Association of Assistive Technology Act Programs (ATAP)

Copyright © 2006 by the Association of Assistive Technology Act Programs (ATAP)

Permission is granted to use the information contained in this document, but users are requested to acknowledge ATAP as the author and source.

Acknowledgements

ATAP wishes to thank the following for their assistance and support during the process of compiling this research.

• Director and Staff from the National Assistive Technology Technical
• Assistance Partnership
• Chairperson of the Kansas Assistive Technology Co-operative (KATCO)
• Program Directors and Staff from the following Statewide Assistive
• Technology Programs
  • Colorado
  • Georgia
  • Illinois
  • Iowa
  • Kansas
  • Maine
  • Maryland
  • Missouri
  • Nebraska
  • New Mexico
  • Oregon
  • Pennsylvania
  • Tennessee
  • Virginia

Introduction

When The Assistive Technology Act of 1998 (the AT Act) was reauthorized in 2004, the manner in which the 56 Statewide Assistive Technology (AT) Programs authorized under the AT Act spent their Federal dollars shifted. The Assistive Technology Act of 1998, as amended, supports state efforts to improve the provision of assistive technology to individuals with disabilities of all ages. The emphasis of the new AT Act is to improve access to and acquisition of AT for individuals of all ages and disabilities in four primary areas: education, employment, community living, and telecommunication and information technology.

In order to receive a grant, a state is required to develop and submit a three-year state plan, with annual revisions, to the United States Department of Education, Rehabilitation Services Administration (RSA), the federal agency responsible for the administration of the AT Act. These plans provide the framework for implementation of the requirements of the AT Act in the individual Statewide AT Programs, as well as documentation of the process and the progress that individual states achieve.

A state plan describes how a state will conduct its state-level and state leadership activities. The Statewide AT Programs are required to allocate 60% of AT Act dollars for state-level activities that include device demonstrations programs, device loan programs and device recycling or reutilization programs; and state financing activities. The remaining 40% of grant monies must be allocated to support state leadership activities. State leadership activities include training and technical assistance, transition, public awareness, and coordination and collaboration activities.

Section 4(e)(2)(A) of the Assistive Technology Act of 1998 as amended describes state financing activities as follows:

“(A) State Financing Activities – The State shall support State financing activities to increase access to, and funding for, assistive technology devices and assistive technology services (which shall not include direct payment for such a device or service for an individual with a disability but may include support and administration of a program to provide such payment), including development of systems to provide and pay for such devices and services, for targeted individuals and entities described in section 3(16)(A), including--

(i) support for the development of systems for the purchase, lease, or other acquisition of, or payment for, assistive technology devices and assistive technology service; or

(ii) support for the development of State-financed or privately financed alternative financing systems of subsidies (which may include conducting an initial 1-year feasibility study of, improving, administering, operating, providing capital for, or collaborating with an entity with respect to, such a system) for the provision of assistive technology devices, such as—

(I) a low-interest loan fund;

(II) an interest buy-down program;

(III) a revolving loan fund;

(IV) a loan guarantee or insurance program;

(V) a program providing for the purchase, lease, or other acquisition of assistive technology devices or assistive technology services; or

(VI) another mechanism that is approved by the Secretary.”

Recognizing that establishing an alternative financing program (AFP) is complex, Congress authorized states, choosing to explore an AFP as a state financing activity, to conduct initial, 1-year feasibility studies. The feasibility studies are individualized, state-specific and based on the perceived need(s). If a state chooses to conduct a feasibility study, the feasibility study must include the study of an AFP. A state may choose to study exclusively the feasibility of an AFP, or may choose to study other state financing activities in addition to researching the feasibility of an AFP for their respective state. In other words, feasibility studies completed from 10/1/05 to 9/30/06, researched the potential for implementing an AFP, improving an existing AFP, or determining the feasibility of an AFP and other state financing activities for an individual state.

