Highlights of Tech Act Project Accomplishments

Executive Summary

Assistive Technology is a critical, and cost-effective tool that allows persons with disabilities to lead independent, productive and healthy lives.

Currently, an estimated 15.6 million people in the U.S. either use some type of specialized assistive technology or have reported they would benefit if they did use assistive technology (LaPlante et al, Technology and Disability, vol 6, pp. 17-28, 1997).

The Technology Related Assistance for Individuals with Disabilities Act (Tech Act), facilitates the development, evaluation, application and delivery of assistive technology devices and services. It is a unique and critical legislative measure, that through monetary assistance to States and Territories, embodies several features that positively impact on the lives of persons with disabilities. These core features of the Tech Act, as exemplified in State & Territory initiatives, include:

Pro-active approach that promotes systems change before and concurrent with the evolution of marketplace demands and legislated changes;

Consumer responsiveness inherent in program design, allows each State and Territory to involve its consumers from the start of planning initiatives, through program design, implementation and evaluation.

Universal approach that addresses the needs of persons with disabilities across ALL AGES and ALL DISABILITIES as they relate to assistive technology.

Flexible approach permitting each State and Territory to administer diverse initiatives that effectively address the assistive technology needs of its residents with disabilities by allowing choice of lead agency and by allowing state and community level planning and decision making.

Development of collaborative relationships between Tech Act Projects private entities, consumers, state agencies and providers that encourages ongoing, interactive partnerships that improve current service delivery systems, avoiding duplication of services and retrofitting.

Challenges that demonstrate the ongoing need for this legislation, include:

Appropriately meeting needs as the population ages and the demand for assistive technology devices and services increases.

Effectively addressing barriers to assistive technology use as technology advances, its prevalence evolves, and funding, government, industry and marketplace demands change.

To address these challenges, it is critical to review the success and impact the Tech Act assistance to States & Territories has had at effecting the challenges laid forth in the original legislation. The attached document summarizes Tech Act project accomplishments and identifies the barriers and challenges that remain.

Mission Statement

To collaborate with persons with disabilities and others at the national level to increase the availability and utilization of assistive technology devices and services for all individuals with disabilities in the United States and territories.

The Association's purposes are:

To promote public awareness of assistive technology at the national level.

To provide training and education about assistive technology on a national basis for stakeholders, including other national social service and business organizations, members of the insurance and healthcare industry, and public office holders/policy makers.

To develop positions on a full range of national assistive technology and disability related issues and to share these positions with other organizations or policy makers, as needed, to ensure that the views of the states and territories and their consumers with regard to assistive technology service delivery are adequately represented.

To provide a forum for exchanging information and promoting the system change accomplishments and activities of the Tech Act Projects.

To identify the need and opportunities for the development of nationally-conducted activities to increase access to assistive technology.

To develop and promote a national agenda.

Tech Act Projects receive funding through grants from the National Institute on Disability and Rehabilitation Research (NIDRR), US Department of Education. This publication does not necessarily reflect the position or policy of NIDRR and no official endorsement of the material should be inferred.

Table of Contents

Introduction

Challenge 1 Resources Are Needed to Pay For Assistive Technology Devices And Services

Challenge 2 There Is Need for Trained Personnel to Effectively Administer, Provide, Fund & Use Assistive Technology

Challenge 3 Providing Information about the Availability and Potential of Assistive Technology

Challenge 4 Providing Outreach to Rural and Underserved Persons about Assistive Technology

Challenge 5 Ensuring Systems Provide Timely Acquisition and Delivery of Assistive Technology Particularly with Respect to Children

Challenge 6 Coordination Among and Between State and Private Entities, Particularly with Respect to Transitions

Challenge 7 Assuring States and Territories Have the Capacity to Provide Assistive Technology

Challenge 8 Individuals with Disabilities Cannot Access Existing Telecommunications and Information Technologies

Challenge 9 Providing Incentives for Commercial Pursuit of the Application of Technology

Coordination among Agencies That Provide or Pay for "AT" Assistive Technology at the Federal Level

Conclusion

Introduction

Enabling Legislation: Overview of Tech Act

The Technology Related Assistance for Individuals with Disabilities Act of 1988, as amended, (Tech Act, USC P.L. 100-407) is a hallmark piece of legislation that has had a significant impact on the lives of persons with disabilities. The Act's definition of assistive technology devices and assistive technology services is broad and flexible enough to accommodate an ever changing array of products and range of individually adapted services. The legislation is considered a prototype because of its emphasis on consumer- responsiveness, allowing consumers to be active partners in the process of knowing about, getting and using devices that meet their needs and facilitating the involvement of consumers in the planning, development, implementation and evaluation of systems designed to meet their needs.

"Critical to the success of Projects is the empowerment of consumers."

The scope of activities allowable under the Tech Act is not limit ed to a specific age group, type of disability or method for overcoming barriers. Under Title I of the Tech Act, each State and Territory had the option of competing f or available funding, select a lead agency and, within the application parameters, develop a project design that responds to the needs of its particular State or Territory. The Tech Act's legislative mandate to examine existing systems and implement policy changes to remove barriers to the effective acquisition of assistive technology devices and services, was and remains a formidable challenge.

Reporting Accomplishments

With the reauthorization of the Tech Act in 1994, a set of "findings" {Sec. 2(6)(A)-(2)(8)}, was included which outlined barriers that posed challenges to the acquisition of assistive technology and governed Project initiatives. Accomplishments, as reported by 41 of the 56 Projects, are included in this document and categorized under the challenges specified in the "findings section" of the Tech Act. Various Tech Act Projects' impacts are presented, after which, remaining factors to full elimination of each of the barriers are noted.

As the accomplishments of Tech Act project initiatives were compiled, it became evident that although Projects function independently, their accomplishments in overcoming barriers to the acquisition of assistive technology were similar. The summary of project accomplishments documents successful strategies used by Tech Act Projects to effect change. Several patterns have emerged that reflect the unique and valuable role Tech Act Projects have fulfilled.

Many Projects have assisted in the development of policies and programs by providing technical assistance and training on assistive technology issues to individuals, private groups, policy makers, and service providers, simultaneous to the amending and development of new policies, regulations and laws. The pro-active nature of project's initiatives is evidenced by the role taken on to assist state and local organizations in identifying and implementing the changes themselves. By assisting those directly responsible for developing, administering, and monitoring policies and programs related to assistive technology devices and services, the likelihood of permanently building capacity, changing policies and effecting an overall paradigm shift is increased.

Critical to the success of Projects is the empowerment of consumers. Consumers empowered by the various Tech Act Projects have participated in program planning, development, implementation and evaluation. The involvement of consumers in a variety of project's initiatives, has ensured that policies and programs recognize and address how, when operationalized, they truly do effect access to assistive technology devices and services for persons with disabilities.

Recognition that access to an assistive technology device or service is not the panacea strongly influenced the ability of Projects to achieve outcomes. Assistive technology, cannot be viewed as a single issue, but must be considered as part of a whole system. The potential of assistive technology is often diminished without access to education, housing, employment, etc. Each relies upon the other. In addition, access to a device or service must be complemented by access to proper evaluations by qualified persons, training, maintenance, and repair services. As in any system, a change of any one of these components can have a dramatic impact on a persons success. Tech Act Projects have been avid promoters of "seeing the big picture" and ensuring that the impact and potential of multiple factors must be considered.

