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### State Grants for Assistive Technology Program **State Plan for Assistive Technology**

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displa ys a valid OMB control number. Public reporting burden for this collection of information is estimated to average 74 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain benefits ( Assistive Technology Act of 1998, as amended, Sec. 4, Pub. L. 108
- 364; 34 CFR 76.102 ). Send comments regardin g the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20210

- 4537 or email ICDocketMgr@ed.gov and reference the OMB Control Number 1820

- 0664. Note: Please do not return the completed State Plan for Assistive Technology form to this address.1820

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2 

### Instructions
Section 4 of the Assistive Technology Act of 1998, as amended (AT Act) establishes grants to states to support comprehensive statewide programs (Statewide AT Programs) that conduct activities that improve access to and acquisition of AT devices and services for individuals with disabilities across the human lifespan and acro ss a wide array of disabilities, and their famil y members, guardians, advocates, and authorized representatives. Section 4(d)(1) of the AT Act requires that states submit an application to the Rehabilitation Services Administration (RSA) to receive a gr ant. RSA calls the application a State Plan for Assistive Technology

(State Plan for AT or State Plan). This document provides the instructions for completing the State Plan that covers the activities of Statewide AT Progra ms for Federal fiscal ye ars 201 2 (October 1, 2011 to September 30, 2012), 2013 (October 1, 2012 to September 30, 2013), and 2014 (October 1, 2013 to September 30, 2014 ). The State Plan for AT must be developed, prepared, and submitted with the advice of the state’s Advisory Council by the Lead Agency designated by

the Governor to carry

out the Statewide AT Program. If an Implementing Entity carries out the Statewide AT Program rather than the Lead Agency , the State Plan for AT can be jointly developed and prepared by the Lead Agency an d Implementing Entity with the advice of the state’s Advisory Council, though the State Plan must be submitted by

the L ead Agency . The Certifying Representative for the Lead Agency must sign the plan. 1
The State Plan describes how the state will cond uct its Statewide AT Program during the period covered b y the plan. The plan is reviewed b y RSA to ensure that it conforms with the instructions in this document and the requirements of the AT Act. RSA may work with the state to adjust the State Plan in order to make the plan approvable. If RSA determines that the State Plan for AT is not approvable, RSA will attempt to resolve the disputed issues after providing the appropriate technical assistance to the state. If no resolution has been reached after reasonable efforts, RSA will provide an opportunity for a hearing in accordance with 34 CFR part 76.202 before the State Plan for AT is disapproved. The State Plan for AT must be amended during the three

- year period of the plan if RSA determines that an amendment is essential, such as in the case of a material change in state law, organization, policy

or agency

operations affecting the information, assurances, or administration of the plan. The state must change or update its plan as needed to ensure th e information contained in it accurately reflects the state’s activities. States should note that the content of the State Plan directly correlates to requirements for reporting annual data to RSA. The instructions contain frequent reminders that “. . . you are required to provide annual data for an y activity

claimed in this State Plan.” This is a reference to the annual data submitted in

1 The Certifying Representative wil l sign the plan via electronic signature. A paper follow

- up will not be required.1820

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3 the “Annual Report for State Grant for Assistive Technology Programs,” OMB #1820

- 0572. For State

- level Activities (a s explained below), this includes the performance measures featured in Section H of this State Plan. When RSA reviews y our annual report, it will use the most recent version of y our State Plan for AT as a reference. Therefore, it is recommended that the state periodically review its State Plan to determine whether changes are necessary . The need for changes must be communicated to RSA and RSA will approve changes in the same manner it approves the initial submission of the Plan. Paper submissions of the State Plan for AT are neither required nor accepted. States will submit plans using RSA’s Management Information Sy stem (MIS). RSA plan s to host training on use of the MIS and will send information about this training to all Statewide AT Programs via e - mail. Visit the following website t o access the MI S: http://rsa .ed.gov. Only individuals with user identification (ID) and passwords can enter data into the MI S. Visit the website address above and select the “Info for New Users” link on the left side of the screen to obtain a user ID and password. Follow the instructions provided on the “Info for New Users” page. RSA recommends that states initiate the process for obtaining user IDs and passwords well in advance of the need to enter data into the MI S. Once you have received a user ID and password and log into the system, select “Data Entry.” Then select your state from the drop

- down menu and scroll down the table to the row labeled “SGAT.” In that row, yo u will check the box next to “SPAT.” Then scroll to the bottom of the page and select “View Information.” On the next screen, information about your state should appear, with two buttons on the right side of the screen: “View” and “Add/Update.” Select “Add/Update” to open your State Plan

. The State Plan is completed by entering information into text boxes, making selections from drop

- down menus, and use of “check boxes.” The format cannot account for every variable in how states conduct their programs. Therefore, a state should select its answers based on the responses that are the most accurate and best describe how the Statewide AT Program operates, even if the description is not exact. In almost all cases, there is an opportunity to clarify using an open - ended text box. A state ne ed not provide information related to activities it does not conduct, but must respond to every item for activities it does conduct. 2 The instructions in this document mirror the screens presented in the MIS. The MI S does not contain instructions, howeve r, so states will need this document when completing the State Plan online.

2 Responding is at the discretion of the state when given the opportunity to provide “additional information,” however.1820

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4 For assistance with completing a plan, contact Robert Groenendaal at (202) 245

- 7393 or Robert.Groenendaal@ed.gov . For technica l support on use of the MIS, contact Ken Schellenberg at (202) 245

- 6589 or Ken.Schellenberg@ed.gov.1820

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5 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Table of Contents**

Screen 1 **A Identification and Description of Le**  **ad Agency and Implementing Entity;**

**Change in Lead Agency or Implementing Entity** Screen 2 **B Advisory Council, Budget Allocations, and Identification of Activities** 

**Conducted C**  **State Financing Activities** Screen 3 Financial loan program Screen 4 A ccess to telework loan fund Screen 5 Cooperative buying program Screen 6 Financing for home modifications program Screen 7 Telecommunications distribution program Screen 8 Last resort program Screen 9 Other program

**D Device Reutilization Activi**  **ties** Screen 10 Device exchange Screen 11 Device reassignment Screen 12 **E Device Loan Activity** 

Screen 13 **F Device Demonstration Activity** 

**G State Leadership Activities**  Screen 14 Training Activities Screen 15 Technical Assistance Activities Scre en 16 Public Awareness Activities Screen 17 Information and Assistance Activities Screen 18 **H Assurances, Measurable Goals and Signatures** 1820

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6 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section A. Identification and Description of Lead Agency and Implementing Entity;**  **Change in Lead Agency or Implementing Entity** 
Section 4(d)(2) of the AT Act requires that the State Plan contain information identifying and describing the Lead Agency and Implementing Entity (if applicable) designate d by the state’s governor. If there is an Implementing Entity , section 4(d)(4)(B) requires that the State Plan include a description of the mechanisms established to ensure coordination of activities and collaboration between the Implementing Entity and the Lead Agency . If the governor chooses to re

- designate the Lead Agency or Implementing Entity , section 4(c)(1)(C) requires that good cause for this change be shown in the State Plan, including wh y that previously designated agency or entity no longer sho uld serve. If the Lead Agency or Implementing Entity

is changing, the information provided in this State Plan should pertain to how the new agency or entity will conduct the Statewide AT Program. The following items are intended to satisfy the requirements just described. **1. Name Given to Statewide AT Program. [Text box]** Instructions : Most Statewide AT Programs have a name for common usage and easy recognition within the state. For example, the Statewide AT Program may be designated as the “Consumer Access to Technology” or CAT program. Provide this title in the text box, as well as the preferred acron ymin parentheses if an acrony m is used. **2. Website dedicated to Statewide AT Program. [Text box]** Instructions : Provide in the text box the link that allows direct access to the website dedicated to your Statewide AT Program, not the general website of the Lead Agency or Implementing Entity

(unless the Implementing entity exists solely

to serve as the Statewide AT Program). Enter N/A if there is n o website dedicated to your Statewide AT Program.
**3. N ame and Address of Lead Agency. [Text box]**  Instructions : Inthe text box, provide complete contact information for the Lead Agency

. This information will be used to print address labels for corresp ondence sent to your program, so enter the mailing address to which yo u want correspondence sent, not the1820

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7 phy sical address (if different). Separate address items such as building names, street names, and box numbers, as applicable. The state can be an ab breviation, but include a 9

- digit zip code. Follow the organizational chart for the Lead Agency from its highest level to the division of the agency

directl y responsible for implementation of the Statewide AT Program. Enter the full name of the agenc y and its divisions as they would be referred to in formal communication, without abbreviations. For example, if the Governor has designated the Department of Disabilities as the Lead Agency , within which there is an Office of Employ ment and Community

L iv ing, within which there is a Bureau of Vocational Rehabilitation that administers the Statewide AT Program: Department of Disabilities Office of Employ

ment and Community

L iving Bureau of Vocational Rehabilitation Administration Building 200 Government Way Suite 1951, Box 22 Any where, WU 77666