The specific focus of this synopsis is to identify and describe initiatives other than Alternative Financing Programs (AFP) that Statewide AT Programs are currently studying, planning or implementing. Most of the activities described in this paper are state financing activities taking place in addition to an established AFP in the state. States conducting feasibility studies to determine the appropriateness of an AFP or to improve an existing AFP have not been included in this research paper.

Information contained in this document should be viewed as examples of what states are currently doing and should not be considered an inclusive list of all state financing activities that have or will be implemented by Statewide AT Program. The information contained in this document reflects information supplied by responding Statewide AT Programs, as well as, information gathered from self-reported responses to an inquiry of the Association of Assistive Technology Act Programs (ATAP) list serve, reports issued by the National Assistive Technology Technical Assistance Partnership (NATTAP), individual state surveys, and presentations at national conferences and/or teleconferences.

Inclusion of an activity in this document does NOT imply that the Rehabilitation Services Administration (RSA) has approved the activity as a state financing activity.

Cooperative Buying

Based on the information collected by ATAP, there are currently five states that have included a cooperative buying strategy as a state financing activity in their state plan. An additional state, Iowa, due to unique circumstances reports a cooperative buying program under its Collaboration Section of the state plan. These cooperative buying programs are in varying stages of development. Two states have fully operational cooperative buying programs; two states are determining the appropriateness of this type of program for their individual states; and another state is seeking to collaborate with an existing cooperative buying program initiated by the state’s department of education.

For the purpose of this document cooperative buying programs are defined as public or private partnerships formed for the bulk purchase and acquisition of assistive technology devices and/or services. Cooperative buying programs are used by public agencies to reduce the overall cost of providing the programs and services under their purview. An example of a cooperative buying activity might include a state purchasing office entering into an agreement with a software developer to purchase large quantities of adapted software at a significantly reduced priced to benefit children with disabilities, children with limited English Proficiency, and other students considered at risk for academic challenges.

Maryland

Maryland’s Statewide AT Program, The Maryland Technology Assistance Program

(MD TAP), formed a 501 (c) (3) nonprofit organization in 1998, now known as Assistive Technology: Loans, Acquisitions, Services, and Training, Inc. (AT:LAST, Inc), which does business as The Maryland AT Co-op (the Co-op). AT:LAST’s initial funding was from MD TAP, the Maryland State Department of Education (Division of Special Education) and fees generated from local school systems. Membership currently has grown to include other public and private organizations.

By conducting competitive bids, negotiating directly with manufacturers and entering into a limited number of reseller agreements, this Co-op uses the combined purchasing power of its member organizations to make AT more affordable. In order to fund AT:LAST, a small percentage mark-up is included in the pricing.

AT:LAST seeks pricing guarantees from the manufacturers for a 6 month period, and bids are sought for a variety of quantities (i.e., < 5, 5 – 24, 25+). In order to ensure a smooth process, the program pre-processes all orders. In other words, clarification is sought about operating platform, cable type, etc., before the purchase order is sent. A strategy promoted by the Co-op as a benefit to vendors and manufacturers is a 100% guarantee of invoice payments within 30 days of receipt. Users of the Co-op’s program are also allowed to put items from multiple manufacturers on the same purchase order. This translates into administrative cost savings as time and dedicated personnel costs are reduced.

In subsequent years of operation, the Maryland Developmental Disabilities Council provided a grant that enabled the Co-op to extend the discounts directly to individuals with a disability(s) and their families enabling them to acquire devices or software needed in the home or community. Parents or individuals generally obtain specific recommendations for the AT device from the therapist or teacher directly involved in the selection process. Once the recommendation for a specific AT device is made, the parent or the individual fills out an application and the Co-op searches for the best price. For individuals and families who need financing to make purchases, AT:LAST works closely with MD TAP’s Guaranteed Loan Program. This AFP provides guaranteed loans at below-market rates. The individual with a disability (or his/her family) pays the Co-op directly.

The Executive Director of AT:LAST notes that establishing a co-operative buying program is time and labor intensive. This program also requires resources to cover expenses while waiting for payment from its customers. AT:LAST provides assistance to help other interested states explore the benefits and replicate the cooperative buying programs in their respective states.

