2004 Survey of State Tech Act Projects Equipment Loan

R E S N A TECHNICAL ASSISTANCE PROJECT REPORTS ON Survey of State AT Act Projects Equipment Loan Programs Equipment Exchange Programs Equipment Recycling Programs and AT Demonstration Centers April 2005 Providing Technical Assistance and Information to the Projects Funded Under the Assistive Technology Act of 1998 April 2005 This publication is available in alternate formats. 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) The RESNA Technical Assistance Project, Grant #H224B020001, is an activity funded by the Rehabilitation Services Administration (RSA), U.S. Department of Education (ED), under the Assistive Technology Act of 1998. The information contained herein does not necessarily reflect the position or policy of RSA/ED or the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), and no official endorsement of the materials should be inferred. CONTENTS Introduction Equipment Loan Programs Equipment Exchange and Equipment Recycling Programs Assistive Technology Demonstration Centers Challenges 1 2 15 31 42 Sample Forms for State AT Lending/Re-Use Activities 44 INTRODUCTION Background The state Assistive Technology Act projects deliver a multitude of services to empower persons with disabilities, their families, and community organizations, so they can assess and obtain requisite assistive technology devices. RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America, collected information in late spring of 2004 to examine the State Grant Programs, known as Title I programs, in four areas that provide individuals with disabilities access to assistive technology devices and services.1 The activities of each AT Act project focus on the implementation of statewide, consumerresponsive programs of technology-related assistance to persons of all ages who experience disabilities. For those who are older or have a disability, the use of assistive technology eradicates barriers to employment and overcomes the everyday challenges of community living. This report highlights the activities of four categories of service that match appropriate technology with an individual’s unique needs, abilities, and goals: (1) equipment loan programs, (2) equipment exchange programs, (3) equipment recycling programs, and (4) assistive technology demonstration centers. Data Collection The state AT Act projects2 received a survey distributed by the RESNA Technical Assistance Project via the Internet, e-mail, and hard copy. The projects returned 44 completed surveys and the results are compiled alphabetically by state in Tables 1 through 7. Tables 1 and 2 summarize the equipment loan programs; Tables 3 and 4 summarize the equipment exchange programs; Tables 5 and 6 summarize the equipment recycling programs; and Table 7 summarizes the assistive technology demonstration centers. While specific state project examples are used to illustrate programmatic services in this report, many other states conduct similar activities. For more information on assistive technology resources in your state or territory, contact the RESNA Technical Assistance Project or the individual AT Act project directly. 1 The Assistive Technology Act of 1998 (AT Act, Public Law 105-394) defines an assistive technology device as ―any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.‖ Assistive technology service is defined as ―any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.‖ 2 State AT Act projects refers to the 56 projects funded by discretionary grants authorized under the AT Act in all 50 states, the District of Columbia, Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands. The Rehabilitation Services Administration (RSA), Office of Special Education and Rehabilitation Services of the U.S. Department of Education administers the AT Act program. Survey of State AT Act Projects 1 EQUIPMENT LOAN PROGRAMS Background By offering individuals with disabilities, service providers, and employers the opportunity to borrow and try out a number of different types of devices prior to making a purchase, equipment loan programs extend immediate short-term loans of assistive technology without the costly investment in a device that may prove unsuitable for the consumer. Loan programs permit hands-on-experience and enhance the facilitation of training associated with assistive technology devices and services through AT Act project personnel. In addition to aiding in the selection process, the loan programs provide temporary replacement equipment to consumers when a personal device is on order or in need of repair. Findings Thirty-three states report operating device loan programs (Tables 1 and 2). Almost all projects report serving all ages and disabilities. In addition to lending equipment, all device loan programs report offering a full array of support services to assist consumers in the selection process. Services range from assessment and demonstration to funding assistance, training, and follow-up. A Variety of Partnerships—While some programs are operated solely by the state project, many others collaborate with community organizations, state agencies, and school districts. A partner or funding source may direct services to a specific area of focus. Iowa, for example, partners with Easter Seals and the Center for Disabilities and Development to serve all ages in addition to working with local education agencies to serve school-age children. Missouri also partners with schools to provide equipment loans. In Nebraska, TechTry is a ―try it before you buy it‖ program for employees and employers funded by the Department of Labor under the Workforce Investment Act to serve working-age adults. The state of Washington collaborates with the King County Library to serve adults through a loan program that is part of a traveling library where patrons check out equipment and other resource materials. South Carolina’s loan program is located in the medical school’s pediatric clinic, providing easy access to physicians, staff, and patients. Wisconsin operates through a network of eight Independent Living Centers and Florida’s program lends devices though its demonstration center. A Variety of Devices—Table 1 lists the many different categories of assistive technology devices that state projects offer through their loan programs. Most states will loan many different categories of devices. Some, however, limit devices to only a few. Resources and staffing influences a state’s capacity to loan a full spectrum of devices. Minnesota, for example, loans only augmentative and alternative communication (AAC) devices. Other states focus on specialized services as well. Nebraska’s TechTry program loans work Survey of State AT Act Projects 2 Table 1. Equipment Loan Programs: Populations Served, Types of Equipment, and Other Services State Arkansas Geographic Area/ Project or Partners Statewide/ Arkansas Rehabilitation Services Statewide/ project only Eligible Ages All Eligible Disabilities All Loan Recipients Users, family members, agencies, service providers, education Service providers, users, family members, agencies Service providers, users 1-10 Types of Equipment Other Services Provided Assessment, demo, follow up, funding assistance, I&R, training Demo, follow up, funding assistance, I&R, group training Assessment, demo, follow up funding assistance, I&R, training Delaware All All 1-10 District of Columbia District-wide/ project only All All 1,3,4,6,7,8,10,11 Florida Northwest Florida/ with partners Statewide/ project only www.gatfl.org All All Georgia All All Users, family members, service providers Users, family members, service providers, business Users, family members, service providers Users, family members, service providers Users, family members, service providers Service providers, users, family members 1-10 1-11 and reference materials Guam Island of Guam/ project only All All 1,2,3,4,7,8,9,10,11 Hawaii Statewide (All Islands)/ project only All All 1-3 Idaho Statewide w/UCP of Idaho www.ucpidaho.org Statewide/ project only www.iltech.org All All 1-10, books and videos Illinois All All 1,2,3,5,6,7,9,10 Assessment, demo, follow up, funding assistance, I&R, training Assessment, demo, follow-up, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, training Demo, follow up, funding assistance, I&R Survey of State AT Act Projects 3 State Indiana Geographic Area/ Project or Partners Statewide/ project only Eligible Ages All All Eligible Disabilities Loan Recipients Users, family members, service providers Users, family members Users, family members, service providers, agencies Users, family members, service providers, agencies, educational instit. Service providers, users, family members, vendors 1-11 Types of Equipment Iowa Kansas Statewide w/Easter Seals and CDD; AEAs regionally Statewide/ with State partners www.atk.ku.edu Statewide w/regional AT centers and KY EIS www.bluegrass-tech.org Statewide w/UCP of Bangor and Husson College www.tecmaine.org Statewide w/Holly Community, Inc., MD AT Coop., and Div. of Rehab. Services www.matcoop.org Statewide w/UCP of MN Statewide/ project only All; school age for AEAs All All 2,3,4,6,8,9,10 All 2-10 Kentucky All All 1-10 Maine All All 1-10 Maryland All All Users, family members, service providers, agencies 1-10 Other Services Provided Assessment, demo, follow-up, funding assistance, I&R, training Assessment, demo, funding assistance, training Assessment, demo, follow-up, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, training, simple repairs Assessment, demo, follow up, funding assistance, I&R, training Minnesota Mississippi All All All All Missouri Statewide/with partners http://etc.rockhurst.edu All All