- 5544 **4. Name, Title, and Contact Information for Lead Agency Certifying Representative. [Text**  **box]** Instructions : Every

grant recipient must appoint a certifying representative that is authorized to be responsibl e for Federal funds. In the text box, provide the name and title of the Certifying Representative for the Statewide AT Program as it should appear on official correspondence. If the Certifying Representative’s title is of a general nature, please provide full information (e.g., if his/her title is “Director,” indicate what he/she is Director of). Contact information for the Certifying representative includes mailing address, phone number, and e

- mail. When providing the address, follow the instructions g iven for the address of the Lead Agency . If the Certifying Representative’s address is the same as the Lead Agency , you must repeat the information. Example: Dr. John Doe, Bureau Chief Department of Disabilities Office of Employ

ment and Community

L ivin g Bureau of Vocational Rehabilitation Administration Building 200 Government Way Suite 1951, Box 22 Any where, WU 77666

- 5544 (123) 456

- 7891 john.doe@bvr.wu.gov1820

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8 **5. Information about Program Director at Lead Agency.**  **[Text box]** Instructions : Your Program Director is the individual officiall y responsible for overseeing the implementation of the grant, though occasionally this individual does not operate the program on a day

- to

- day

basis. Your Lead Agency may use different terminology for this position (e.g., Principal Investigator). This may or may not be the same individual as your Certifying Representative. If your Program Director is the same as your Certifying Representative, you still must provide all of the information required in this item. In the text box, provide the following information about the Program Director:

 His/her name and title

- Include his/her title as it relates to the Statewide AT Program . For example, an employ ee of the Bureau of Vocational Rehabilitation might be called a Program Specialist within the agency , but he or she is considered the Program Director for the Statewide AT Program. His/her title should be entered as “Program Director,” because this is the role the individual play s in relationship to the Statewide AT Program.
 Address

- Follow the same instructions for previous address

- related items.
 Phone number.
 E

- mail.
 % full

- time equivalent (FTE) dedicated to the Statewide AT Program

- Enter the number followed b y the p ercent sign. 100% FTE indicates that the individual exclusively

works on the Statewide AT Program (100% = 40 hours per week). While the FTE may

fluctuate for those who are not 100%, enter the FTE that has been formally

identified in the individual’s job description. **6. Information about Program Contact(s) at Lead Agency. [Text box]**  Instructions : Many

L ead Agencies have a number of individuals who are responsible for the Statewide AT Program in some capacit y. For example, the Governor has designated the Department of Disabilities as the Lead Agency , within which there is an Office of Employ ment and Community

L iving, within which there is a Bureau of Vocational Rehabilitation that administers the Statewide AT Program. The Bureau of Vocational Rehabili tation has a Branch Chief designated as responsible for AT programs throughout the bureau. This person supervises a Program Specialist, who oversees a Contract L iaison that works directl y with the subcontractors conducting the activities of the Statewide AT Program. All of these individuals would be considered Program Contacts and all should be identified in this section if not previously identified as the Certifying Representative or Program Director. However, this does not mean that every person involv ed in the Statewide AT Program should be named. Name onl y those who have oversight, who are paid using grant funds, and to whom RSA and others should correspond about the program. If an individual is not paid using grant funds but performs duties and fun ctions that make them a Program Contact, he or she should also be included here. Provide the same information about each program contact that you provided for the Program Director.1820

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9 **7. Telephone at Lead Agency for Public. [Text box]**  Instructions : Th e contact information provided for RSA’s use may be different from the contact information for the public. Statewide AT Programs often have 1

- 800 numbers to which inquiries about the program from the public are routed to information and referral specialist s or others. Provide this information in the text box. I f this information has been provided previousl y, repeat it here.
**8. E -**  **mail at Lead Agency for Public. [Text box]**  Instructions : The contact information provided for RSA’s use may be different fro m the contact information for the public. Statewide AT Programs often have general e

- mail addresses for inquiries about the program from the public. Provide this information in the text box. If this information has been provided previously , repeat it her e. **9. Select the most appropriate descriptor of the agency/division/bureau directly responsible for the Statewide AT Program within the Lead Agency. [Drop**  **- down menu]**  Instructions : The drop

- down menu offers the following choices (select one):

o General o r Combined Vocational Rehabilitation Agency o Vocational Rehabilitation for the Blind Agency o State Education Agency o University o Health and Human Services Agency o Aging and Disability

(or similar) Agency o Other Though the name of the Lead Agency , or division of that Lead Agency , responsible for implementing the Statewide AT Program may be self

- explanatory , sometimes it is not clear the “ty pe” of state agency

it is. To complete this item, select the t ype of entity with which the Statewide AT Program considers it self most affiliated. This may not necessarily

be the highest level of the Lead Agency . For example, the Statewide AT Program may be housed in a State Education Agency , but is directly implemented by

a General Vocational Rehabilitation Agency

that is hou sed within that State Education Agency . If the Statewide AT Program is more closely affiliated with the General Vocational Rehabilitation Agency than the State Education Agency as a whole, select General or Combined Vocational Rehabilitation Agency

. **10. If Other was selected for question 9, identify and describe the agency.**  **[Text box]** Instructions : “Other” should be selected onl y when none of the available choices can reasonabl y be applied to the ty pe of Lead Agency . The description should be brief and explain that agency ’s function in a manner that makes it clear why none of the other choices appl y.1820

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10 **11. Does your Lead Agency contract with an Implementing Entity to carry out the Statewide AT Program on its behalf?**  **[Drop -**  **down menu]** Instructi ons : The drop

- down box above allows you to select “y es” or “no.” A state either has a Lead Agency

alone or has both a Lead Agency and an Implementing Entity . The Implementing Entity

is a subcontractor separate from the L ead Agency

. The Lead Agency does not also name itself as the Implementing Entity . If you answer “y es” to this question, yo u must complete the information about the Implementing Entit y that follows. If you answer “no,” you do not complete items related to an Implementing Entity

. **If you answered no to question 11, you may skip ahead to the items on**  **change in Lead Agency or Implementing Entity. Otherwise, you must answer the following questions.**  **12. Name and Address of Implementing Entity. [Text box]**  Instructions : Follow the same instructions for item 3. **13. Information about Program Director at the Implementing Entity. [Text box]**  Instructions : Follow the same instructions for item 5. **14. Information about Program Contact(s) at Implementing Entity. [Text box]**  Instructions : Fol low the same instructions for item 6. **15. Telephone at Implementing Entity for Public. [Text box]**  In structions : Follow the same instructions for item 7.
**16. E -**  **mail at Implementing Entity for Public. [Text box]**  Instructions : Follow the same instructions for item 8. **17. Select the most appropriate descriptor of the type of organization that is the Implementing Entity. [Drop**  **- down menu]**  Instructions : The drop

- down box offers the following choices (you may select onl y one):

o AgrAbility

Program o Alliance for Technology Access Center o Bank or other financial institution o Easter Seals o Independent Living Center o Institution of Higher Education o Non

- categorical disability organization o Organization that primarily serves individuals who are blind or visua lly impaired o Organization that primarily serves individuals who are deaf or hard of hearing o Organization that primarily serves individuals with developmental disabilities o Organization that primarily serves individuals with phy sical disabilities1820

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11 o Organizatio n focused specificall y on providing AT o Protection and Advocacy organization o UCP o Other It may not be clear what ty

pe of Implementing Entity it is based on the title alone. To complete this item, select the ty pe of entity

with which the Implementing Entity considers itself most affiliated. Many organizations could be categorized using a number of the descriptors provided. Use the following rules when deciding how to indicate the ty pe of organization:  If applicable, the national affiliation of an entity s hould be selected before other descriptors (e.g., if an organization is an Alliance for Technology Access Center, choose this national affiliation rather than “organization focused specificall y on providing AT”). These include:  AgrAbility

Program  Alliance for Technology Access Center  Easter Seals  Independent Living Center  Protection and Advocacy organization  UCP  If a private entity

has no national affiliation, use the following more general descriptors.  Bank or other financial institution

– Self

- explanatory

.  Non

- categorical disability organization

– This is an organization that serves individuals with disabilities without a particular focus by age or disability

t yp e, and, while it may

provide AT services, is not exclusively

dedicated to providing AT serv ices. Also select this if the entity

serves two or more of the ty pes of disabilities in the bullets below.  Organization that primarily serves individuals who are blind or visually impaired

– Self

- explanatory

.  Organization that primarily serves individuals who are deaf or hard of hearing

– Self

- explanatory

.  Organization that primarily serves individuals with developmental disabilities

– Self

- explanatory

.  Organization that primarily serves individuals with phy sical disabilities

– Self

- explanatory.  Organizati on focused specificall y on providing AT

– These generall y are organizations exclusively dedicated to providing AT

- related, rather than general or disability

- specific, assistance to consumers.  Other

– See instructions for item 18.1820

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12 **18. If Other was sel ected, identify and describe the entity. [Text box]**  Instructions : “Other” should be selected onl y when none of the available choices can reasonabl y be applied to the ty pe of Implementing Entity . The description should be brief and explain that entity ’s function in a manner that makes it clear why none of the other choices appl y.