In reviewing the impacts that AT:LAST has made on the access and acquisition to assistive technology devices, it was noted that due to the cost effective and efficient results of this program, school budgets for AT have increased in dollar amounts and the number of items available for all students.

Oregon

Oregon ’s Statewide AT Program, Technology Access for Life Needs (TALN), has operated a small scale, informal cooperative buying program for about 2 years. The initial program was a collaborative effort among TALN, the State of Oregon’s Vocational Rehabilitation (VR) Program, Dell Inc., Blinksoft, and Enablement. Currently, the number of participating vendors has increased to twelve, and any program or individual can benefit from the reduced pricing available through the cooperative buying program.

A specific set of recommendations regarding devices, accommodations and adaptations for the individual consumer are made at the completion of an AT evaluation reimbursed by non-AT Act dollars. The written evaluation recommendations are sent to the referral source/purchaser. With the identification of the most appropriate device, and the decision to purchase the device made, the entity or individual then decides whether or not to use the services of the cooperative buying program. TALN charges 10% above cost of the discounted device if the program serves as the conduit for an individual to participate. To date this arrangement has not posed any problems for individuals using the service. Anecdotal information revealed that TALN’s cooperative buying program was an easier and more cost effective option due to the investment of time and energy necessary to do the comparison shopping.

The disadvantages of this arrangement include its vendor dependency and the time commitment necessary to complete the task. Overtime, however, this collaboration has evolved, and now some vendors watch for deals and inform TALN of discounts and special offers that are available. This, ultimately, helps to decrease the time required to complete cost-comparison research.

Georgia

Georgia ’s Statewide AT Program, Georgia Tools for Life, held a series of Town Hall Meetings to determine the best approach for Georgia to use in pursuing a cooperative buying program. Staff at Georgia Tools for Life felt that the Maryland AT:LAST model (see above) was a concept worth pursuing, but wanted to make sure that this model was the best approach to meet the needs of the state. It was imperative to the ultimate success of any program pursued to ensure that the planning be done well and correctly in order to recruit participation of the targeted agencies, programs and individuals. It was recognized that the time needed for answering questions of potential partners could be significant at times. Local vendors, agencies’ representatives, consumers and others were targeted for participation in these meetings. Questions considered included:

• Who will run the program?

• Who needs to be a member of the planning and implementing committee?

• How will local vendors participate and fare in this process?

• What is the most effective way to work with the Maryland AT:LAST model?

• Should the project enter into a specific Memorandum of Understanding with the Georgia State Department of Education?

Georgia Tools for Life staff are currently working with one of its Assistive Technology Resource Centers and is collaborating with the Georgia Department of Education to determine the best strategies to pursue to ensure a successful and sustainable resource.

Maine

Maine’s Statewide AT Program, the Maine Consumer Information and Technology Training Exchange (MaineCITE), is examining interest among state departments to develop a cooperative buying program.

MaineCITE recognized that there are a predictable number of certain types of AT devices that state agencies, responsible for providing AT and Durable Medical Equipment (DME) to its eligible clients, purchase regularly. This reality coupled with decreasing amounts of available funding led to a feasibility study to explore the appropriateness of a cooperative buying program. MaineCITE identified and convened a group of nineteen stakeholders from various state agencies, consumer organizations, vendors, private

agencies, the center for independent living and the m-Power Program, Maine’s multi-million dollar, state-funded AFP.

It was decided to collect data on who purchased the equipment, as well as the types and amounts of equipment purchased. During collection of data, it was documented that one of the challenges facing this effort was the lack of a uniform definition of AT among state departments. What one department classified as software, another department might classify as AT due to the adaptive or “special” nature of the software.

