DEPARTMENT

of HEALTH 

and HUMAN 

SERVICES 

FY 2017 Annual Report to 

Congress on the Assistive 

Technology Act of 1998, as 

Amended 

Prepared by 

ADMINISTRATION FOR 

COMMUNITY LIVING
2 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

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3 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

TABLE OF CONTENTS

EXECUTIVE SUMMARY ...................................................................................................................... 4

INTRODUCTION..................................................................................................................................... 6

ASSISTIVE TECHNOLOGY ACT HISTORY ..................................................................................... 6

ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED ............................................................ 7

STATE-LEVEL ACTIVITIES ................................................................................................................... 7

STATE LEADERSHIP ACTIVITIES ....................................................................................................... 7

STATE-LEVEL ACTIVITIES ................................................................................................................... 8

DEVICE DEMONSTRATION PROGRAMS ........................................................................................... 8

DEVICE LOAN PROGRAMS ............................................................................................................... 10

DEVICE REUTILIZATION PROGRAMS ............................................................................................. 11

STATE FINANCING ............................................................................................................................. 13

State Financing – Cash Loan Programs ............................................................................................ 13

Other State Financing Programs that Provide AT ............................................................................ 14 

Other State Financing Programs that Reduce the Cost of AT .......................................................... 14 

CONSUMER SATISFACTION RATINGS OF STATE LEVEL ACTIVITIES ........................................ 15

STATE ACTIVITIES PERFORMANCE MEASURES ..................................................................... 15

Acquisition Performance ...................................................................................................................... 15

Access Performance .............................................................................................................................. 16

STATE LEADERSHIP ACTIVITIES ..................................................................................................... 16

Training................................................................................................................................................. 16

Public Awareness .................................................................................................................................. 16

Information and Assistance................................................................................................................... 17

Technical Assistance ............................................................................................................................. 17

INITIATIVES FROM THE FIELD ..................................................................................................... 18

CONCLUSION ....................................................................................................................................... 19

Resource Information ............................................................................................................................. 20

List of Tables 

Table 1: Number of Device Demonstrations by AT Type .......................................................................... 9

Table 2: Number of Individuals by Type who Participated in Device Demonstrations ............................. 9

Table 3: Number of Short-term Device Loans by Type of Borrower ....................................................... 10

Table 4: Number of Devices Loaned by AT Type ................................................................................... 11

Table 5: Device Reutilization Summary by AT Type .............................................................................. 12

Table 6: Number of Recipients, Devices, and Savings by Type of Reutilization Activity ...................... 13

Table 7: Types and Dollar Amounts of AT Acquired with Financial Loans ............................................ 14

Table 8: Consumer Satisfaction with State-level Activities ..................................................................... 15

Table 9: Percentage of Technical Assistance provided by Agency Type ................................................. 17
4 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

EXECUTIVE SUMMARY 

People with disabilities and older adults use assistive technology (AT) to engage in employment, 

education, and all aspects of community living. AT can help individuals eat, bathe, read, walk, hear, 

communicate, and generally live more independent lives. In FY 2017, State and Territory AT programs 

served over 500,000 individuals by providing AT demonstrations, training, and information and referral, 

improving such individuals’ chances to advance socioeconomically and achieve optimal self-sufficiency 

and independence. 

Section 4 of the Assistive Technology Act of 1998, as amended (AT Act) authorizes grants to support 

programs that increase knowledge about, access to and acquisition of assistive technology devices and 

services for individuals with disabilities and older Americans. These programs include fifty-six 

statewide AT programs that provide device demonstrations, device loans, device reutilization, training, 

technical assistance, public awareness, and assistance with obtaining funding for AT. Statewide AT 

programs are required by law to collect data on their activities and provide annual progress reports to the 

Administration for Community Living (ACL). 

“State-level” and “state leadership” activities provide a continuum of services that reach a wide variety 

of individuals and provide access to a broad range of technologies. AT Programs enable individuals 

with disabilities, their representatives, and others working with them, to make informed decisions about 

accessing and acquiring technologies. The streamlined process for awareness of and access to AT 

allows consumers to receive information about a device and become familiar with it through 

demonstration and short-term device loan programs prior to making a costly purchase. When consumers 

are ready to acquire a device, the reuse and state financing programs provide an affordable purchasing 

avenue. 

This report is a compilation of data from these programs for FY 2017, contains information about the 

state-level and state leadership activities of the statewide AT programs, and highlights anecdotes of 

consumers maintaining their independence by utilizing various assistive technology through state-level 

AT activities. It is preceded by an introduction to the purpose of the document and a history of the AT 

Act and is followed by resource information containing contacts and data on each state AT program. 

ASSISTIVE TECHNOLOGY SERVICES FLOW: How Consumers Access and Acquire AT Devices 

The AT Act authorizes state leadership and state level activities designed to provide an integrated continuum of AT services 

for people with disabilities and older adults. The service flow begins with the individual learning about AT through public 

awareness, training and information and assistance; then exploring AT through device demonstration and/or borrowing AT 

to try-out and make informed decisions about what AT will work best. When the individual has made an informed decision, 

the individual can acquire AT for little or no cost through reuse programs or, if eligible, through financial loan programs or 

other financing options available. Each activity within the continuum provides critical access or acquisition to AT. 
5 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

FY 2017 AT Program Achievements from State-Level Activities Resulting in Positive Outcomes 

for Individuals with Disabilities 

Device Demonstration Programs

• 80,096 individuals participated in 49,056 device demonstrations.