**19. Describe the mechanisms established to ensure coordination of activities and collaboration between the Implementing Entity and the state. [Text box]**  Instructions : Acc ording to section 4(c)(1)(B) of the AT Act of 1998, as amended, the Implementing Entity

must carry

out its responsibilities through a subcontract or other administrative agreement with the L ead Agency . Your description should identify the mechanism used and how the Lead Agency provides oversight and holds the Implementing Entity accountable for appropriate implementation of the Statewide AT Program. **20. Is the Lead Agency named in this State Plan a new or different Lead Agency from the one designated by**  **the Governor in your previous State Plan? [Drop -**  **down menu]** Instructions : The drop

- down menu allows y ou to select “y es” or “no.” The “previous state plan” was the plan under which the Statewide AT Program operated from October 1, 2005 until the submissi on of this State Plan. If a change in Lead Agency alread y has been approved b y RSA under the previous State Plan, the state can select “no.” If you select “no,” and you use an Implementing Entity, move on to the questions about changing Implementing Enti ties. **If you answered no to question 20, and you do not use an Implementing Entity, you may skip ahead to the next section. Otherwise, you must answer the following**  **questions. 21. Explain why the Lead Agency previously designated by your state shoul**  **d not serve as the Lead Agency. [Text box]**  Instructions : Describe all factors that led the state to consider changing from the previous Lead Agency

or Implementing Entity , such as concerns about performance, state policies that require periodic competiti on for contracts, or restructuring of state government. **22. Explain why the Lead Agency newly designated by your state should serve as the Lead Agency. [Text box]**  Instructions : Describe how and wh y the new Lead Agency was chosen to implement the State wide AT Program and justify the appropriateness of the choice. **23. Is the Implementing Entity named in this State Plan a new or different Implementing Entity from the one designated by the Governor in your previous State Plan? [Drop**  **** **down menu]** Instruct ions: The drop

- down box above allows you to select “y es,” “no” or “not applicable.” The “previous state plan” was the plan under which the Statewide AT Progr am operated from October 1, 2008 until the submission of this State Plan. I f a1820

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13 change in Impleme nting Entity already has been approved b y RSA under the previous State Plan, the state can select “no.” **If you answered no or not applicable to question 23, you may skip ahead to the next section. Otherwise, you must respond to items 24 and 25.**  **24. Explain why the Implementing Entity previously designated by your state should not**  **serve as the Implementing Entity. [Text box]** Instructions: Follow the same instructions for item 21. **25. Explain why the Implementing Entity newly designated by your st ate should serve as**  **the Implementing Entity. [Text box]** Instructions: Follow the same instructions for item 22.1820

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14 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section B: Advisory Council, Budget**  **Allocations, and Identification of A ctivities**  **Conducted** Section 4(c)(2) of the AT Act requires the Statewide AT Program to establish a consumer majority advisory council that provides consumer

- responsive, consumer

- driven advice to the state for planning of, implementation of, and evaluation of the activities carried out through the grant, including setting measurable goals

. Exceptions to these requirements are allowed under section 4(c)(2)(E) if the requirements will affect existing state statutes, rules, or official policies relating to adv isory

bodies or require changes to existing governing bodies of incorporated agencies. The following items provide assurances related to and identify compliance with the requirements of section 4(c)(2). **1. In accordance with section 4(c)(2) of the AT A ct of 1998, as amended our state has a**  **consumer -**  **majority advisory council that provides consumer -**  **responsive, consumer**   ** driven advice to the state for planning of, implementation of, and evaluation of the** **activities carried out through the grant, including s etting measurable goals. This**  **advisory council is geographically representative of the State and reflects the diversity of the State with respect to race, ethnicity, types of disabilities across the age span,**  **and users of types of services that an individu al with a disability may receive. [Drop**  **** **down menu]** Instructions : You must read and verify the statement by

selecting “y es” or “no” from the drop

- down menu (though N/A is available on the dropdown list, it cannot be selected). This statement assures that the advisory council is representative of the state in terms of geograph y and diversity and meets the purposes and performs the functions required under the AT Act. Your CertifyingRepresentative’s signature on the state plan attests to the statement bei ng true as of the date of submission of the State Plan for AT. **2. The advisory council includes a representative of the designated State agency, as defined in section 7 of the Rehabilitation Act of 1973 (29 U.S.C. 705). [Drop**  **- down**  **menu] 3. The advisor**  **y council includes a representative of the State agency for individuals who are blind (within the meaning of section 101 of that Act (29 U.S.C. 721)). [Drop**  **- down**  **menu] 4. The advisory council includes a representative of a State center for independent l**  **iving described in part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et**  **seq.). [Drop -**  **down menu]**1820

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15 **5. The advisory council includes a representative of the State workforce investment board established under section 111 of the Workforce In**  **vestment Act of 1998 (29 U.S.C. 2821). [Drop**  **- down menu]**  **6. The advisory council includes a representative of the State educational agency, as defined in section 9101 of the Elementary and Secondary Education Act of 1965. [Drop**  **** **down menu]** Instructions : For items 2

- 6 above, verify that your council has each of the members listed by selecting “y es” or “no” or “not applicable” from the drop

- down menus. In order to select “y es,” you must have an official representative of the applicable agency on record as named and appointed to the council at the time of submitting this plan. In order to select “not applicable,” yo u must either not have a separate agency for individuals who are blind or not be required to have a member because existing statutes, rules or policies related to advisory bodies or governing bodies of Statewide AT Programs would be affected. **7. The advisory council includes other representatives (list below). [Text box]** Instructions: Many

advisory councils include agency

or other organizatio n representatives beyond those required under the AT Act. In the text box, identify those members and the entities they

represent here, though you need not provide personal names. Do not list consumer representatives here

. **8. The advisory council incl udes the following number of individuals with disabilities that**  **use assistive technology or their family members or guardians: [Number field]** Instructions : Section 4(c)(2)(B)(ii) of the AT Act requires that a majority , not less than 51 percent, of the me mbers of the advisory council be individuals with disabilities that use assistive technology

or their famil y members or guardians. Enter the number of these individuals that are current members of your council. In order to include an individual, he or sh e must be on record as named and appointed to the council at the time of submitting this plan. This total cannot include agency representatives from the previous lists.
**9. If the Statewide AT Program does not have the composition and representation**  **requ ired under section 4(c)(2)(B), explain here. [Text box]**  Instructions : Provide the reasons that you do not have representatives of the required agencies or do not have a consumer

- majorit y on your council and where yo u are in the process of filling vacant positions. I f the composition of your council is different from the requirements of 4(c)(2)(B) because existing statutes, rules or policies related to advisory bodies or governing bodies of Statewide AT Programs would be affected, explain here. You do n ot need to explain if you selected “not applicable” because you do not have a separate agency

for individuals who are blind in your state.1820

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16 **10. Proposed Budget Allocations.**

**State -**  **level Activities Proposed Budget Allocation for**  **Entire Annual Award State Financing Activities**  **Drop -**  **down menu Device Reutilization Activities**  **Drop -**  **down menu Device Loan Activities**  **Drop -**  **down menu Device Demonstration Activities**  **Drop -**  **down menu State Leadership Activities**  **Drop -**  **down menu**
Instructions : Each of the drop

- down menus offers the following selections (choose one):

o Not performed due to comparability o Not performed due to flexibility o 1 to 10,000; o 10,001 to 20,000; o 20,001 to 30,000; o 30,001 to 40,000; o 40,001 to 50,000; o 50,001 to 60,000; o 60,001 to 70,00 0; o 70,001 to 80,000; o 80,001 to 90,000; o 90,001 to 100,000; o More than 100,000. During the course of this State Plan, you will receive at least three annual awards. The amount to report here is not the amount you plan to spend on a particular activity over the course of three ye ars. Itis the amount you plan to spend from each annual award. This means you may

have to update this information on an annual basis if (a) the amount of yo ur award increases or decreases significantl y or (b) you choose to change the amount of funds dedicated to an activity or activities. To answer the above items, select the amount of funds closest to the amount y ou plan to spend on the activity

from your annual AT Act award onl y

– not funds y ou may spend on this activity

from oth er sources. You will report financial support received from other sources in a later item. Annual awards can be spent over a two

- year period. If your program requires the two

- ye ar period to expend your total award you should report the total amount spe nt from the annual award, not the amount you plan to spend every calendar ye ar (e.g., if your annual award generally

is for $400,000 indicate the total amount of that $400,000 that y ou plan to dedicate to this activity).1820

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17 If RSA has not provided y our annu al award b y the time you are required to complete or update your state plan, you should assume relatively level funding (based on the am ount yo u received for FY 2011 ) for each annual award provided during the period of the State Plan. If you will not s pend an y funds on an activit y, it is assumed you are not conducting it because either (a) comparable financial support for that activity is provided from state or other non

