**DEPARTMENT**

**of HEALTH**

**and HUMAN**

**SERVICES**

**FY 2018 Annual Report to Congress on the Assistive Technology Act of 1998, as Amended**

**Prepared by**

**ADMINISTRATION FOR**

**COMMUNITY LIVING**

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**TABLE OF CONTENTS**

EXECUTIVE SUMMARY4

INTRODUCTION6

ASSISTIVE TECHNOLOGY ACT HISTORY6

ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED7

STATE-LEVEL ACTIVITIES7

STATE LEADERSHIP ACTIVITIES7

STATE-LEVEL ACTIVITIES8

DEVICE DEMONSTRATION PROGRAMS8

DEVICE LOAN PROGRAMS10

DEVICE REUTILIZATION PROGRAMS12

STATE FINANCING13

State Financing – Cash Loan Programs13

Other State Financing Programs that Provide AT14

Other State Financing Programs that Reduce the Cost of AT14

CONSUMER SATISFACTION RATINGS OF STATE LEVEL ACTIVITIES15

STATE ACTIVITIES PERFORMANCE MEASURES15

Acquisition Performance15

Access Performance15

STATE LEADERSHIP ACTIVITIES15

Training15

Public Awareness16

Information and Assistance17

Technical Assistance17

INITIATIVES FROM THE FIELD18

CONCLUSION19

Resource Information20

**List of Tables**

Table 1: Number of Device Demonstrations by AT Type9

Table 2: Number of Individuals by Type who Participated in Device Demonstrations9

Table 3: Number of Short-term Device Loans by Type of Borrower10

Table 4: Number of Devices Loaned by AT Type11

Table 5: Number of Recipients, Devices, and Savings by Type of Reutilization Activity12

Table 6: Device Refurbishment Summary by AT Type13

Table 7: Types and Dollar Amounts of AT Acquired with Financial Loans14

Table 8: Consumer Satisfaction with State-level Activities15

Table 9: Percentage of Technical Assistance provided by Agency Type18

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 2018, State and Territory AT programs served close to 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 2018, 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.

**FY 2018 AT Program Achievements from State-Level Activities Resulting in Positive Outcomes for Individuals with Disabilities**

ADMINISTRATION FOR COMMUNITY LIVING

**FY 2018 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) 2018.

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 prior legislation.  Rather than focusing the efforts of states on systems-change 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 protection and advocacy AT programs.  As mandated by the 2004 amendments, the U.S. Department of Education’s 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.
**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)

In 2014, the Workforce Innovation and Opportunity Act (WIOA) transferred administration of the AT Act to the Department of Health and Human Services’s Administration for Community Living (ACL). This data report provides a national summary of Section 4 grantee statewide AT program activities and outcomes for FY 2018.

ASSISTIVE TECHNOLOGY ACT OF 1998, AS AMENDED

20 	FY 2018 REPORT TO CONGRESS ON THE 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 (1) a portion of the funds equally to all states, and (2) a portion of funds to states based on the population of the states.  Funding levels for FY 2018 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).[footnoteRef:2]1 [2: 1 http://www.catada.info/.] 

STATE-LEVEL ACTIVITIES

State-level activities include the following:

· **State financing activities**, which can be:

· 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

· 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.[footnoteRef:3]2 [3: 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.] 

· **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 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 Ac*t 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, 2020, and was used by all grantees to report FY 2018 annual progress report data summarized in this Report to Congress.  

**A NATIONAL DATA SUMMARY OF STATE ASSISTIVE TECHNOLOGY PROGRAMS: FISCAL YEAR 2018**

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 2018 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’ was the largest category, comprising 19% of all demonstrations. Nine additional device categories comprised between 1% and 15% 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.”

Table 1: Number of Device Demonstrations 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 2018. Last accessed December 2019.

As illustrated in Table 2, individuals with disabilities (41 percent) comprised almost half of those participating in device demonstrations in FY 2018, followed by family members, guardians, and authorized representatives (23 percent). 

Table 2: Number of Individuals who Participated in Device Demonstrations

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 2018. Last accessed December 2019.

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 2018, 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.

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**Independence and Access to Devices**

“T” is a 48-year-old man with a history of progressive multiple sclerosis. T contacted the Washington Assistive Technology Act Program (WATAP) to help him achieve his goals of improving voice volume output, using a telephone, and accessing devices that might provide improved access to music, books, environmental controls, and movies. 