Many outcomes and accomplishments have been achieved through the effective use of collaborative, as opposed to adversarial, relationships. Tech Act Projects often find themselves assuming the role of facilitator or catalyst as opposed to the role of provider, monitor or enforcer of laws and regulations. Through collaboration, Projects are able to increase the understanding and skills of state and/or local agencies and identify ways to pool resources and energies to address barriers.

Despite the use of similar principles as the basis to achieve outcomes, project activities and accomplishments have varied greatly depending on their State or Territory and methods used to respond to the specific needs of its citizens. Each State or Territory operation is unique based on its geography, populace, cultural diversity or way of governing. The grant assistance to States has allowed Projects to design approaches that reflect the uniqueness of their state or Territory. Project accomplishments achieved because of the degree of flexibility allowed among Projects in accomplishing tasks, validate the inherent benefits of endorsing project diversity.

Barriers to Full Execution of Legislative Directives

Efforts to achieve permanent systems change under the Tech Act have been hindered by several factors. Three factors that have either hindered the degree of progress feasible or resulted in new challenges are:

Dynamic Nature of Systems

As policies and procedures of assistive technology funding sources (e.g. education, vocational, rehabilitation, employment, healthcare, developmental services, public and private funding etc.) undergo change on a national and state level, efforts to identify barriers and create strategies to address them is complicated. Individual eligibility, covered services, qualified personnel, and methods for service delivery, are all aspects of a dynamic whole known as a "system." Any alteration in one of the factors, inevitably impacts all or some of the others, making the notion of permanent systems change an oxymoron.

Evolution and Expansion of the product market for assistive technology

New products are constantly evolving as are the applications for their use. Consequently, the number of persons who can benefit from these products increases as does the need for a growing variety of service delivery initiatives.

Cyclical federal funding process

The cyclical federal process for assistance to States, Territories and Commonwealths, has enabled Projects to benefit from one another's experiences and initiatives. Conversely, it has also impeded Projects ability to build national momentum to address identified barriers, particularly on the federal level.

Challenge 1

Resources Are Needed to Pay For Assistive Technology Devices And Services

[USC P.L. 100-407]

Accomplishments/Outcomes:

Increased Knowledge Levels;

Minnesota created a directory of funding sources for assistive technologies that has been requested and distributed to over 50,000 individuals, providers and public funding sources.

Rhode Island completed a Medicaid handbook for consumers that explains in multiple languages the Medicaid funding process for assistive technology.

Legislative Measures

Illinois provided technical assistance to amend state legislation to allow for monetary compensation for consumers to purchase assistive technology devices and services if they have been a victim of a violent crime.

Indiana impacted managed care issues by sponsoring the "grievance procedures" bill (HB 1663) for Managed Care issues. They are currently refining legislation such as a definition for "medical necessity".

Kentucky promoted and helped pass legislation that resulted in the establishment of an Assistive Technology Loan Corporation, providing a resource of low interest loans to consumers to purchase assistive technology.

Missouri assisted in the development of legislation to allow for an equipment distribution program that provides individuals with disabilities adaptive devices such as text telephones, amplifiers, telebraillers, hands-free phones.

Effects on Organizational Structures

New York and Utah, like many other Projects, established regional centers within existing organizations to demonstrate products, provide technical assistance and guidance to consumers regarding the resources and processes available to pay for assistive technology devices and services.

Hawaii established equipment loan programs, including two in Public Libraries.

Maryland, in cooperation with First National Bank, set up a financial loan program for assistive technology in the Baltimore Metropolitan area.

New Hampshire established an equipment recycling program that serves as a less expensive resource from which consumers and payers, such as Medicaid, can purchase durable medical equipment.

Connecticut initiated a joint venture with state and private sector funding. At just under $3,000,000 this fund is a self-supporting resource providing an additional source of funding for assistive technology.

Impact on Policies

New York and California helped develop policies to more cost-effectively fund Alternative and Augmentative Communication (AAC) Devices within Medicaid.

Illinois, like many other Projects, was successful in getting Medicaid to cover AAC devices for children and adults.

Wyoming helped clarify policies governing payment responsibility for the purchase of assistive technology by the state Vocational Rehabilitation agency.

Improved Practices

New York collaborated with the State Department of Health to effectively identify how resources could be managed and made available for evaluations and device lending and distribution through the Early Intervention Program.

Kentucky developed an assistive technology matrix that is now available on the state Department of Education homepage and is made available to special education teachers to make timely pre approved purchase of assistive technology paid for with state Education Technology funds.

North Dakota provided technical assistance to its Vocational Educational agency to develop a 3 year plan in the area of assistive technology including best practices for effectively funding such equipment.

Adequate Resources to Pay for Assistive Technology Devices and Services Unmet Needs:

Innovative and alternative sources for providing assistive technology, such as loan and recycling programs are necessary as needs grow and funding in Medicaid, Medicare and other public funding programs decrease or are held constant. Tech Act Project expertise will be needed more to assist in developing guidelines, policies and practices to ensure access, consistency, continuity, quality and cost-effectiveness for funding assistive technology devices and services within new health care delivery systems, such as managed care. The number of individuals needing access to alternative resources to pay for assistive technology will increase as welfare reform legislation decreases the number of persons eligible for public program supports.

Challenge 2

There Is Need for Trained Personnel to Effectively Administer, Provide, Fund & Use Assistive Technology

[USC P.L. 100-407]

Accomplishments/Outcomes:

Increased Knowledge Levels

Kansas provided training to 3,328 individuals with disabilities to better understand uses for assistive technology devices.

Oklahoma worked with state Office of Personnel Management and the Department of Central Services to increase state employee knowledge about assistive technology.

The Northern Mariana's Islands enhanced the knowledge levels of individuals with disabilities, their family members, guardians, advocates, and authorized representatives to effectively provide assistive technology.

Illinois developed a legislative internship for consumers from Centers on Independent Living called the "Legislative Training Program and Manual" to become leaders in their communities and advocate for policies affecting persons with disabilities.

Legislative Measures

Illinois passed legislation to develop the "Assistive Technology Evaluation and Training Centers," that allowed the Department of Human Services to establish one or more centers that provide comprehensive training of personnel to assure effective delivery of assistive technology.

Effects on Organizational Structures

Rhode Island helped form "Technology Teams" within schools systems in Rhode Island to more effectively deliver assistive technology by incorporating the expertise of parents, consumers, providers in developing the IEP Transition Plans.

Pennsylvania promoted the incorporation of assistive technology within higher education programs and curriculum.

Kentucky utilized 15 existing regional center as resources for information and technical assistance on issues related to assistive technology.

The Indiana Tech Act project developed and implemented 4 training modules: Assistive Technology for Persons Who Are Elderly, Assistive Technology on the Job, Technology for Infants and Toddlers, and Assistive Technology for Education. These modules cover the laws concerning technology and the specific area covered, general assistive technology possibilities, or teaming, making the match, and assessment profile forms. These have been presented to various agencies such as the Area Agencies on Aging and Vocational Rehabilitation Services.