- Federal sources in accordance with section 4(e)(1)(B) of the AT Act or (b) y ou are exercising flexibility

under section 4(e)(6) of the AT Act. However, y ou must enter a funding level for State Leadership activities, as the AT Act does not allow comparability or flexibility

for State Leadership. “Spending” funds on an activity is not l imited to purchasing equipment, providing subcontracts to other entities, conference costs, etc. Itcan include administration of an activity

. Funds are considered to be spent when staff being paid under your annual award dedicate their time to the speci fic activity

. The time spent by staff should be a program/personnel cost that can be translated into a dollar figure. However, simply

serving on an advisory

board or providing technical assistance to an organization engaged in an activity is not consi dered administering an activity (the cost of providing TA would be reflected under your State L eadership allocation, for example). Promoting an activit y during speaking engagements or distributing brochures about an activity is not considered administerin g an activity. To count the expenditure of staff time on an activity , the level of involvement must be such that the activity could not be carried out without the Statewide AT Program’s personnel. **11. For every activity for which you selected “claiming comparability” in item 10, describe**  **the comparable activity: [text box]** Instructions : In the text box, explain in the simplest terms possible what the comparable activity is, who conducts the activity , who supports the activity , and what makes it compara ble both in terms of resources supporting the activity and how the activity

is related to the purposes of the AT Act.
**12. Describe your planned procedures for tracking expenditures for State -**  **level and State Leadership activities: [text box]**  Instructio ns : In the text box, explain in the simplest terms possible what processes and procedures are in place to ensure the program is funds in accordance with the AT Act (i.e., how your program knows it is spending no more than 40% of its funds on State L eaders hip Activities and at least 5% of that 40% on transition

- related activities).1820

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18 **13. State Financing Activities Performed.**

**State Financing Activities Activities**  **Performed (select all that**  **apply) Financial loan program**  **Check box Cooperative**  **buying program Check box**  **Financing for home modifications program Check box**  **Telecommunications distribution program Check box**  **Last resort program Check box**  **Other program Check box** 

Instructions : Using the above, identify all ty pes of state financing activities conducted b y yo ur Statewide AT Program. The answers y ou provide here will determine the format of the remainder of the State Plan (i.e., for every activity you check, a screen with questions about that activity

will appear in the State Plan). The information you provide here should be consistent with the information y ou provided related to proposed budget allocations. If yo u indicated that you will allocate funds for state financing, it is expected that at least one activity w ill be indicated here; if you indicated that you are claiming comparability or exercising flexibility , it is expected that you will answer zero to all activities. Note that yo u are required to provide annual data for any activity claimed in this State Plan. **Other Activities Performed.**

**Device Reutilization, Device Loan, and Device Demonstration Activities**  **Number of Activities**  **Performed**

**How many device exchange programs do you support? Number field** 
**How many device reassignment programs do you support ?**  **Number field**
**How many device loan programs do you support? Number field** 
**How many device demonstration programs do you support? Number field** 

Instructions : Using the above table, identify the number of device exchange, device reassignment, device loan, and device demonstration activities conducted by your Statewide AT Program. A “zero” indicates that you do not conduct the activity , whereas any number above zero indicates that you conduct the activity . Enter a number above “one” onl y if you cond

uct two or more separate and distinct forms of the activity (e.g., you1820

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19 operate two device reassignment programs

– one that reassigns computers only and a different one that reassigns AT such as durable medical equipment). The number of programs you supp ort is not equivalent to the number of sites at which you conduct the activity . A state may have several sites at which device loans are provided, but these sites still constitute a single, comprehensive device loan program because they all serve the same function. In this case, the state would report one device loan program. Alternatel y, a state may

have one site with two separate and distinct device loan programs. The same building may

house a device loan program that can be accessed by anyone and a s eparate device loan program that can be accessed by onl y school personnel. In this case, the state would report two device loan programs. The answers you provide here will determine the format of the remainder of the State Plan. If you enter “zero” for any activity , you will not provide information related to it. I f you enter “one” for an y activity , you will provide information about it. I f you enter a number above “one,” you will provide information about each activity separately

(e.g., if you operat e two reassignment activities as given in the previous example, you will provide one set of information about your computer reassignment and one set of information about yo ur AT reassignment). The information you provide here should be consistent with the information you provided related to proposed budget allocations. If you indicated that you will allocate funds for an activity , it is expected that at least one activity will be indicated here; if you indicated that yo u are claiming comparability or ex ercising flexibility , it is expected that you will answer zero. Note that you are required to provide annual data for any activity claimed in this State Plan. **14. What is the baseline year for measurable goals for this State Plan? [Number field]** Instru ctions : Data on yo ur measurable goals for this State Plan will be provided under “Assurances, Measurable Goals and Signatures.” To format that page correctly , enter 2007 in this number field.1820

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20 

## Instructions for Items that Appear for Every **State -**  **level and State Leadership Activity** Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. For the purposes of the following portio ns of the State Plan, there is no distinction between a Lead Agency or Implementing Entity

in terms of implementation. If an Implementing Entity is used, the State Plan reports on how that entity is implementing the Act. Section 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d) (7) also requires that the State Plan include a description of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Lea dership activities among public and private entities. Sections C

- G of this State Plan contain items intended to meet these requirements. Each section may

request unique information about specific activities, but there is a core set of information that is required for every activity . The items and instructions shown below appl y to every State

- level and State Leadership activity , with two exceptions:

 information about the ye ar when the program began conducting the activity is not required of State Lea dership activities; and

 the option to provide additional information does not appear when there is a text box for describing the activity , as it is assumed that all pertinent information will be provided in that description. Use the below as your referen ce throughout the State Plan, as the instructions will not be repeated in each section. **Enter the year when the program began conducting this activity. [Number field]** Instructions : Enter the year that the Statewide AT Program began conducting this activ ity , to the best of your knowledge, in the number field. The year can be an y ye ar since the passage of the first version of the AT Act in 1988 and even may pre

- date the AT Act. You may estimate the y ear if you have justification for the estimate. If the Statewide AT Program conducted this activity , then stopped the activity , then restarted it, enter the y ear in which it restarted, not the original ye ar.1820

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21 **Who conducts this activity? Check all that apply. The Statewide AT Program. [Check**  **- box to indica**  **te “yes”] Other entities (e.g., contractors).**  **[Check -**  **box to indicate “yes”]** Instructions : Le ad Agencies/Implementing Entities implement their activities in many way s. Some implement their activities directly using their own staff and resources, others u se subcontractors, and others use combinations of both. Remember, the Implementing Entity is considered the Statewide AT Program, not an “other entity .” Indicate how your program conducts this activity using the following rules: Select “y es” for “The Statewide AT Program” and do not select “Other entities” if this activity is carried out exclusivel y by emplo ye es of the Lead Agency /Implementing Entity

working directly with consumers using Lead Agency /Implementing Entit y facilities and resources. Regio nal sites that are staffed by employ ees of the Lead Agency /Implementing Entity

are considered part of the Statewide AT Program. Select “y es” for BOTH “The Statewide AT Program” and “Other entities” if the Lead Agency /Implementing Entity

carries out the a ctivity

using its employ ees and facilities to work directly with consumers and AL SO uses some subcontracts or other agreements with external organizations whose own employ ees, facilities, and resources are used to work directl y with consumers. Select ONLY “Other entities” if the Lead Agency /Implementing Entity

does not work directl y with consumers using Lead Agency /Implementing Entity

facilities and resources and instead uses external organizations only

. DO NOT indicate that “other entities” are conduc ting the activity if you mean that the activity is conducted in “coordination and collaboration” with other entities. You will use the following item to indicate whether you coordinate and collaborate. **The Statewide AT Program provides and/or receives t he following support (choose all that**  **apply). Provides financial support to other entities via an agreement with the Statewide AT**  **Program. [Check**  **- box to indicate “yes”]**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Pro**  **gram. [Check**  **- box to indicate “yes”]**  **Receives financial support from the state. [Check**  **- box to indicate “yes”]**  **Receives in -**  **kind support from the state. [Check**  **- box to indicate “yes”]**  **Receives financial support from private entities. [Check**  **- box to indicate “ye**  **s”] Receives in**  **- kind support from private entities.**  **[Check -**  **box to indicate “yes”] Coordinates and collaborates with other entities for the purpose of establishing a new**  **program or service. [Check**  **- box to indicate “yes”]**  **Coordinates and collaborates with oth er entities for the purpose of expanding an existing**  **program or service. [Check**  **- box to indicate “yes”]**  **Coordinates and collaborates with other entities for the purpose of reducing duplication of programs or services.**  **[Check -**  **box to indicate “yes”]**1820

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22 Instruct ions : Id entify

all ty pes of support provided and received under this activity , as well as whether you conduct it in coordination and collaboration with other entities, by selecting “yes” as appropriate. Do not confuse these options with the use of an Impl ementing Entity (for purpose of these questions, the Implementing Entity is the Statewide AT Program). Provides financial support to other entities via an agreement **or** Provides in