Through a WATAP AT Specialist, T was provided a demonstration of a voice amplification system and a digital assistant (Amazon Echo) with WiFi switch controllers. Significant improvement was noted with initial trials of the voice amplification system, and he was able to operate Amazon Echo Show and the switch controllers. T was excited to complete even the simplest independent activities using this technology. After the demo, T was able to borrow the devices. After it was determined these were good matches, T was provided an Amazon Echo Show and two wireless interface switches to control a fan and a table lamp with funding from a private MS foundation fund. 

T now uses Echo to correctly answer questions, identify movies of interest, see favorite music lyrics, make a phone call, read books, and operate his room fan. T stated that the equipment had significantly improved his quality of life. To quote T, “She’s like my new best friend.” 

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 short-term 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 2018, fifty-six AT Programs reported providing 32,353 short-term loans of AT devices to individuals or entities.  Individuals with disabilities were the largest group to whom devices were loaned (39 percent), followed by representatives of education (20 percent). Please refer to Table 3 for a more detailed breakdown. 

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

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 2018. Last accessed December 2019.

Devices for computers and related devices (18 percent) were the most common types of AT devices loaned in FY 2018, followed by speech communication devices (17 percent), and devices for learning and cognition (15 percent).  Seven additional device categories accounted for the remaining 50 percent of the device loans made (Table 4). 

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 2018. Last accessed December 2019.

Sixty-seven percent or 21,702 device loans were made to individuals for the primary purpose of decision-making.  Other reasons borrowers cited for wanting a short-term device loan included accommodation (18 percent), a loaner during repair/waiting for funding (7 percent), and for training/personnel development (7 percent).  AT acquired through device loan programs was primarily used for community living (64 percent), education (30 percent), and employment (6 percent). 

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**Jonay: Eye-Gaze Success.**

Jonay is a teenage girl who is quadriplegic and uses a wheelchair. She is non-verbal and did not have a functional way to communicate with her peers, teachers, and family members using conventional words. Due to her medical condition, Jonay has limited movement of her hands and fingers and cannot operate a standard computer or communication device. 

The loan bank at the Colorado AT program allowed Jonay and her family to borrow three different eye gaze devices for a diagnostic trial. Eye gaze devices allow people with limited mobility to use eye movement to convey their thoughts. The family determined that a Tobii i-12 with eye gaze technology and customized larger buttons and a smaller screen would meet Jonay’s needs and still be accessible for face-to-face interactions. 

For the first time, Jonay was able to make requests for food and drink, and to share her basic wants and needs. Her family members said: “Thank you for giving this teenager a way to get her teenage words out into this world and to say things that are on her mind! The possibilities are limitless. We are now meeting to explore options to fund the device for use every day at school and at home.”

DEVICE REUTILIZATION PROGRAMS

Assistive technology reutilization involves transferring a previously owned device from someone who no longer needs it to someone who does.  Device reutilization 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 lending 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 2018, 59,149 consumers received a total of 70,673 reutilized devices from fifty-five AT Programs, resulting in an overall savings of $28 million. As shown in Table 5, the most common device reutilization activity was device refurbishment. Ninety-seven percent of recipients received devices through a device refurbishment program, saving $26.6 million and providing the greatest savings to recipients. As Table 6 shows, the vast majority of AT devices provided through refurbishment programs were for ‘mobility, seating’ (51 percent) and ‘daily living’ (36 percent). AT acquired through device reutilization programs was primarily used for community living (95 percent), and was also used to support education (3 percent), and employment (2 percent).

Table 5: 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 2018. Last accessed December 2019.

Table 6: Device Refurbishment Summary 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 2018. Last accessed December 2019.

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**Locating AT Post-Hurricane Matthew**

In August 2018, 17 months after Hurricane Matthew hit North Carolina, the North Carolina Assistive Technology Program (NCATP) got a call from NC Emergency Management regarding two hurricane survivors needing AT and durable medical equipment. The survivors needed a manual reclining wheelchair, a standing lift, an electric hospital bed, and a lift chair. Both individuals lived in the Roberson County area (a very rural portion of North Carolina).  

Frank Harden, NCATP’s reuse coordinator, contacted individuals across the state to locate the items needed. Within hours, he found a gentleman near Raleigh who had recently lost his wife from a lengthy illness. He wanted to donate durable medical equipment to the NCATP reuse program. The items to be donated were exactly the items needed by the two hurricane survivors.

NCATP arranged for pickup and delivery to the survivors, about 2 hours from Raleigh, and within 2 days of the original request, they had all the equipment they needed.