Impact on Policies

Iowa collaborated to designate a point of contact for assistive technology issues within the Iowa Division of Vocational Rehabilitation and provides annual training to those designees. This resulted in standard and uniform practices statewide which has increased the timeliness of AT delivery. An assistive technology checklist for rehabilitation counselors was developed and incorporated into the policy manual. Policies were developed for transitioning AT from school to work which were also adopted by the Bureau of Special Education. Developed an assistive technology checklist for rehabilitation counselors that was incorporated into the policy manual.

Improved Practices

Maine, Wyoming and Nevada have incorporated assistive technology in the course curriculum of providers.

Mississippi collaborated with a university to provide assistive technology evaluations for underserved populations and training for consumers and service providers. The capacity of school districts to respond to the AT-related needs of students has increased as a result of systems-change efforts directed toward both policy and practice.

Delaware, with the Department of Public Instruction jointly appointed an AT/Education Task Force to examine the barriers to assistive technology and subsequently added AT--related language to statewide educational policy.

Increased Skill Levels

New York collaboratively developed and implemented a training curriculum "Toward Reasonable Solutions: Assistive Technology for School-Age Children and Young Adults" with the State Education Department, Office of Special Education Services. This training was designed to assist school districts, in collaboration with families and assistive technology providers, to meet the assistive technology needs of school-aged children and young adults by identifying existing barriers within their district and developing ways to address the barriers on a local level. Over 580 persons have been trained under this program.

Iowa collaborated with the University of Iowa College of Law, Legal Services Corp., Iowa State Bar Association, Volunteer Lawyers Project, and the Protections & Advocacy to provide training and technical assistance to attorneys in the state about AT issues. Approximately 100 law students have been trained in assistive technology issues through individual case representation and policy work.

Texas established a statewide orientation and in--service training on assistive technology for early intervention for ECI providers and families.

Nebraska fostered the growth of the "Peer Support Network," linking community volunteers who experience disabilities and use assistive technology, to a network to provide one-to one support, community awareness, and to work in a network to provide systems change. This initiative included building of leadership and advocacy skills among the volunteers.

Louisiana collaborated with the Department of Education and a state university to present annual Assessment Team Training Institute for 200 speech/language pathologists, occupational therapists, physical therapists, assistive technology specialists, pupil appraisal personnel, rehab counselors school administrators and others.

Vermont's project developed and supported the Rehabilitation Engineering Technician Program at Vermont Technical College. This is a two-year program teaching principles of adapting technology to meet the needs of people with disabilities, kind of a blend of engineering and human services. Graduates go on to work for vendors, schools, non- profits and state agencies. At least five graduates are employed and their effect on quality prescription and use of assistive technology has been tremendous. This is the only program of this type in the nation.

Virgin Islands, through an in service program, trained hundreds of teachers, parents and service providers residing on assistive technology.

Indiana conducted an Empowerment and Advocacy training. Many people have received training to be able to take control of the events happening in their life concerning independence, medical situations, and daily living activities. Some people from these training have gone on to form other groups, task forces or to become volunteers in an agency to continue advocacy for themselves and for others.

Hawaii developed "Winners at Work", which does employment training and placement for DD clients as well as many others with disabilities.

Assuring Trained Personnel to Effectively Prescribe, Distribute and Provide Assistive Technology - Unmet Needs:

As federal and state legislative mandates about assistive technology change, training about the policies to execute the legislation will be required. As funding sources for assistive technology change (i.e. from Medicaid to managed care or insurance to individual payer), new groups will need to be trained regarding the use, application, cost-effectiveness, benefits and best practices for evaluating and using assistive technology. Much of the training that has occurred thus far has largely been focused on consumers and providers. As the entities that fund assistive technology change, training will need to be directed toward the new payers. Similarly, as more managed care organizations are used to provide services to persons with disabilities, primary care physicians that are not as familiar with meeting the needs of individuals with disabilities will need training on the uses for assistive technology. New training will be required as new technologies develop. The training will need to include demonstrations on new applications for technology and will require the development of best practices for funding such technology among a variety of service providers.

Challenge 3

Providing Information about the Availability and Potential of Assistive Technology

[USC P.L. 100-407]

Accomplishments/Outcomes:

Increased Knowledge Levels

Maryland has developed a World Wide Web Site which offers monthly editions of an electronic newsletter and as of December 1, 1997 an interactive bulletin board for exchange of information on assistive technology.

Hawaii presented the Harry and Jeanette Weinburg Tools for Life Expo.

Connecticut implemented Gadgets & Electronics: Total technology - This statewide assistive technology trade fair is a valuable tool for keeping consumers, professionals and the general public aware of current available technology. Seeded with Project money, this will be a self supporting event by next year.

Wisconsin developed Web sites for public access to information about assistive technology.

New York built upon an existing Information and Referral service. Since 1990, Project staff have responded to over 20,000 information and referral calls that were specifically related to assistive technology.

Georgia developed a "Dollars and Sense" guide for providing information about funding for assistive technology devices and services.

Nebraska made available a toll free number for consumers to call when needing Technical assistance for assistive technology equipment and funding issues.

Alaska operated a statewide Information and Referral System.

Minnesota provided scholarships to individuals with disabilities, their family members and professionals to attend conferences focused on explaining and demonstrating the uses for assistive technologies.

Oklahoma developed and distributed a comprehensive funding manual providing consumers/service providers with information on all public/private resources that fund assistive technology.

California developed the Accessing Assistive Technology resource book in multiple languages and distributed it to over 25,000 individuals.

Delaware operated an efficient, professional network of Assistive Technology Resource Centers throughout the state, giving consumers, family members, and service providers hands-on access to a wide range of AT for demonstration and short-term loan. Staff also have provided technical assistance, and training workshops to more than 8,000 individuals throughout the state.

New Mexico has developed a powerful software tool that can track funding for assistive services and devices with: Medicaid, Medicare, Vocational Rehabilitation, Special Education, Private Insurance and Veterans Administration. The software program, is Macintosh and Windows 95 compatible, and provides information on funding, statistical data, device eligibility and service providers.

Legislative Measures

Illinois introduced a bill to create the "Assistive Technology Evaluation and Training Centers", that among other responsibilities, would provide information to consumers, their family members providers and advocates about the uses for and potential of assistive technology and costs.

Effects on Organizational Structures Established a Consumer Advisory Council to guide the direction and advise the Tech Act project in North Carolina.

Coordinated the development of a statewide Assistive Technology Action Committee comprised of North Dakota state administrators of public and private agencies, and consumers and supported by the governor's office for the purpose of sponsoring a statewide consumer oriented assistive technology event to identify and collaborate in reducing barriers to the proper acquisition of assistive technology.

Created three regional Demonstration Centers in collaboration with the South Dakota state agencies and Independent Living Centers. This program is important to children receiving devices quickly and impacts over 200,000 citizens.

Established an assistive technology devices Clearinghouse in Arkansas that offers individuals current information, device-specific training, state-of-the art technology for loan and technology exchange and recycling opportunities.

Entered into a memorandum of understanding with the Northern Marinas College Department of Education to operate the Abilities Center. The Center is designed to function as a One Stop Shop for parties interested in purchasing or selling Assistive Technology devices and or support services. The MOU is currently pending final approval, which is expected before the end of this fiscal year.