- kind support to other entities via an agreement

- Select either or both of these if you subsidize an external entity to conduct this activity

on your behalf either in part or in whole. What you answer here should be consistent with what y ou answered for “Who conducts this activity?” (i.e., if you said ye s to “Other entities” yo u must indicate the provision of either financial or in

- kind support to other entities). If you select either financial or in

- kind support (and you may select both if appropriate), it is assumed that an agreement of some kind exists between the Lead Agenc y/ Implementing Entity and AT Act resources are supporting that agreement. It also is assumed that the organization is providing you with data on its activities. If no AT Act resources are being used to support this activity and you do not have data on it , you should reconsider whether it is appropriate to claim it in your State Plan. Use the following (for this item and all other items) to determine whether the support is financial or in

- kind:  Select “financial support” only when funds are being provide d to the organization by the Lead Agency

/Implementing Entity

.  Select “in

- kind support” only if a tangible resource that could be assigned a value is donated to the organization. Examples of in

- kind contributions could be providing storage space at no c harge, creating and distributing promotional materials at no charge, transporting items at no charge. In rare cases, personnel support could be considered in

- kind support. If Lead Agency /Implementing Entity personnel are using their time to support the o rganization, the involvement and donation of time must be substantive and more than routine oversight of a subcontract or other administrative/clerical functions. Do not include service on an advisory

board or other similar activity and do not include ver

bal promotion during public awareness activities. An example of providing personnel support would be assisting with screening applications (e.g., loan applications, requests for used devices) on a regular basis or providing ongoing training and technical assistance to an organization free of charge. Forgoing indirect costs is not considered providing in

- kind support. Receives financial support from the state **or** Receives in

- kind support from the state

- Select either or both of these (as appropriate to the circumstance) if the Statewide AT Program receives support from a state agency to conduct the activity . This does not mean the state agency has to designate support directl y for the activity , but if a state agency provides general support for the State wide AT Program as a whole, the program must have apportioned some of that support specificall y for the activity. This does not include ty pical administrative and logistical support that the L ead Agency would provide to any

program under its purview. It must be support above and beyond that provided for a ty pical program

. Receives financial support from private entities **or** Receives in

- kind support from private entities

– Select either one of these (as appropriate to the circumstance) if the Statewide AT1820

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23 Program receives support from a private entity (such as a non

- profit organization) to conduct the activity . This does not mean the private entity has to designate support directly for the activity , but if the private entity provides general support for th e Statewide AT Program as a whole, the program must have apportioned some of that support specifically for the activity

. Coordinates and collaborates with other entities for the purpose of establishing a new program or service **or** expanding an existing program or service **or** reducing duplication of programs or services

– Select as man y of these as is applicable. Providing a subcontract to another entity does not automatically

mean you are conducting an activity in coordination and collaboration

. Use the f ollowing description of coordination and collaboration to determine whether yo u coordinate or collaborate in carrying out this activity :  C oordination and collaboration involves working with other entities to improve access to AT devices and services. C oordination and collaboration may include improving how the Statewide AT Program implements state

- level or state leadership activities or how the Statewide AT Program assists other entities to provide similar activities on their own. Further, the Statewid e AT Program and other entities must be working together for a specific purpose:  to establish a service that did not exist previously ;  to enable expansion of an activity geographically

or to groups not previously

served; or  to eliminate duplicative serv ices.  For example, a Statewide AT Program could work with a local organization to establish a monthly

pick

- up and drop off schedule for used/recycled AT devices in a part of the state previously un - served.  However, not all activities in which a State wide AT Program participates with other entities are considered coordination and collaboration. If the coordination and collaboration is intended to result in a change in policies, procedures or funding for AT beyond improving the delivery of state

- level and state leadership activities, the activity

might be better described as technical assistance. In addition, if the Statewide AT Program has a contract with an entity to provide a specific service, that interaction would not ty pically be reported under c oordination and collaboration. Additionally , use of a bank or community

- based organization (CBO) involved in a financial loan program would not be considered coordination and collaboration, and the provision of in

kind or personnel support alone is not th e basis for coordination and collaboration.1820

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24 **If you conduct this activity by providing financial or in -**  **kind support to other entities, identify the kinds of entities you support in column (a) of the following table.**  **If you receive financial or in -**  **ki nd support from the state to conduct this activity, identify**  **the state entities that provide this support in column (b) of the following table. If you receive financial or in**  **- kind support from private entities, identify the private**  **entities that provide th is support in column (c) of the following table.**  **If you coordinate and collaborate with other entities in conducting this activity, identify those entities in column (d) of the following table.** 

**Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collaborate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agency**  **Easter Seals Educati**  **on -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation -**  **related agency**  **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organization Organization that primarily**  **serves individuals who are blind or visually impaired**  **Organization that primarily serves individuals who are deaf or hard of hearing**  **Organization that primarily serves individuals with developmental disabilities**  **Organization that primarily serves individuals**  **with physical disabilities Organization focused specifically on providing**  **AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other**
Instructions : If you indicated that you provide financial or i n - kind support to other entities, receive financial or in

- kind support from either state agencies or private entities, or conduct this activity in coordination and collaboration with other entities, use the table to indicate the t ypes of agencies/entities from which you receive the support or with which y ou collaborate. The information provided in this table must be consistent with the information provided in the previous question. If in the previous question you answered “yes,” this activity receives fin ancial support from the state, the above table must have at least one selection in column “b.” Select all organizations that apply . For example, in column “a” indicate all organizations to which you provide support. Selecting all that apply does not mean checking all descriptors that1820

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25 apply to an individual organization. Onl y one descriptor per organization should be selected (e.g., if you have one subcontract with an Easter Seals, you select onl y Easter Seals, not Easter Seals and organization that s erves individuals with developmental disabilities). Many organizations could be categorized using a number of the descriptors provided. Use the following rules when deciding how to indicate the ty pe of organization:  You can select more than one organization if more than one organization is involved in the activity

(e.g., if you have three subcontracts to three different organizations, you would make three selections). However, if you have more than one different organization involved but the same descri ptor applies to them, you can select that descriptor onl y once (e.g., if you subcontract to two different Easter Seals and one UCP, yo u select only

two

- Easter Seals and UCP).  If applicable, the national affiliation of a private entity should be selecte d before other descriptors (e.g., if an organization is an Alliance for Technology Access Center, choose this national affiliation rather than “organization focused specificall y on providing AT”). These include:  AgrAbility

Program  Alliance for Technology Access Center  Easter Seals  Independent Living Center  Protection and Advocacy organization  UCP  If a private entity

has no national affiliation, use the following more general descriptors. Do not use these descriptors when categorizing a state agency (e.g ., your state vocational rehabilitation for the blind agency should be an emplo ym ent

- related agency instead of organization that primarily serves individuals who are blind or visually impaired). These include:  Bank or other financial institution

– Self

- e xplanatory

.  Non

- categorical disability organization

– This is an organization that serves individuals with disabilities without a particular focus by age or disability t ype, and, while it may

provide AT services, is not exclusively dedicated to providing A T services. Also select this if the entity serves two or more of the t ypes of disabilities in the bullets below.  Organization that primarily serves individuals who are blind or visuall y impaired

– Self

- explanatory

.  Organization that primarily serves indiv iduals who are deaf or hard of hearing

– Self

- explanatory.  Organization that primarily serves individuals with developmental disabilities

- Self

- explanatory

.  Organization that primarily serves individuals with phy sical disabilities

- Self

- explanatory

.1820

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26  Organization focused specificall y on providing AT

- These generally are organizations exclusively dedicated to providing AT

- related, rather than general or disability

- specific, assistance to consumers.  If you receive support from or collaborate with a state a gency , use the following descriptions to determine the ty pe of agency :  Education

- related: This category can include any

ty pe of educational entity such as early

childhood, elementary , secondary , special education, remedial education, adult basic educatio n, continuing education. 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). It does not incl ude Institutions of Higher Education, which has its own category

.  Employ

ment

- related: This category includes employ

ment training programs, vocational rehabilitation programs and other programs related to employ ment. It can include providers of employment and/or training services, public and private agencies and organizations that provide or regulate emplo ym ent services, such as state employ ment 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.  Health, allied health and rehabilitation

- related: This includes hospitals, health clinics, mental health agencies and organizations, and managed care providers. This category can also include organizations for ph ys icians, phy sicians’ assistants, nurses, nurse practitioners, psychologists, psychiatrists, occupational therapists, phy sical therapists, speech pathologists, audiologists, r ehabilitation counselors, hospital discharge planners and other hospital employ ees.  Community

L iving

- related: This category includes agencies providing 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 governmental entities who primarily provide or regulate community living and related services (e.g. a State Department of Aging, Public Utilities Commission and State Housing Authority .) Itdoes not include Centers for Independent L iving, which has its own category

.  Technology

- related: This includes entities whose primary purpose is delivery of technology

devices or services. 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.1820

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27  An Inst itution of Higher Education can be considered either a state agency or private entity depending on the ty

pe of college or university . In either case, institution of higher education should be selected rather than education