Mostly service providers Users, family members, service providers, agencies All loans to agencies with signed agreement 2 1,2,3,9,10 Demo, I&R, training Assessment, demo, follow-up, I&R, training Follow-up, funding assistance, I&R 1,2,3,4,5,7,8,9,10 and Telecom equipment for Internet access Survey of State AT Act Projects 4 State Montana Geographic Area/ Project or Partners Statewide/ project only Eligible Ages All All Eligible Disabilities Loan Recipients Users, service providers, agencies Users, family members, service providers, agencies, employers N/A 1-11 Types of Equipment Other Services Provided Assessment, demo, follow up, I&R, training Assessment, demo, follow up, I&R, training Nebraska Statewide w/NE Dept. of Labor and Work Force Investment Act (TechTry) www.nde.state.ne.us/ATP Statewide w/Dept. of Public Health at one center only Statewide/ with partners www.ndipat.org All (ATP); Adults and Older Adults (TechTry) All 2,3,5,8 and work station modifications (TechTry) North Carolina All All 1-10 Demo, funding assistance, I&R Assessment, demo, follow-up, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, training Demo, follow up, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, training Funding assistance, I&R, ―support person‖ to assist with device Assessment, demo, I&R Assessment, demo, follow-up, funding assistance, I&R, training North Dakota All All Users, family members 1,2,3,4,5,6,7,9,10 Northern Mariana Islands Three Islands/ project only All All Users, family members, service providers Users, family members, service providers, agencies Users, family members, service providers, agencies N/A 1,3,4,5,6,7,8,10,11 Oklahoma Statewide w/4 Centers for Independent Living Statewide/ project only All All 1-10 Oregon All All 1,2,3,8 Pennsylvania South Carolina Statewide w/ Office of Vocational Rehabilitation http://disabilities.temple .edu/atlend Statewide/ project only All All 1,2,3,4,5,7,9,10 All All South Dakota Statewide/ project only All All Users, family members, service providers Users, family members, service providers 1,2,3,5,7,8,9,10 1-10 Survey of State AT Act Projects 5 State Utah Vermont Washington Geographic Area/ Project or Partners Northern Utah/ other agencies cover rest of state Statewide w/ VT Parent Info. Center King County w/ King County Library Statewide/ project only Eligible Ages All Eligible Disabilities All Loan Recipients Users, family members, service providers N/A Service providers Types of Equipment 1,2,4,5,6,7,10 Other Services Provided Assessment, demo, I&R, training Assessment, demo, I&R, training Demo, follow-up, funding assistance, I&R, training Assessment, demo, I&R, training All Adults, older adults All All 1,2,3,5,7,9,10 1,7,9 West Virginia All All Wisconsin Statewide w/ 8 Independent Living Centers (by county) Statewide/ project only http://wind.uwyo.edu /wynot/assistive/bank .asp All All Users, family members, service providers, agencies, vendors, schools Users, family members, service providers, agencies Users, family members, service providers 1-10 1-10 Wyoming All All 1,2,3,4,6,7,9,10 Assessment, demo, follow up, funding assistance, I&R, training Demo, follow-up, funding assistance, I&R Key - Types of Equipment 1 - aids for daily living 2 - augmentative communication 3 - computer access and software 4 - Durable medical equipment 5 - environmental controls 6 - mobility devices 7 - recreation 8 - seating/positioning 9 - sensory aids 10 - toys 11 - transportation Survey of State AT Act Projects 6 stations and access modifications. Few programs insure equipment beyond a project’s umbrella coverage, but states such as Georgia, Idaho, and Minnesota maintain separate insurance for loan equipment. Loan Duration and Associated Fees—While the majority of projects report a two-week to one-month loan period, short-term equipment loans vary from one day to six months. Kentucky offers long-term loans for people with terminal illnesses and may charge a sliding rental fee for short-term loans based on the value of the assistive technology device. Georgia also collects a fee from borrowers for certain AAC devices. Most of the states, however, do not charge consumers for a device loan. Projects such as Maine and Idaho report charging consumers a $5 annual membership fee that can be waived and a $50 to $500 membership fee to organizations, agencies, and schools. A few projects report customer expenses such as a security deposit in Oklahoma, a late fee in Minnesota and Vermont, and a return or shipping and handling fee in Illinois, South Carolina, and South Dakota. A Variety of Staffing Patterns—Variability exists in the staffing of loan programs across states. Some projects maintain paid, credentialed staff such as speech pathologists, occupational therapists, rehabilitation engineers and other assistive technology practitioners (ATPs). Other projects staff programs with volunteers, including persons with disabilities. Staffing is directly linked to the program’s budget, allocation of general project dollars, and number of centers. North Carolina, for example, maintains a total of 17.5 FTE staff located in 11 centers and satellite offices across the state. Sufficient funding to retain qualified staff and train new staff enhances the level of assistive technology services. A Variety of Funding Sources—While the majority of device loan programs are dependent on AT Act funding, many projects diversify efforts by combining federal funds with state appropriations, foundation grants, and donations. Iowa’s equipment loan program receives funding from Easter Seals and the Center for Disabilities and Development. Illinois received $500,000 in state funds for equipment loan activities in 2001. Missouri’s budget of approximately $200,000 includes general state revenues. Nebraska received $300,000 from the Department of Labor for the TechTry program. Delaware secured state and federal grants in addition to AT Act funding for a budget of $280,000. Utah makes small grants available to other agencies to support loan closets and the state project received $35,000 in one-time funding for the Center for Assistive Technology. South Dakota received a $2 million legislative appropriation over 2 years to assist individuals with neuromuscular diseases. Ongoing funding—the high cost of adding new devices and keeping inventory current to meet statewide demand—remains one of the greater challenges of sustaining device loan programs. Survey of State AT Act Projects 7 Table 2. Equipment Loan Program: Loan Details, Tracking, and Budget State Arkansas Loan Terms 2-6 weeks Loan Fees None Number of Loans Last Year 426 Loan Tracking Computer software Statewide information system Loan agreement form Budget/Source $30,000; AT Act dollars $280,000; AT Act dollars, other state and federal grants AT Act dollars Comments Person using AAC device must have training in its use Program for instate residents only Program is cross age, disability and any agency affiliation Loan program operated through demo center Interagency partnerships and innovative outreach efforts. Delaware 2 weeks, can be extended District of Columbia 4 weeks None, borrower responsible for replacement if lost or damaged None 692 45 Florida 30 days None 6-7 per month Computer software, log book Database tracking system $30,000 from AT Act $20,000; AT Act dollars, state funds, donations, events AT Act dollars Private funding for equipment $104, 062 with $10,000 from AT Act dollars, other grants, donations, United Way $500,000 State GRF in 2001 Georgia Varies from 1 week to 2 months Guam Hawaii 30 days 6 weeks Fee charged to VR; fee on some AAC; shipping & handling None None 3468 (average of 289 items on loan each month) 56 15 ID tags and forms Computer database MS Access database Idaho 2 weeks to 3 months $5 annual fee for consumers, $50$500 for agencies, schools 827 Loan banks need to be available on neighbor Islands Annual fee is waived if consumer cannot pay. Borrowers must belong to program. Illinois 4-6 weeks Return S&H fee 616 Computer database Survey of State AT Act Projects 8 State Indiana Iowa Loan Terms 90 days As long as needed; 3-6 months for AEAs and CDD 3 weeks to 6 months Loan Fees None None Number of Loans Last Year 27 N/A Loan Tracking Computer program Computer software Budget/Source $25,000 from AT Act $20,000 to Easter Seals; $10,395 to CDD Comments Kansas None 1834 Computer software and bar code Software and bar code $22,000 State funds; $22,000 AT Act AT Act, usage fees, state and foundation grants, donations and fundraising events $145,000; AT Act, membership fee, fee for service, grants AT Act dollars, donations, grants, subcontracts Kentucky 30-90 days Maine 2 weeks to 1 month $10-$150 rental fee based on value, $25-$35 S&H, late fee and replacement or damage fee Late fee to begin 9/1/04 2298 IPAT works with Easter Seals, AEAs and CDD to develop their own loan programs Funding partners can request preference to consumer base Long-term loan for terminal illnesses, toy adaptations 465 Computer software and bar code Case files and paper tracking Program requires annual membership Operates 3 centers across the state: Baltimore, Eastern Shore and West MD Aug. Comm. only Offer 90 day loans Partnership with schools provides equipment loan, reimbursement and outcome data Maryland 3-6 weeks Return shipping, $25 computer rental at Eastern Shore center Late fee None None N/A Minnesota Mississippi Missouri 30 days 90 days 6 weeks, can be extended 211 138 1265 Database Database and forms Bar code $38,400; AT Act provided $5000 AT Act dollars $200,000; General State revenue, AT Act, dedicated state funds Survey of State AT Act Projects 9 State Montana Loan Terms 1 month Loan Fees None