**State Grants for Assistive Technology Program**

**Annual Progress Report (AT APR)**

**Instruction Manual and Definitions**

**This document was prepared by the Center for Assistive Technology Act Data Assistance under Grant No. 90AN0001-01-00 by the U.S. Department of Health and Human Services.**

**Table of Contents**

**I. GENERAL INSTRUCTIONS**

A.  Reporting Period   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    1

B.  Reporting Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1

C.  Non-responders . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2

D.  Anecdotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2

E.  Instructions for Determining Geographic Distribution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2

F.  Classification of Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  3

G.  Classification of Individuals and Entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  15

H.  State Improvement Outcomes  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

I.  Performance Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  17

J.  Customer Satisfaction Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  20

**II. GENERAL DEFINITIONS**

A.  Comparability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   22

B.  State Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    22

**III. SECTION-SPECIFIC INSTRUCTIONS AND DEFINITIONS**

A.  General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   23

B.  State Financing  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  23

C.  Device Reuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  25

D.  Device Loans  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   27

E.  Device Demonstrations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    27

F.  Training  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    29

G.  Technical Assistance  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   30

H.  Public Awareness and Information and Assistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   30

I.  Additional and Leveraged Funds   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   32

**Instruction Manual and DefinitionsState Grants for Assistive Technology Program**

**Annual Progress Report (AT APR)**

This document contains information needed for completing the State Grants for AT Program Annual Progress Report (AT APR).  The AT APR is designed to provide the Administration for Community Living (ACL) with the data necessary for program planning and reporting to Congress, the Secretary of Health and Human Services and other entities. The AT APR is organized by the state-level and state leadership activities outlined in the AT Act of 1998, as amended (P.L. 108-364) (AT Act).  Lead agencies or implementing entities will report on these state-level and state leadership activities and will provide data required by Section 4(f) of the Act and other necessary data.  

Information from individual states will be available to the public once the information is complete and formally submitted.  Questions regarding potential uses of the information submitted by individual states should be directed to Robert Groenendaal, Program Specialist, ACL, U.S. Department of Health and Human Services, 330 C Street SW, Switzer Building, Room 1317B, Washington, DC  20201, Robert.Groenendaal@acl.hhs.gov, 202.795.7356.  

This instruction manual is organized in the following manner:

I.General Instructions 

II. General Definitions

III.Section-Specific Instructions and Definitions

# I. General Instructions

## A.Reporting Period  

The reporting period is the federal fiscal year, which begins on October 1 of each year and ends on the following September 30.  

## B. Reporting Data 

Programs****must collect and report data on activities****that are supported using funds from their State Grant for AT under section 4 of the AT Act. Each Statewide AT Program submitted a State Plan identifying these activities.****Data should not be reported for state-level activities if the Statewide AT Programs has opted for “Comparability” [See Definition in Sec2 (A)] or “State Flexibility” [Sec2 (B)].  

States may have described state-level or state leadership activities in their State Plan that are supported or supplemented with non-AT Act funds (e.g. the state administers a telecommunications equipment distribution program that uses non-AT Act dollars to pay for devices and services.)  Data from these activities (such as individuals served) should be reported in the appropriate section (State Financing in the example given) and the funding amount should be reported in the first table in the “Additional and Leveraged Funding” section.  

## C.Non-responders

The performance measure data elements and consumer satisfaction data elements include nonresponders.  Reporting and use of nonresponse information is different for the performance measure data as compared to consumer satisfaction data.  A complete description of the reporting and use of nonresponse data can be found in the subsequent sections on performance measures and consumer satisfaction.  

## D.Anecdotes

For each of the state-level activities, you will be asked to provide anecdotal information about consumers, or others that benefited from program activities, during the reporting period.  Generally, a consumer is an individual with a disability or his or her family, but in some cases it may be appropriate to provide an anecdote about a professional.  Please make these entries as specific and concise as possible and include the following information:  

· What AT device, service or information did the consumer need?

· How did your Statewide AT Program help the consumer obtain that device, service or information?

· What barrier(s) did your Statewide AT Program help the consumer overcome?

· How did obtaining that device or service improve that consumer’s life?

· How did it improve the consumer’s access to education, employment, or community living?  You will be asked to check which of these outcome areas the anecdote addresses.  

Other instructions to follow in providing anecdotes:

· Limit each anecdote to 1800 characters or less.  

· Try to avoid using brand names for AT devices as those are not understandable to readers.  Describe the AT device instead for example, “software that enlarges screen display” instead of ZoomText.  Use language that is understandable to an uninformed audience.  

· Do not repeat the same anecdote in multiple sections.

· Do not identify any consumers by name or use other details that would allow a consumer to be identified.

· Be sure that the example clearly fits within the appropriate activities supported by the AT Act.

Anecdotal information also is requested for some state leadership activities.  Instructions on what to include in anecdotes for these activities are provided in the reporting system.  

## E.Instructions for Determining Geographic Distribution

Section 4(f) of the AT Act requires that Statewide AT Programs provide data on the geographic distribution of consumers served by state financing activities and individuals participating in training activities.  To meet this requirement, it will be necessary for you to ascertain the county of residence of an individual receiving services or training; or, in the case of a professional receiving training, you need to ascertain the county in which the professional generally provides services.  

Once you know the county where the individual resides or serves, you must determine the Rural Urban Continuum Code (RUCC) for that county.  The 2013 RUCCs form a classification scheme that distinguishes metropolitan counties by size and non-metropolitan counties by degree of urbanization and proximity to metro areas. 

The standard Office of Management and Budget (OMB) metro and non-metro categories have been subdivided into three metro and six non-metro categories, resulting in a nine-part county codification as follows:

· 1 - Counties in metro areas of one million population or more 

· 2 - Counties in metro areas of 250,000 to one million population 

· 3 - Counties in metro areas of fewer than 250,000 population 

· 4 - Urban population of 20,000 or more, adjacent to a metro area 

· 5 - Urban population of 20,000 or more, not adjacent to a metro area 

· 6 - Urban population of 2,500 to 19,999, adjacent to a metro area 

· 7 - Urban population of 2,500 to 19,999, not adjacent to a metro area 

· 8 - Completely rural or less than 2,500 urban population, adjacent to a metro area 

· 9 - Completely rural or less than 2,500 urban population, not adjacent to a metro area 

For purposes of this data collection, these nine codes are combined into two levels:

· Codes 1-3 are considered “metro”

· Codes 4-9 are considered “non-metro”

When required by this instrument, you will categorize individuals into one of these two groups based on the RUCC for their county.  Finding the RUCC for any county is done in the following manner:

1.  Go to:  https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/

2.  Download the 2013 Rural-Urban Continuum Codes (excel spreadsheet) 

3. Scroll to your state (list is alphabetical by state) and select your counties.  

4. Column E provides the RUCC code for each county.  

You will be responsible for tallying how many individuals fall into each grouping of RUCC and then provide the final number in the appropriate area of the data collection instrument.  