• Projecting a modest $100 savings realized by just half of the total demonstrations conducted

results in national savings of $2.4 million.

Device Loan Programs

• Over 52,000 AT devices loaned on a short-term basis to individuals with disabilities, service

providers and agencies.

Using an average savings of $1,000 per loan with more than one device associated results in

national savings of over $15 million.

Projecting a minimum $10 per day rental fee for the average loan period of 35 days, results in

national savings of almost $4.2 million for devices borrowed.

•

•

Device Reutilization Programs

• Consumers saved over $29 million on nearly 75,000 gently used devices.

• 82% of recipients indicated that they would not have been able to afford the AT or obtain it from

other sources if it were not for the reuse services.

State Financing

• 853 borrowers obtained financial loans totaling $7,665,522 to buy 876 devices.

4,357 recipients acquired 5,768 devices valued at $3,836,113 from other state financing programs

that directly provide AT using external funding sources.

2,093 recipients acquired 3,735 AT devices with a savings of $1,573,345 from other state

financing activities.

93% of recipients indicated an AT device could not be obtained without the assistance of the state

financing activity.

•

•

•
6 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

ADMINISTRATION FOR COMMUNITY LIVING

FY 2017 Annual Report to Congress on the

Assistive Technology Act of 1998, as Amended

INTRODUCTION 

The Assistive Technology Act of 1998, as amended by Public Law 108-364 (AT Act of 1998, as amended, 

will be referenced in this report as the AT Act or Act) requires that the Secretary of Health and Human 

Services submit to Congress a report on the activities funded under the AT Act. Specifically, the 

Secretary of Health and Human Services is required to provide annually to Congress: (1) a compilation 

and summary of the information provided by state Section 4 grantees in annual progress reports to the 

Department of Health and Human Services; and (2) a summary of state Section 4 State Plan applications 

and an analysis of the progress of the states in meeting the measurable goals established in state 

applications under Sec. 4(d)(3) of the AT Act. This document serves as the Report to Congress for 

Fiscal Year (FY) 2017. 

This report summarizes data from the fifty-six Section 4 formula funded state AT program grantees, 

including all 50 states of the United States, the District of Columbia, Puerto Rico, the U.S. Virgin 

Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands. The term, 

AT Program, is used to describe all fifty-six Section 4 grantees. 

ASSISTIVE TECHNOLOGY ACT HISTORY 

In 1988, Congress passed the Technology-Related Assistance for Individuals with Disabilities Act (P.L. 

100-407) (Tech Act) to assist states with identifying and responding to the assistive technology (AT) 

needs of individuals with disabilities. Competitive grants awarded under the Tech Act were used by 

states to create systemic changes that improved the availability of assistive technology devices and 

services. States were provided with flexibility in the design of their programs, and this flexibility 

continued when the Tech Act was reauthorized in 1994 (P.L. 103-218). 

The Tech Act was reauthorized again in 1998 as the Assistive Technology Act of 1998 (P.L. 105-394; 

AT Act of 1998). The AT Act of 1998 required states to conduct capacity-building activities that 

increased the availability of funding for, access to, and provision of, AT devices and services and 

allowed states to conduct other discretionary activities as well. Title III of the AT Act of 1998 

authorized the Alternative Financing Program (AFP) to help individuals with disabilities and their 

families fund the purchase of AT devices or services. 

The AT Act of 1998 was amended in 2004 by P. L. 108-364 (AT 

Act). The amendments significantly changed the preceding 

legislation. Rather than focusing the efforts of states on systemschange activities, the AT Act requires states to conduct activities 

that directly provide individuals with disabilities and others with 

support to access and acquire AT. The program was changed 

from a competitive discretionary grant program to a formula state 

grant program with Section 4 providing formula grants to state 

AT programs and Section 5 providing formula grants to 

What is Assistive Technology 

(AT)? 

AT is any item, piece of equipment, or system, 

whether acquired commercially, modified, or 

customized, that is commonly used to increase, 

maintain, or improve functional capabilities of 

individuals with disabilities. 

(Source: AT Act of 1998, as amended, 29 USC §3002) 
7 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

protection and advocacy AT programs. As mandated by the 2004 amendments, the U.S. Department of 

Education, Rehabilitation Services Administration (RSA), assumed responsibility for administering 

programs under the Act as of December 2004. Previously, the Department of Education’s National 

Institute on Disability and Rehabilitation Research (NIDRR) administered the Act. 

In 2014, the Workforce Innovation and Opportunity Act (WIOA) transferred administration of the AT 

Act to the Department of Health and Human Services, Administration for Community Living (ACL). 

This data report provides a national summary of Section 4 grantee statewide AT program activities and 

outcomes for FY 2017. 

ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Section 4 of the AT Act authorizes the formula-based State Grant for AT Program and requires a 

common set of activities to be provided by all AT programs (with some limited exceptions explained 

below) to create consistency among grantees. With these grant funds, states develop and maintain 

statewide AT programs that conduct “state-level” activities and “state leadership” activities. Any funds 

appropriated above the FY 2004 level (which constitutes the base year amount) are allocated according 

to a formula that provides a portion of the funds equally to all states and a portion of funds based on the 

population of a state. Funding levels for FY 2017 for all fifty-six grantees along with other activity data 

are available from ACL’s data analysis and reporting assistance grantee, the Center for Assistive 

Technology Act Data Assistance (CATADA).1

STATE-LEVEL ACTIVITIES 

State-level activities include the following: 

 State financing activities, which can be: 

o Systems for the purchase, lease or other acquisition of or payment for AT devices and services 

(though states may not directly pay for AT devices and services for individuals with disabilities); 

or 

o Alternative financing systems, such as low-interest loan funds, interest buy-down programs, 

revolving loan funds, loan guarantees or insurance programs or other mechanisms for the 

provision of AT devices.2

 Device reutilization programs that support the exchange, repair, recycle or other reutilization of 

AT devices. 

 Device loan programs that provide short-term loans of AT so that individuals can try out devices or 

fill a temporary need for a device. 

 Device demonstration programs in which personnel familiar with AT demonstrate a variety of 

devices and services and provide information about AT vendors, providers and repair services. 

STATE LEADERSHIP ACTIVITIES 

State leadership activities include 

 Training and technical assistance comprises the development and dissemination of training 

materials, conducting training, and providing technical assistance to enhance the AT knowledge, 

skills and competencies of individuals. Five percent of state leadership funds must be used for 

training and technical assistance for students with disabilities who are getting ready to move from 

 

1 http://www.catada.info/. 

2 While they possess some similarities, “alternative financing systems,” as included under Section 4 state financing activities, need not be the same as those

formerly funded under Title III of the AT Act of 1998, which contains many specific statutory requirements.
8 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

school to adult life, including employment, post-secondary education, or independent living, and 

adults who need AT assistance to maintain or transition to community living. 

Public awareness activities designed to provide information on the availability, benefits, 

appropriateness and costs of AT devices and services, including a statewide information and referral 

system. 

Coordination and collaboration of activities among public funders under Title III of the AT Act 

and private entities responsible for policies, procedures or funding of AT devices and services 

specifically to provide AT. 





All state level and major state leadership activities are described in greater detail in this report. 

Section 4(e)(1)(B) of the AT Act allows states to opt out of funding a state-level activity if that 

activity is supported comparably with non-federal funds. Section 4(e)(6) of the Act provides 

states with the flexibility to carry out only two or three of the state-level activities. States that 

carry out all four state-level activities may use a maximum of 40 percent of their federal funds 

for state leadership activities. States that carry out two or three state-level activities may use a 

maximum of 30 percent of their funds for state leadership activities. 

The AT Act includes specific data collection requirements for state-level and state leadership activities, 

state improvement outcomes, leveraged funding, performance measure outcomes and consumer 

satisfaction. A data collection instrument developed to collect the Secion 4(f) required data elements 

was approved by the Office of Management and Budget (OMB) through October 31, 2017, and was 

used by all grantees to report FY 2017 annual progress report data summarized in this Report to 

Congress. 

A NATIONAL DATA SUMMARY OF STATE ASSISTIVE TECHNOLOGY PROGRAMS: 

FISCAL YEAR 2017 

STATE-LEVEL ACTIVITIES 

DEVICE DEMONSTRATION PROGRAMS 

Device demonstrations compare the features and benefits of a particular AT device or category of 

devices for an individual or small group of individuals (U.S. Department of Education [ED], 2011). 

Device demonstrations allow individuals and groups to make informed choices about an AT device prior 

to acquiring it. Along with providing demonstrations, AT Programs are required to provide 

comprehensive information about state and local assistive technology vendors, providers, and repair 

services. 

During the FY 2017 reporting period, all fifty-six AT Programs conducted device demonstrations as part 

of their state-level activities. State AT Programs classify device demonstration into 10 categories. 

‘Daily living’ and ‘mobility, seating’ were the two largest demonstration categories, each comprising 18 

percent of all demonstrations. Five additional device categories comprised between 7 percent and 15 

percent of all demonstrations (see Table 1). For more information on how AT devices are defined and 

classified, please visit https://catada.info/federal-reporting-forms/ and select “Classification of AT 

devices.”
9 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Table 1: Number of Device Demonstrations by AT Type 

Type of AT Device Number of Demos Percent

Daily living 8,606 18%

Mobility, seating 8,498 18%

Speech communication 7,391 15%

Computers and related equipment 6,087 12%

Vision 5,280 11%

Learning, cognition 4,793 10%

Hearing 3,649 7%

Recreation, sports, and leisure 2,030 4%

Environmental adaptations 2,092 4%

Vehicle modification and transportation 630 1%

TOTAL 49,056 100%

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

As illustrated in Table 2, individuals with disabilities (42 percent) comprised almost half of those 

participating in device demonstrations in FY 2017, followed by family members, guardians, and 

authorized representatives (24 percent). 