Number of Loans Last Year 407 Loan Tracking Bar code, computer database Budget/Source $10-20,000 allocated for equip. purchases Comments Advertises through program web site, newspapers, materials, fact sheets. Nebraska 2 weeks to 1 month None 10 (TechTry since April 1, 2004) Website and paper copies of loan agreement forms $10,000-$25,000 from AT Act and VR; $300,000 from Dept. of Labor for TechTry AT Act general dollars $70,000; AT Act Donation and CNMI Choice Program AT Act dollars North Carolina 2 weeks None (no shipping) $10-$40, late fee None (S&H may be requested by other islands) Security deposit at some sites Rental fee None 2566 Computer database Computer database Manual tracking, phone call, letter Computer database, bar codes Paper tracking Computer software TechTry is a ―try it before you buy it‖ program for employers and employees. Must be work related. Satellite sites give easier access to AT North Dakota Northern Mariana Islands Oklahoma 6 weeks 6 weeks 938 10 6 weeks to 3 months 2 weeks to 1 month 2-8 weeks 386 Oregon Pennsylvania 5,500 devices 4,000 requests Service to Groups grant $810,000 state funds; approx. $30,000 federal support (AT Act) South Carolina 2 weeks to 30 Return shipping 114 Bar code AT Act dollars 170 volunteer ―local branches‖ promote program and assist consumers with loan applications Program located Survey of State AT Act Projects 10 State Loan Terms days Loan Fees Number of Loans Last Year Loan Tracking Budget/Source Comments on same floor as USC Pediatrics Clinic for easy access to MD, staff and patients $2 million legislative appropriation over 2 years for neuromuscular diseases State project provides small funds to other agencies to replace/expand equipment South Dakota 2 weeks to 30 days S&H on computers 200 Tracking log $16,000; AT Act Utah Depends None 175 Paper form $18,000 AT Act; $35,000 one time State funds to UCAT Vermont Washington 30 days 2 weeks $25/day late fee None 75 (9 months) 30 Paper system Card catalog AT Act dollars $1,000; AT Act Part of traveling library, patrons can check out equipment West Virginia Wisconsin 1 month 2 weeks to 30 days 2 months Shipping & handling None 45 125-250 (varies by center) 37 Paper system Computer software Software AT Act $23,000 AT Act, general Tech Act, other funds AT Act dollars Program is operated through 8 ILCs Wyoming None Survey of State AT Act Projects 11 Marketing and Pooling of Resources to Increase Numbers Served—The majority of loan programs report a few hundred users per year through computerbased tracking such as a software database or bar code system. Indeed, the capacity to lend a variety of devices contributes to the variability of users or borrowers from state to state. Awareness of the location of assistive technology centers, however, is the first step toward getting technology in the hands of those who need it most. Marketing to a state project’s population base, therefore, is a key component of continued success. Program marketing consists of many formats including newsletters, brochures, conferences and training events, websites, and in-person outreach. Several states have pooled their resources to increase the numbers served. The Mid-Atlantic Accessible Education-Based Information Technology Consortium is an example of states getting together with the goal of reaching as many people as possible. The consortium comprises six state projects funded under the authorization of the AT Act: Pennsylvania, Delaware, Maryland, Virginia, West Virginia, and the District of Columbia. The Institute on Disabilities at Temple University coordinates the consortium. Equipment Loan Program Spotlight: Pennsylvania’s AT Lending Library The Institute on Disabilities, University Center of Excellence in Developmental Disabilities, at Temple University in Philadelphia is the lead agency for Pennsylvania’s Initiative on Assistive Technology (PIAT). Established in 1992, PIAT maintains Assistive Technology Resource Centers (ATRCs) in locations across the Keystone state: Community Resources for Independence, Three Rivers Center for Independent Living, Life and Independence for Today, United Disability Services, Center for Independent Living of Northcentral Pennsylvania, United Cerebral Palsy of Central PA, UCP of Northeastern PA, and Easter Seals. As a result of conducive public policy (the ―Governor’s Disability Agenda‖ set by then-Governor Ridge) and advocacy, in 1997 the Pennsylvania General Assembly appropriated funds to provide free equipment loans to people with disabilities and older Pennsylvanians across the state. As the designated ―lead agency‖ for the Assistive Technology Act program, the Institute on Disabilities was designated to implement Pennsylvania’s Assistive Technology Lending Library. Funded by private contributions as well as federal and state dollars, Pennsylvania’s Technology Lending Library partners with 170 volunteer ―local branches‖ to promote the program and assist consumers in completing loan applications. State funding for the program has ranged from $500,000 to $890,000, and the 2005-06 appropriation is anticipated at $810,000. In addition, the program leverages contributions from vendors and manufacturers as well as from individuals who have benefited from the program. Survey of State AT Act Projects 12 In order to serve as many potential consumers as possible, Pennsylvania’s Assistive Technology Lending Library (the ―Lending Library‖) contacted organizations throughout Pennsylvania with the goal of placing a local branch in each of the state’s 67 counties. For effective outreach, the device loan program sought applications from organizations to establish local branches that were already natural sources of information and assistance for persons with disabilities. Given the geography and demographics of the state, it was recognized that there was a need to provide Pennsylvanians easier access to assistive technology resources. The program targeted local branches in places where people could meet—non-profit and advocacy organizations, resource centers, libraries, local governments, independent living centers, colleges, and volunteers in the business community. To qualify as a local branch, volunteer agencies must adhere to access requirements of the Americans with Disabilities Act and agree to provide the following: 1. Outreach information about the Assistive Technology Lending Library. 2. General assistance to consumers regarding the Assistive Technology Lending Library inventory. 3. Referral to other resources for evaluations, assistance with product selection, more information regarding items in the lending library catalog, and referral for funding assistance. 4. Assistance to consumers regarding completion of the device loan application. Local branches also provide optional services: 1. Information to consumers regarding status of device loan applications. 2. Interim contact with consumers during their loan period. 3. Follow-up contact with late returns. 4. Free set-up and training on assistive technology devices. 5. House a selection of assistive technology devices for demonstration and use in outreach efforts. In addition to publicity, visibility, and public recognition, local branches receive the following: 1. Assistive Technology Lending Library resource inventory book and information about the policies, procedures, and inventory of the library. 2. Materials relating to promoting the Assistive Technology Lending Library, applications, and general assistive technology information, in print and alternate formats including a quarterly newsletter, the AT Focus. 3. Training and technical assistance. 4. Invitations to attend product trainings demonstrations and trainings, either at reduced or no cost. 5. Opportunities to host training events. Survey of State AT Act Projects 13 Access to functional equipment is extremely important since assistive technology is expensive and often cannot be returned or easily replaced if a poor purchase decision has been made. The current inventory includes an extensive selection of devices that help people communicate with others, control their environment, hear what others are saying, perform everyday activities, access computers, and read printed materials. Those who wish to borrow a device can call toll free to obtain a loan application or pick one up from a local lending library branch or download an application from the web. The centralized inventory is housed in southwestern Pennsylvania. There is no cost to consumers for delivery and pickup of loan devices, which is handled through UPS. 2004-05 shipping costs are expected to reach $100,000. A specified loan period is displayed in the equipment catalog and a borrower who requires assistance learning how to use a device can call a regional ATRC toll free to locate available resources for assistance or services of a support person. The Lending Library does not provide such support, although minimal troubleshooting may be available by phone. ATRCs play a key role in assuring the library is ―consumer responsive‖ while at the same time consumers are ―responsible borrowers.