Another challenge identified during the process was the varying ability of state departments to identify the specific requested data. MaineCare (Maine’s Medicaid program) and MaineCITE staff collaborated in an effort to identify the most commonly purchased items under the MaineCare program. It was anticipated that MaineCare’s data would supply a key foundation to the data collection process. Unfortunately, due to limited internal capacity, MaineCare was unable to gather the data at this time. In the Maine Department of Education there was no state-level data collection to reliably identify AT purchases made at the local level. Instead a representative sample of local school administrative units (SAU) provided an estimate of types and numbers of AT purchased among Maine’s schools. Due to the current state of the data collection process within the state’s Vocational Rehabilitation program, data on the number and types of equipment provided to eligible clients was not available. The two largest vendors of Durable Medical Equipment in the state joined the group and furnished data on the most commonly purchased (through either public or private funding sources) DME from each of their businesses.

A final decision regarding implementation of a cooperative buying program has not been made. Data analysis and discussions will continue in Year 2 activities.

Tennessee:

In its state plan, the Tennessee Statewide AT Program, Tennessee Technology Access Program (TTAP), reported that a cooperative buying program would be examined. During the development process, it was learned that the Tennessee State Department of Education had partnered with the Maryland AT:LAST Program and was pursuing an educational buying consortium to extend AT discounts to Tennessee Schools.

Feeling that it was not cost effective to duplicate this cooperative buying effort, the Director of TTAP explored options for collaborating in the educational cooperative buying arrangements already underway. A variety of resources (marketing, mass mailing, etc) were offered by the TTAP to assist the State Education Cooperative Buying program. The offers were not, however, accepted by the State Education Cooperative Buying program.

As a parallel measure, the Director of the TTAP asked his 5 regional centers to monitor the AT purchases being made through each of the centers. These regional centers provide a range of services to individuals with disabilities living within their respective area of the state. If data from the 5 AT Program’s regional centers demonstrated a need and the political and cultural factors in the state indicated that the educational initiative had been well received, then timing might be right to pursue a cooperative buying program for the Tennessee Vocational Rehabilitation program. The limited initial indications are that the regional centers did not see a need for a cooperative buying program. Therefore, a decision was made by TTAP not to pursue a cooperative buying program at this time.

Iowa:

Although the Iowa Program for Assistive Technology (IPAT), the Statewide AT Program did not officially commit to an AT cooperative buying activity in their state plan as a state financing activity for the Iowa Statewide AT Program, there is an on-going AT cooperative buying activity that is currently reported in the collaboration section of the IPAT state plan. IPAT does not currently manage the cooperative buying program. IPAT, however, was responsible for the original set up of the program as a systems change activity under prior years of program operation. Since the program has been a proven successful model operating for many years, the decision was made to include Iowa’s efforts in this paper.

Iowa’s Education AT cooperative buying program has been operational for 5 years and is operated by one of the Area Education Agencies (AEA). The AEAs are regional entities of the Iowa Department of Education responsible for many of the educational AT services in its geographical area. Personnel at one of the AEAs manage the state’s educational cooperative buying program.

Initially, identified needs of special education and special interests were not included in the state’s educational cooperative buying program. The AT cooperative buying program began at the local level when the AT liaisons at the respective AEAs began to realize that duplicate purchases of devices and software were being made by individual AEAs. These AT liaisons organized a bulk buying arrangement that soon became staff intensive. Possessing data on amounts and types of devices and software being purchased, the AT liaisons requested that special education and special interest items be included in the state’s general educational cooperative buying program for all types of school supplies and equipment. It was agreed that each of the AEAs pays a portion of the salary and benefits of the person managing the educational cooperative buying program.

Iowa’s Education cooperative buying program has different offers every year. In order to determine the AT related items available for purchase under the state contract, the AEA program manager responsible for the entire state’s educational buying program works with IPAT staff and the AEA AT Liaison. Using the identified individual needs of students and past history, the specific types of AT to be included on the annual list are identified. Once the types of devices and software are determined, a prediction of quantities is made. Generally, items included in the cooperative AT buying program are AAC devices, and AT software such as JAWS, Kurzweil, and Intellitools

Once the types of devices and software are identified, the AEA program manager begins the process of negotiating with the various vendors. With negotiations to determine availability and the cost of the items complete, a list of available items is published. The state educational cooperative buying booklet lists all items, including AT devices and software, available through the program. The book is mailed to all schools and is also available on-line. The offers contained in the book are extended to schools, AEAs and sometimes to parents, community colleges, libraries, etc. The discounted rate for items is available only when the purchases are made through the state contract for the cooperative buying program.