For example, through state financing activities you provide six loans during one reporting period:

· Person A lives in a county with a RUCC of 2

· Person B lives in a county with a RUCC of 4

· Person C lives in a county with a RUCC of 8

· Person D lives in a county with a RUCC of 6

· Person E lives in a county with a RUCC of 9

· Person F lives in a county with a RUCC of 3

So, the totals for these six result in:

## F.Classification of Devices 

Throughout the reporting system you are asked to classify the devices provided.  There are ten categories for classifying devices.

· Vision

· Hearing

· Speech communication

· Learning, cognition, and developmental

· Mobility, seating, and positioning

· Daily living

· Environmental adaptations

· Vehicle modification and transportation

· Computers and related

· Recreation, sports, and leisure

Many devices can fit into more than one category depending on how they are used by a consumer.  You must choose one category where a device belongs in each instance you are reporting and may not count a device more than once.  For example, under your state financing activities your financial loan program may provide one loan to one consumer for one computer.  Though this computer may be classified in many of the ten categories, it must be counted only once and placed in one category in this instance.  This does not mean a computer must always go into the same category every time a loan for a computer is provided, however.  When it is not immediately obvious in which category you should classify a device, you should classify it based on the functional need that is served by the “assistive” aspect of the device.  

For example, while telephones are used for communication, not all telephones are immediately categorized in speech communication. A telephone could be classified in different categories, depending on the functional needs of the user. When the primary difficulty is seeing the dial, a large button phone would be classified under Vision.  When the primary difficulty is hearing another person on the phone, an amplified phone would be classified under Hearing.  When the primary difficulty is having one’s speech understood on the phone, an adapted phone would be classified under Speech Communication.  When the primary difficulty involves another function (or multiple functions) the phone would be classified under Daily Living.  

A component of a larger system should be classified according to the function or primary use of the larger system.  For example, a mouth stick that is used to provide access to a communication system such as Pathfinder would be classified under Speech Communication. A mouth stick that is used to type papers would be classified under Computer Access.  A mouth stick that is used generically as an aid to daily living would be classified as Daily Living.

Services are classified according to the AT category associated with the service.  For example, an audiological evaluation would be classified under Hearing.

Each category below includes a description, decision rules, and examples that will assist you in deciding whether a device should go into a particular category.  Devices must be reported in one of these categories as there is no “Other” category.  

### 1. Vision

***Definition:*** Products designed to assist with vision

***Decision rules:***  Products intended to facilitate access and participation for people who are blind or visually impaired are classified in this category, even if they are used for activities of daily living, computer access, reading/learning, way finding/travel, recreation, etc.  Products in this category characteristically provide output of information through large print/display, synthetic speech or Braille/tactile.  If the adaptation is for an individual who is both visually impaired and hearing impaired, categorize according to the primary functionality of the device.   Reading systems to accommodate vision are classified here while similar systems to accommodate learning are classified accordingly. A TTY with Braille output is classified as hearing.  A telephone with both a large print keypad and amplification for listening may be classified in either vision or hearing.  

***Examples:***

· Magnifiers including CCTV systems; 

· Talking scales, blood pressure gauge, glucometer etc.; 

· Screen readers, screen magnifiers and Braille displays; 

· Daisy or Victor Readers; 

· PDA’s with large print, speech or Braille output; 

· Talking or Braille GPS, white canes, talking or tactile compass, etc.; 

· OCR reading systems, talking thermostats, household appliances etc.  

2.Hearing

***Definition:*** Products designed to assist with hearing

***Decision rules:***  Products intended to facilitate access and participation for people who are deaf or hard of hearing are classified in this category, even if they are used for activities of daily living or could have another application for people with other disabilities or for other functions.  Products intended to facilitate telephone usage for individuals with hearing disabilities are categorized here, rather than as aids to daily living.  If the telephone adaptation is for an individual who is both visually impaired and hearing impaired, categorize under EITHER vision or hearing.  Products that amplify voice are classified here if the purpose is to enhance the volume of speech produced by an individual without a disability, in order for his/her speech to be heard by persons who are deaf or hard of hearing.  This category also includes systems that provide for text communication, both via telecommunication (text messaging; TTY) and face to face (Interpretype).  Peripherals designed to facilitate access or otherwise support the use of a device for hearing (e.g. neck loop induction coils; TeleLink phone couplers; conference microphone; telephone signalers) are counted in this category.

***Examples:***

· Personal amplification systems (hearing aids, PocketTalker Pro, etc.)

· Assistive Listening Systems (FM; loop; infrared, sound-field, large area, personal)

· Wireless headphones to enhance TV listening (e.g. DirectEar; TV Listener)

· Daily living aids that use visual or tactile rather than audible signals (e.g. vibrating alarm clock; smoke alarm with strobe light; door bell with flashing signal; etc.)

· Instant messaging devices (used as portable TTY)

· Daily living aids with enhanced audible signals (Sonic Boom Alarm Clock)

· Amplified Telephones, in-line amplifiers for telephones, cell phone amplifiers

· Text telephones (TTYs), Voice carryover (including CapTel) and Hearing carryover telephones and Signaling devices (visual and/or tactile alerting to incoming phone calls)

· Classroom Captioning System

· iCommunicator (Voice to text system)

· AudioSee (enhanced view of speaker for speech reading, in addition to FM capabilities)

· InterpreType dual keyboard system

3.  Speech Communication

***Definition:*** Products designed to assist with speaking and face-to-face communication for individuals with speech disabilities.

***Decision rules:***  Products intended to facilitate computer access and usage for written communication is classified under Computers.  Products intended to facilitate telephone usage for individuals with speech disabilities will be classified under activities of daily living, EXCEPT when the adaptation is for an individual who is deaf or hard of hearing in which case it is classified under hearing.  Products that amplify voice are classified here if the purpose is to enhance the volume of speech produced by an individual with a disability, in order for his/her speech to be audible by persons without disabilities.  If the purpose of the amplifier is to enhance the volume of speech produced by an individual without a disability, in order for his/her speech to be heard by persons who are deaf or hard of hearing, the device is classified under hearing.  Peripherals designed to facilitate access or otherwise support the use of a device for speech communication (e.g. mounting systems; carrying cases, switch or mouth stick used for access) are counted in this category.

***Examples:***

· Speech generating devices such as BIGMack; DV4; ChatPC; DynaWrite; Pathfinder; talking photo album

· Communication boards/books

· Software with speech output e.g. Speaking Dynamically Pro

· Software that provides symbol sets for use in developing “low tech” communication boards/books or “high tech” overlays e.g. BoardMaker; Picture This!