‖ ATRCs follow a set of policies and procedures that help maintain communication with borrowers and reduce loss (e.g. notice of when the device is going to be shipped, or if they have to wait for a device, suggestion of alternate devices: reminder of approaching the end of the loan period; follow up with devices that are returned with missing components). Borrowers receive a ―Satisfaction Survey‖ several weeks after an item is returned. This survey also asks for a report on any outcomes, including plans to purchase the device (and who will pay). The survey also directs borrowers to contact Pennsylvania’s Initiative on Assistive Technology for additional assistance in identifying the devices and services they need, or for assistance in finding funding for those devices and services. The evaluation component is funded through federal dollars, as is a portion of staff support in processing applications in SE Pennsylvania. Survey of State AT Act Projects 14 EQUIPMENT EXCHANGE AND EQUIPMENT RECYCLING PROGRAMS Background Equipment exchange programs match individuals who require assistive technology devices with people donating or selling used equipment that is no longer needed by publishing a list of items wanted and items for sale in an electronic or print format. The actual transaction, including payment and delivery of an item, is negotiated between the buyer and seller. Exchange programs regularly follow up with a phone call, e-mail, or mail survey to assess satisfaction or determine if an item is still for sale. An increase in availability of assistive technology and a reduction in cost of devices are essential to meeting the needs of citizens with disabilities. Equipment recycling programs receive, recondition, and store used assistive technology devices for re-use either by selling or donating to persons needing such devices. An associated higher level of services and cost clearly exists with refurbishing assistive technology that might otherwise be discarded, but the increased investment and involvement results in a greater reward, especially for individuals who cannot afford to buy personal devices. Recycling programs offer assistive technology and computers through a website and on-line listing. Computers, wheelchairs and other durable medical equipment are most commonly recycled. Certain restrictions may apply to devices that will be accepted such as the age of the computer or operability of the DME. Computers, in general, must be Internet capable and possess a specified processor. The programs are promoted via web sites, newsletters, brochures, and presentations. Outreach to participants is often coordinated with other agencies to pick up, store, clean or refurbish, and deliver used equipment. Findings Thirty states report operating equipment exchange and/or recycling programs (Tables 3, 4, 5, and 6). Nine have an exchange program only, eleven only recycling, and ten operate both. All projects operate statewide except in Florida, where service is currently dedicated to persons residing in the northwest part of the state. Staff associated with the state projects provide most of the services. The most popular items to exchange or recycle are computers, DME such as wheelchairs, walkers, and beds, and other forms of assistive technology devices. The programs are promoted via web sites, newsletters, brochures, presentations, and other outreach. Range of Services and Associated Fees—Exchange programs comprise a published list of items for sale or items wanted. There is minimal, if any, involvement by the project in actual negotiation or delivery of an item between the buyer and the seller. In recycling programs, on the other hand, a third party Survey of State AT Act Projects 15 is typically involved, which may include pick up and delivery of items, storage, and refurbishing. There is clearly an associated higher cost with equipment recycling, but also a higher level of services and involvement. While most exchange programs do not charge fees, a number of recycling programs have a implemented a fee for services. For example, Florida charges $35 per system and Ohio charges $25 for computer recycling. Some states, such as Georgia and Louisiana, report a delivery or shipping and handling fee. Maine has a $50 annual membership fee. Programs Primarily Funded by General AT Act Dollars—Most of the exchange and recycling programs are funded by general AT Act dollars. However, some states, such as Florida, Georgia, Missouri and Pennsylvania, have designated a few thousand to tens of thousands of dollars for their projects. Kansas received a $200,000 in-kind match by the lead agency. Nebraska received $100,000 from state programs and grants. And in Utah, the state provides funding for personnel space. Quantifying Benefits by Tracking Equipment Value—A few states were able to quantify benefits of their exchange or recycling programs by tracking the value of the equipment through the program. For example, Kansas’ equipment exchange program brought back $267,000 worth of equipment in its first year. In Nebraska, TechConnectors provided 80 used computers to vocational rehabilitation clients at an estimated savings of $80,000. In Oklahoma, the costbenefit of the exchange program last year was $163,002. A Variety of Innovative Practices—There are several innovative practices among the states. Connecticut uses a business model with its NEAT Marketplace. The Marketplace includes 25,000 square feet of computer lab, displays, accessible meeting and classroom space. Organizations, vendors and evaluators pay fees to use the services, which help sustain the operation. They are looking to make this a regional program to leverage costs among neighboring states. In Georgia, the ReBoot program operates with 85% consumer involvement. Indiana is working toward a statewide clearinghouse for all exchange programs. The Iowa project supports refurbishing by Easter Seals. In Louisiana, recycled computers are delivered to the home. Nebraska’s TechConnectors program offers recycled assistive technology and computers through a web site and on-line listing. In Maine, surplus equipment is donated to Costa Rica through the Rotary Club, and computers are donated to families. North Carolina contracts with a private nonprofit organization to operate its Technology Exchange Post equipment listing. Survey of State AT Act Projects 16 Table 3. Equipment Exchange Programs: Populations Served, Types of Equipment, Restrictions, and Fees State Arkansas Exchange Exchange Geographic Area Served Statewide Eligible Ages All Eligible Disabilities All Equipment Types Mostly DME (Recycling) All (Exchange) Any AT devices, DME Computers, AT, cell phones, DME Restrictions Recycled devices repaired in house Delaware and surrounding region Pentium 1 or faster Program Fees None Other Services None Delaware Exchange Statewide All All None Georgia Exchange www.gatfl.org Statewide All All Idaho Exchange Statewide All All Indiana Exchange Statewide All All Vehicles, wheelchairs, beds, lifts, walkers All including vehicles None Delivery, S&H (ReBoot computer recycling). None for GTrade (equip. exchange) None Assessment, software & computer training. In working condition Iowa Kentucky Exchange http://http://www. Uiowa.edu/infotech/ UERS/HTM Exchange www.katsnet.org Statewide All All All (primarily DME and vehicles) All (Exchange List) Computers (recycling) All None None for free listing, fee for items listed for sale None Assessment and I&R through state project Evaluations available for a fee None Statewide All All Missouri Exchange Statewide All All Items on Exchange List ―as is;‖ working devices for recycling None Technology fee for people receiving computers None All services provided Services provided through AT program Survey of State AT Act Projects 17 State New York Exchange Exchange www.oapwd.org Both Geographic Area Served Statewide Eligible Ages All Eligible Disabilities All Equipment Types AT devices (non medical) All (Exchange Post) Computers (Christina Foundation and AT Project All Restrictions None Program Fees None Other Services I&R, printed materials Informal assessment, try out, loan, training, follow up as needed North Carolina Statewide All All North Dakota Exchange www.ndipat.org Recycling www.atohio.org Exchange http://oec.okstate.edu Both Exchange Exchange Statewide All All None (Exchange Post) Recycled computers stay in region (ATP) None None (no shipping) None Ohio Statewide All All Computers None $25 I&R Oklahoma Statewide All All All None None Follow up Oregon Pennsylvania South Dakota Statewide Statewide Statewide All All All All All All DME All All Equipment in good condition None None Listing fee None None Same as loan library None Assessment, delivery, training Phone assistance None Utah Washington Exchange Exchange http://wata.org Exchange Exchange (varies by ILC) Statewide Statewide All All All All All All None None None None West Virginia Wisconsin Statewide By County All All All All All All None None None Varies None All Survey of State AT Act Projects 18 Table 4. Equipment Exchange Programs: Service Provided, Number of Users, and Budget State Storage Refurbishing Pick-up/ Delivery Yes Number of Users/Listings Last Year 136 people, 145 devices 146 Follow-up Budget/Source Comments Arkansas Yes Yes Phone and survey Phone/E-mail AT Act general dollars AT Act general dollars $40,000 (ReBoot); $1500 (G-Trade); $45,000/center from AT Act AT Act dollars General AT Act dollars Delaware No No No Georgia Yes Yes Yes 242 recipients Satisfaction surveys by phone, mail, email, visits Equipment listing is kept current Phone call DME vendors donate some parts Program acts as broker only with web-based listing ReBoot 85% operated by consumers. Idaho Indiana No No No Yes No Yes 57 people, 175 devices 86 listings; 27 matches Iowa Yes Yes Yes N/A N/A N/A Kentucky Yes Yes Yes 371 computers (recycling program) N/A AT Act general dollars Working toward single statewide clearinghouse for all exchange programs IPAT maintains listing of used equipment via UERS; IPAT supports refurbishing by Easter Seals KATS operates Exchange List, private group does computer recycling Missouri New York No No No No No No 124 listings; 56 exchanges 169 selling; 216 looking, 6 matches Monthly to check status Telephone