Individual schools, local AEAs , families, or other entities are responsible for completing their own orders. The AEA managing program has no role in the actual purchasing process for a variety of reasons. When the individual entities purchase the devices and/or software, the issue of ownership and license is clear. Additionally, if the managing AEA were to be responsible for all the purchases, the cost of the program would increase and an unnecessary delay in the procurement process might result.

The Iowa Educational cooperative buying program has been well received by participating schools and individuals. In fact, it was reported anecdotally that superintendents and/or teachers who have left the Iowa education system have inquired about continuing to participate in the Iowa cooperative buying program. In the 2005 school year, $187,000 was saved on AT educational software alone. These savings were use to create access to information and books for students who use text readers.  The availability of electronic books and resources reportedly resulted in $1.8 million savings statewide.

Coordination of Funding and Services

The infrastructure of some states makes the coordination of public funding and services more feasible than others. This infrastructure creates an environment in which the state does business expecting collaboration among its agencies and programs. Existing partnerships or unique state-specific circumstances enhance the success of the model of coordination of funding and services. Information gathered to date suggests that currently one state is involved in the Coordination of Funding and Services as a state financing activity.

Coordination of Funding and Services provides an opportunity for state systems to identify whole person needs while preserving funding mandates for educational necessity, medical necessity and/or vocational necessity. This specific coordinated systems model overtime has evolved into a system of care that meets the identified needs of citizens through collaborative efforts of individual state entities. It was reported by the state included in this research that the system of care delivery network had been undoubtedly strengthened using coordination of funding and services.

The AT Act in Section 4(e)(2)(A) explains that state financing activities may include “support and administration of a program to provide…” payments for AT devices and services. For the purposes of this paper, Coordination of Funding and Services is defined as a formal agreement between state agencies and programs where resources are shared across programs to meet the AT needs of common clients. These agreements are focused on increasing access to and acquisition of AT devices and services across the lifespan.

Nebraska:

The Statewide AT Program in Nebraska, The Nebraska Assistive Technology Partnership, was originally funded in l989. Due to the expertise demonstrated in the Statewide AT Program, the state’s Vocational Rehabilitation (VR) program began to contract some of its AT assessments to this partnership. The specific recommendations made as a part of the partnership assessments resulted in the most appropriate AT devices and services being made available to the individual VR client. Through this coordinated and collaborative effort, the VR program realized substantial savings. When the State Department of Health and Human Services (DHHS) became aware of the savings realized by VR, DHHS expressed an interest in partnering with the AT Program to perform AT assessments for its eligible clients. Specifically, DHHS pledged more than a half million dollars for purpose of AT assessments. In both instances, the monies represented by the respective contracts between the Statewide AT Program and VR or DHHS augmented the respective agency’s funds used to purchase AT devices and services for eligible clients.

This collaborative effort began almost a decade ago and today includes nine agencies (Health and Human Services, Vocational Rehabilitation Part B, Vocational Rehabilitation, Educational Service Unit #10, Housing Developers Association, Nebraska Department of Education Child Find, Nebraska Department of Education, Special Populations, Health and Human Services HOPWA, and Veterans Affairs Vocational Rehabilitation) encompassing l9 programs. The partnership receives more than $1.3 million from its participating members. The Nebraska DHHS has documented that the average cost of the AT Home Modifications Services under the Home and Community Based Waiver has risen 1% in 3 years versus the 8 to 10% annual increase experienced in other areas of Medicaid.

Consumers complete one application identifying their technology needs, home modification requests and financial status. This information is used to coordinate funding among the 19 programs. Another cost-saving measure generated by the effort is that the partnership serves as a conduit to recycling used equipment. Equipment that was purchased by one agency, and that is no longer needed by the original recipient, is made available to an eligible person from another system.

The following advantages were reported for this type of partnership.