Table 2: Number of Individuals who Participated in Device Demonstrations 

Type of Individual Number of Participants Percent

Individuals with disabilities 33,845 42%

Family members, guardians, and authorized representatives 19,220 24%

Representatives of education 10,845 14%

Representatives of health, allied health, and rehabilitation 7,647 10%

Representatives of community living 4,854 6%

Representatives of employment 2,410 3%

Representatives of technology 1,275 1%

TOTAL 80,096 100%

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

Individuals who participated in device demonstrations were surveyed by AT Programs about the main 

purpose of the AT device for which they attended the demonstration. In FY 2017, community living 

was listed as the most common purpose (66 percent), followed by education (23 percent) and 

employment (11 percent). 

For AT Program purposes, education is defined as participating in any type of educational program. 

Similarly, community living is defined as participating in and carrying out daily activities in the 

community, using community services, or living independently. Employment means finding or keeping 

a job, getting a better job, or participating in an employment training program, vocational rehabilitation 

program, or other program related to employment. Lastly, information technology/telecommunications 

is defined as using computers, software, websites, telephones, office equipment, and media. 
10 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

DEVICE LOAN PROGRAMS

Device loan programs allow AT consumers and professionals who provide services to individuals with 

disabilities to borrow AT devices for use at home, at school, at work, and in the community on a shortterm basis. The purpose of a device loan may be to assist in decision-making, to fill a gap while the 

consumer is waiting for device repair or funding, to provide a short-term accommodation, to facilitate or 

support self-education by a consumer or professional, or to provide other training (ED, 2011). 

During FY 2017, fifty-five AT Programs reported providing 37,239 short-term loans of AT devices to 

individuals or entities. Individuals with disabilities were the largest group to whom devices were loaned 

(36 percent), followed by family members, guardians, and authorized representatives (22 percent). 

Please refer to Table 3 for a more detailed breakdown. 

Table 3: Number of Short-term Device Loans by Type of Borrower

Type of Borrower Number of Device Borrowers Percent

Individuals with disabilities 13,299 36%

Family members, guardians, and authorized 8,128 22%

representatives

Representatives of education 7,652 21%

Representatives of health, allied health, and 5,341 14%

rehabilitation

Representatives of community living 1,671 4%

Representatives of technology 575 1.5%

Representatives of employment 573 1.5%

TOTAL 37,239 100%

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

Devices for computers and related devices (17 percent) were the most common types of AT devices 

loaned in FY 2017, followed by speech communication devices (16 percent), and devices for ‘daily 

living’ (15 percent). Seven additional device categories accounted for the remaining 52 percent of the

device loans made (Table 4). 

Device Demonstration and Employment

Kirk needed the right technology to work from home. Since he is blind and has arthritis, he worked 

with the Kansas AT Program and Kansas Rehabilitation Services to determine what technology he 

needed. After receiving device and software demonstrations as well as short-term loans, Kirk 

received a laptop with JAWS, Duxbury, and Open Book; a scanner; a smart phone with tactile 

markers; and a Braille Focus 40 for Braille display. These new devices and technology enabled 

Kirk to study for, and pass, an exam to work as a vision specialist. Kirk works as a vision specialist, 

providing technical assistance over the phone to rural Kansans and individuals in other Midwest 

states. 
11 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Table 4: Number of Devices Loaned by AT Type 

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

Sixty-eight percent or 25,320 device loans were made to individuals for the primary purpose of decisionmaking. Other reasons borrowers cited for wanting a short-term device loan included accommodation 

(18 percent), a loaner during repair/waiting for funding (6 percent), and for training/personnel 

development (7 percent). AT acquired through device loan programs was primarily used for community 

living (54 percent), education (39 percent), and employment (7 percent). 

DEVICE REUTILIZATION PROGRAMS 

Assistive technology reutilization involves transferring a previously owned device from someone who 

no longer needs it to someone who does. Device reutilzation falls into two activity categories. The first 

one, device exchange, usually occurs through an online forum where sellers and buyers can connect. 

Recycling, refurbishment, and repair (RRR) and/or open-ended loan is the second category. In this type 

of program, devices are typically obtained from individuals who no longer need them, are refurbished, 

and then provided to new owners. Open-ended loan programs use the same process, collecting 

previously used devices and refurbishing them as needed, and then loaning them to individuals who can 

use them as long as they are needed. The expectation is that the devices would be returned to the 

program at some point. For the purposes of this report, the second category—RRR and/or open-ended 

loan—will be referred to as device refurbishment. 

In FY 2017, 57,782 consumers received a total of 74,205 reutilized devices from fifty-five AT 

Programs, resulting in an overall savings of $29.9 million. As Table 5 shows, the vast majority of AT 

devices provided through reutilization programs were for ‘mobility, seating’ (47 percent) and ‘daily 

living’ (38 percent). 