- related agency

.  Use “Other” o nl y when the entity cannot reasonably be categorized in an y of the way s provided. “Other” should be used rarel y. **Select the option that best describes from where this activity is conducted. [Drop -**  **down menu]**  Instructions : The drop down menu offers the f ollowing selections (choose only one):

o One central location o Regional sites o A combination of a central location and regional sites Use the following guidance to select the choice that best or most closely describes the location from which you conduct th is activity

. One central location

– Select this if your state conducts this activity from a single site that houses all employ ees and resources engaged in the activity . It may be the case that employ ees or resources travel from this site to other place s, but they are based at a single site, and the other places are not established/permanent sites. Sites that simply serve as referral sources or provide minimal assistance to a central location are not considered regional sites. Remember that this is tie d to the activity

itself, so two different activities could take place at two different central locations. Also, if in previous items you indicated that you use subcontractors, it does not automatically

mean you use regional sites. For example, your Stat ewide AT Program may have a building on a university campus that houses the staff and devices for a device loan program. The university

campus is the central location for that program. You also may contract with a CBO in another part of the state to oper ate an AFP as your state financing activity . If the employ ees and resources for operating the AFP are housed at the CBO, the CBO is considered the central location for state financing and not a regional site. Regional sites

– Select this only if you co nduct this activity from at least two sites that operate relativel y independently without any of them being considered the main site or headquarters (if one of them is considered the headquarters you would choose a combination of central location and regio nal sites instead). Regional sites can be directly managed by

the Lead Agency /Implementing Entity

or can be subcontractors. For example, the Lead Agency may employ three part

- time staff people at three different one

- stop centers in the state. Those one

stop centers have their own small inventory of devices purchased by

the Lead Agency

and the part

- time staff use those devices to provide device demonstrations on a regular basis. These could be considered regional sites. Sites that simply serve as referr al sources or provide minimal assistance to a central location are not considered regional sites. For example, if all of the devices for your loan program are located at a central site along with those responsible for operating the program, but independent living centers provide referrals and you often send devices to independent living centers for pick

- up by consumers, the independent living centers are not considered regional sites.1820

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28 A combination of central location and regional sites

– Select this onl y if yo u have a site that is considered the main site or headquarters that houses the majority of employ ees and resources and regional sites that also have their own employees and resources. For example, if the majority of the devices for your loan program are located in a central inventory along with those responsible for operating the loan program, but independent living centers under subcontract house their own, smaller inventories and have staff assigned to do loans, you would have both a central locat ion and regional sites. **If you indicated the use of regional sites, from how many regional sites is the activity conducted? [Number field]**  Instructions: When entering the number of regional sites, do not include the central location if yo u answered “a combination of central location and regional sites.” **This activity is available (choose all that apply). [Check boxes]**

**By website By phone**  **By e -**  **mail By mail**  **In person** Instructions : Consumers may be able to access this activity to in a number of way s . Identify all the way s that a consumer can access this activit y. By website

– Select this if consumers can access the activity by visiting a website. Usuall y this means being able to do more than get general information about the activity . Rather, con sumers can engage in the activity via website (e.g., request a loan or demonstration). This is different from sending an e

- mail, which is its own option. By phone

– Select this if consumers can call y our program to access this activity

. By e

- mail

– Usua lly

this means being able to do more than get general information about the activity sent b y e - mail. Rather, consumers can engage in the activity via e

- mail (e.g., request a loan or demonstration). By mail

– Select this if material for this activity is sent out, like want

- ads in a newsletter or some other hard cop y format, or if the consumer can request assistance b y s ending a letter. In person

– Select this if there is a location or locations to which a consumer can go to make an initial contact to re ceive assistance. **Provide any additional information about this activity you wish to share. [Text box]**  Instructions : Use the text box to provide any important information about this activity that is essential to understanding it in context, that you fee l is not appropriatel y captured b y the items alread y included, or that you believe makes this activity unique.1820

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29 The following two items are not requested for every State

- level or State Leadership Activity , but they do appear in many

of the activities. U se the following instructions every time these items appear. Note, similar items appear in the section on Device Exchange, but the options are different from those featured below. That section contains its own instructions. **Select the option that best d escribes the policy of the program for charging individuals**  **with disabilities for a device or loan or demonstration or training or technical assistance. [Drop**  **- down menu]**  **Select the option that best describes the policy of the program for charging professi onals**  **for a device or loan or demonstration or training or technical assistance. [Drop -**  **down menu]**  Instructions : The drop

- down menu offers the following options (choose one):

o Nothing o A flat fee o A fee on a variable or sliding scale o A fee is assigned based on the device o A financial donation is requested o A donation of time or other non

- financial commitment is requested o An annual fee or similar regular pay ment arrangement o The fee is based on the length/complexity /value/type o The fee is based on the purpose o Mul tiple subcontractors are used and they set their own policies o Other Many programs support their activities by charging some kind of fee. Here y ou will identify whether you charge a fee and if so what that fee is based upon. Even though exceptions may be made in particular cases, choose the answer that is closest to your policy . When selecting the answer, if you use a hierarch y to determine the fee, indicate which option begins the hierarch y. Example: I f it is your policy to charge a flat fee, but when a consumer indicates that he or she cannot pay

the fee you then would charge on a sliding scale, select “flat fee” because it is your policy default. Use the following to assist you in determining which selection to make: It also is possible that yo u hav e different policies under different circumstances. For example, some organizations pay

an annual fee while others do not. I f this is the case, select the answer that applies in the majority of cases. Nothing

– Self

- explanatory. Flat fee

– You charge a set amount for participation in the activity

. Fee on a variable or sliding scale

– You charge differing amounts based on the recipient’s ability to pay

.1820

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30 Fee is assigned based on the value/type/length/complexity

– The amount of the fee depends on the quality

or t ype of device (e.g., the higher quality or better or more expensive the device, the more the recipient is charged); or how long the device is needed (e.g., the longer the loan the more is charged); or how complex the demonstration is (e.g. the m ore devices that need demonstrating or the greater the expertise needed for the demonstration, the more expensive). Financial donation is requested

– There is no set charge, but you do request that individuals pay what they

can or believe is appropriate. Donation of time or other non

- financial commitment is requested

– You do not request money from recipients, but ask that they repay your program through some form of service, either to the program itself or to the community

. An annual fee or similar regu lar payment arrangement

- An individual or entity pay s membership dues or a subscription fee to use the program and does not pay for each individual device/loan/demonstration. The fee is based on the purpose

– You may or may not charge depending on what the device will be used for. Perhaps y ou do not charge for a device loan if a consumer is using it for decision

- making or to fill a gap, but you do charge if a professional uses a device fo r an evaluation or to provide training at a conference. Multiple subcontractors are used and they set their own policies

– If the charging of fees is at the discretion of subcontractors and those subcontractors set their own policies, there is an option to indicate this. I f you use subcontractors but y our subcontract s stipulate if/how fees are to be charged for all subcontractors, do not select this and instead reflect the policy you appl y to all. If you use onl y one subcontractor, do not select this and respond to the item based on that one subcontractor’s policy

. Other

– This should be selected onl y if the fees charged cannot reasonabl y be described using one of the other options.1820

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31 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section C: State Financing Activities**
The AT Act d escribes state financing activities as activities that increase: “access to, and funding for, assistive technology devices and assistive technology services (which shall not include direct pay ment for such a device or service for an individual with a disab ility but may include support and administration of a program to provide such pay ment), including development of sy stems to provide and pay for such devices and services, for targeted individuals and entities described in section 3(16)(A), including

— (i) support for the development of sy stems for the purchase, lease, or other acquisition of, or pay ment for, assistive technology devices and assistive technology services; or (ii) support for the development of State

- financed or privatel y financed alternativ e financing sy stems of subsidies (which may include conducting an initial 1

- ye ar feasibility study of, improving, administering, operating, providing capital for, or collaborating with an entity with respect to, such a s ys tem) for the provision of assistiv e technology devices, such as

— (I) a low

- interest loan fund; (II) an interest bu y - down program; (III) a revolving loan fund; (IV) a loan guarantee or insurance program; (V) a program providing for the purchase, lease, or other acquisition of assistive technology devices or assistive technology services; or (VI) another mechanism that is approved b y the Secretary .” For the purposes of this State Plan, state financing activities include financial loan programs, home modification programs, telecommunications distribution programs, last resort funds, and other activities. Each of these activities is defined in the corresponding section of this State Plan. Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a descript ion of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a description of the State

- level and State L eadership Activities the state will support with st ate funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activities among public and private entities. The following items are intended to meet these requirements for State Financing Activi ties. Respond only to the items that correspond with the State Financing Activities you selected in Section B of this Plan.1820