• Ability to leverage funds from many funding sources

• Provision of a comprehensive approach to meet an individual’s spectrum of needs

• Availability of AT expertise to ensure appropriate services are delivered

• Identification of needs by the consumers

Nebraska’s experience suggests that when state programs fund home modifications, doors are opened for additional AT. This coordinated funding strategy in Nebraska has demonstrated that aging in place is possible when AT is provided. Some of the elders who have benefited from the AT have indicated that aging in place is a better alternative than assisted living. Reports from state personnel suggest that quality of life has been improved by this coordination of funding and services model. In some cases it was reported that elders never required, or at least, delayed moving to a more restrictive placement as they aged.

The most commonly identified unmet needs in Nebraska continue to include home and vehicle modifications, vehicles and computers.

Individual-Specific Funding Strategies

Alternative Financing Programs are popular programs that help to meet the AT needs of many citizens. However, states have indicated that there are many needs that simply

can not be met by an AFP. Statewide AT Programs participating in this study also noted that many individuals who apply for low interest loans in their respective states are not approved for funding. These unmet needs materialize for a variety of reasons ranging from ineligibility for a low interest loan or any third party funding program, to choosing not to access loan funds for a variety of personal reasons. Some states, having documented unmet AT needs of their citizens, established Last Resort Fund Programs.

New approaches to old problems began to emerge in some of the year 1 state plan activities of the Statewide AT Programs. While the funding strategies and mechanisms used by the states differ, a common theme reported included the states’ observation of rising numbers of individuals for whom no other source of funding was either available or feasible. The Individual-Specific Funding Strategies included in this paper are Last Resort Funds Programs and Individual Funding Plans.

1. Last Resort Fund Programs

Section 4(e)(2)(A) of the AT Act specifically prohibits the use of AT Act funds to provide direct payment for an AT device or service. This statutory language therefore prohibits the use of AT Act dollars as the source of last resort funds. AT Act funds, however, can be used to administer a last resort fund or program that is funded by other sources. Many states leverage state dollars and dedicate them as last resort funds. However, the major challenge facing these programs is inconsistent and unpredictable amounts of state funds that are available from year to year to meet the established need. Virginia, New Mexico and Illinois are among the states that operate a Last Resort Fund Program.

Illinois:

The Statewide AT Program in Illinois, the Illinois Assistive Technology Program (IATP) administers the TechConnect Low Interest Loan Program that provides funds for AT devices to eligible individuals. The TechConnect staff also record the individuals who do not qualify for either a low interest loan or the telework program. These individuals are referred to the IATP Last Resort Funds Program. This Program was established with state appropriated funds and consequently is not guaranteed funding. The availability and amount of funding varies from year to year.

The IATP director and staff review the referrals to the Last Resort Fund and make the final determination to approve funding. Applicants are required to show they have exhausted all other funding options. Funds are disbursed on a first-come, first-served basis. The cap for each applicant is $20,000.

Last Resort Funds Program monies have funded a total of three hundred sixteen (316) loans. Two hundred and fifty-one (251) of these loans, approximately 70%, have been made to individuals who did not qualify for the state’s low interest loan program. Most of the Last Resort Fund monies have been used for vehicle modifications (66%). The next most common request was for home modifications (14%).

New Mexico:

The Statewide AT Program, New Mexico Technology Assistance Program (NMTAP) has determined that there is a need for a Last Resort Fund Program. At the present time, NMTAP and its Advisory Committee are considering a contract with a non-profit agency to develop the fund of last resort.

The issues identified as challenges in establishing a privately funded Last Resort Fund Program by the NMTAP during Year 1 include:

• Reluctance of the public to provide personal funds to a State Agency;  

• Requirement for a $10,000 deposit by the Community Foundation to start a development account;

• Costs for fund raising services are extremely high with no guarantee of results,

•  Other AT program demands; and,

• Level of current staffing that is too small to accomplish the mandated activities of the AT Act.