Provided a guide book that includes a self evaluation for public agencies in New Mexico to comply with Section 508 of the Rehabilitation Act. This self audit instrument also provided employers with a means to assess needs and the ability of provide reasonable accommodations to employees within public and private employment organizations and helps consumers increase information regarding their rights to obtain assistive technology devices and services in the workplace.

Impact on Policies

New York has provided information and technical assistance on assistive technology to other agencies and has been able to affect policies in the following ways: Information provided by the project allowed assistive technology to be included in the Early Intervention State Statute; assisted the State Education Department in the development of a memorandum on school district responsibility for access to assistive technology and a memorandum clarifying district authority to transfer devices; assured assistive technology provider capacity to be a required consideration in Medicaid Managed Care arrangements; assured assistive technology was included as a priority in the Developmental Disabilities Planning Council Federal Plan; help develop state policy with the Governor's Task Force on Information Resource Management, to ensure equitable access to information technologies and electronic equipment for employees and the general public with disabilities; serves in advisory and decision-making capacity on several Bell Atlantic telecommunications initiatives, including the Telecommunication Equipment Distribution Program and the development and awarding of grants for the expansion of the States telecommunications infrastructure with assured access for persons with disabilities.

Improved Practices

New York facilitated and funded the development of guidelines for acquiring wheelchairs and seating systems through the Medicaid program so that evaluation and decision-making procedures could be implemented to ensure appropriate, consistent and cost-effective purchases by Medicaid.

South Dakota changed and increased the options for solutions to problems resulting from disability in VR, education, and elderly through increased access to assistive technology via the statewide equipment loan library, regional coordinators, I&R and training.

Increased Skill Levels

Wyoming provided statewide "Parental Advocacy Training" for parents of children with disabilities to assist them to effectively advocate for assistive technology within the special education system.

Texas conducted a statewide orientation and in-service training on assistive technology for ECI providers and families.

Iowa collaborated with 4 other Tech Projects and the AMA to develop a training module for physicians on assistive technology. Iowa has incorporated this training into Univ. Of Iowa College of Medicine Family Practice Gerontology Residency Program and the University of Osteopathic Medicine clinical programs. Iowa provided the accompanying guidebook, "Guidelines for the Use of Assistive Technology: Evaluation, Referral, Prescription" to Family Practice and Internal Medicine physicians in private practice in the state. Iowa developed an additional module for use in continuing education programs by community physicians through the Iowa Hospital Association.

New York collaboratively developed a training module with the State Education Department called "Toward Reasonable Solutions: Assistive Technology for School-Aged Children and Young Adults." This training built the capacity of school districts, families and providers to meet the assistive technology needs of school-aged children and young adults.

Maryland, in conjunction with the Division of Rehabilitation Services has established the Universal Workplace, a demonstration, display and loan center, for hands -on presentation of assistive and adaptive technology.

Providing Information about the Availability and Potential of Assistive Technology - Unmet Needs:

A consistent and ongoing mechanism to provide information about the availability and potential of evolving technology to consumers, providers, employers and payers will be needed especially as Americans age and the number of persons with disabilities increases. Continually changing systems (i.e. healthcare, education, vocational rehabilitation, telecommunications) will require that consumers will need to have access to updated information about the funding policies of new insurers and programs covering assistive technology devices and services. As industry develops new technologies, new methods for effectively evaluating the applications of this technology and assuring availability of information about the potential uses of the technology will be needed.

Challenge 4

Providing Outreach to Rural and Underserved Persons about Assistive Technology

[USC P.L. 100-407]

Accomplishments/Outcomes:

Increased Knowledge Levels

Through a grant from the Maryland program, the NFB was able to expand its Newsline Service, which reads from five major newspapers to registered participants through the telephone.

California developed the Accessing assistive Technology resource book in multiple languages and distributed it to over 25,000 individuals throughout.

Missouri delivered information and advocacy services and regional outreach center allowing individuals with disabilities to obtain assistive technology.

Rhode Island completed and disseminated a Medicaid Handbook for consumers that explains Medicaid and is written in English and Spanish through agencies and organizations.

Iowa increased the awareness levels of over 4,000 under-served and under-represented consumers in the state through: a) the "small changes ..BIG DIFFERENCES" awareness projects for the elderly, persons with HIV/AIDS, parents of infants and toddlers with disabilities, and the chronically mentally ill; and b) Project Reaching Out to African Americans and Hispanics.

New Mexico and Alaska raised awareness of assistive technology for American Indians with disabilities throughout the country when they produced a series of videos entitled " American Indians with Disabilities Public Awareness Campaign." This model consumer responsive awareness and outreach program was aired on 513 public Radio Stations in 241 Native American communities and 30 States for four years to build awareness of the importance of assistive technology in the lives of American Indians with Disabilities. Operated two thirty-two foot mobile trailers filled with assistive technology devices which are pulled to remote areas of the state where consumers are able to try items not available in their communities. The program has reached over 200,000 citizens over the last four years.

Effects on Organizational Structures

Alabama collaborated with the state Commission on Aging to provide training on low tech, low cost independent living devices for over 6,000 seniors with limitations. Through shared knowledge and experience, it is estimated that a total of 24,000 seniors were affected.

Improved Policies

The Arizona Technology Access Program supported 11 consumers from various Arizona reservation communities to attend the first annual joint conference of the Aging American Indians and those with disabilities. Assistive technology, disabilities issues, cultural issues and self-advocacy, were the focus of the conference. The Arizona Indian Council on Aging subsequently produced a resolution in support of efforts to recognize and enforce equal status of American Indians with Disabilities in Arizona.

Improved Practices

Minnesota reached out to over 80,000 individuals through mobile outreach programs that provide assessment , evaluation, fitting customization, repair and maintenance of assistive technology via the statewide equipment loan library, regional coordinators, I &R, and training.

Minnesota awarded over $2 million in grants and scholarships to improve access and awareness of assistive technology, 75% in rural areas.

Minnesota gave "Regional Assistive Technology Grants" to 43 community organizations to purchase expensive high tech items otherwise unavailable in small communities, provide seed money to match public and private resources, conduct rural training, recreation for individuals with disabilities, multi cultural and multilingual outreach, development of new technologies.

Providing Outreach to Rural and under Represented Areas about Assistive Technology Devices and Services - Unmet Needs:

As the population of elderly persons grows and the number of persons living in rural areas increases, more outreach to these areas and populations regarding assistive technology devices and services will be required.

More outreach regarding assistive technology will need to be provided by Tech Act Projects as a growing number of Americans use English as a second language.

As the health care system changes to accommodate the efficiency of managed care and more hospital mergers take place, fewer providers will be available to administer assistive technology to rural and underserved populations. Alternative approaches such as telemedicine will be utilized more heavily. Tech Act Projects will be needed to lessen service delivery gaps by continuing to provide information and technical assistance regarding the provision, access, acquisition, evaluations for and funding of assistive technology in rural and underserved areas.

Challenge 5

Ensuring Systems Provide Timely Acquisition and Delivery of Assistive Technology Particularly with Respect to Children

(USC P.L. 100-407)

Accomplishments/Outcomes:

Increased Knowledge Levels

New York customers with disabilities can access information, technical assistance and guidance through the Project's Regional TRAID Centers. At the RTCs, customers identify their desired outcome. Staff assist the individual and track progress across milestones of gaining awareness, exploring options, selecting, acquiring and using the assistive technology that meets individual need. In 1996, over 13,600 contacts were made with customers. With assistance from the RTCs, over 10% of these individuals acquired and used the device or service they identified as needed. (The average cost per contact was $39.44 for most individuals and $45.80 for early intervention customers.)