call App. $50,000; AT Act Primarily by State; AT project funds materials Staff position is State funded Survey of State AT Act Projects 19 State Storage Refurbishing Pick-up/ Delivery Yes North Carolina Yes Yes Number of Users/Listings Last Year 1020 items (Exchange Post) 150 items, 50 people (ATP) 15 computers (Christina Fdn.) Follow-up Budget/Source Comments Quarterly surveys $17,655 (Exchange Post); other w/ general AT Act dollars Exchange Post operated under contract to private nonprofit North Dakota Oklahoma No No No No No No 125 persons, 132 items Phone and mail satisfaction survey AT Act dollars Oregon Pennsylvania Yes No Yes No No No 237 subscribers, 40 items sold, 24 items donated Telephone survey AT Act dollars and small grant $5000; Title I South Dakota Utah Yes No Yes No Yes No 108 items, purged at 6 months 50 users, 25 exchanges N/A 80 people, 125 devices None State funds AT Act; State funds for 1.5 FTE and space General project Donations $230,000 CIL support, general Tech Act funding, donations Program uses WVATS list serve Program varies considerably by each ILC Began as AT Act program, now provide TA and limited funding Washington West Virginia Wisconsin No No Yes No No Yes No No Yes E-mail None ILC Contacts Survey of State AT Act Projects 20 Equipment Exchange Program Spotlight: Delaware’s AT Exchange The lead agency for the Delaware Assistive Technology Initiative (DATI), established in 1991, is the University of Delaware’s Center for Applied Science & Engineering. DATI supports the operation of Assistive Technology Resource Centers in each of Delaware’s three counties. Delaware’s equipment exchange program is operated by the state project without other entities. Designed to facilitate exchanges only between individuals, not for the use of vendors or distributors, the AT Exchange accepts listings from Delaware as well as neighboring states and includes almost anything related to AT, such as vehicles, hospital beds, and even accessible homes for sale. Participation in the program is free. The exchange program acts only as a broker and therefore transfer of equipment is between potential buyers and sellers. AT Act dollars support the staff that manage the exchange program—one staff person oversees the program as a part of her other job responsibilities and another staff member manages the equipment exchange feature on the website as a part of her job responsibilities. Delaware’s website contains a section on frequently asked questions and lists categories of device entries for easy access as follows: Ambulation/Positioning Communication Computers/Software Controls/Switches Educational Management Hearing Home Management/Accessibility Other Personal Care Recreation Scooters Vehicles/Accessories Survey of State AT Act Projects 21 Vision Vocational Management Wheelchairs/Accessories The exchange program in Delaware provides consumers the ability to reach directly a funding specialist for relevant information pertaining to medical insurance funding for an item purchased on the AT Exchange. The program staff follow-up with equipment matches. Both exchange and recycling programs are also important sources of recreational equipment for persons with disabilities since such assistive technology devices generally are not purchased by public or private funding entities. Equipment Recycling Program Spotlight: Georgia’s ReBoot The lead agency for Georgia Tools for Life, established in 1991, is the Georgia Department of Labor Vocational Rehabilitation Program in Atlanta. Georgia’s Technology Resource Centers are comprised of Disabilities Connections in Macon, Metro Atlanta ATRC/ReBoot in Tucker, TECH-ABLE, Inc. in Conyers, and Walton Options for Independent Living in Augusta. Georgia DOL/VR/Tools for Life Program collaborates with Techknowledge, Center for Assistive Technology & Environmental Access (CATEA) at the Georgia Institute of Technology in Atlanta, a nationally renowned library of resources that is funded by the state of Georgia at no cost to consumers. In collaboration with Friends of Disabled Adults and Children (FODAC) and the above Tools for Life partners, ReBoot was created at the beginning of 1998. A non-profit, collaborative effort of many groups, ReBoot’s 12,440 square foot equipment depot and repair shop promotes ―independence for people with disabilities through computer recycling.‖ The recycling program now partners with more organizations, including National Cristina Foundation (NCF), Closing the Gap, RESNA, and ICAN, Increasing Capabilities Access Network, to enhance recycling and training services to residents of Georgia. Closing the Gap is a leading source on hardware and software applications for persons with disabilities. ReBoot enjoys membership in the NCF Network, which concentrates on computer solutions and training that leads to more independence and productivity. RESNA provides technical assistance and ICAN is a network of assistive technology resources. ReBoot also coordinates with the Georgia Telecommunications Equipment Program, which is a valuable resource for Georgians who are hard of hearing. The 6 ReBoot training centers located in Georgia are operated by people with disabilities, for people with disabilities. Dedicated volunteers account for 85% of the ReBoot staff that acquires, evaluates, repairs, upgrades, and distributes Survey of State AT Act Projects 22 recycled computers. The program charges $10 for the disposal of non-working computers, monitors, and printers. Contributions of working Pentium computers, monitors, keyboards, printers, software, speakers, cables, modems, and other accessories are tax-deductible. A corporate donor proclaimed, ―Everyone wins with ReBoot! Not only do we get to clean out our desks and closets of our older equipment, but, we get a tax deduction, we save the environment, volunteers get to learn about computer evaluation and repair, and people with disabilities receive darn good computer equipment. What an idea!‖ ReBoot readily accepts donations of many different items: office furnishings and supplies, material handling equipment, cars, trucks and other vehicles, pallet racking and shelving, forklifts, medical equipment and copiers in addition to laptop computers, desk top computers, file servers, mid-range and mainframe systems, data communications equipment, current software, and telephone equipment. Through a partnership with CollectiveGood!, a mobile phone recycling resource, cell phones are also accepted by ReBoot. The program uses several adaptive software and hardware packages for recycled computers. Software supports include ScreenReader, WordSmith v2.0, Read and Write, Type & Talk, and JAWS for Windows. Hardware supports include alternative keyboards, IntelliKeys, adapted keyguards, and a switchadapted trackball. It only costs an average of just over $250 to recycle each computer. The amount is not insignificant, but the investment is worth every penny, especially when it makes a difference in communicating, learning, working, and promoting independence for persons with disabilities. Access to the ReBoot Computer Re-utilization service begins with an application and volunteer tracking form. Donations and volunteers keep the waiting list moving as quickly as possible. Upon receipt of an application, including the selection of computer packages and a signed agreement, a consumer is notified of participation in the program. The director of ReBoot attributes its effective recycling program to an approach that focuses on the following keys to success: 1. Stand by your vision and mission, your guide in all matters. 2. Know where you can find pockets of money. Reuse programs require tools, parts, and operational support to meet production goals. 3. Keep it simple. Just a few essential forms to track activities will suffice. Electronic communications, on-line applications, and database management without paper is even better. 4. Develop relationships with potential corporate partners. 5. Market services by targeting the donors you want. Don’t get overwhelmed by donations. 6. Tell donors what you will and will not accept. Be selective. 7. Identify program needs—volunteers, transportation, sources of funding. 8. Let the input of your customers shape services. Survey of State AT Act Projects 23 9. Increase customer ownership by providing on-the-job training through opportunities to volunteer. 10. Develop numerous relationships with community organizations to increase involvement with underserved and rural populations. 11. Respect and appreciate all of your volunteers—PC user groups, corporations, and customers. 