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32 

### Financial loan program A financial loan program provides financial loans for purchase of AT devices and services. A financial lo an program may make loans directl y (revolving loans) or may make partnership loans using dollars from another source, usuall y a financial institution. **1. Enter the year when the program began conducting this activity. [Number field] 2. Who conducts th**  **is activity? Check all that apply. The Statewide AT Program**  **Other entities (e.g. contractors) 3. The Statewide AT Program provides and/or receives the following support (choose all**  **that apply). Provides financial support to other entities via an agreem**  **ent with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives in**  **- kind support from the state.**  **Receives financial support from private entit ies.**  **Receives in -**  **kind support from private entities. Coordinates and collaborates with other entities for the purpose of establishing a new**  **program or service. Coordinates and collaborates with other entities for the purpose of expanding an**  **existing progra m or service.**  **Coordinates and collaborates with other entities for the purpose of reducing duplication of programs or services.**  **4. If you conduct this activity by providing financial or in -**  **kind support to other entities, identify the kinds of entities y**  **ou support in column (a) of the following table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table. If you receive financial or in**  **- kind support from private entities, identify the private**  **entities that provide this support in column (c) of the following table. If you coordinate and collaborate with other entities in conducting this activity,**  **identify those entities in column (d) of t he following table.** 

**Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution**  **Community Living agency Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency**1820

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33 **Independent Living Center Institution of Higher Educa**  **tion Non**  **- categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing**  **Organization that primarily se rves**  **individuals with developmental disabilities**  **Organization that primarily serves individuals with physical disabilities**  **Organization focused specifically on providing AT**  **Protection and Advocacy Organization Technology agency**  **UCP Other**  **5. Select the option that best describes from where this activity is conducted. One central location**  **Regional sites A combination of a central location and regional sites**  **6. If you indicated the use of regional sites, from how many regional sites is the activity**  **conducted? [Number field] 7. This activity is available (choose all that apply).**  **By website By phone**  **By e -**  **mail By mail**  **In person 8. Enter the total endowment of the activity. [Number field]**  Instructions : Your total en dowment is the full amount of funding you would have available for loans if all of your funds were in a bank account and you had no outstanding loans. Your total endowment begins with the initial investment made to establish y our financial loan program. For example, if a title III AFP received $300,000 in Federal funds and provided $100,000 in matching funds, you began with $400,000. Your financial loan program may

have gained interest over the ye ars, so your current endowment may be greater than $400,00 0; likewise, you may have had a number of defaults that reduced your program’s endowment below the $400,000. Whatever this amount is, do not deduct outstanding loans or administrative costs before reporting it. Another way of looking at this number is how much money you have in the bank plus how much money you have out in existing loans. You may provide approximate, or rounded, totals rather than exact.1820

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34 **9. Select the option that best describes the primary source of capital used to begin the activity.**  **[Drop -**  **down menu]** Instructions : The drop

- down menu offers the following selections (choose one):

o Section 4 of the AT Act of 1998, as amended o Title III of the AT Act of 1998 o Title Iof the AT Act of 1998 o Another federal source o A state source o A private source Choose only

one answer, as this item asks for the primary source of initial capital that started the program, meaning the source that provided the largest contribution to get the loan program off the ground. If your financial loan program is a title III AFP funded when the match was 1 to 1, select title III of the AT Act of 1998 as the primary source even though the state contribution was equal. **10. Select the option that best describes the primary source of support for ongoing operation of the ac**  **tivity. [Drop -**  **down menu]** Instructions : The drop down menu offers the following selections (choose one):

o Section 4 of the AT Act of 1998, as amended o Interest and investments from the original source of capital o Another federal source o A state source o A priv ate source Choose only

one answer, as this asks for the primary source of funds that maintain the financial loan program, meaning the source that provides the largest contribution to maintenance of the program. **11. Even if they are not the primary sou rce of support, do you support this program using**  **section 4 funds? [Check box for “yes”]** Instructions: Even if funds provided under the AT Act are not the primary source of funds supporting the program, a Statewide AT Program still may be dedicating res ources to a financial loan program. To answer ye s, the funds must either be provided to the financial loan program or must be used to support the program directl y in some way. Staff time used to serve on advisory boards or for normal program oversight ar e not included as resources.1820

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35 **12. This activity offers the following types of assistance (select all that apply). [Check**  **boxes] Revolving loans**  **Loan guarantees Low interest loans**  **Interest buy -**  **downs Preferred interest loans**  Instructions: Id entify all ty pes of loans your program offers, regardless of whether an y loans of that ty

pe are currently

outstanding. The ty

pes of loan products are defined as follows: Interest buy

- down loan: A loan in which AT program funds are used to buy down the interes t 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 pay s the lending institution for a portion of the interest on the loan, resulting in lower interes t pay ments for the consumer over the long term. 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 loan in which the Statewide AT Program guarantees that the loan to a con sumer is secure and will be repaid, thus increasing the lender’s willingness to loan funds. Low

- interest loan: Ina low

- interest loan, a Statewide AT Program establishes an agreement with a lending institution to provide loans for AT at “preferred” inte rest rates. Preferred interest rates are highl y variable and context

- specific, depending upon such factors as the prime lending rate, the borrower’s credit rating, and whether the loan is secured. The mechanism or mechanisms b y which states arrange for le nding institutions to provide low

- interest loans for AT are variable, but ty picall y include a requirement that the Statewide AT Program deposit its funds with the lending institution. The interest that the Statewide AT Program’s funds would normally generate is then used b y the lending institution to supplement the interest it charges consumers on loans for AT, thus resulting in lower interest rates paid by the consumers. There are two t ypes of low

- interest loans:
**a. Low**
**- interest loan (at or below prime r**  **ate*):** A loan at interest rates that are at or below the prime rate. See below for a definition of prime rate. **b. Preferred interest loan:**  A loan offered at an interest rate that is lower than the consumer would normally pay , but not as low as the prime rate*. See below for a definition of prime rate. Revolving loan: A loan 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 fun ds 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.1820

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36 **Prime Rate:** The prime rate is the average majority prime rate charged b y banks on short

term loans to business, quoted on an investment basis. The Federal Reserve notes that the "Rate posted b y a majority of top 25 (b y assets in domestic offices) insured U.S.

- chartered commercial banks. Prime is one of several base r ates used by banks to price short

- term business loans." To determine whether a loan was made above, at, or below prime rate, check the national prime rate at the following website for the date on which the loan was closed: http://www.federalreserve.gov/Releases/H15/data/Daily/H15_PRIME_NA.txt
**13. The lowest loan amount provided as established by the policies of the activity (leave blank if N/A). [Number field]**  Instru ctions: The response to this item must be based on your established, written policies. This is not the lowest actuall y provided in a given year, but the lowest given yo ur policies. Leave it blank if your policies do not specify a lowest. **14. The highe st loan amount provided as established by the policies of the activity (leave**  **blank if N/A). [Number field]** Instructions: The response to this item must be based on your established, written policies. This is not the highest actually provided in a given ye ar, but the highest given yo ur policies. Leave it blank if your policies do not specify a highest. **15. Provide any additional information about this activity you wish to share. [text box]**1820

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37 

# Assistive Technology State Grant **Program State Plan fo**  **r FY 2009 -**  **2011 Section C: State Financing Activities**  **Cooperative buying program** Cooperative bu yi ng programs purchase AT in bulk at a discount from AT suppliers and then pass the savings on to consumers. **1. Enter the year when the program began conducti ng this activity. [Number field]**  **2. Who conducts this activity? Check all that apply. The Statewide AT Program**  **Other entities (e.g. contractors) 3. The Statewide AT Program provides and/or receives the following support (choose all**  **that apply). Pro**  **vides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives in**  **- kind support from t**  **he state. Receives financial support from private entities.**  **Receives in -**  **kind support from private entities. Coordinates and collaborates with other entities for the purpose of establishing a new**  **program or service. Coordinates and collaborates with other e**  **ntities for the purpose of expanding an existing program or service.**  **Coordinates and collaborates with other entities for the purpose of reducing duplication of programs or services.**  **4. If you conduct this activity by providing financial or in -**  **kind supp ort to other entities,**  **identify the kinds of entities you support in column (a) of the following table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table.**  **If you receive financial or in -**  **kind support from private entities, identify the private entities that provide this support in column (c) of the following table.**  **If you coordinate and collaborate with other entities in conducting th is activity,**  **identify those entities in column (d) of the following table.**1820

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38 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the state**  **c.**

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agency**  **Easter Seals Education**  **- related agency**  **Employment -**  **related agency Health, allied health, and rehabilitation**  **** **related agency Independent Living Center**  **Institution of Higher Education Non**  **- categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of**  **hearing Organization that primarily serves**  **individuals with developmental disabilities**  **Organization that primarily serves individuals with physical disabilities**  **Organization focused specifically on providing AT**  **Protecti on and Advocacy Organization**  **Technology agency UCP**  **Other 5. Select the option that best describes from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central location and regional sites 6.**  **If you indicated the use of regional sites, from how many regional sites is the activity conducted? [Number field]**  **7. This activity is available (choose all that apply). By website**  **By phone By e**  **- mail**  **By mail In person** 1820