· Artificial larynx

· Devices that produce text but not voice output for face-to-face communication (e.g. Crespeaker)

· Voice clarifiers (e.g. Speech Enhancer)

· Voice amplifiers (e.g. Falck amplifier)

· Stuttering aids

4.Learning, Cognition, and Developmental 

***Definition:*** Products to provide people with disabilities with access to educational materials and instruction in school or other environments; products that assist with learning, and cognition.

***Common subcategories:***

Cognitive aids

Early intervention aids

Instructional materials

Memory Aids

General Personal Organization Tools

Sensory/Developmental Stimulation Products

***Decision rules:***  Products intended to mitigate, compensate, or address learning or cognitive limitations should be classified here along with products used to facilitate computer access for individuals with learning/cognitive limitations.  Products designed to assist people who are blind or visually impaired with reading, organization, learning, computer access, etc. are classified under vision.  Toys (adapted and not) are reported under Recreation, Sports and Leisure even if used to teach cause and effect.  

***Examples:***

· Calculators and measurement tools

· Clocks/Timers/Wake-up Systems

· Electronic Reference Tools and Money Management Tools

· Memory Aids

· Electronic Notetakers, Portable Word Processers, and Recording Devices

· Electronic Organizers/Personal Digital Assistants

· Scientific Equipment

· Educational/Instructional Software (computer based instructional applications used to teach cause and effect, reading, language, spelling, math, writing, science, history, etc) 

· Cognitive/Perceptual Training Software

· Tape or other audio players (except as related to vision) 

· Text-to-speech systems (WYNN, Read and Write Gold, etc. – not related to vision)

· FM systems (to support auditory processing  - not related to hearing loss)

5.   Mobility, Seating, and Positioning

***Definition:***  Products whose main focus is on augmenting or replacing the functional limitations of an individual’s mobility. 

***Decision rules:***Wheelchair restraints associated with seating & positioning (shoulder or safety belts) are classified in this category.  Wheelchair restraints (tie downs: 4-belt & docking or lock downs: trailer-hitch) associated van locks which allow a power chair user to drive and/or be transported safely is classified under “Vehicle Modification and Transportation.”

***Examples:***

· Ambulatory aids: low tech aids such as canes, walkers or crutches

· Orthotics & prosthetics

· Wheelchairs: dependent (such as strollers & transport chairs) & independent manual mobility (4-wheels propelled independently)

· Scooters and power chairs: functionally matched motorized independent power mobility bases

· Seating and positioning – considerations based on postural control & deformity management, pressure & postural management, and/or comfort & postural accommodation. (such as pelvic guides, contoured seating systems, head supports)

6.Daily Living

***Definition:*** Devices that enhance the capacity of people with disabilities to live independently, especially AT that assists with Instrumental and other Activities of Daily Living, (ADLs, IADLs) such as dressing, personal hygiene, bathing, home maintenance, cooking, eating, sleeping, breathing, shopping and managing money.

***Common Subcategories:***

Personal hygiene, care and toileting

Dressing and apparel, and aids to dressing

Housekeeping, cleaning, maintenance

Cooking and eating

Handling, reaching, manipulating

Alerting and signaling

Household management, bill paying (not cognitive, vision, or hearing AT)

Telephony equipment

***Decision rules:***  Architectural/home adaptations or modifications are classified under Environmental adaptations. Life safety and life support devices and systems that do not involve home modifications are categorized here including medical and respiratory equipment. Devices intended to accommodate specific disabilities, such as hearing or vision, are assigned to those categories. Devices that assist with personal organization are classified as Learning, Cognition and Developmental AT. Devices used to accommodate multiple disabilities are categorized here. Devices that assist persons with motor impairments not categorized elsewhere are included here. EADLs that also function as environmental controls are classified according to their primary use. Telephony equipment not intended to accommodate other categories of disabilities is listed here.  Switches controlling daily living aids or unknown devices are reported here.  Otherwise switches are reported with the category of devices controlled.  

***Examples:***

· Writing guides, adapted writing implements

· Modified or large-handled tools and utensils

· Eating/feeding equipment, including dentures; spiked cutting board, jar opener

· Zipper pulls, button hooks, needle threader

· Personal pager, multi-sensing/multi-sensory alerting devices

· Wheelchair desks/trays 

· Reacher

· Wheelchair/walker bag 

· Switch-adapted food processor or other appliance

· Large-button telephone (not for vision or cognitive accommodation).

### 7.Environmental Adaptations 

***Definition:*** Environmental and structural adaptations to the built environment that remove or reduce barriers and promote access to and within the built home, employment and community facilities for individuals with disabilities.  Environmental adaptations usually involve building construction, engineering, and architecture, but also include environmental controls and switches that can control a large portion of or an entire living environment.  Environmental adaptations are typically permanent or semi permanent structures, modifications or additions.  

***Decision rules:*** Adaptations or modifications to vehicles are classified under Vehicle modifications.  Adaptations to furniture such as chairs, couches, beds, etc., would generally be classified under Mobility, Seating, and Positioning.   Items or structures that are portable or temporary, rather than permanent or semi-permanent, is generally classified in another related category to address a functional limitation.  For example, shower chairs, commodes, raised toilet seats and similar portable items should be classified in the daily living category where as a roll in shower, wall or floor mounted grab bars, installed ramps, etc. would be classified here because they become part of the building structure.   

***Examples:***

· Accessible HVAC controls, accessible plumbing fixtures and controls

· Adapted playground equipment and structures

· Alarm and Security Systems

· Cabinetry and Storage equipment

· Door/Gate Openers including farm and ranch gates/latches

· Environmental controls and switches that control them (i.e., electronic systems that enable people to control various appliances, lights, telephones, security systems etc.) 

· Flooring and Surface materials/Detectable warning surfaces

· General Environmental Access Products

· Lifts

· Lighting/lighting controls

· Ramps

· Signage/signaling products

· Workstations/Desks/Tables, Home-workplace adaptations

· Adapted farm equipment that is not reported as Vehicle Modification and Transportation such as sprayers, seeding systems, augers, etc.

8.Vehicle Modification and Transportation

***Definition:*** Products that give people with disabilities independence and enhance safety in transportation through adaptation of vehicles.

***Decision rules:***  Vehicle ramps are classified in this category. Versatile/portable****ramps (temporary adaptation) and wheelchair lifts (permanently installed in buildings) are classified under Environmental adaptations.   

***Examples:***

· Adaptive shoulder and seat safety belts

· Tie downs and lock downs that secure the wheelchair to the vehicle floor

· Hand controls

· Extended directional mirrors.

· Vehicles and vans modified with lifts, ramps, raised roofs, etc.   

· Adapted farm vehicles such as tractors and other self-propelled vehicles modified with hand controls, GPS, lifts and ramp systems. 

9.Computers and Related

***Definition:*** Hardware and software products that enable people with disabilities to access, interact with, and use computers at home, work, or school. Includes modified or alternate keyboards, switches activated by pressure, touch screens, special software, voice-to-text software. 