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). Ninety-six percent (96%) of recipients indicated an AT device could not be obtained without the assistance of the state financing activity.

State Financing – Cash Loan Programs

Thirty-four state AT Programs reported data on financial loans made. These programs issued 908 loans for AT device(s), totaling $7,867,423. The average annual income of loan recipients was $43,555, and the national average interest rate was 3.89 percent. 

Out of 908 loans issued, 25 percent were made to applicants with annual incomes of less than $15,000, and another 25% were made to applicants with annual incomes between $15,001 and $20,000. The overwhelming majority of total loan dollars issued (73 percent) was for ‘vehicle modification and transportation technologies,’ averaging $20,551 per loan. ‘Hearing AT’ ranked first in number of devices financed, averaging $3,538 per loan. For a more detailed breakdown of loans by device type, refer to Table 7.

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

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 2018. Last accessed December 2019.

Other State Financing Programs that Provide AT

Eighteen 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), are 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 2018, these programs served 3,359 individuals and provided 4,859 AT devices. Almost half (49 percent) of the total technologies funded were hearing and vision devices.  Environmental adaptations constituted 18 percent ($677,509) of the total value of AT provided ($3,722,993) 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 2018, these other financing activities served 2,190 individuals, and 2,333 devices were acquired at a total savings of $712,610. Out of all the AT categories, hearing AT resulted in the highest savings to consumers ($1,891 per device). Devices for learning and cognition (1,172 devices) and vision (524 devices) combined made up 72 percent of acquired devices through other financing activities. This resulted in moderate savings per device ($80 for each item for learning and cognition, and $905 for each vision device).

Recipients of state financing activity services reported the primary purpose for which AT was needed. Sixty-one percent of respondents cited community living as the primary purpose, followed by education (32 percent) and employment (7 percent).

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**Latrisa: AT Devices to Help with Low Vision**

Latrisa, a single mom, became partially blind in January 2017. She learned about the Louisiana Assistive Technology Access Network (LATAN), and became familiar with some assistive devices for vision, including an Amigo HD video magnifier and MAGic Screen Reading and Magnification Software.

Latrisa was able to use LATAN’s new AT Lease Program to help her to afford the devices she needed to see. She reported that being able to lease the devices allowed her a little freedom, and she was able to get a seasonal job with Amazon because she has this assistive technology.

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 2018. Last accessed December 2019.

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-term device loans for the purpose of acquisition. Seventy-three percent of consumers stated that they could only afford AT through these programs, 16 percent said that the AT needed was only available to them through AT programs, 8 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 three 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-eight percent of respondents stated that an AT device would meet their needs, or those of someone they represent.  Another eight percent of consumers stated that an AT device would not meet their needs (which is still an important decision outcome), and four 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 2018, AT Programs trained a total of 107,658 participants. Individuals with disabilities (29 percent) were closely followed by representatives of education (23 percent) as the types of individuals who were most likely to receive training.  Fifty-six 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-two 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 eight percent of the participants.  AT funding/policy/practice and information technology/telecommunication access trainings represented a combined fourteen percent of the participants.

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 in FY 2018: 

· Colorado AT Program faculty and staff have been invited speakers at numerous conferences over the last year. The program’s executive director presented a live streaming event in Las Vegas at the Consumer Electronics Show. She was able to reach over 200,000 people with information on the value of AT for the aging population. She also presented on software and app accessibility at the Grace Hopper Women in Computing Conference to an audience of over 20,000. 

· The Maine AT Program’s director appeared on the Maine Calling Show on Maine Public Radio on March 1, 2018. The director explained the impact of AT in the lives of individuals with disabilities, and described examples of AT devices for education, work, and community living. During the call-in section of the radio broadcast, the director answered several questions from callers about AT resources in Maine. The showed aired to an estimated public audience of 100,000.

· Nevada AT Program partner Easterseals Nevada, NV Disability Advocacy and Law Center, and United Way provided outreach to Nevada’s Hispanic community to demonstrate what AT is, what devices are available, and how to access the devices. The main focus was on children and how to access services through the school district. The NATE Project (run by Easterseals) was shared as a resource to learn about and try out devices. Outreach occurred through events at three different community centers, and raised public awareness significantly.

· Virginia AT Program staff provided an “AT @ Work” presentation at the Virginia Manufacturing Association’s conference as a main event. The presentation covered how AT devices/services fit well with the “lean manufacturing” philosophy implemented by manufacturers. Participants were primarily business owners and managers. Staff educated attendees on the benefits of AT, as well as the benefits of hiring qualified Virginians with disabilities.