Type of AT Device Number Loaned Percent

Computers and related 9,010 17%

Speech communication 8,305 16%

Daily living 7,844 15%

Mobility, seating 7,492 14%

Learning, cognition 7,126 14%

Vision 4,166 8%

Environmental adaptations 3,562 7%

Recreation, sports, and leisure 2,432 5%

Hearing 2,382 4%

Vehicle modification and transportation 53 <1%

TOTAL 52,374 100%

Device Loan and Education 

A 9-year-old student, Brian, needed assistance with reading. His family contacted the Oklahoma 

AT Program to borrow the C-Reader Pen before purchasing it. With the use of the pen, Brian was 

able to read without assistance. Having this device was a big boost to his confidence. Brian is now 

able to read with independence and enjoy it! 
12 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Table 5: Device Reutilization Summary by AT Type

Type of AT Device # of 

 Devices 

Percent of Devices Total Savings Percent of Savings 

Mobility, seating 34,638 47% $19,787,763 66%

Daily living 28,259 38% $5,108,330 17%

Environmental adaptations 4,190 6% $860,471 3%

Computers and related 2,182 3% $573,952 2%

Hearing 1,638 2% $233,581 <1%

Speech and communication 901 1% $1,409,107 5%

Learning/cognition 835 1% $150,545 <1%

Vision 833 1% $597,541 2%

Recreation, sports, and leisure 442 1% $130,872 <1%

Vehicle modification and 287 <1% $1,146,622 4%

transportation

TOTAL 74,205 100% $29,988,784 100%

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

As shown in Table 6, the most common device reutilization activity was device refurbishment. Ninetyseven percent of recipients received devices through a device refurbishment program, saving $27.9

million. Of the services provided through reutilization programs, device refurbishment activities 

provided the greatest savings to recipients. AT acquired through device reutilization programs was 

primarily used for community living (92 percent), and was also used to support education (5 percent), 

and employment (3 percent). 

Highlighting Innovative State Partnerships

State Medicaid programs in Kansas and Oklahoma have years of experience in collaborating with their

state AT Act Programs in the implementation of comprehensive reuse programs, achieving tremendous

cost-savings in the healthcare systems through these partnerships. 

 Kansas has collected over 11,359 items of equipment, valued at $16.8 million since 2003. 

Approximately 90% of this donated equipment was originally purchased through private insurance 

or private funding sources. In total, the Kansas Reuse program has reassigned over 9,676 pieces of 

equipment valued at over $13,426,563. Using return on investment (ROI) analysis, in 2017-2018,

the Kansas program reassigned 693 devices valued at $815,525, with program costs of $285,000, 

yielding an ROI of $2.86 for every dollar invested. 

 In Oklahoma, the program has resulted in over $4,176,496 in healthcare savings to agencies and 

individuals since 2012. Over the period, 7,043 devices were reassigned, including 3,654 devices to 

SoonerCare (Oklahoma Medicaid) members, resulting in $1,364,350 in SoonerCare program cost 

savings in the first six years. 
13 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Table 6: Number of Recipients, Devices, and Savings by Type of Reutilization Activity 

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

STATE FINANCING

State financing activities assist individuals with disabilities to acquire needed AT though three types of 

programs: (1) financial loan programs that provide cash loans that borrowers can use to purchase AT, 

(2) other activities that result in direct AT provision, and (3) additional activities that allow consumers to 

obtain AT for a reduced cost. Funds authorized under the AT Act of 1998, as amended, cannot be used 

to purchase AT devices or services directly for consumers (ED, 2011). 

State Financing – Cash Loan Programs 

Thirty-five State AT programs reported data on financial loans made. These programs issued 853 cash 

loans for AT device(s) totaling $7,665,522. The average annual income of loan recipients was $43,231 

and the national average interest rate was 3.68 percent. Out of 853 loans issued, 23 percent were made to 

applicants with annual incomes of less than $15,000; another 23 percent were made to applicants with 

annual incomes between $15,001 and $20,000. The overwhelming majority of total loan dollars issued 

(72 percent) was for vehicle modification and transportation technologies, averaging $21,450 per loan. 

Hearing AT ranked first in number of devices financed, averaging $3,746 per loan. For a more detailed 

breakdown of loans by device type, refer to Table 7. 

Activity Number (%) of 

Device Recipients

Number (%) 

of Devices

Total Savings 

to Recipients

Percent of Savings

to Recipients

Recycle/refurbish/ 

repair (device 

refurbishment)

55,773 (97%) 69,995 (94%) $27,969,789 93%

Device exchange

TOTAL 

2,009 (3%)

57,782 (100%) 

4,540 (6%)

74,205 (100%) 

$2,018,995

$29,988,784 

7%

100% 

Device Reutilization and Employment 

Graziela, a 32-year-old elementary school teacher with spina bifida, was referred to the Puerto Rico 

AT program by her co-workers. She used a manual wheelchair for mobility. However, one of the 

casters was badly damaged, resulting in an unsafe ride. Graziela had been waiting for a new 

wheelchair from a local agency, but it was uncertain how much longer she would have to wait, or 

even if she would finally get the wheelchair at all. Through Puerto Rico’s reuse program, Graziela 

received a wheelchair that met her needs at home and at school. Now she is back to teaching 

classes and performing her regular duties in and out of the classroom. 
14 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Table 7: Types and Dollar Amounts of AT Acquired with Financial Loans