***Decision rules:***  Classify standard computers and computer-related devices (those that will be used without any adaptations) in this category, along with input adaptations used to mitigate, compensate or address motor limitations. Do not include computer adaptations used to address vision or learning, cognitive or developmental limitations.  

***Examples:***

· Standard software

· Standard hardware

· Computer accessories

· Alternative keyboards and pointing devices

· Switches and scanning software used for computer access

· Touchscreens

· Voice recognition systems

10.Recreation, Sports, and Leisure Equipment

***Definition:***Products not already classified in other categories that help persons with disabilities to participate in sport, health, physical education, recreation, leisure, and dance events. 

***Common subcategories:***

· Toys and games

· Sports equipment

· Fitness equipment

· Specialized wheelchairs and recreational mobility equipment

· Musical instruments and related devices

· Arts, crafts and photography equipment

· Gardening and horticultural equipment

· Hunting, fishing, shooting equipment

· Camping, hiking and other outdoor recreational equipment

· Audio and video entertainment equipment

***Decision rules:*****Devices intended to accommodate specific disabilities, such as hearing or vision, are assigned to those categories. Specialized products designed specifically for recreational, leisure or athletic pursuits are categorized here.  Devices that may have other uses, but are selected as AT for a recreational setting, should be categorized here. Devices for environmental control that also serve as entertainment system controls (e.g. television remote) are classified according to their primary use.

***Examples:***

· Toys, adapted toys and games (includes toys used for developmental purposes such as teaching cause and effect.) 

· Tennis wheelchairs; beach wheelchairs

· Skiing equipment; sled/sledge hockey equipment

· Gardening tools and equipment; 

· Playing card shuffler; 

· Adapted camera and other photography equipment; 

· Adaptive exercise equipment (not used in a rehabilitation setting); 

· Adaptive equipment for fishing, hunting, and camping; 

· Adaptive musical instruments and accessories (not used in a school setting); 

· Entertainment system remote control not used for lights, heat or other environmental control.

## G.Classification of Individuals and Entities

Throughout the reporting system you are asked to classify the individuals and entities that participate in a program or receive services based who they represent and/or the purpose of their interaction.  There are seven categories for classifying individuals and entities as follows.  

**Individuals with disabilities*:***As defined in the AT Act, an “individual with a disability” means any individual of any age, race or ethnicity who has a disability; and who is or would be enabled by an AT device or an AT service to minimize deterioration in functioning, to maintain a level of functioning, or to achieve a greater level of functioning in any major life activity.

**Family members, guardians and authorized representatives:**A person who is related to an individual with a disability, who is the legal guardian of an individual with a disability, or who is authorized by an individual with a disability to act on that individual’s behalf or who participate in an activity with an individual with a disability such as friends and advocates.  

**Representatives of Education:**This category includes****individuals and entities whose primary purpose is education****and/or those who interacted with the AT program primarily for purposes related to education**.**This category can include any type of educational entity such as early childhood, elementary, secondary, special education, remedial education, adult basic education, continuing education, and post-secondary programs.  It includes****both public and private****educational agencies and organizations and federal, state, and local governmental entities who primarily provide or regulate educational services (e.g. State Education Agency). This category also includes interactions focused on training of graduate students and undergraduate students.  

**Representatives of Employment:**  This category includes****individuals****and entities whose primary purpose is employment and/or those who interacted with the AT program primarily for purposes related to employment.  This category includes seeking employment, maintaining current employment or expanding employment options.  It includes participating in employment training programs, vocational rehabilitation programs and other programs related to employment.  It can include employers, or firms that employ workers or assist them in becoming employed, and providers of employment and/or training services to enable individuals with disabilities to become employed, include those representing public and private agencies and organizations that provide or regulate employment services, such as state employment agencies, one-stop career centers, state vocational rehabilitation agencies, community rehabilitation programs, vocational training programs, training providers approved under the Workforce Investment Act, and apprenticeship programs.******

**Representatives of****Health, Allied Health and Rehabilitation:**This category includes individuals****and entities whose primary purpose is health care, allied health and health related rehabilitation services**,**and**/**or those who****interacted with the AT program primarily for purposes related to health care, allied health and rehabilitation.  It****includes those from hospitals, health clinics, mental health agencies and organizations, and managed care providers**.**This category can also include employees of such organizations, such as physicians, physicians’ assistants, nurses, nurse practitioners, psychologists, psychiatrists, occupational therapists, physical therapists, speech pathologists, audiologists, rehabilitation counselors, hospital discharge planners and other hospital employees.  

**Representatives of Community Living:** This category includes****individuals****and entities whose primary purpose is to support community living and/or those who interacted with the AT program primarily for purposes related to community living.  This category includes carrying out daily activities, participating in community activities (e.g., social and recreational activities), using community services (e.g., public transportation and libraries) and living independently.  It can include individuals representing community living issues but who are employed by independent living centers, disability-related nonprofits, agencies that provide services for seniors, and other related social service and community organizations.  This category can also include both public and private organizations and federal, state, and local government entities that primarily provide or regulate community living and related services (e.g. a State Department of Aging, Public Utilities Commission and State Housing Authority.) 

**Representatives of Technology:** This category includes individuals****and entities whose primary purpose is delivery of technology devices or services and/or those who interacted with the AT program primarily for purposes related to technology.  This category includes using computers, software, Web sites, telecommunications, office equipment, and media.  This category can include technology experts such as computer programmers, web and application developers, information technology professionals and procurement officials along with manufacturers and vendors of information technology, telecommunications products, and assistive technology devices.  

Sometimes an individual or entity could fit into more than one category depending on the program or service utilized and who they represent via their participation.  You must choose one category in which to classify each individual or entity and may not count them in multiple categories.  In addition, the name or type of organization that employs the individual may or may not reflect how they should be categorized.  A professional or other representative of an entity may be classified differently depending upon who they primarily represent in their interaction with the program or service.  For example:  

1)  An individual with a disability might work for a technology vendor, but they are accessing the device loan program to obtain a loaner while their personal AT is being repaired.  That person should be classified as an individual with a disability as he/she accessed the loan program representing himself/herself as a consumer. 

2) An occupational therapist (OT) employed by a hospital who participates in a device demonstration as part of an IEP team would be reported under “Representative of Education.”  That same OT might borrow devices to use in an evaluation as part of her work at the hospital and would be classified as “Health, Allied Health, Rehabilitation” under type of borrower.  

3) Representatives of State Early Intervention Programs (IDEA Part C) should be reported in the category that best fits the lead agency for Part C or the agency delivering the Part C services, most typically Health or Education. 

In most sections, individuals****and entities must be reported in a category as “other” is not an option.  In some sections “unable to categorize” or “unknown” is an option when the program contact with the participant or recipient is limited and it is acceptable for the participant or recipient to not provide such information.  