12. Identify individual goals so each applicant receives an appropriate computer system. Survey of State AT Act Projects 24 Table 5. Equipment Recycling Programs: Populations Served, Types of Equipment, Restrictions, and Fees State Arkansas Recycling Recycling Geographic Area Served Statewide Eligible Ages All Eligible Disabilities All Equipment Types Mostly DME (Recycling) All (Exchange) Higher end items, not computers Computers Restrictions Recycled devices repaired in house Some restrictions on consignment items Must be Internet capable Pentium 1 or faster Program Fees None Other Services None Connecticut Florida Recycling www.neatmarketplac e .org Recycling Statewide All All Membership fee for vendors $35 per system Delivery, S&H (ReBoot computer recycling). None for GTrade (equip. exchange) None Up to 30 day trial Northwest Florida Statewide All All Georgia Recycling www.gatfl.org All All Computers, AT, cell phones, DME Basic HW/SW instruction Assessment, software & computer training. Guam Recycling Island of Guam Statewide All All Indiana Recycling All All Wheelchairs, crutches, walkers All including Vehicles None In Working Condition None for free listing, fee for items listed for sale Assessment, try out, follow-up Evaluations available for a fee Survey of State AT Act Projects 25 State Iowa Recycling Recycling http://http://www. Uiowa.edu/infotech/ UERS/HTM Recycling www.equipment exchange.ku.edu Recycling www.katsnet.org Geographic Area Served Statewide Eligible Ages All Eligible Disabilities All Equipment Types All (primarily DME and vehicles) DME Restrictions None Program Fees None Other Services None Kansas Statewide All All None Follow up Kentucky Statewide All All Louisiana Recycling Statewide All All All (Exchange List) Computers (recycling) Computers Items on Exchange List ―as is;‖ working devices for recycling None Maine Recycling www.tecmaine.org Statewide All All Wheelchairs, DME, computers Maryland Recycling Specific counties All All Missouri Recycling Statewide All All ADLs, AAC, DME, computer HW/SW All Computers w/Pentium or higher; wheelchairs less than 5 yrs. Old Computers by age and condition None Technology fee for people receiving computers Shipping and small fee on some equip. $50 annual membershi p fee All services provided Assessment, try out, follow up None Consults for appropriate matches Services provided through AT program None Survey of State AT Act Projects 26 State Montana Recycling Recycling http://ruralinstitute.umt.e du/HDC/maep.asp Geographic Area Served Statewide Eligible Ages All Eligible Disabilities All Equipment Types Computer hardware, adaptive equipment Restrictions None Program Fees None Other Services All Nebraska Recycling www.techconnectors .net Recycling Recycling Statewide All All All None None I&R, funding assistance Nevada North Carolina Statewide Statewide All All All All All All (Exchange Post) Computers (Christina Foundation and AT Project Computers None None (Exchange Post) Recycled computers stay in region (ATP) None None (no shipping) Follow up Informal assessment, try out, loan, training, follow up as needed Ohio Recycling www.atohio.org Recycling Recycling Statewide All All None $25 I&R Oregon South Dakota Virgin Islands Wisconsin Statewide Statewide All All All All DME All Equipment in good condition None Listing fee None Recycling Virgin Islands All All Computers, wheelchairs All None None Recycling (varies by ILC) By County All All Varies Same as loan library Assessment, delivery, training AT resource centers for try out All Survey of State AT Act Projects 27 Table 6. Equipment Recycling Programs: Services provided, Numbers of Users, and Budget State Storage Refurbishing Pick-up/ Delivery Yes Number of Users/Listings Last Year 136 people, 145 devices 10,000 people, Approximately 350 major items Follow-up Budget/Source Comments Arkansas Yes Yes Phone and survey None AT Act general dollars $50,000 startup from AT project, now at $5M operation Connecticut Yes Yes Yes DME vendors donate some parts Uses business model with multifunction center. Fees for organizations, evaluators and vendors. ReBoot 85% operated by consumers. Florida Georgia Yes Yes Yes Yes Yes Yes 80 242 recipients Guam Indiana Yes No Yes Yes Yes Yes 25 86 listings; 27 matches Satisfaction surveys by phone, mail, email, visits Site visits, phone calls Phone call $10,000; AT Act $40,000 (ReBoot); $1500 (G-Trade); $45,000/center from AT Act General AT Act, donations General AT Act dollars Iowa Yes Yes Yes N/A N/A N/A Working toward single statewide clearinghouse for all exchange programs IPAT maintains listing of used equipment via UERS; IPAT supports refurbishing by Easter Seals Survey of State AT Act Projects 28 State Storage Refurbishing Pick-up/ Delivery Yes Kansas Yes Yes Number of Users/Listings Last Year 600 + users Follow-up Budget/Source Comments Telephone Kentucky Yes Yes Yes 371 computers (recycling program) N/A $200,000 in-kind match by lead agency; federal match by State Medicaid AT Act general dollars Louisiana No No Yes 10 computers Phone call AT Act dollars, some donations Maine Yes No Yes Maryland Yes Yes Yes N/A Not at present AT Act dollars, donations, grants App. $50,000; AT Act $101,000 from state programs and state grants KATS operates Exchange List, private group does computer recycling Computers are delivered to home Surplus equipment donated to Costa Rica, computers donated to families Provide TA, training and computer repairs Missouri Nebraska No Yes No Yes No Yes 124 listings; 56 exchanges 189 recycled items, 110 recycled computers Monthly to check status Not at present TechConnectors offers recycled AT and computers and website w/online classifieds Nevada Yes Yes Yes 1000 clients annually Phone contact and surveys AT Act dollars and donations Survey of State AT Act Projects 29 State Storage Refurbishing Pick-up/ Delivery Yes North Carolina Yes Yes Ohio Oregon South Dakota Virgin Islands Wisconsin Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Number of Users/Listings Last Year 1020 items (Exchange Post) 150 items, 50 people (ATP) 15 computers (Christina Fdn.) 120 people Follow-up Budget/Source Comments Quarterly surveys $17,655 (Exchange Post); other w/ general AT Act dollars Exchange Post operated under contract to private nonprofit Collect feedback $50,000 AT Act dollars and small grant State funds 20 computers 80 people, 125 devices ILC Contacts AT Act dollars $230,000 CIL support, general Tech Act funding, donations Program varies considerably by each ILC Survey of State AT Act Projects 30 ASSISTIVE TECHNOLOGY DEMONSTRATION CENTERS Background Equipment demonstration centers allow consumers, families, and community organizations the opportunity to see the latest technology, get a demonstration or training on specific devices, ask questions of trained staff, and receive funding or other purchasing assistance. Although expensive to maintain and staff, demonstration centers serve a unique role since most assistive technology devices are not readily available in commercial retail outlets. Experimentation with new and existing devices is essential to making the right choice. Demonstration centers provide hands-on training and evaluation of the correct assistive technology to enhance the everyday activities of persons with disabilities. Findings Thirty-eight states report operating assistive technology demonstration centers (Table 7). All centers serve all ages and all disabilities. Almost all centers provide a complement of services to help visitors. This can include assessment, demonstration, funding assistance, short-term loan, and training. A Variety of Partnerships and Number of Centers—The number of centers in each state ranges from one to as many as 12 in New York, 15 in Michigan and over 20 in Missouri. Several projects support centers in cooperation with partner agencies. For example, Kansas maintains five centers with Rehabilitation Services. Kentucky coordinates a network of regional AT centers. New York operates its centers with Early Intervention programs. Missouri presents 21 programs from Independent Living Centers, five with community organizations, and 40 through individual contractors. Oklahoma operates six of its 11 centers with area agencies on Aging and four with Centers for Independent Living. Vermont maintains centers at four locations: a vocational rehabilitation office, a technical college, a parent information center, and in the main project office. Delaware exhibits one center in each of its three counties. Associated Fees—Although many centers do not charge a fee to access a number of available services, several projects, including Georgia, have begun fee for services. Idaho collects minimal fees, demonstration centers in Kansas and North Carolina invoice third party agencies when possible, and Indiana charges for a full evaluation. Vendors, evaluators, and community organizations pay fees to utilize Connecticut’s NEAT Marketplace, which contains 25,000 square feet of computer lab, assistive technology displays, and accessible classroom and meeting space. Survey of State AT Act Projects 31 A Variety of Staffing Patterns—There is a wide variety of staffing patterns for centers from fully-credentialed assistive technology providers to allied health professionals (speech and occupational therapists), computer science professionals, educators, assistive technology coordinators, and volunteers. A Variety of Innovative Practices—The survey results reveal a number of innovative practices. Michigan operates through mobile van units and public libraries to focus on hard of hearing seniors and persons with cognitive challenges. Missouri provides assistance to people who need adaptive telephone or computer equipment through the Telecommunications Access Program. South Carolina also works with its state telecommunication equipment loan program. Florida operates a fully accessible cyber café in one of its centers. Georgia enjoys interagency partnerships and innovative outreach with demonstrations in homes and schools. Louisiana provides off-site demos at local malls, agencies, and conferences. Connecticut’s NEAT Marketplace is looking to expand services into neighboring states by operating regional programs. A Variety of Challenges—Many states find it difficult to expand programs due to the costs of buying new equipment or maintaining existing devices. A few of the rural states find it difficult to reach underserved populations. Idaho reports distance to services or the costs of locating centers within reasonable travel distance as a barrier for many individuals. AT Demonstration Center Spotlight: Tennessee’s STAR Center The lead agency for the Tennessee Technology Access Project (TTAP), established in 1988, is the Department of Human Services, Division of