Type of AT Device

1%

# of Devices 

Financed

Device 

Percent 

Dollar 

Value of Loans 

Dollar 

Percent 

Average Loan 

Amount 

Hearing 350 40% $1,311,221 17% $3,746

Vehicle modification and 

transportation 

257 29% $5,512,541 72% $21,450

Computers and related 66 8% $46,043 $697

Mobility, seating and positioning 65 7% $287,048 4% $4,416

Daily living 44 5% $130,235 2% $2,960

Vision 43 5% $107,241 1% $2,494

Environmental adaptations 34 4% $238,897 3% $7,026

Learning/cognition 14 2% $6,250 <1% $446

Recreation, sports, & leisure 3 <1% $26,055 <1% $8,685

Speech communication 0 0% $0 0% $0

TOTAL 876 100% $7,665,522 100% $8,751

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

Other State Financing Programs that Provide AT

Seventeen states reported data on other financing activities that resulted in the acquisition of AT devices 

and services. These programs typically purchased AT, using external funding provided to the AT 

Program by another agency, and directly provide that AT to eligible recipients. These programs are 

frequently limited in focus, only providing a particular type of AT (such as telecommunications), or 

restricted to individuals with a specific kind of disability (autism), or require individuals be eligible for a 

specific funding source (such as IDEA) to obtain the AT. 

In FY 2017, these programs served 4,357 individuals and provided 5,768 AT devices. Almost half (48 

percent) of the total technologies funded were hearing devices. Environmental adaptations constituted 

23 percent ($892,391) of the total value of AT provided ($3,836,113) but made up only 4 percent of 

total devices funded. 

Other State Financing Programs that Reduce the Cost of AT 

Nine states reported data on other state financing activities that allowed consumers to obtain assistive 

technology at a reduced cost. These programs included cooperative buying programs, a vision 

equipment lease program, and device design, fabrication and development. 

In FY 2017, these other state financing activities served 2,093 individuals, and 3,735 devices were 

acquired at a total savings of $1,573,345. Out of all the AT categories, hearing AT resulted in the 

highest savings to consumers ($6,184 per device). Devices for learning and cognition (1,083 devices), 

speech communication (888 devices), and vision (582 devices), combined, made up 68 percent of 

acquired devices through other financing activities. This resulted in moderate savings per device ($93 

for each item for learning and cognition, $37 for each device for speech communication, and $711 for 

each vision device). 
15 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Recipients of state financing activity services reported the primary purpose for which AT was needed. 

Seventy-seven percent of respondents cited community living as the primary purpose, followed by 

education (19 percent) and employment (4 percent). 

CONSUMER SATISFACTION RATINGS OF STATE LEVEL ACTIVITIES 

AT Program consumers were asked to report their satisfaction with the services they received from four 

state-level activities. Device reuse, state financing, device loan, and device demonstration programs 

each received combined highly satisfied and satisfied customer satisfaction ratings of 99% percent. 

Please refer to Table 8 for more details about the level of consumer satisfaction, response rates, and 

number of consumers in each of the four activities. 

Table 8: Consumer Satisfaction with State-level Activities

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data 

Assistance – National Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. 

Last accessed October 2018. 

STATE ACTIVITIES PERFORMANCE MEASURES 

Acquisition Performance 

Consumers were surveyed about why they utilized state financing services, device reutilization 

programs (i.e., device exchange and device refurbishment), and short-ended loans for the purpose of 

State-level 

Activity

Highly 

Satisfied

Satisfied Satisfied 

Somewhat

Not at all 

satisfied

NonrespondentsTotal # of 

Consumers

Response Rate 

Percentage

State Financing 4,429 (84%) 782 (15%) 43 (1%) 11 (0%) 2,038 7,303 72%

Reutilization 47,440 (89%) 5,635 (11%) 151 (0%) 61 (0%) 4,495 57,782 92%

Device 

Demonstration

66,265 (85%) 10,679 (14%) 540 (1%) 124 (0%) 2,488 80,096 97%

Device Loan 31,220 (88%) 3,947 (11%) 352 (1%) 77 (0%) 1,643 37,239 96%

State Financing and Community Living 

In 2013, Peter experienced a stroke. As a result, it was difficult for him to move his upper and lower

extremities, requiring him to use a motorized scooter. However, this option did not address all of 

his mobility needs. 

Peter was connected to the Guam AT Program, where he expressed interest in purchasing an 

accessible vehicle. When he met with AT staff in March 2017, he was given information on various 

AT options and got help applying for an Akudi Loan to help finance the purchase. When Peter’s 

loan was approved, he received additional assistance in purchasing an accessible van, which 

involved working with an off-island vendor and shipping company, with the whole process taking 

six months. 

After just a few weeks of using the vehicle, Peter shared that his quality of life significantly 

improved, and going around the island was much more enjoyable and stress-free. He is able to 

participate in day-to-day activities, run errands, and do things with his wife, 26 grandchildren, and

15 great-grandchildren. An accessible vehicle has given Peter a renewed feeling of independence.
16 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

acquisition. Sixty-eight percent of consumers stated that they could only afford AT through these 

programs. Sixteen percent said that the AT needed was only available to them through AT programs, 

and 11 percent responded that the AT was available to them through other programs, but these systems 

were too complex or the wait time to acquire a device was too long, and five percent responded none of 

the above. 