Virginia  

In addition to its AFP, Virginia also has a state-funded Consumer Service Fund (CSF) that acts as last resort funds. The CSF is available to Virginians with physical or sensory disabilities who have not been successful at obtaining funding for a needed AT device or service through any public, private or civic existing funding sources including those available through the Assistive Technology Loan Fund Authority (ATLFA). Successful applicants are required to share in the costs based on their ability to pay.

CSF is designed for the purchase of direct goods and services. These funds cannot be used for paying on-going living expenses, medical bills, or for reducing pre-existing debt. Items requested from CSF must be directly related to removing or reducing barriers created by a physical or sensory impairment.

A panel of people with disabilities, representatives of the Centers for Independent Living, and interagency representatives review the CSF applications on a quarterly basis. Successful applicants are given funding by demonstrating critical need, exhausting all other resources, meeting CSF priorities and providing supporting documentation.

Level of funding varies from year to year. Currently, requests for funding exceed dollars available for funding them.

2. Individual Funding Plans

Providing direct, individual funding assistance is a concept that was planned and implemented in FY 05-06 by three states as part of their state financing activities. Information and referral has always been a required activity under the AT Act and the prior grant program of the Technology-Related Assistance Act of l988. The Individual Funding Plan strategies, planned and implemented during FY 05-06 as a state financing activity, emphasized services for individuals who were unable to find an appropriate funding source for the procurement of AT devices or services. The Individual Funding Plan concept is designed to meet individual needs by assisting in identifying the most appropriate or effective way to pay for needed AT devices and services given the individual’s specific situation.

Kansas:

Kansas’ Statewide AT Program, Assistive Technology for Kansans (ATK) currently operates an Alternative Financing Program (AFP) established with federal funds requiring a state match. In addition, ATK and its partner in the AFP, Kansas Assistive Technology Co-operative (KATCO) are currently pursuing the option of Individual Development Accounts (IDA). IDAs are dedicated matched-savings accounts that provide incentives for low-income individuals to build investment accounts to purchase AT. In order to qualify, the individual or family must have income of less than or equal to 300% of the federal poverty level (FPL). Annual maximum contribution to the IDA is $5,000. The total amount in the IDA cannot exceed $50,000.

These accounts are managed by community organizations and held in local financial institutions. Contributions from low-income individuals are matched using private and public sources. Money contributed by the individual is not counted as an asset and money provided by private sources can be claimed as a tax credit. The current tax credit is $25,000. Employers who contribute to IDA matches may receive wage subsidies.

Individuals can use IDAs to save for assistive technology. The money contributed on a monthly basis to the IDA by the individual is matched 1:1, 2:1 or more (up to 5:1). Over time the amount in the IDA is larger than what the individual would have been able to save himself/herself.

As of the date of this report no AT IDA’s have been established. The community-based organization, KATCO, operates the financial loan program and is currently in the process of selling the tax credits. The money raised from the sale of these tax credits will serve as the match for the IDAs. Strategies to be pursued in the continuation of this work include:

• Assessing the level of interest in purchasing tax credits among vendors with whom the AFP works,

• Contacting Trust Officers at larger banks and banks that the AFP does or has done business with in the past to determine their level of interest in the tax credits being offered, and

• Approaching local community foundations in specific cities around Kansas to inform them of the existence of the AT-IDA. These foundations are repositories of money for people who want to contribute money, but do not know where they want their money to go. The community foundations make the decisions for them. It is anticipated that the AT-IDA concept would be an appropriate resource for inclusion by some of these foundations.

Pennsylvania:

In Year One of the State Plan for the AT for The Commonwealth of Pennsylvania’s Statewide AT Program, Pennsylvania’s Initiative on Assistive Technology (PIAT) plans for state financing activities included the support and administration of a statewide system of individualized assistance in obtaining funding for AT.