## H.State Improvement Outcomes

The AT Act requires reporting on “the outcomes of any improvement initiatives carried out by the state as a result of activities funded under this section, including a description of any written policies, practices, and procedures that the State has developed and implemented regarding access to, provision of, and funding for, assistive technology devices, and assistive technology services, in the contexts of education, health care, employment, community living, information technology and telecommunications, including e-government” (Section 4(f)(2)(B)(ix)).

You are asked to report no more than two MAJOR state improvement initiative outcomes (i.e., the results of your Statewide AT Program activities that have produced improved policies, practices, procedures or funding of AT at the state or local level) in the “State Improvement Outcomes” section of the data collection system.  Such improvements may result from coordination and collaboration activities, technical assistance activities or other improvement initiatives involving the Statewide AT Program and those public and private agencies that are responsible for policies, practices and procedures that deliver or fund AT.  

Only report improvement initiatives that are funded, at least in part, by AT Act funds.  Types of improvements include obtaining new or expanded AT funding, protecting AT funding, reducing AT cost to consumers, increasing AT expertise in service delivery systems, expanding or protecting system eligibility to obtain AT, establishing new or expanded access requirements, protecting access requirements, and increasing cost effectiveness and cost-savings in systems.  

## I.Performance Measures 

***Instructions***

For training, device demonstration, device loan, device reutilization and state financing, states must use the performance measure questions provided by ACL to collect data for the performance measures identified in their State Plan for AT.  

***Use of Performance Measure Questions***

Four documents are provided to gather performance measure data:  one for the decision-making access measure (device demonstration and one of the device loan purposes), two for acquisition measures (state financing, reuse and three of the device loan purposes) and one for IT/Telecommunications (training).  Because the performance measure questions have been approved by the Office of Management and Budget (OMB), they cannot be modified.  Programs should make the documents available in accessible formats and can translate them into other languages as long as the questions remain consistent with the OMB approved language.  

Programs may elect to incorporate the performance measure questions into their own data collection system, so long as the language is not modified.  For example, programs may include the questions in application forms or may ask the questions of program participants as part of their interaction with the program or service.  Programs may also add items or questions that do not in any way change the performance measure questions.  

***Who Must Provide Performance Measure Data***

Consumers served by state financing activities and recipients of reutilized devices who are identified as those included in the performance measure (see Reutilization, section A table) must provide a response to the acquisition questions. There are two primary reasons the number of individuals receiving devices through reutilization may not match the number for whom performance measure data can be collected.  

(1) Many device exchange programs have little direct contact with device buyers.  As a result it may not be possible to collect performance measure data on these exchanges from either the buyer or the seller.   

(2) Some organizations that have an obligation to provide AT may provide it via reutilization but are unable to respond to the performance measure questions.  For example, a school that has an obligation to provide an AT device identified in a child’s IEP may obtain the device through the reutilization program.   The school is not able to respond affirmatively to any of the performance measure questions because the issue of affordability or availability are not allowable reasons to limit access to AT under IDEA.  

States that solely administer a device exchange program and do not operate, or opt for comparability for another acquisition activity such as device recycling/refurbishing/repair or state finance activity are strongly encouraged to collect acquisition performance measure data on those using the exchange program.  Otherwise, the state will not have data to report related to the acquisition performance measurement.

For device loan, states will collect access performance measure data only from customers who obtained device loans for decision-making purposes.  Device loans made for the other three purposes will have an acquisition performance measure collected.  

When device loans or device demonstrations are provided to multiple participants:

(a)  If the end user is directly involved, performance measure data is collected about the end-user only, not the other participants.  For example, if an individual’s family accompanies him or her to a demonstration, performance measure data would not be collected about the family members;

(b) If an intermediary is borrowing a device or having a demonstration on behalf of multiple end-users, the performance measure data may be collected from either the intermediary or from the end-user.  For example, a speech pathologist may borrow on behalf of 5 students.  You may collect performance information related to the speech pathologist’s borrowing experience alone, or you may ask for data on all 5 students separately.

***How and When to Collect Performance Measure Data***

Programs may collect performance measure data in a manner that best meets their needs.  The data can be collected in person, via phone, via mail, or online, including being integrated into an online exchange system.  Regardless of the method of data collection, programs should collect the data at the appropriate time.  For example, some information can be obtained during intake, while other information cannot be obtained until after the service has been delivered.  In the case of device loans, service delivery is considered complete when the device is returned.  In the case of device demonstrations, service delivery is complete when the device demonstration has concluded.  To produce valid data, you should try to obtain as high a response rate as possible.  

If performance measure data for an individual served during the current reporting period has not been provided to you by the date on which annual reports are due, do not include that individual in the number served during the current reporting period.  Instead, include that individual in the number served during the following reporting period and report his or her performance measure data during the following reporting period.  

***How to Record Nonrespondents***

For state financing, recycling, device exchange, and device demonstration, all nonrespondents (individuals who are included in the performance measure data collection but for whom you are unable to obtain data) will be included in the denominator for calculation of performance on the measure.  

For device loan, nonrespondents in excess of 35 percent will be included.  For example, suppose that your program served 100 customers and obtained responses from 55 of them.  This means that 45 percent of your customers were nonrespondents.  Ten percent, or 10, of the nonrespondents would be included in the denominator.  

***Determining Primary Purpose for Which AT Devices or Services Are Needed***

The performance measures require that consumers be categorized by the primary purpose for which AT devices or services are needed.  Brief descriptions of these categories are as follows:  

***Employment:*** The individual or entity requested services from the AT program primarily for purposes related to employment. This category includes seeking employment, maintaining current employment or expanding employment options. It includes participating in employment training programs, vocational rehabilitation programs and other programs related to employment. 

***Education:*****The individual or entity requested services from the AT program primarily for purposes related to education. This category includes participating in any type of educational program, including early childhood, elementary, secondary, special education, remedial education, adult basic education, continuing education, and post-secondary programs.

***Community living:*****The individual or entity requested services from the AT program primarily for purposes related to community living. This category includes carrying out daily activities, participating in community activities (e.g., social and recreational activities), using community services (e.g., public transportation and libraries) and living independently.

This categorization may be done by the consumer, by the State AT Program based on their interaction with the consumer, or a combination of both.  State AT Programs must categorize non-respondent data (since the consumer has not responded.)  Customers must be categorized by a single primary purpose for which AT devices/services are needed.  For example:

(1)  A consumer uses her computer in almost all aspects of her life, including e-mail communication, participating as a community volunteer, doing homework for a class she is taking and in her work as a teacher.  However, her progressive disability is making it increasingly hard for her to type.  Through demonstration activities, she tries out different kinds of dictation software and makes a choice about which software to purchase.  Her access to AT through demonstration activities could fit into any of the four primary purposes (Employment, Education, and Community Living).  In a conversation with a staff member about determining the primary purpose, she notes that the class she is taking is related to advancing in her job. A decision is made that employment is the primary purpose at this time.