Access Performance 

Consumers were surveyed about the kind of decisions they were able to make as the result of a device 

demonstration or short-term device loan. Eighty-seven percent of respondents stated that an AT device 

would meet their needs, or those of someone they represent. Another seven percent of consumers stated 

that an AT device would not meet their needs (which is still an important decision outcome), and five 

percent did not make a decision. 

STATE LEADERSHIP ACTIVITIES 

Training 

Training activities are instructional events, planned in advance for a specific purpose or audience. 

Examples of training include classes, workshops, and presentations that have a goal of increasing skills, 

knowledge, and operational competence with the technology, as opposed to training intended only to 

increase general awareness of AT (ED, 2011). 

In FY 2017, AT Programs trained a total of 125,783 participants. Individuals with disabilities (27 

percent) were closely followed by representatives of education (24 percent) as the types of individuals 

who were most likely to receive training. Forty-four percent of participants attended trainings about AT 

products and services, which focused on increasing skills and competencies in using AT and integrating 

AT into different settings. Twenty-nine percent of participants attended trainings on a combination of 

any or all of the following topics: AT products/services, AT funding/policy/practice, and information 

technology/telecommunication access. Trainings on transition for students with disabilities in education 

and transition for adults to independent living were attended by nine percent of participants. AT 

funding/policy/practice and information technology/telecommunication access trainings were attended 

by six percent of training participants combined. 

Public Awareness

Public awareness activities include public service announcements, Internet outreach and social media, 

radio talk shows and news reports, newspaper stories and columns, newsletters, brochures, and public 

forums. The exact number of people who receive information through these public awareness activities

is large, but is often difficult to quantify precisely, and estimates must be reported (ED, 2011). Due to 

the difficulty of quantifying, FY 2017 was the first year that data for public awareness activities were 

submitted as anecdotes. The following are a handful of many exciting and innovative outreach and 

awareness efforts conducted by AT programs: 

 Indiana’s three widely distributed and popular podcasts have highly engaged audiences in 

over 160 countries. AT program staff created over 400 “Tech Tip” videos on YouTube that 

have been viewed over 500,000 times. 

 Louisiana’s AT program hosted an exhibit at the Louisiana State Fair’s “Senior Day at the 

Fair” to raise awareness among seniors about the benefits of AT with regard to functional 
17 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

limitations related to aging. 2,500 people from across the state attended the fair. The exhibit 

attracted many seniors who picked up literature, with over 250 people signing up to receive 

targeted information. 

North Dakota’s blog “Assistive” is in its 5th year. With its focus on user anecdotes, general 

AT information, and funding, it has attracted people from all over the world. In 2017, the 

blog had 134,870 visitors. Due to the blog’s visibility, the AT program has received many 

calls and emails from people with disabilities, their family members, and the professionals 

that work with them. 

In 2017, the Ohio State AT Program reached out to school districts more than they ever had 

in the past. To familiarize schools with services and promote new programs directed at 

schools, AT staff mailed annual reports to all 612 school superintendents in the state. The 

efforts were productive, generating numerous referrals, and expanded the program’s reach. 





Information and Assistance 

Information and assistance (I&A) activities are those in which state AT Programs respond to requests 

for information or put individuals in contact with other entities. These other entities can provide 

individuals with information and intensive assistance on AT devices/services or AT funding. 

In FY 2017, 324,688 individuals were recipients of I&A. Of the two I&A content areas, information 

about specific AT products/devices/services was the most common, with 81 percent of recipients 

requesting this type of information. Nineteen percent received information on obtaining funding for AT. 

The largest recipient group of I&A was family members/guardians/authorized representatives (28 

percent), followed by individuals with disabilities (23 percent), representatives of education (14 

percent), representatives of health, allied health, and rehabilitation (14 percent), and representatives of 

community living (9 percent). The remaining recipient types were representatives of technology (5 

percent), representatives of employers and employment services (5 percent), and others (3 percent). 

Technical Assistance

Technical assistance (TA) is provided by state AT Programs to help programs and agencies improve 

their services management, policies, and/or outcomes. As a result of technical assistance and other 

activities, some AT Programs report state improvement outcomes with policy, practice, or procedure 

improvements that result in increased access to and acquisition of AT in the state. In FY 2017, the fiftysix grantees reported providing a majority of technical assistance to educational agencies (33 percent) 

and community living agencies (26 percent). 

Table 9: Percentage of Technical Assistance provided by Agency Type

Source: U.S. Department of Health and Human Services, Administration for Community Living, Center for Assistive Technology Act Data Assistance – National 

Assistive Technology Act Data System, State Grants for AT Program annual progress report aggregate data for FY 2017. Last accessed October 2018. 

Program/Agency Type Receiving TA Percent

Education 33%

Community living 26%

Employment 15%

Technology (IT, Telecom, AT) 13%

Health, allied health, and rehabilitation 13%

TOTAL 100%
18 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

INITIATIVES FROM THE FIELD 

Community Living 

North Dakota (ND) ASSISTIVE Program staff commented on the proposed renewal of the Medicaid 

1915(c) Home and Community-Based Services (HCBS) Medicaid waiver. The AT program requested 

that the waiver be amended to include AT evaluations under the Specialized Equipment (SE) and 

Environmental Modifications (EM) portions, and requested that the qualifications for professionals 

providing AT evaluations under EM portion of the ND HCBS waiver be comparable to the Minnesota 

Elderly Waiver and Alternative Care Program. The comments also contained research with comparison 

to other states’ services and other North Dakota waivers.