Marianas Islands has designed an "Abilities Center" that will function as a 'One-Stop Shop" for individuals to increase knowledge levels when purchasing, or selling assistive technology and accessing necessary support services.

Legislative Measures

The Illinois Project assisted the Attorney General's Office in amending the Victim and Witness Compensation Act, by adding provisions whereby expenses for purchase, lease or rental of equipment and any necessary modifications to real and personal property to ensure its accessibility or usability in connection with any functional limitations sustained by the victim of a violent crime can be paid for.

Effected Organizational Structures

The Alabama Projects newly established statewide assistive technology recycling center provided 140 people with disabilities with equipment in its first 3 months of operation; projecting 600 individuals and families will be assisted annually.

Influenced Policies

The Massachusetts Project was instrumental in the issuance of a definitive clarification that assistive technology covered under rehabilitation technology is not subject to pursuit of comparable benefits under the regulations for the Rehab Act as amended in 1992.

Pennsylvania, in conjunction with the legal advocacy community, pursued and monitored legal remedies to increase access to assistive technology in schools and the EPSDT provisions of Medicaid.

Kansas expanded assistive technology devices listed on State Contract and effected streamlining of procurement policies while Alaska has exempted assistive technology from state purchasing procedures to expedite their acquisition.

Indiana clarified problems such as timely payment of a communication device and resolved inconsistencies in billing codes and units. This has been important because of the large number of consumers effected.

Connecticut is working with the Department of Administrative services, to modify state purchasing procedures. This should result in less delay for consumers who get assistive technology through state agencies. As part of this process we are discussing 508 compliance as well.

The New Mexico "ABLE" statewide bank loan program provides an innovative way for special education students and families in 83 out of 88 school districts to obtain "loaner equipment" for try-outs and use in evaluation and assessments for communication and computer devices prior to purchases.

Kentucky developed an Assistive Technology Matrix and arrangements for its availability on their state's Education Department Home Page has enabled teachers to make timely pre approved purchases, paid for with state Education Technology funds.

Delaware expanded the potential for timely access and delivery for children by quadrupling Medicaid expenditures for DME in the last five years, with the major proportion of the spending increase attributable to purchases for 0-5 year olds (i.e. sevenfold increase) and a sixfold increase to the 6-17 age group.

Ensuring Timely Acquisition to Assistive Technology - Unmet Needs:

Tech Act Projects will be needed to evaluate newly implemented, streamlined procurement and Assistive Technology transfer policies and to ascertain cost efficiencies.

Evaluations will be needed to determine the impacts of policies aimed at improving timely acquisition of equipment. Without such evaluations, barriers to the timely acquisition of equipment can not be determined. Consequences such as the abandonment of devices because of changes in a consumer' s needs or personal characteristics will continue to occur.

After implementation of innovative approaches designed to decrease waiting time for assistive technology, documentation, evaluation and recommended replication of such approaches needs to occur.

New uses for emerging information technology provides a potential avenue to decrease waiting periods for acquisition of assistive technology.

Challenge 6

Coordination Among and Between State and Private Entities, Particularly with Respect to Transitions

(USC P.L. 100-407)

Accomplishments/Outcomes:

Increased Knowledge Levels

Alabama, in concert with their Commission on Aging, provided training to over 6,000 seniors on low tech, low cost independent living devices and projects a knowledge and experience impact on 24,000 senior citizens.

Oklahoma collaborated with Office of Personnel Management and Department of Civil Services to secure "508" training for state agency employees. New Mexico's Information and Telecommunications Accessibility Self-Audit Instrument (I/TASI) and guidebook allows self evaluation of compliance with "508"; expands employers' abilities to make reasonable accommodations, and increases consumers' information on rights to obtain "AT" in the workplace.

Legislative Measures

Minnesota Project was instrumental in the passage of both the Inter-operability and Access to Computers in grades K -12 and Equipment Transfer and Reassignment statutes.

Effects on Organizational Structures

California established the State Interagency Committee on Technology-Related Assistance to reduce duplication of state efforts and coordinate state agency provision of assistive technology to consumers and employees.

Wisconsin initiated a model system for assistive technology advocacy, information, assessment, tryout, and purchasing coordination through the independent living centers.

Rhode Island formatted "Technology Teams" enabling school systems to assist families, school personnel and students to incorporate assistive technology in IEP and Transition Plans.

Puerto Rico developed a collaborative agreement with state agencies, (i.e. Vocational Rehabilitation, Department of Health), public private institutions (Rio Pedras Campus, Polytechnical University) for provision of assistive technology.

Vermont collaborated with Vocational Rehabilitation Department of Employment and Training to make all twelve of DET's regional offices true "one-stop shops" for persons with disabilities. All sites have the equipment necessary so that consumers with vision, hearing or mobility impairments can access all the services DET has to offer. Each site has newly trained staff to assist the consumers. This is leading to expanded employment choices for individuals as well as stopping some of the segregation between vocational rehabilitation and the Department of Employment & Training.

New York made policy inroads including expanding their existing I & R database and service as the NYS Department of Health Central Directory of Early Intervention Program, a resource which is used by families and care coordinators.

Impact on Policies

New York facilitated the issuance of Education Department field memoranda regarding access to "AT" in the IEP, and the transfer of "AT" equipment which was co-signed by the State Comptroller.

New York was able to facilitate and fund a collaborative project with the Department of Health to develop guidelines for evaluating, prescribing and funding wheelchairs and seating, positioning systems within the State Medicaid program.

Utah Assistive Technology Interagency Agreement clearly lays out how all State agencies that provide "AT" cooperate in its delivery.

Rhode Island made an agreement with the Division of Special Needs of the Department of Education includes a mechanism for dissemination of policies relating to the purchase of "AT" for children 3 - 21.

South Dakota established a statewide equipment loan library increased access while creation of two inter-agency "AT" purchase agreements involving Education, VRS, Services for the Blind, Social Services, Labor and VA reduce cost to each agency and smooth transition for the consumer, potentially assisting 60,000 individuals with disabilities in the state.

Wyoming has agreed in principal, and drafting is underway on the agreement between Division of Vocational Rehabilitation and Department of Education to reduce cost, increase student access, and improve transition coordination for assistive technology.

Iowa collaborated with state agencies that resulted in the following: new policies regarding assistive technology service delivery in Special Education and the Division of Vocational Rehabilitation; created designated assistive technology service providers within a state agency; provided annual and ongoing training on assistive technology service delivery issues to designated assistive technology teams in each region of the state for education and Vocational Rehabilitation.

Coordination Particularly with Transitions - Unmet Needs:

Successful collaborations (e.g. committees, task forces, interagency agreements, resource teams etc.) need to be sustained with consistent membership and expertise to avoid the need for new personnel and new training to address mutually important issues.

Evaluation mechanisms will need to be initiated which track the use, impact on abandonment, consumer satisfaction, and cost efficiencies resulting from implementation of "AT" transfer and transition policies and procedures.

