continue to get more requests for training, presentations, and exhibits as well as tours of the Center than we can handle. We have to pick and choose which requests we can accept." CONCLUSION The AT Act has provided many Americans with disabilities with the tools they need to promote their independence, leave or avoid institutions, and join the greater American community. State AT project staff serve as facilitators and catalysts for change. They coordinate various service systems within the state, and serve as AT experts to educators, employers, service providers, businesses and other organizations, and health care providers. Individuals and entities turn to them for answers about AT applications and policies regarding people with disabilities. State AT projects are meeting AT Act goals, achieving measurable results, and-in creative and diverse ways-enabling consumers to access and benefit from AT devices and services. Funds invested in state AT projects are providing essential services, fulfilling federal policy goals for people with disabilities, and saving taxpayer money by allowing individuals to live more independently, with reduced needs for in-home care and with fewer persons institutionalized. However, as the general population ages, more people will need AT, just when federal and state resources are being reduced. AT is a necessary fact of life for thousands of Americans with disabilities and holds the key to a positive quality of life for many of them-something everyone in our nation deserves. WORKS CITED Ehrlich, N.J. (2002). The AT/IT survey of persons with disabilities. Arlington, VA: Rehabilitative Engineering and Assistive Technology Society of North America (RESNA). Hayes, M.G. (2002). Assistive technology financial loan programs. Arlington, VA: Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). Rehabilitative Engineering and Assistive Technology Society of North America (RESNA) Alternative Financing Technical Assistance Project. (2002). Analysis of the First Year of Operation of the Federal Alternative Financing Program for Individuals with Disabilities. Arlington, VA: RESNA. FOOTNOTES 1 Assistive Technology Act of 1998, Pub. L. No. 105-394, Section 2 (b) (1), 112 Stat. 3630. 2 Ehrlich, N.J. (2002). The AT/IT survey of persons with disabilities. Arlington, VA: Rehabilitative Engineering Society of North America (RESNA). 3 Section 508 of the Rehabilitation Act requires the federal government's electronic and information technology to be accessible to people with disabilities. The AT Act requires states that receive AT Act funding comply with Section 508. March 2003 Produced by RESNA Technical Assistance Project 1700 North Moore Street, Suite 1540 Arlington, VA 22209-1903 703-524-6686 (V), 703-524-6639 (TTY) 703-524-6630 (FAX) . This publication is available in alternative formats. The RESNA Technical Assistance Project, Grant #H224B020001, is an activity funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U. S. Department of Education (ED), under the Assistive Technoloby Act of 1998. The information contained herein does not necessarily reflect the position or policy of NIDRR/ED or the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), and no offical endorsement of the materials should be inferred. RESNA in an interdisciplinary association of people with common interest in technology and disability. RESNA is the grantee funded under the AT Act to provide technical assistance and information to the AT Act projects.