Rehabilitation Services in Nashville. TTAP Resource Centers are housed in six regional facilities across the state: East Tennessee Technology Access Center (ETTAC) in Knoxville, Technology Access Center of Middle Tennessee in Nashville, Mid-South Access Center for Technology, University of Memphis Center for Rehabilitation and Employment Research in Memphis, Assistive Technology Center at Signal Centers, Inc in Chattanooga, and West Tennessee Special Technology Access Resource Center (STAR) in Jackson. The STAR Center is a model demonstration, resource, and training center focusing on comprehensive and effective assistive technology service delivery. The Center was founded in West Tennessee in 1988 by a volunteer group of parents, rehabilitation professionals and educators with the assistance of the City of Jackson, Madison County, United Way, community businesses, and private citizens. The STAR Center began in donated space with a staff comprised entirely of volunteers. By 1994, the Center had grown to include ten paid staff members and purchased its own building with contributions from the community, a grant from the State of Tennessee Division of Rehabilitation Service, and local businesses and industry. The STAR Center rapidly added Survey of State AT Act Projects 32 more paid staff to expand services and acquired an additional facility in downtown Jackson. In 2004, under the guidance of CEO and Founder Margaret Doumitt, the Center purchased and renovated a 33,000 square foot facility that will allow the staff of over 50 highly technical professionals and more than 600 volunteers to continue to serve over 17,000 individuals each year. The STAR Center’s Programs and Services Art Therapy – Evaluation and Training Therapists use art-related strategies with principles of psychology to assist children and adults with disabilities toward non-artistic goals: development of cognitive skills, improved attention, memory, and problem solving. Assistive Technology Services – Environmental Controls and Workplace Accommodation Environmental control evaluation provides options for people with disabilities to control their environment independently through the use of voice or movementbased switches or computer commands. This service provides information targeted to customize a work environment or job for an individual’s specific needs in the workplace. Augmentative Communication – Evaluation and Training This program offers children and adults with expressive communication disorders an alternative method of communication. It includes evaluation of speech, language, voice, communication, auditory processing, and/or auditory rehabilitation status. Job Placement, Job Readiness, Job Coaching, Self-Employment, and Supported Employment Services This program assists people with disabilities in preparing for and obtaining competitive employment. Job Readiness teaches resume writing, interviewing, good work habits and interpersonal relationship skills. It also includes follow-up and on-the-job coaching. Self-Employment provides opportunities for people with disabilities to operate their own business. Supported Employment offers individuals with disabilities the opportunity to achieve employment and independence goals with the support of Placement Specialists. High Tech Services – Software Training, Technician Training, and Technology Loan High Tech Training teaches the use of workplace software in order for clients to reach their goals of competitive employment. Technician Training teaches classroom and hands-on proficiency in the following areas: how to build, upgrade, and repair computers; troubleshoot problems; install operating systems and applications; and perform planned maintenance. Survey of State AT Act Projects 33 Music Therapy – Evaluation, Screening, and Training Therapists prescribe use of music and music related strategies to assist or motivate a person towards specific non-musical goals. Therapists use music and musical instruments in a one-on-one setting to effect changes in clients’ cognitive, physical, communication, social, and emotional skills. Outreach, Information, and Advocacy Services Provides information, advocacy, and resources to individuals with disabilities, and promotes public awareness. Personal Assistance and Nursing Services – Direct Care This program is a one-on-one support service for individuals with Developmental Disabilities to ensure opportunities to grow and expand their level of independence both at home and in the community. Nursing care is available for clients with medical needs. Prevocational and Learning Lab Services – Evaluation and Training Computer Access/Assistive Technology Evaluation provides technology and software options to children and adults with disabilities, their families, and professionals in education, rehabilitation, and health services. In the learning lab, people with disabilities use computer technology to achieve their goals of effective learning, efficient working, and/or independent living. Receivables Management – Training This p rogram provides training for people with physical disabilities in the following fields: bill collection, skip tracing, data entry, and check collection pre-certification, and provides job placement upon graduation. Vision Services – Functional Vision, Low Vision, and Orientation & Mobility Evaluation and Training Survey of State AT Act Projects 34 This program offers a variety of services that assist adults and children with visual impairments to learn, work, and live independently. The Low Vision program strives to enable an individual to use their remaining vision as effectively as possible. The Orientation and Mobility program provides individuals with skills and adaptive equipment, which enable them to develop their ability to travel independently using one-on-one instruction. Vocational Assessments – Evaluation Vocational assessments identify an individual’s job-related strengths, weaknesses, abilities, and interests. The STAR Center also developed the first mobile assistive technology bus in the nation, The Access Express. The Access Express is a 42 foot long mobile technology bus that travels the roads of 21 counties in West Tennessee and goes to the people who cannot come to STAR. The bus is equipped with the capacity to perform services offered at the STAR Center’s programs on-site including: 1. Computer Access Evaluations for STAR's vocational rehabilitation program. 2. Assistive Technology Evaluations aimed at school-age children in the development of Individual Educations Plans. 3. Augmentative Alternative Communication Evaluations for children and adults who experience challenges with speech. 4. Workplace and Home Accommodation Evaluations to achieve high levels of independence. 5. Outreach Services target AT awareness at schools, universities, hospitals, and conferences. All of the services provided by the STAR Center reflect the foundation of the Center's mission and values to "ensure that all individuals with disabilities or other special needs maximize their potential for independence and achieve their personal goals of employment, effective learning, and independent living through assistive technology, assistive aids, and support services." The rapid achievements of the rural West Tennessee STAR Center paved the way for the development of the East Tennessee Technology Access Center in Knoxville and the Technology Access Center of Middle Tennessee in Nashville. Survey of State AT Act Projects 35 Table 7. Technology Demonstration Centers: Populations Served, Services Provided, Fees, and Number Served State Number of Demo Centers/ Partners 1 Eligible Ages Eligible Disabilities All Services Provided Assessment, demo, follow up, funding assistance, I&R, short term loan, training Demo, I&R, short term loan, training, funding assistance via low interest loan program Demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, funding assistance, I&R, short term loan Assessment, demo, follow-up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, funding Program Fees Number of Visitors/Demos Last Year 670 Comments Arkansas All None Connecticut 1 w/NEAT Marketplace www.neatmarket place.org All All Delaware 3 All All Vendors pay for booth space, get more with membership fee None 10,000 Uses innovative business model with multifunction center One center in each county 1356 District of Columbia 1 All All Only for service providers who use the center for evaluations None 600 Florida 4 w/other partners All All 2000 Center is set up in different stations for AAC, blind & VI, etc. Fully accessible ―cyber café‖ in one demo center Georgia 5 www.gatfl.org All All None 4744 requests 2959 I&R services Interagency partnerships & innovate Survey of State AT Act Projects 36 State Number of Demo Centers/ Partners Eligible Ages Eligible Disabilities Services Provided assistance, I&R, short term loan, training Program Fees Number of Visitors/Demos Last Year 1068 provided AT 1713 training/TA Comments Guam 1 All All Hawaii Idaho 3 w/Tutu’s House, Kauai, and Lihue Public Library 3 w/UCP of Idaho and Kootenai Medical Center All All Assessment, demo, follow-up, funding assistance, I&R, short term loan, training Demo, I&R, shortterm loan, training None 511 outreach. AT demos in homes, schools and TA for IEPs. Also work closely with VR AT staff. Has teleconference capability w/ISDN Only for extensive training Minimal and can be waived 300 Extensive computer resources available All All Illinois 1 www.iltech.org All All Indiana 1 All All Assessment, demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, I&R, short term loan Assessment, demo, follow-up, funding assistance, I&R, short term loan, training 552 