· The West Virginia Assistive Technology System (WVATS) was contacted by the local television station to discuss accessible playgrounds. WVATS partnered with Kanics Inclusive Design Services to provide a two-segment interview about the components of accessible playgrounds and equipment for adaptive play. Equipment from the WVATS loan library was featured in the interview, which was aired across the state twice. Following the broadcasts, loans for adapted recreation equipment increased. WVATS also received more calls about how to adapt certain activities.

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 2018, 221,175  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 individuals with disabilities (25 percent), followed by representatives of health, allied health, and rehabilitation (21 percent), family members/guardians/

authorized representatives (17 percent), representatives of education (15 percent), and representatives of community living (9 percent).  The remaining recipient types were representatives of employers and employment services (6 percent), representatives of technology (5 percent), and others (2 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 2018, the fifty- six grantees reported providing a majority of technical assistance to educational agencies (34 percent) and community living agencies (26 percent). Please see Table 9 for more information.

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 2018. Last accessed December 2019.

Leveraged funding is frequently secured by state AT Programs and is used to expand and maximize services. In FY 2018, state AT Programs leveraged $21.1 million from federal, state, local, and private sources. These leverage dollars were used to supplement $28 million in Section 4 AT Act formula grant funding for FY 2018 and expand program reach in all AT Act authorized activities. This report highlights close to $63 million in savings and benefits delivered by state AT Programs in FY 2018 to nearly 500,000 service recipients.

INITIATIVES FROM THE FIELD

*Community Living*

The North Carolina Assistive Technology Program (NCATP) received a high-impact technology grant from the Christopher and Dana Reeves Foundation in 2018. These funds have been used to establish the NC RAMMP (Ramp Access Makes Mobile People) program, providing temporary portable ramps for individuals impacted by medical conditions or natural disasters. Policies, procedures, and leveraged funding have been developed ensuring the RAMMP program will continue following the one-year grant funding.

*Employment*

Over this past year, Assistive Technology Program of Colorado (ATP) has worked tirelessly in meetings with the state’s Department of Vocational Rehabilitation (DVR) to establish a memorandum of understanding (MOU) regarding shared responsibilities and priorities around AT. The AT Program and the DVR have a renewed formal relationship, and will work together to offer education to DVR counselors. ATP has already received increased referrals for clients needing AT assessments and device demonstrations as well as requests for training. 

The MOU outlines the process of referral for AT services and the responsibilities of both agencies to provide information and resources around AT with regard to device demonstrations, device loans, alternate financing, training, technical assistance, and information and referral. DVR will continue to serve on the AT Coalition, sit on the advisory board for the Colorado Technology Act Program, and collaborate with the AT Program.

*Education & Transition*

The Illinois Assistive Technology Program (IATP) introduced legislation to address how AT is incorporated into students’ Individualized Education Programs (IEPs). One bill requires that parents and guardians of students with IEPs will be informed about the availability of AT. If the IEP team determines the student does not need AT, parents will be given notification in writing of why that determination was made. They will also be given information about the IATP, including contact information. Additionally, the Illinois State Board of Education is developing guidance on how local districts can record unsuccessful AT trials in the IEP to inform future trials and exploration and support quality AT considerations. 

*Information and Communication Technology Accessibility*

Oklahoma ABLE Tech provides training and technical assistance on the accessibility of electronic and information technology (EIT) to all Oklahoma state agencies, higher education institutions, and the state’s Career and Technology Education system. With the recent changes to federal EIT standards, Oklahoma had to revise its state EIT standards to be in compliance. ABLE Tech worked closely with the Oklahoma Office of Management and Enterprise Services to revise Oklahoma’s EIT standards to meet the latest national guidelines for accessibility.

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.

Resource Information

Contact and other information on each State AT Program[footnoteRef:4]5 can be found on the Center for Assistive Technology Act Data Assistance (CATADA) website.  The CATADA website also provides an overall summary data report[footnoteRef:5]6 for Fiscal Year 2018 that provides data on the major AT Act activities by state. [4: 5 https://catada.info/state.html.]  [5: 6 https://catada.info/at/?report=summary.] 

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 website[footnoteRef:6]7 and on the CATADA website.[footnoteRef:7]8 [6: 7 https://www.acl.gov/about-acl/reports-congress-and-president.]  [7: 8 https://catada.info/catada-publications/.] 

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 2018. Washington, D.C., 2018.

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