(2)  Another consumer also uses his computer in nearly all aspects of his life, and he obtains a refurbished computer through reutilization activities.  Although he plans to use the computer in a job search when he finishes his training program next year, he decides that his immediate goal at this point in time is to further his education, and education is identified as the primary purpose.

## J.Customer Satisfaction Surveys 

***Instructions***

***Use of Survey Instruments***

States must use the survey instrument provided by ACL to collect customer satisfaction data.  Because the instrument has been approved by the Office of Management and Budget (OMB), the questions cannot be modified in any way.  The survey instruments should be made available in accessible formats. States can translate the survey instruments into other languages as long as the questions remain consistent with the OMB approved language.  

Programs may elect to incorporate the survey questions into their own reporting system, so long as the language in the questions is not modified.  For example, programs may include additional items in the survey that do not in any way change the items provided or programs may take the items from the survey and insert them into their own instrument.

***Who to Survey***

Customer satisfaction data, like performance measure data, must be associated with a particular activity.  That is, you must be able to report customer satisfaction data separately for state financing, reutilization, device loans and device demonstration.

For all state-level activities, states will survey all program participants and/or individuals reported as served, not just those who were identified as included in performance measure data collection.  

***How and When to Survey***

Programs may administer the survey at any time after services are provided in a manner that best meets their needs.  The survey can be administered in-person, via phone, via mail, or online, including being integrated into an online exchange system so long as the mechanism allows the respondent to remain anonymous if they so choose.  To produce valid data, you should try to obtain as high a response rate as possible.

If satisfaction surveys are done anonymously, it will not be possible to align the surveys with individual service recipients.  However, anonymous surveys can and should be identified as associated with a particular reporting period.  Survey responses received after submission of satisfaction data for a particular reporting period should NOT be reported in the next period.  Those responses should be used for program improvement purposes only.  

***How to Record Nonrespondents***

Nonrespondents will not be included in the denominator for calculation of performance on the customer satisfaction measures.  However, the reporting system will calculate a response rate for the consumer satisfaction data for informational purposes. 

# II. General Definitions

This General Definitions section contains definitions that apply throughout the reporting system.  Section-specific instructions and definitions are included in the next section.

## A.Comparability

As described in Section 4 (e)(1)(B) of the AT Act, a state shall not be required to carry out a required state-level activity if the amount of financial support provided from state or other nonfederal resources or entities for that activity is comparable or greater than the amount that the state would have expended for the activity. Do not report data for any state-level activities for which your state claimed comparability.  At the beginning of each section, there is an opportunity to report that you have claimed comparability and therefore are not reporting data.

## B.State Flexibility

As described in Section 4(e)(6) of the AT Act, a state may carry out any two or more of the required state-level activities, meaning a state can choose not to conduct up to two activities.  As reported in some State Plans, some states have chosen not to conduct all four state-level activities.  You will not report data for any State-level activity for which your Statewide AT Program claimed state flexibility.  At the beginning of each section, there is an opportunity to report that you have claimed flexibility and therefore are not reporting data. Regardless of whether a state has claimed flexibility for selected state-level activities, Statewide AT Programs are required to report data on all State Leadership activities.

III. Section-Specific Instructions and Definitions

## A.General Information

In the General Information section, please enter information about the lead agency in items 2-12.  If the lead agency is carrying out the program with no separate implementing entity, please check the box in item 13.  If there is an implementing entity, complete items 14-24.  A state has either a lead agency only or a lead agency and a separate implementing entity.  The lead agency is not considered the implementing entity.

## B.State Financing

***Instructions***

In Section C, Item 3, you will be asked to report on cost savings consumers realized as a result of state financing activities that allow consumers to obtain AT at reduced cost. The column “Savings to Consumers” should reflect the total savings to consumers for all AT devices/services of the type reported in that row.

For each type of AT device, enter the total estimated current purchase price of the devices and the total amount for which devices were sold.  The system will calculate the resulting savings to consumers.  Use the manufacturer’s suggested retail price (MSRP) to determine the current purchase price of the device.  Using estimates is acceptable when exact pricing is not available.  If you are unable to find the exact price for a particular item, use the value of a comparable device.  You may need to identify multiple similar devices and do an average to estimate a MSRP.  If the device was given away, use a sale price of zero in your calculations.******

***Definitions***

***Administrative role:***The system calls for reporting on financial loan programs in which the Statewide AT Program has a financial investment or administrative role.  An administrative role reflects direct dedication of staff time to assist an individual in securing a loan, such as assisting an individual with completing a loan application.  This does not include general staff time cultivating a relationship with a lending institution or providing general guidance to a consumer. 

***Approved-loan not made:***  This includes loans that were approved but not accepted by the consumer and loans that were withdrawn after review. 

***Cooperative buying activities:*** Cooperative buying programs purchase AT in bulk at a discount from AT suppliers and then pass the savings on to consumers. 

***Default:***A loan is in default, on or before, 120 days in which the borrower has not made the scheduled payment for the balance still owed; or at which time the organization administering the loan paid the lending institution the remaining agreed upon balance of loan.  Do not count any payments that may have been made by the loan administering organization on behalf of the borrower during that 120-day period.  The amount in default, for a reporting period should reflect total net losses during the reporting period, specifically the amount unpaid on a loan considered “in default” and/or any loan guarantee payout amounts minus the amount of collateral recovered.

***Financial loan program(s):***** A state financing activity that provides loans for purchase of AT devices and services and for which the program can report the number of applications received, approved and rejected; the default rate; the range and average interest rate; and the range and average income of approved applicants.  A financial loan program may make loans directly (revolving loans) or may make partnership loans using dollars from another source, usually a financial institution.

***Interest buy-down loan:***A partnership loan in which AT program funds are used to buy down the interest rate of a loan. The AT program uses funds to reduce the interest rate that lending institutions offer to consumers for loans to purchase AT. The AT program pays the lending institution for a portion of the interest on the loan, resulting in lower interest payments for the consumer over the long term.

***“Last resort” activities:***Programs that provide AT, or funds to purchase AT, to consumers when other acquisition options are not readily available.  These may be programs operated with funds that are earmarked for particular types of consumers (such as children), particular types of AT (such as home modification), or for individuals who meet certain income limitations.  States may not use AT Act dollars to provide funds or devices directly to individuals.  AT Act dollars may be used to administer a last resort fund comprised of non-AT Act dollars.  

***Loan guarantee or insurance program:*****The grantee uses its funds to guarantee all or a portion of loans for AT. A guaranteed loan is a partnership loan in which the Statewide AT Program guarantees that the loan to a consumer is secure and will be repaid, thus increasing the lender’s willingness to loan funds.  

***Partnership loan:*** A loan administered by and using dollars from a source other than the Statewide AT Program, usually a financial entity, for which the Statewide AT Program has an investment through interest or principal buy-down, loan guarantee, agreement with a financial institution based on an investment deposit, or other financial/administrative role that was approved in a State Plan.

