State AT Program Priorities – August 2012
In response to a request for information about State AT Program activity priorities, a brief on-line survey (5 questions) was
distributed to State AT Program Directors. A total of 41 State AT Program Directors responded and the following summarizes the data submitted.
1. The first question asked Directors to rank the priority of each of the 4 state level activities (as described in the AT Act)
based on consumer needs in their state. Device Loan was the highest ranked priority followed by Reuse, Device Demonstration and Financial Loan.
These rankings are summarized in Table 1.
2. State AT Programs were also asked to rate the level of unmet need in their state for each of the 4 state level activities. For all four
state level activities, the majority of states reported “some unmet needs”. Device Loan was the activity with the largest
number of State AT Programs reporting “significant unmet needs”. Both Financial Loan and Device Demonstration had a large
number of State AT Programs who reported limited unmet needs. This data is summarized in the Table 2.
3. If the State AT Program reported an unmet need, they were asked to describe the verification used to confirm those needs.
- By far the most frequently reported verification for device loan, reuse and device demonstration program unmet needs were extensive waiting lists for devices/services. State AT Programs are simply not able to maintain inventory sufficient to respond to consumer demand, especially for popular high end devices (AAC, iPad based, etc.). One state reported a reuse program closing (one that serves 50% of the state) as verification.
- Many states also reported out-of-date technology in their inventories for device loan and device demonstration as verification of unmet need. Again this problem was greatest for popular high end devices such as AAC devices.
- A few states reported specific areas of the state that the current program did not serve as verification of an unmet need based on geographic location.
- Two states without a financial loan program reported consumer request to establish one as verification of need and another state reported a loan program that is running low on capitol as verification of financial loan need.
4. State AT Programs were asked which of the 4 state level activities they would allocate funding to if additional dollars were
available thru the Section 4 formula. Almost all states indicated they would use additional funding to support Device Loan activities,
which is consistent with this activity being the top ranked priority and an activity with significant unmet need. Reuse and Device
Demonstration were also identified by a large majority of states as activities for which additional dollars would be allocated. A little
less than half of State AT Programs indicated they would allocate additional funding to Financial Loan activities.
This data is summarized in the chart to the left. Please note the split between states that would and would not
allocate additional dollars to financial loan activities was not based on program administration (e.g. whether or not the program was
internal or external). The decision was consistent with the state perceived need for additional funding to meet cash loan demands. Many
states with a cash loan program saw the existing program as adequately funded (regardless of who operated the program). The relatively
few states without a cash loan program were evenly split on allocating new dollars to establish one or not based on state needs. Some states
also reported issues unique to their cash loan program (the bank partner pulled out) as the rationale for not allocating additional
funding to cash loans at this time.
5. State AT Programs were asked to describe the outcome if an additional $100,000 was made available for each of the 4 state level activities.
- By far the most common response was that the additional funding would increase device inventory in reuse, device loan and device demonstration activities – subsequently decreasing or eliminating waiting lists and significantly increasing the number of consumers served. States estimated the increase in individuals served to be from 200 to over 1000 in a year for each of these activities.
- For financial loan, the responses were much more varied (e.g. the additional $100,000 would allow a financial loan program to start up, would allow an existing program to begin direct lending, or would decrease the interest rate through greater interest buy-down.) A couple of states noted that the additional funding would be placed in the loan fund to earn investment income for program sustainment.
- While other state financing activities were not specifically identified in this question, one state reported that the additional funding would be used to develop a cooperative buying program so that AT could be purchased by consumers at a lower cost. Another specifically called out the need for “other” state financing activities that “don't require the consumer to pay.” Based on the calls this State Program receives, they have many people who “don't have the ability to get AT funded through third-party payers and don't have the financial means to buy it themselves (or pay back a loan)”.
- For all 4 activities, many states noted that additional funds would be used for marketing and outreach to ensure equitable access to services.
Based on this survey data, State AT Programs collectively see the greatest consumer needs for expanded device loan and reuse activities.
Obviously individual state needs can vary but overall these two activities were identified as a high priority and more significantly unmet
consumer needs. Additional funding would have a direct impact on both activities by expanding device inventories and significantly increasing
the number of individuals served.