In 1998, PIAT established the Pennsylvania Assistive Technology Foundation (PATF) to implement and administer an alternative financing loan program in the state of Pennsylvania. PATF is now an independent and separately operated 501 (3) organization. PATF, while successful and highly utilized, does not meet the needs of all individuals seeking financial assistance. In consultation with stakeholders, PIAT devised a statewide system to provide individual technical assistance for individuals 1.) not eligible for a loan from the Pennsylvania Assistive Technology Foundation (PATF); 2.) not choosing to participate in a PATF program (i.e., does not want to borrow money to finance the AT; or, 3.) not able to find an easy solution for obtaining the needed AT device or service (i.e., are having difficulty navigating public funding streams, need AT that costs more than most single payers, such as waivers or charitable organizations, will allow, and thus, need a package of funding from multiple sources.

Information regarding the availability of individual funding assistance was routinely given to all individuals who access PIAT’s information and referral systems, including both its central office and subcontractors. A dedicated email account was established to provide an electronic means for consumers interested in funding assistance. This email account is monitored regularly by PIAT staff.

Individualized assistance for funding was defined as assistance entailing repeated, periodic contacts lasting at least 15 minutes and extending over several weeks or months, for a total of 15 to 20 hours. This activity ends when the individual obtains the device, or it is mutually concluded that there is no source of affordable or appropriate funding through which the individual can acquire AT.

Colorado:

A feasibility study conducted 5 years ago concluded that funding and other necessary supports were not available to establish a financial loan program in Colorado. The work to improve access to AT for people living in Colorado did not stop, however. A subcommittee of the then advisory council formed the AT Coalition. This Coalition was comprised of people with disabilities and representatives of various public programs in the state. The vision of the AT Coalition was for all Coloradans to receive the needed AT devices and services at any stage in life, particularly when transitioning across various systems such as from an educational to a vocational or higher educational system. Anecdotal reports indicate that Colorado is unique in that the state is acknowledged as being visionary in establishing and supporting programs that enable people with disabilities to obtain AT through its Medicaid, Education, and Vocational Rehabilitation programs and generous charities.

Recognizing the requirements of the Assistive Technology Act of 1998, as amended, Colorado implemented an online questionnaire to study the feasibility of a low interest AT loan program. Surveys were also available to be faxed or surface mailed and staff distributed surveys at meetings to help increase the response rate. Discussions took place with neighboring states that had low interest loans programs in place to identify interest and potential for establishing a partnership to meet any identified need for a low interest loan by a Coloradan with a disability(ies). A national Access Loan Program was also researched as a resource that could be marketed to individuals with disabilities in Colorado for improving access to AT devices. The decision was made to use the Access Loan Program of the American Association of People with Disabilities (AAPD).  AAPD has access to the Digital Credit Union, where low interest loans originate. Membership in AAPD is required before application to the Access Loan Program can be made.   Consideration is being given to subsidizing AAPD membership fees when the membership fee prevents the individual from applying to the Access Loan Program.

Another initiative pursued by Colorado included the creation of an online database, AT Funding $ources. The decision to develop this fully-accessible, secure, HIPPA compliant, statewide online database was precipitated by a recognized lack of a ‘one-stop’ shop for learning about funding opportunities, and the absence of a single process for determining the appropriate funding mechanism for an individual.

This online database currently has over 1800 entries identifying potential funding sources and is being beta tested. Extremely positive feedback is being received and the plan is to have the database live by January 2007.When operational, AT Funding $ources will assist an individual in navigating the funding maze that exists across various agencies. The Department of Education, the Division of Vocational Rehabilitation, State Medicaid services and others have committed to facilitating the adoption of the resource database. This single point of entry will help people determine where and how to proceed to secure funding to meet their current AT device and service needs. Staff will provide periodic monitoring to determine if the individual received the necessary AT devices and services.

Summary

Having completed Year 1 of a three-year state plan process, states are beginning to plan and implement a variety of state financing activities. Most of the activities reported in this paper appear in the state plans of the respective states and are being utilized to expand access and acquisition of AT devices

These state financing activities take many forms and utilize a diverse set of strategies to leverage federal, state and private dollars to meet the needs of individuals who require AT devices. In some instances the savings realized by state systems has been reinvested to expand access to AT. Regardless of the strategies used to address financing of assistive technology, there is one undisputable fact - the need for AT devices and services far exceeds the current level of available resources.