***Revolving loan fund (or revolving loan):*** A loan fund that uses Statewide AT Program funds for loans.  The AT program directly provides the funds that are to be loaned out and retains full control over to whom and at what terms the funds are loaned. As loans are repaid, the money is lent out again to other AT consumers — that is, the same money “revolves” out to other borrowers as earlier borrowers return it to the program.

***Telecommunications equipment distribution program:*** A program to distribute telecommunications equipment that serves the needs of people with disabilities, including safety needs during emergencies. States may not use AT Act dollars to provide funds or devices directly to individuals.  AT Act dollars may be used to administer a telecommunications distribution program comprising non-AT Act dollars.  

## C.Device Reuse

***Instructions***

For refurbishment and repair activities, you will be asked to report the total estimated value of devices that were refurbished and/or repaired and reassigned or placed on open-ended loan.  

Use the Manufacturer’s Suggested Retail Price (MSRP) to determine the original value of the device.  If you are unable to find the exact price for that particular item, attempt to locate a comparable item and use the price for that device. You may need to identify multiple similar devices and do an average to estimate a MSRP.  Using estimates is acceptable when exact pricing information is not available.

***Instructions for Data Collection on Device Exchange***

Device exchange activities are those in which devices are listed in a “want ad”-type posting and consumers can contact and arrange to obtain the device (either by purchasing it or obtaining it for free) from the current owner.  Exchange activities do not involve warehousing inventory and do not include repair, sanitation or refurbishing of used devices.  

In some cases, a Statewide AT Program serves as an intermediary directly involved in making this exchange; in others the consumer and current owner make this exchange without the involvement of the Statewide AT Program.  Data on device exchange may be difficult to gather if your program does not serve as an intermediary role where you are directly involved in the exchange.  

If you operate a device exchange you have options for collecting data.  You may choose to report data by collecting information from the current owner of the device; collecting information from the recipient of the device; or collecting information from a combination of the recipient and current owner.  You can choose to exclude exchange device recipients from performance measure data reporting simply because you are unable to or it is too difficult to collect such data.  Exchange is the only activity that offers this opt-out option for performance measure data.  

Example #1:  You may choose to contact those who removed devices from your exchange during this reporting period.  Many of these individuals will report that they removed the posting because the device was successfully exchanged.  If you confirm with the “seller” that the exchange took place as a result of your device exchange rather than for some other reason, you likely already know the device (meaning you can categorize it and estimate the current purchase price) and the seller can tell you for how much the device was sold (or transferred at no cost).  The seller may have interacted with the buyer to the extent that he can provide you with performance measure data.  If so, you can obtain all of the needed information from the seller.

Example #2:  You may take the steps in Example 1; however, the seller does not have enough information to help you with the performance measures.  The seller may be willing to provide you with contact information for the buyer so you can do a follow up and obtain performance measure information.  This is an instance of obtaining information from both buyer and seller.

Example #3:  You may build a feature into your system that does not allow a buyer access to the seller’s information without first providing you with contact information.  You then may follow up with each of these buyers to see if they purchased devices from sellers.  From those who made a purchase, you can get the purchase price and performance measure information.

**CAUTION:**   If your program operates a device exchange program as the ONLY activity yielding an “acquisition” performance measure, you are strongly encouraged to gather and report performance measure data on the exchange program.  If, however, you operate another type of reutilization activity or one or more state financing activities you may choose to use only those activities to generate the required device acquisition performance measure data.    

***Definitions***

***Device exchange activities:*** Activities in which devices are listed in a “want ad”-type posting and consumers can contact and arrange to obtain the device (either by purchasing it or obtaining it for free) from the current owner.  Exchange programs do not involve warehousing inventory and do not include repair, sanitation or refurbishing of used devices.  In some cases the Statewide AT Program acts as an intermediary during the exchange, in other cases the Statewide AT Program is not involved in the transaction.

***Device refurbish/repair and reassignment and/or open-ended device loan activities:*** Activities in which devices are accepted (usually by donation) into an inventory are sanitized and refurbished as needed, and then reassigned to a new owner (by sale or give away) or placed with a new user via open-ended loan.  Repair activities are those in which devices are repaired for an individual (without the ownership of the device changing hands) which prevent the owner from needing to purchase a device.  

## D.Device Loans

The purpose of the loan may be to assist in decision making, to serve as a loaner while the consumer is waiting for device repair or funding, to provide an accommodation on a short-term basis for a time-limited event, or for training self-education or other personnel development activities.  Access performance measure data is collected on device loans with a decision-making purpose.  Acquisition performance measure data is collected on device loans with all other purposes.  

***Definitions***

***Device borrower:*** An individual, group of individuals, or entity that receives a short-term device loan for the purpose of making a decision, serving as loaner, providing an accommodation or for training, self-education or other professional development activity.  

***Short-term device loans***:  An occasion on which a device or devices are borrowed by an individual/entity who will use the device to make a decision (one decision) based on data, judgments, and other relevant information gained from trial use of the device in a natural environment, as a loaner during device repair or while waiting for funding (no decision is involved), to provide an accommodation (no decision is involved), or for training, self-education or other professional development activity (no decision is involved).  

***Length of short-term device loans:*** The standard length of loan established by each grantee’s policies or practices reported in calendar days.   Open-ended device loans, in which the device borrower can keep the device for as long as it is needed, are a form of device reuse and should be reported under that activity rather than device loans. 

## E.Device Demonstrations

***Instructions***

Device demonstrations compare the features and benefits of a particular AT device or category of devices for an individual or small group of individuals.  The purpose of a device demonstration is to enable an individual to make an informed choice.  

Whenever possible, the participant should be shown a variety of devices.  Device demonstrations should not be confused with training activities at which devices are demonstrated.  Training activities are instructional events designed to increase knowledge, skills, and competencies, generally for larger audiences.  

Device demonstrations also should not be confused with public awareness activities at which devices are demonstrated.  The key difference is that device demonstrations are intended to enable an individual to make an informed choice rather than merely making him or her aware of a variety of AT.  

***Definitions***

***Device Demonstrations:*** In a device demonstration for an individual, guided experience with the device(s) is provided to the participant with the assistance of someone who has technical expertise related to the device(s).   This expert may be in the same location as the participant or may assist the participant through Internet or distance learning mechanism that provides real-time, effective communication to deliver the necessary device exploration.  

A demonstration is characterized by its interactive nature whereby the participant can interact with an expert to increase their knowledge and understanding about the details and functions of a device; the participant drives the demonstration and has the ability to interact and have their individual questions about the device addressed.  If the demonstration is conducted via the internet or distance learning mechanism it must be a real-time, interactive demonstration that provides one-on-one assistance to the participant.  A web-based demonstration that is archived or is a static presentation without interaction is considered an awareness activity, not a demonstration. 