New opportunities have recently emerged that will allow for enhanced public/private partnerships that further coordination of services for consumers, and will require training regarding effective employment transitions through implementation of legislative responsibilities.

Viable alternative uses (e.g. try-outs, demos, assessments, lending, recycling etc.) Must be sought for the remaining inventory of equipment not transitioned with students under transfer agreements.

Challenge 7

Assuring States and Territories Have the Capacity to Provide Assistive Technology

(USC P.L. 100-407)

Accomplishments/Outcomes:

Increased Knowledge Levels

Missouri developed and distributed an Alternative Communication Resource Guide to state agencies, community providers and individuals with disabilities providing information and resources to assist in the delivery of alternative communications such as interpreting services, real-time captioning, braille, and large print.

Minnesota produced a comprehensive statewide directory of funding for assistive technologies reaching over 50,000 individuals and organizations.

Alabama collaborated with the Commission on Aging to provide training on low tech, low cost independent living devices for over 60,000 seniors with limitations. Through shared knowledge and experience, it is estimated that a total of 24,000 seniors were affected.

New Hampshire developed an information and referral system that has responded to over 3000 requests for information from residents.

Maine increased assistive technology related capacity and knowledge base of Centers for Independent Living, Client Assistance Program, Parent Training and Protection and Advocacy organizations.

New Mexico developed and tested in a guide book with a self evaluation for agency compliance with section 508 of the Rehabilitation Act. This self-audit instrument provides employers in New Mexico with a means to assess needs and the ability to provide reasonable accommodations to employees within public and private employment organizations and helps consumers increase information regarding their rights to obtain assistive technology devices and services within the workplace.

During the third year of an evolving project to ensure consumer involvement, the Northern Marianas Islands will train consumers to conduct needs assessments and evaluating satisfaction with AT services.

Legislative Measures

Arizona established a 15 member advisory board, made up of majority of consumers from around the state who use AT, key state agency representatives, a service provider representative, and a vendor representative. Significant outcomes include the development and prioritization of 23 activities to affect changes in regulations, laws and practices; The board supported and gave recommendations to the Arizona Center for Disability Law (ACDL) for the passage of an Arizona AT lemon law.

Minnesota passed legislation in assuring consumers have access to assistive technology.

South Dakota passed a law expanding the telephone distribution program for deaf and deaf/blind individuals.

North Carolina helped develop new state legislation to make the state equipment purchasing process more flexible for individuals with disabilities.

Illinois introduced a bill in Illinois that created the Assistive Technology Evaluation and Training Center Act. The bill provides that the Department of Human Services shall establish one or more centers that offer comprehensive evaluations for assistive technology, and training for professionals who provide AT on uses and costs.

Impacted Organizational Structures

Arizona conducted a survey of all Consumer Action Network (CAN) members to identify barriers to assistive technology and possible solutions, and to identify strategies for improved collaboration among AzTAP, its advisory board and the CAN. Survey results were compiled and shared with the 21 CAN members from around the state to participate in brainstorming meeting with AzTAP staff in order to generate priorities for the project and to improve communication. Recommendations were subsequently submitted to the new advisory board, along with other needs data.

Kentucky established an assistive technology delivery system for the state early intervention system utilizing 15 regional points of entry statewide and including, training, loan libraries, equipment tracking and service monitoring. The system served 996 participants in 1996.

Rhode Island formed "Technology Teams" in school systems related to assisting families, schools and students to incorporate assistive technology in the IEP and Transition Plans.

North Dakota coordinated the development of a statewide Assistive Technology Action Committee comprised of North Dakota state administrators of public and private agencies, consumers, and supported by the governor's office for the purpose of sponsoring a statewide consumer oriented Assistive technology event and to identify and collaborate in reducing barriers to assistive technology.

The Island of St. Thomas and St. Croix established two Assistive Technology Centers.

Georgia established seven Tech Resource Centers to reach out to rural areas.

Wisconsin coordinated purchase of assistive technology through Wisconsin Independent Living Centers to conduct assessments and loan.

By working collaboratively with the Nebraska State Education Department, established an assistive technology center for straining and technical assistance for all state schools.

Louisiana influenced the Department of Rehabilitation to hire a Technology Program Manager and establish rehabilitation technology as a priority for the agency.

New York funded four local, not-for-profit organizations to develop a computer recycling program to enable persons with disabilities with no resources to have access to computers.

Impact on Policies

Connecticut was a key participant in working toward the development of statewide guidelines in the public schools. These guidelines will be issued by the State Department of Education and will be a key step toward statewide consistency in addressing the AT needs of students.

New York assisted the State Education Department in assuring the inclusion of assistive technology in the Early Intervention State Statute; assisted the State Education Department in developing a memorandum on school district responsibility for access to assistive technology and a memorandum clarifying district authority to transfer devices; assured that assistive technology provider capacity is a required consideration in Medicaid Managed Care arrangements; ensured that assistive technology was included as a priority in the DDPC Federal Plan; helped develop state equipment and information access policy for the Governor's Task Force on Information Resource Management to ensure equitable access to information technologies for employees and the general public with disabilities; serves in a decision making capacity on Bell Atlantic telecommunications initiatives to develop and award grants for expanded telecommunications infrastructure with assured access for persons with disabilities.

Illinois influenced the State Department of public aid to include Augmentative Communication devices as a covered service for children and adults allowing nearly 160 Augmentative communication devices to be approved. The Illinois project was also asked to assist in drafting the guidelines for approval of Augmentative communication.

Alabama collaborated with the Department of Rehabilitation services to introduce 12 policy changes leading to increased coverage of assistive technology. This systems change will affect the more than 38,000 individuals provided VR services in Alabama annually.

Pennsylvania, in conjunction with the Pennsylvania legal advocacy community, pursued and monitored legal remedies to increase access to Assistive technology in Medical Assistance.

Kansas streamlined state purchasing policies and expanded purchasable assistive technology devices listed on the Kansas state contract.

Missouri developed recommendations to assist the Division of Medical Services to implement the state's Medicaid managed care program and the "Permanently and Totally Disabled Pilot Project" with particular emphasis on the inclusion of consumer protections that have been nationally recognized as a model for use in other States.

Iowa collaborated with state agencies that resulted in the following : new polices regarding assistive technology in Special Education and the Division of Vocational Rehabilitation; created a designated assistive technology service provider within a state agency; provided annual and ongoing training on assistive technology service delivery issues.

Nevada ensured better capacity to provide assistive technology by persuading both the Vocational Rehabilitation and Blind Services agencies to adopt "Tech Points" as part of their Nevada state plan.

North Dakota facilitated activities to develop assistive technology guidelines within the Department of Public Instruction, clarified and modified procedures within the Medicaid process, provided technical assistance to VR in developing 3 year plans in the area of Assistive technology and technical assistance.

New York collaborated with the Department of Health, Early Intervention Program, to adopt an outcome funding approach to select and administer the Regional TRAID Centers to improve the outcomes for consumers, management and allocation of resources. With the assistance of the Regional TRAID Centers, over 1,300 individuals acquired a device or service in 1996, the first year of outcome based contracts with the Regional TRAID Centers.

New York facilitated and funded the development of guidelines for the State Medicaid program involving the evaluation and decision making process for approval of wheeled mobility, seating and positioning equipment.