Health Care 

Michigan AT Program staff worked with people in the mental health recovery community to provide 

technical assistance on how to include AT in their recovery work. Staff assisted in creating a short 

video on the importance of AT and other supports for people in recovery. 

Employment

The Workforce Innovation and Opportunity Act outlines service delivery with special attention to AT. 

The act specifically mandates collaboration between State AT Programs and Vocational Rehabilitation 

(VR) Services. Iowa State AT Program collaborated with Iowa VR, outlining how lives would be 

impacted by additional referral and engagement with one another’s services. This advocacy resulted in 

the creation of an AT leadership team at Iowa VR, comprised of ten staff members from across Iowa. 

AT staff provided AT training in the Assistive Technology Demonstration Center to the Iowa VR 

leadership team. 

Education & Transition 

Arizona’s AT Program’s program director met with representatives from the Arizona Developmental 

Disabilities Planning Council. The goal was to explore strategies for strengthening collaboration 

between the organizations, and to ensure that Employment First initiatives address AT issues for high 

school students with disabilities as part of the transition process into post-secondary education, 

employment, and independent living. The AT program director now attends monthly Employment First 

meetings to provide input and recommendations. 

Information and Communication Technology Accessibility 

As part of the implementation of Local Law 238, an AT specialist on information technology and 

computer access from Puerto Rico’s AT program conducted a series of training sessions on creating 

accessible documents at the University of Puerto Rico’s various campuses around the island. 

Additionally, AT staff provided individual support to professors, webmasters, and librarians on how to 

improve the accessibility of web pages and other online documents such as syllabi and presentations. 

Leveraged funding is frequently secured by State AT Programs and is used to expand and maximize 

services. In FY 2017, State AT Programs leveraged $21.8 million from federal, state, local and 

private sources. These leveraged dollars were used to supplement $26.4 million in Section 4 AT 

Act formula grant funding for FY 2017 and expand program reach in all AT Act authorized 

activities. This report highlights close to $65 million in savings and benefits delivered by State AT 

Programs in FY 2017 to over 600,000 service recipients. 
19 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Voting Accessibility 

In collaboration with the Protection & Advocacy for Voter Access Program, the Wyoming AT Program 

hosted a training on voting and accessibility. The training provided information on voting rights for 

individuals with disabilities, and hands-on training on two voting machines that are used throughout 

Wyoming. Also demonstrated were AT devices used in the voting booth. 

Aging 

Due to demographic shifts, the Florida AT program adjusted its service delivery model to focus more on 

delivering services to an aging population. The staff developed senior kits for each Regional 

Demonstration Center to provide device loans, demonstrations, trainings, and public awareness 

activities. A wide range of devices are included in the kit, such as rescue and locate devices, home 

automation units, medication reminders, and simple vehicle modifications. 

CONCLUSION 

State-level and state leadership activities provide a continuum of services that reach a wide variety of 

individuals and provide access to a broad range of technologies. AT Programs enable individuals with 

disabilities and older adults, their representatives, and others working with them to make informed 

decisions about accessing and acquiring technologies. The streamlined process allows consumers to 

receive information about a device and become familiar with it through demonstration and short-term 

device loan programs prior to making a costly purchase. When consumers are ready to acquire a device, 

the reuse and state financing programs provide an affordable purchasing avenue. 
20 FY 2017 REPORT TO CONGRESS ON THE ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

Resource Information 

Contact and other information on each State AT Program5

can be found on the Center for Assistive 

Technology Act Data Assistance (CATADA) website. The CATADA website also provides an overall 

summary data report6for Fiscal Year 2017 that provides data on the major AT Act activities by state. 

Staff of the Administration for Community Living (ACL) produced this Report to Congress, with 

assistance from the Center for Assistive Technology Act Data Assistance (CATADA) under Grant No. 

90AN0001-01-00. The mention of trade names, commercial products or organizations in this report 

does not imply endorsements by the U.S. government. This publication also contains uniform resource 

locators (URLs) for information created and maintained by organizations outside of the federal 

government. This information is provided for the reader’s convenience. The Administration for 

Community Living does not control or guarantee the accuracy, relevance, timeliness, or completeness of 

this outside information. Further, the inclusion of information or URL does not reflect the importance of 

the organization, nor is it intended to endorse any views expressed, or products or services offered. 

This publication is available in accessible digital format on ACL’s website7and on the CATADA 

website.8

This report is in the public domain. Authorization to reproduce it in whole or in part is granted. While 

permission to reprint this publication is not necessary, the citation should be U.S. Department of Health 

and Human Services, Administration for Community Living, Annual Report to Congress on the 

Assistive Technology Act of 1998, as Amended, for Fiscal Year 2017. Washington, D.C., 2017. 

5 https://catada.info/state.html. 

6 https://catada.info/at/?report=summary. 

7 https://www.acl.gov/about-acl/reports-congress-and-president.

8 https://catada.info/catada-publications/.