If a demonstration is to be conducted without the participant having direct (hands-on) access to the devices to be demonstrated, the interaction must be structured to ensure the device can be adequately explored to enable decision-making.  For many types of AT devices, it will not be possible to provide adequate interaction in a demonstration without the device being in the hands of the participant.   For example, a demonstration of a daily living aid like a “pill minder” might be done with the participant asking the demonstrator to fill, set and use the device while they watched on interactive video that might provide adequate information for decision- making.  However, having a demonstrator “show” a Braille note taker to an individual with a vision disability via interactive video would not be adequate.  

***Device demonstration referral:***  Following a device demonstration, provision of information about a specific source where the customer may obtain additional information or services related to the devices demonstrated.  A referral must provide a consumer with information on how to contact that source directly.  Referrals may be made to funding sources, service providers, vendors or repair services.  Do not include referrals to other components of your Statewide AT Program. Report only on referrals that result from demonstration activities, not referrals made through an information and referral service.

## F.Training

***Definitions***

Training activities are instructional events, usually planned in advance for a specific purpose or audience, designed to increase participants’ knowledge, skills, and competencies regarding AT.  Such events can be delivered to large or small groups, in-person, or via telecommunications or other distance education mechanisms. In general, participants in training can be individually identified and could complete an evaluation of the training.  Examples of training include classes, workshops, and presentations that have a goal of increasing skills, knowledge, and competency, as opposed to training intended only to increase general awareness of AT.

***Distinguishing Training Activities from Public Awareness Activities***

Training activities have more depth and breadth than public awareness activities and are focused on skill building and competency development. If the purpose of a training session is to create awareness, the training session should be counted under public awareness, not under training.  In general, participants in training can be individually identified, while in awareness activities it may not be possible to identify each individually. 

Working with individual consumers on how to use a particular AT device or troubleshooting problems with devices should be reported under Information and Assistance.

***Distinguishing Training from Technical Assistance***

Training is designed to teach, present or guide individuals in order to impart knowledge, skills and competencies.  Technical assistance is focused on providing extensive assistance to state or local agencies or other entities (rather than individuals) and generally involves problem solving to achieve a mutually agreed upon goal. Technical assistance may involve multiple contacts and interactions over an extended period of time. 

In some cases, training may be a component of technical assistance.  Training that is provided as part of technical assistance can be reported here, but only if the training was one of other several technical assistance activities.  If training was the only technical assistance activity, it can be reported as either training or technical assistance, but not both.  

## G.Technical Assistance

***Definitions***

See previous section, “Training,” for the AT Act’s description of “technical assistance.”

Technical Assistance (TA) is defined as direct problem-solving service provided by Statewide AT Program staff to assist programs and agencies in improving their services, management, policies and/or outcomes.  TA may be provided in person, by electronic media such as telephone, video or e-mail and by other means.  The following are examples of technical assistance:  needs assessment, program planning or development, curriculum or materials development, administrative or management consultation, program evaluation and site reviews of external organizations, and policy development.

Mandatory transition activities that are technical assistance are reported in this section; mandatory transition activities that are training are reported in the training section.

***Distinguishing Technical Assistance from Information and Assistance***

Technical assistance is provided to agencies or other organizations, not to individuals.  Intensive support provided to an individual, for example assisting an individual troubleshoot problems with an AT device or address a funding issue, is reported in Information and Assistance.  Technical assistance typically includes multiple contacts/interactions over an extended period of time with an agency or organization.  Less intensive support services, including single-contact requests for information or limited assistance, should also be reported under Information and Assistance.  

***Distinguishing Technical Assistance from Training***

Training is designed to teach, present or guide participants in order to impart knowledge, skills and competencies to individuals, while technical assistance may be designed to help entities (not individuals) improve their policies, practices and procedures and generally involves problem solving. 

In some cases, training may be a component of technical assistance.  Training that is provided as part of technical assistance can be reported in the training section, but only if the training was one of many several technical assistance activities.  If training was the only technical assistance activity, it can be reported as either training or technical assistance, but not both.  

## H.Public Awareness and Information and Assistance

***Definitions***

***Public Awareness:***

Public awareness activities are designed to reach large numbers of people, including activities such as public service announcements, radio talk shows and news reports, newspaper stories and columns, newsletters, brochures, public forums and social media. Because actual numbers of recipients is difficult if not impossible to track accurately, data reporting for public awareness is descriptive in nature.

***Information and Assistance:***

Information and assistance (I&A) activities are those in which the AT program responds to requests for information and/or puts individuals in contact with other agencies, organizations, or companies that can provide them with needed information on AT products, devices, services, and/or funding sources, or providing intensive assistance to individuals about AT products, devices, services, and/or funding sources.  This information may be provided in person, over the telephone, via email, or by some other means. 

***Distinguishing Public Awareness from Training***

The intended outcome of an activity should determine whether it is reported under public awareness or training.  Presentations made for the purpose of general awareness should not be reporting as training.  Training sessions are those with the intended outcome of participants applying new knowledge or skills in addressing AT device/service issues.  **Note:** Activities should be counted in only one category. 

## I.   Additional and Leveraged Funds 

Although the AT Act does not include a formal definition of leveraged funding or other contributed resources, Section 4(f)(2)(B)(x) calls for Statewide AT Programs to report, “...the source of leveraged funding or other contributed resources, including resources provided through subcontracts or other collaborative resource-sharing agreements, from and with public and private entities to carry out State activities described in subsection (e)(3)(B)(iii), the number of individuals served with the contributed resources for which information is not reported under clauses (i) through (ix) or clause (xi) or (xii), and other outcomes accomplished as a result of such activities carried out with the contributed resources....”  

If a state receives non-AT Act funds and uses those funds to conduct activities authorized under the AT Act these funds should be reported as leveraged funds or contributed resources under “Additional and Leveraged Funds.”  For example --

A state may receive telecommunications funding to provide adaptive telephone equipment to eligible individuals in their state.  This activity could be a state financing activity if so reported in the State Plan.  The recipients of this service would be reported under state financing and the amount and source of funds reported in the Leveraged Funds section.  Or such program might not be included in the State Plan even though it is an authorized AT Act activity.  In that case, the activity would be reported in the Leveraged Funds section only.

Funding reported on in this section may or may not be considered program income.

### Definitions

Dollars reported in Leveraged Funding Sections A or B must be categorized by fund source.  The definitions of each category are as follows:  

Federal – Grants that are received directly by the State AT Program from federal agencies, e.g. HHS/ACL, ED/OSEP, etc.

Public/State Agency – Grants, contracts, memorandum of understanding and similar agreements between the State AT Program and state or other public agencies with associated dollars, e.g. federal flow through, dedicated state funds, etc.

State Appropriations – State dollars/general state funds directly appropriated to the State AT Program;

Private – Grants, contracts, memorandum of understanding and similar agreements with private agencies funded with dollars that can be of any type.  

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