Tennessee established first contract by an Assistive technology center with an LEA to provide training and student evaluations and to develop school based technology teams to work with other LEAs in Tennessee.

Wyoming reached an agreement with the Division of Rehabilitation and the Department of Education to reduce the cost of assistive technology for students with disabilities for all parties involved while increasing student access to assistive technology and improve transition coordination.

Wyoming established the "Sports and Outdoor Assistive Recreation (SOAR)" program to improve access to existing outdoor recreation by people with disabilities through the use of assistive recreation technology.

Missouri developed recommendations for language in the Medicaid Managed Care Program to improve consumer protections and assure access to assistive technology and related services for Medicaid eligible persons with disabilities.

Delaware collaboratively formed the Assistive Technology Work Group with Delaware division of Mental Retardation to determine mechanisms whereby the goal of comprehensive AT-related service delivery may be achieved. In order to determine the extent of the financial and personnel commitment necessary to achieve the goal, a study is underway to evaluate the AT-related need of a subset of DMR population. Delaware is conducting this study with the DMR and the Developmental Disabilities Planning Council. The results of the study will inform future financial projections and budgetary allocations, and will support the refinement of a personnel training agenda.

Texas assured that assistive technology is addressed in the state rehabilitation plan and state supported employment strategic plan.

New Mexico implemented, through the "Cooperative Agreements" with schools districts plan, an assistive technology loan program. The Program requires the school to tie IEP goals to purchase of assistive technology equipment and timely implementation.

Alaska established a wide variety of services to assure that individuals throughout the state have access to assistive technology.

Arkansas expanded the capacity of state agencies to effectively tap Medicaid dollars for assistive technology for children and adults.

South Dakota created two tier-agency assistive technology purchasing agreements involving, Education, VRS, Services to the Blind, social Services, Labor and VA, which reduces the cost to each agency and provides a smooth transition for the client.

Oklahoma brought together Medicaid and the Department of Education to increase the number of school districts that will become Medicaid providers.

South Dakota developed, with three other agencies, an equipment recycling program which brings low cost assistive technology to 720,000 citizens.

Delaware increased the capacity of school districts to respond to the AT-related needs of students has increase as a result of systems- change efforts directed toward both policy and practice. The Delaware Department of Public Instruction jointly appointed an AT/Education Task Force to examine the barriers to AT access.

Increased Skill Levels

Nebraska enhanced the capacity of organizations, such as the Centers for Independent Living, Goodwill, Paralyzed Veterans of America , United Cerebral Palsy Associations, Educational Service Units and state agencies to create awareness and provide hands-on trial use of devices.

Idaho increased the number of service providers with "AT" expertise via a wide range of in- service and pre-service training.

Assuring Capacity to Provide Assistive Technology Devices and Services - Unmet Needs:

As government agency responsibilities are shifted with changing administrations, technical assistance is needed for changing staff to assure there is adequate knowledge and skill levels to assess the value, provide and adequately fund assistive technology.

Similarly, in healthcare, as managed care companies are used to provide health care, education must be provided on an ongoing basis to assure there is adequate capacity to provide assistive technology device and services.

As the demand for assistive technology grows with the aging population and recognition of the benefits of assistive technology, the capacity to provide quality devices and services will become more difficult. As a result, the Tech Act Projects will play an even more critical role in assuring there is capacity within state and private organizations to provide high quality, cost-effective assistive technology devices and services.

Challenge 8

Individuals with Disabilities Cannot Access Existing Telecommunications and Information Technologies

(USC P.L. 100-407)

Accomplishments/Outcomes:

Increased Knowledge Levels

New Jersey through collaboration with Bell Atlantic has hosted interactive video conferences and public forums to reach rural populations.

New Mexico developed an information and telecommunications accessibility self audit instrument (I/TASI) and guidebook which expands agencies capabilities to self-evaluate compliance with Section 508 of Rehab Act, provides employers with both a means to assess need and the ability to make reasonable accommodations, and increases consumer's information regarding their rights to obtain "AT" in the workplace.

Legislative Measures

Massachusetts Technology Project played a major role in the development of the Telecommunications Access Advisory Committee report containing consumer-friendly, industry and disability consensus recommendations for implementation of the accessible telecommunication provisions of Section 255 of the federal Communications Act of 1996.

New Hampshire fostered passage of the Telecommunications equipment distribution program bill that now enables delivery of telecommunication equipment to low income residents of the state.

Missouri passed legislation establishing an equipment distribution program providing individuals with disabilities adaptive devices needed to access basic telephone service (amplifiers, telebraillers, hands-free phone etc.)

Pennsylvania passed legislation to allow for the Telecommunications Device Distribution Act. Almost 500 devices went to more than 250 eligible recipients in the first 10 months of operation of the Telecommunications Device Distribution Act.

Impact on Policies

New York Project served in both advisory and decision-making capacity on state and private Bell Atlantic telecommunication initiatives to develop and award grants for the development of the State telecommunications infrastructure and assures access to persons with disabilities; to develop policy and processes for distribution of telecommunications equipment through the Bell Atlantic Equipment Distribution Program and participating on Bell Atlantic's Universal Design Committee to ensure access to existing and newly-developed products and services.

Maine introduced assistive technology access issues into statewide telecommunications discussion and the inclusion of "AT" into local school technology plan guidelines.

Missouri delayed state agency procurement of inaccessible software via an Office of Administration policy, which prohibited purchasing until adequate assurance of compliance with Section 508 of the Rehab Act was obtained.

New Mexico Project set a national precedent in developing a written 508 policy, signed by the Governor in 1991 and incorporated into the Procurement and Procedures Section of the State's Information Systems Plan under the authority of the Information Services Council.

Improved Practices

Maine has developed the statewide capacity for consumers and schools to communicate about assistive technology through electronic networks.

Massachusetts successfully used Section 508 of the Rehab Act to leverage state government information technology purchasing power to convince Microsoft Corporation to develop Microsoft Active Accessibility, ensuring better compatibility between screen readers and applications running on Windows 95.

The Arizona program supported the computer needs and Internet access of several CAN communities in order that they have more timely information regarding AT, better communication between and among their members, better communication among other CAN communities, and ongoing access to the activities of the advisory board.

The Arizona program supported the development and operations of the Easter Seal's Computer Placement Program (CPP) and the Arizona Families On-Line (AFOL) program. Together these two programs place computers in the homes of persons with disabilities and provide them with greater communication and information by providing access to the Internet.

Arizona established several Internet virtual conference centers as a way to improve the practices of the AzTAP advisory board. Each board member will soon be equipped with Internet access and will be able to participate as an active committee member regardless of location or disability. Most conference sites are also visible to any member of the public with Internet access.

Access to Telecommunication - Unmet Needs:

Tech Act Projects must be available to keep other agencies, organizations and providers abreast about the implementation of provisions of the Federal Telecommunication Law and the emerging applications of telecommunications in new areas (e.g., telemedicine, distance learning, banking, cable shopping networks, access to public events, voter registration, etc.) to ensure applications are accessible for persons with disabilities.

The Tech Act Projects must continue to serve as a liaison to ensure participation of consumers with disabilities in product, program, and service planning activities and be assured principles of accessibility and universal design are incorporated in program design to reduce costly retrofitting.