None 322 Full evaluation at $100/hour 7 Survey of State AT Act Projects 37 State Kansas Number of Demo Centers/ Partners 5 w/ KS Rehabilitation Services Eligible Ages Eligible Disabilities All Services Provided Assessment, demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, funding assistance, I&R, short term loan, training Demonstration, funding assistance, I&R, training Assessment, demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, funding assistance, I&R, short term loan, training Demonstrations Program Fees rd All None (3 party fees collected when possible) Number of Visitors/Demos Last Year 2310 Comments Kentucky 6 w/AT Regional Centers All All Louisiana N/A All All Fees based on services provided, sliding scale and can be waived None 1414 (from three centers) 458 people Extensive staff experience, good vendor relationships, open lab weekly Demos are done off-site at malls, agencies, conf. Maine 1 w/other entities All All Maryland Michigan 3 w/Holly Community, Inc., Western MD Hospital, Division of Rehab. Services 15 w/local projects All All None N/A Consumers help run center at Western MD Hospital All Hard of hearing, seniors, cognitive disabilities None 621 visitors Uses mobile units and libraries Survey of State AT Act Projects 38 State Mississippi Number of Demo Centers/ Partners With TK Martin Center, Dept. of Mental Health, Univ. of Southern Mississippi 21 IL Centers; 5 community organizations; 40 contractors 1 Eligible Ages Eligible Disabilities All Services Provided Assessment, demo, training Program Fees Number of Visitors/Demos Last Year Comments All One center has fees Missouri All Montana All Individuals who need adaptive telephone or computer equipment All Nebraska 5 w/State agencies and VR programs All All New York 12/ NYS Early Intervention Program All All Device delivery through Telecommunicati ons Access Program (TAP) Assessment, demo, follow up, funding assistance, I&R, short term training Assessment, demo, funding assistance, I&R, short term training Demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, funding assistance, I&R, short term loan, None 4369 device demos All demos lead to obtaining a device through TAP 1.0 FTE O/T, 0.5 FTE P/T, 0.5 FTE Electrical Engineer, 0.5 FTE AT user Demo centers provide variety of equipment for IL and employment None 802 people None 125 people None North Carolina 11 w/ local partners All All Fees to agencies for assessments, feature matching, TA, 4279 received demos, 2679 children received equipment loans 12,306 NCATP staff (17.5 FTE) run 11 regional centers and provide Survey of State AT Act Projects 39 State Number of Demo Centers/ Partners Eligible Ages Eligible Disabilities Services Provided training Program Fees Number of Visitors/Demos Last Year Comments North Dakota 1 All All Northern Mariana Islands 1 All All Assessment, demo, follow-up, funding assistance, I&R, short term loan, training Assessment, demo, funding assistance, I&R, short term loan, AT Low Interest Loan Demo, follow up funding assistance, I&R, short term loan, training Assessment, demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow up, I&R, short term loan, training consultation, training, seminars Hourly fee services None 100 Oklahoma 11 w/4 CILs and 6 Area Agencies on Aging 2 w/Portland State University All All None 275 Oregon All All Hourly fee, service package rates Puerto Rico 1 All All None 488 The demo center is the only one in Puerto Rico that serves all needs and disabilities Survey of State AT Act Projects 40 State Rhode Island Number of Eligible Ages Demo Centers/ Partners 2 w/Tech All Access of RI and East Bay Education Collaborative 1 All Eligible Disabilities All Services Provided Short Term Loan Program Fees None Number of Visitors/Demos Last Year 458 visitors Comments Centers serve children and youth; offer lending library South Carolina All TA and consultation None 150 Work with Telecom. Equipment Loan Program South Dakota 4 All All Tennessee 5/ publicprivate partnerships All All Assessment, demo, follow-up, funding assistance, I&R, short term loan, training Assessment, demo, follow-up, funding assistance, I&R, short term loan, training None 30 Flat rate and hourly All centers part of Alliance for Technology Access; also have mobile bus assessment unit 200 (AT Act Center) Utah Vermont 11 w/CILs, AT Project, Services for Blind and VI, Center for Deaf and HH, State Center for AT 4 w/VT Parent Info Center and VT Division of All All Assessment, demo, follow up, funding assistance, I&R, short term loan, training Assessment, demo, follow-up, I&R, short term None All All None Centers located in VR office, technical Survey of State AT Act Projects 41 State Number of Demo Centers/ Partners Voc. Rehab. Eligible Ages Eligible Disabilities Services Provided loan, training Program Fees Number of Visitors/Demos Last Year Comments college, parent info center and project office Virgin Islands 2 All All Washington 1 w/Easter Seals 7 w/Division of Rehabilitation Services Varies by ILC All All West Virginia All All Wisconsin All All Wyoming 1 School age, adult, older adult All Demonstration, funding assistance, I&R, short term loan, training Demonstration, follow-up, funding assistance, I&R Assessment, demo, I&R, short term loan, training Assessment, demo, follow up, funding assistance, I&R, short term loan, training Demonstration, funding assistance, I&R, training None 200 None Varies by center 3687 devices (reported by one center) Programs vary considerably by each ILC None 300 Survey of State AT Act Projects 42 CHALLENGES As a general statement, it can be said that many AT Act projects are doing a lot with a little to operate equipment loan programs, exchange and recycling programs, and demonstration centers. There is great value in providing access to assistive technology devices and services through these programs that reach and impact consumers, families, and providers across states. Several programs operate with relatively small budgets and leverage support from other agencies, volunteers, and the community. As one state remarked, ―The project receives partial funding from other sources, but this is not enough to sustain the project. We are continuously looking at additional funding sources to supplement our project.‖ Another state summarized the concerns of many, ―Without continued Tech Act funding, increased fees will have to be charged, some services will be cut entirely, and fewer services will be available to those who have no other funding.‖ Consequently, a lot of concern has been generated among the states with regard to whether the programs could be maintained without continued federal funding. The lack of continued permanent funding contributes to challenges associated with hiring and retaining qualified staff and maintaining sufficient equipment inventories to meet the demand for AT. According to one state, ―We need sufficient funding to sustain highly qualified staff and sufficient funding to keep equipment inventory current and large enough to meet statewide demand.‖ Another state noted, ―We need funding to maintain staff that have expertise, for training new staff, and continued funding to keep resources up to date and in good working order.‖ In addition to facing challenges with maintaining their programs, most states find it difficult to expand programs due to the costs of buying new equipment or the upkeep of existing devices. One state cited the following as a major expense: ―Upkeep and repair of equipment, and having it ready to loan again. It frequently comes back damaged or not working.‖ Several AT Act projects are trying to develop strategies to sustain programs with little or no new funds. A common strategy is to collaborate with other agencies, either financially or through in-kind partnerships, and to move programs and services off federal funds. Some states, such as Illinois, New York, and Pennsylvania, have obtained state funds. Others, like Iowa, have established contracts with disability agencies such as Easter Seals. There are other creative ways to supplement AT Act funds. Some projects, like Kentucky, Vermont, West Virginia, and Maryland, have physically located centers within other agencies or offices. Several projects, including Georgia, have begun or are considering fee for services and a few states are establishing nonprofits or foundations to attract other types of grants. Nebraska, for example, has expanded programs through grant sources. Survey of State AT Act Projects 43 One state noted, ―We have diversified funding streams to include fee for service, state funds, independent living funds, grants, and fundraising. Some of the centers would not survive without Tech Act funds.‖ AT Act projects provide valuable services to consumers, families, service providers, and agencies across all the states. Equipment loan programs increase awareness of AT and ensure proper choice before purchasing. By borrowing and trying equipment first, an individual can avoid the wrong purchase and thus save money. Exchange and recycling programs reuse equipment that might be discarded or provide a device to someone who may have difficulty affording AT. Demonstration centers allow hands-on access to equipment not readily available to the public. It is costly, however, to display a variety of devices, purchase new equipment, keep devices in working order, and properly staff the centers. The AT Act projects can only help themselves by continuing to widely promote their programs, diversify their funding base, and, in the end, show real value for the people they serve. Survey of State AT Act Projects 44 SAMPLE FORMS FOR STATE AT LENDING /RE-USE ACTIVITIES Survey of State AT Act Projects 45