Opportunities for leveling the playing field by providing outreach to underserved populations and alleviation of distance and transportation barriers with telecommunications technologies, and employment options for, can be realized through the Tech Act Projects.

Tech Act Projects will be needed to coordinate improved telecommunication access efforts with initiatives for new product and/or technology applications generated through Defense Tech Transfer, Federal Labs and other NIDRR Rehab Engineering grantees.

Challenge 9

Providing Incentives for Commercial Pursuit of the Application of Technology

(USC P.L. 100-407)

Accomplishments/Outcomes:

Legislative Measures

Massachusetts, Connecticut, Idaho, South Dakota, Kansas, Oklahoma, Missouri, Rhode Island, Minnesota and Louisiana have passed lemon laws or warranty legislation covering a variety of assistive technology to make manufactures accountable in quality design, fair marketing strategies, and sale of reputable equipment.

Improved Practices

The Minnesota Project made Regional Assistive Technology Grants to 43 community organizations who used it to provide seed money to match public and private resources and develop new technologies.

The New York Project, in collaboration with the NYS Developmental Disabilities Planning Council, funded competitive Innovation Grants to local organizations and entities to develop new applications of assistive technology, from device development (a device to monitor traffic for persons who are blind or visually impaired), to modifying service practices (the development and use of adapted dentistry tools and practices to treat persons with developmental disabilities).

Commercial Pursuit of Application of Assistive Technology - Unmet Needs:

Further legislative measures that clarify "unusable equipment" based on defective product features and workmanship are needed to assure consumer protections.

Tech Act Projects are needed to increase the ranks of informed consumers with disabilities, empowering them to utilize their purchasing power within the marketplace to insist on quality products, thereby, giving manufacturers incentives to pursue universal design and production of commercial applications of techno-logy responsive to consumer/purchaser needs.

Tech Act Projects will be needed to design and implement monetary or market share incentives that can augment effective production and purchase of assistive technology required by an evolving marketplace of increased company mergers and expanded managed care delivery arrangements.

Tech Act Projects will be needed to track and evaluate Innovative mechanisms for public/private partnerships and community involvement focused on technology development, creating incentives for replication of successful ventures.

Coordination among Agencies That Provide or Pay for "AT" Assistive Technology at the Federal Level

Tech Act Projects have made significant changes in addressing many of the other "challenges" cited in the findings section of the law. Much still remains to be done.

Tech Act Project's ability to build a national momentum to respond to proposed federal regulations and program changes, fostering more consistent interpretation at state level needs to be strengthened. Opportunities at the federal level to infuse consistency, collaboration between federally funded initiatives and consumer responsive access in the design of programs is needed. Better data collection, analysis, evaluation and reporting is also needed to assure Tech Act Project' have effectively impacted systems and achieved outcomes.

Dr. Katherine Seelman, Director of NIDRR, also noted some barriers to the effective acquisition and integration of assistive technology when she said the following before the United States House of Representatives Committee on Science and Subcommittee on Technology on July 15, 1997.

"Looking to the future, population trends as well as trends in technological developments will require attention. Massive and pervasive changes in mainstream technology will create not only new opportunities, but also new barriers.

With respect to trends in the globalization of technology, and the concomitant rapid economic changes, many experts believe that the U.S. and international markets for assistive technology will:

experience significant growth in the years ahead,

be very receptive to the introduction of new devices,

need to respond to consumer demand for improvements to the quality of existing assistive technology devices, and

Demographic studies reveal the trend to the aging of the U.S. population, and that is a trend experienced by other industrialized nations. An older population has greater assistive technology needs that a younger population. Older Americans use assistive technology to prolong the time they can live independently in the community and to reduce the costs of long-term care."

These factors and trends are evidence of the continued and increasing need for assistance to States and Territory's Tech Act Projects. The accomplishments of Tech Act Projects thus far substantiate the merits of the Tech Act as a mechanism for state, federal and private sector coordination and collaboration to effect systems change adequate to ensure access to assistive technology into the next century.

Conclusion

"Our strength is our diversity, our history is rich with experience, our commitment is to the consumer . . . "

In 1988, when Congress passed the "Technology-Related Assistance for Individuals with Disabilities Act", they affirmed a national, federal-level commitment to insuring that individuals with disabilities in all states would gain knowledge of, access to, and funding for assistive technology. Congress recognized that AT is integral to empowering consumers to achieve independence, productivity, and inclusion in education, the workforce and community life. Access to assistive technology is a fundamental right that is inextricably interwoven with the right to an appropriate education, equal opportunity for employment, accessible housing, and public access. For often, without the appropriate assistive technology, these other rights are severely compromised. The fifty-six state and territorial Tech Act projects have risen to the challenge of the Tech Act to effect the systems change necessary to meet the assistive technology needs of consumers with disabilities.

Many of the accomplishments of the Tech Act Projects are summarized in this document.

The beauty of the Tech Act is that it is the vehicle through which every state and territory can respond to the unique needs of consumers in that region yet also share with and learn from 55 other projects with the same primary focus - a focus serving a constituency that is rare among entities meeting the needs of individuals with disabilities in that it serves consumers cross-age and cross-disability. The breadth of this focus has been both a blessing and a curse. The blessing is the expectation that we will be all things to all people. The curse is the expectation that we will be all things to all people. Tech Act Projects have risen to that challenge, not only by forming a collaborative network among themselves but more importantly by becoming strong collaborative partners with (and often subcontractors to) state agencies, private businesses, non-profits such as Centers for Independent Living, United Cerebral Palsy, Easter Seals, UAP's, and other service providers in their states. This collaboration has resulted in revolving loan programs, statewide recycling of AT, regional demo and tryout centers, technical assistance and training for both consumers and professionals, and the development of effective and consumer responsive protocols for Departments of Education, Medicaid offices and Vocational Rehabilitation, to name just a few examples.

What Congress did not anticipate ten years ago as the Tech Act was authorized was the impact that the unprecedented rapid developments and changes in the field of mainstream technology would have an the world of assistive technology. New technologies bring new opportunities for consumers with disabilities but also bring new challenges in accessibility and funding. As research and development of better technologies continues in the private and public sector, there must be a concurrent effort to insure accessibility and appropriate policy development.

Congress could not have anticipated the seismic shift to Managed Care and its' serious impact on private and public insurance coverage of assistive technology. Service delivery systems are not static and satisfactory resolutions of AT issues achieved five years ago can be instantaneously changed in the blink of a statute amendment or a policy revision.

Other challenges include the aging of the general population coupled with an increased expectation of maintaining independence in the home for as long as possible, building capacity in states to provide quality assistive technology devices, services, training, and referral that keeps pace with changes in technology, and developing alternative sources of funding AT as public funding programs decrease or stay level-funded.

The primary challenge for the future is to maintain all the benefits gained by consumers under the Tech Act while assuring an ongoing ability and expertise to adjust to future developments and changes in the field of assistive technology. The role that Tech Act projects play of collaborative facilitator of best practices is a vital role to maintain and every state and territory must have the opportunity to do so. Our strength is our diversity, our history is rich with experience, our commitment is to the consumer and we stand ready and able to meet the challenges of the twenty-first century with increased state responsibility joined with an ongoing national commitment to ensuring that all individuals with disabilities have the assistive technology they need to enjoy full and productive lives.

ATAP