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39 **8. Describe the activity. [T ext box]**  Instructions: Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. This explanation should m ake it clear how this activity is related to the purposes of the AT Act. Italso should describe who the activity is intended to serve, specificall y if only particular populations of individuals are served by the activity or if there are qualifications fo r participation in the activity . The role of the Statewide AT Program in carrying out the activity should be explained clearly . The example provided below is for a Last Resort Fund, but a similar concept should be applied here. Example: Our Statewide AT Program supports a Last Resort Fund (LRF). The state Department of Community L iving placed $500,000 in an interest

- bearing account in 2006. The interest generated from this account is used to purchase AT devices for individuals with disabilities in n eed who apply to the LRF. The LRF can be accessed by an individual of any age with any

disability . However, onl y individuals with disabilities who can clearl y establish a need for AT but who do not qualify for AT through other s ys tems such as Medicaid, V R, or special education, and cannot pay for a device on their own can receive a device paid for through this fund. Once an individual is determined qualified to receive a device through the LRF, he or she generall y is referred to our device loan or device demonstration program or to other qualified parties for assistance in determining the appropriate AT. The LRF also checks with reuse programs to see if the device is available used before making a new purchase. Once the AT has been selected, the LRF wor ks with the vendor of that AT and the funds are paid directly to that vendor, who then provides the device to the consumer. While no AT Act funds are used to purchase devices (all purchases are paid for with interest from the account started by the commun ity

living agency), the Statewide AT Program incurs all costs of administering the LRF. Staff time is dedicated to reviewing applications, working with the vendors who provide the AT, processing all of the funds, and following

- up with the recipient once a device is obtained. Additional resources are used to make and disseminate promotional materials about the LRF.1820

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40 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section C: State Financing Activities Financing for home modification**  **s program** A home modification program finances home modifications, including the addition of wheelchair ramps. States may not use AT Act dollars to provide funds or devices directly to individuals. AT Act dollars may be used to administer a home modification program comprising non

- AT Act dollars. **1. Enter the year when the program began conducting this activity. 2. Who conducts this activity? Check all that apply.**  **The Statewide AT Program Other entities (e.g. contractors)**  **3. The Statewide AT Prog ram provides and/or receives the following support (choose all**  **that apply). Provides financial support to other entities via an agreement with the Statewide AT**  **Program. Provides in**  **- kind support to other entities via an agreement with the Statewide AT**  **Pro gram.**  **Receives financial support from the state. Receives in**  **- kind support from the state.**  **Receives financial support from private entities. Receives in**  **- kind support from private entities.**  **Coordinates and collaborates with other entities for the purpose of establishing a new**  **program or service. Coordinates and collaborates with other entities for the purpose of expanding an**  **existing program or service. Coordinates and collaborates with other entities for the purpose of reducing**  **duplication of programs or ser vices.**  **4. If you conduct this activity by providing financial or in -**  **kind support to other entities, identify the kinds of entities you support in column (a) of the following table.**  **If you receive financial or in -**  **kind support from the state to conduct th is activity,**  **identify the state entities that provide this support in column (b) of the following table. If you receive financial or in**  **- kind support from private entities, identify the private**  **entities that provide this support in column (c) of the followi ng table.**  **If you coordinate and collaborate with other entities in conducting this activity, identify those entities in column (d) of the following table.** 1820

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41 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive sup**  **port from**  **these private**  **entities d.** 

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agency**  **Easter Seals Education**  **- related agency**  **Employment -**  **rela ted agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organization Organization that primarily serves**  **individuals who are blind or v isually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing**  **Organization that primarily serves individuals with developmental disabilities**  **Organization that primarily serves individuals with physical disab**  **ilities Organization focused specifically on**  **providing AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other 5. Select the option that best describes from where this activity is conducted.**  **One central locatio n**  **Regional sites A combination of a central location and regional sites**  **6. If you indicated the use of regional sites, from how many regional sites is the activity conducted? [Number field]**  **7. This activity is available (choose all that apply). By**  **website By phone**  **By e -**  **mail By mail**  **In person**1820

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42 **8. Describe the activity. [Text box]** Instructions : Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. This explanation should make it clear how this activity is related to the purposes of the AT Act. Italso should describe who the activity is intended to serve, specificall y if only particular populatio ns of individuals are served by the activity or if there are qualifications for participation in the activity . The role of the Statewide AT Program in carrying out the activity should be explained clearly . The example provided below is for a Last Resort Fund, but a similar concept should be applied here. Example: Our Statewide AT Program supports a Last Resort Fund (LRF). The state Department of Community L iving placed $500,000 in an interest

- bearing account in 2006. The interest generated from this account is used to purchase AT devices for individuals with disabilities in need who apply to the LRF. The LRF can be accessed by an individual of any age with any

disability . However, onl y individuals with disabilities who can clearl y establish a need for AT but who do not qualify for AT through other s ys tems such as Medicaid, VR, or special education, and cannot pay for a device on their own can receive a device paid for through this fund. Once an individual is determined qualified to receive a device through the LRF, he or she generall y is referred to our device loan or device demonstration program or to other qualified parties for assistance in determining the appropriate AT. The LRF also checks with reuse programs to see if the device is available used before making a new purchase. Once the AT has been selected, the LRF works with the vendor of that AT and the funds are paid directly to that vendor, who then provides the device to the consumer. While no AT Act funds are used to purchase devices (a ll purchases are paid for with interest from the account started by the community

living agency), the Statewide AT Program incurs all costs of administering the LRF. Staff time is dedicated to reviewing applications, working with the vendors who provide the AT, processing all of the funds, and following

- up with the recipient once a device is obtained. Additional resources are used to make and disseminate promotional materials about the LRF.1820

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43 

# Assistive Technology State Grant **Program State Plan for FY 200**  **9 -**  **2011 Section C: State Financing Activities**  **Telecommunications distribution program** This is a program to distribute telecommunications equipment that serves the needs of people with disabilities, including safet y needs during emergencies. States may not use AT Act dollars to provide funds or devices directl y to individuals. AT Act dollars may be used to administer a telecommunications distribution program comprising non

- AT Act dollars. **1. Enter the year when the program began conducting this activity. 2. Who conducts this activity? Check all that apply.**  **The Statewide AT Program Other entities (e.g. contractors)**  **3. The Statewide AT Program provides and/or receives the following support (choose all that apply).**  **Provides financial support to other entities via an agreement with the Statewide AT**  **Program. Provides in**  **- kind support to other entities via an agreement with the Statewide AT**  **Program. Receives financial support from the state.**  **Receives in -**  **kind support from the state. Receives financial supp**  **ort from private entities. Receives in**  **- kind support from private entities.**  **Coordinates and collaborates with other entities for the purpose of establishing a new program or service.**  **Coordinates and collaborates with other entities for the purpose of expand ing an**  **existing program or service. Coordinates and collaborates with other entities for the purpose of reducing**  **duplication of programs or services. 4.**  **If you conduct this activity by providing financial or in -**  **kind support to other entities, identify**  **the kinds of entities you support in column (a) of the following table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table. If you**  **receive financial or in -**  **kind support from private entities, identify the private entities that provide this support in column (c) of the following table.**  **If you coordinate and collaborate with other entities in conducting this activity, identify those enti**  **ties in column (d) of the following table.**1820

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44 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access**  **Center Bank or other financial institution**  **Community Living agency Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center I**  **nstitution of Higher Education Non**  **- categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing**  **Orga nization that primarily serves**  **individuals with developmental disabilities Organization that primarily serves**  **individuals with physical disabilities Organization focused specifically on**  **providing AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other 5. Select the option that best describes from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central location and regional sites 6. If you indicated the use of regi**  **onal sites, from how many regional sites is the activity conducted? [Number field]**  **7. This activity is available (choose all that apply). By website**  **By phone By e**  **- mail**  **By mail In person** 1820

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45 **8. Describe the activity. [Text box]** Instructions: Expla in in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. This explanation should make it clear how this activity is related to the purposes of the AT Act. Italso should describe who the activity is intended to serve, specificall y if only particular populations of individuals are served by the activity or if there are qualifications for participation in the activity. The role of the Statewide AT Program in carrying out the activity should be explained clearly . The example provided below is for a Last Resort Fund, but a similar concept should be applied here. Example: Our Statewide AT Program supports a Last Re sort Fund (LRF). The state Department of Community L iving placed $500,000 in an interest

- bearing account in 2006. The interest generated from this account is used to purchase AT devices for individuals with disabilities in need who apply to the LRF. The LRF can be accessed b y an individual of any age with any

disability . However, onl y individuals with disabilities who can clearl y establish a need for AT but who do not qualify for AT through other s ys tems such as Medicaid, VR, or special education, and c annot pay for a device on their own can receive a device paid for through this fund. Once an individual is determined qualified to receive a device through the LRF, he or she generall y is referred to our device loan or device demonstration program or to o ther qualified parties for assistance in determining the appropriate AT. The LRF also checks with reuse programs to see if the device is available used before making a new purchase. Once the AT has been selected, the LRF works with the vendor of that AT and the funds are paid directly to that vendor, who then provides the device to the consumer. While no AT Act funds are used to purchase devices (all purchases are paid for with interest from the account started by the community

living agency), the Statew ide AT Program incurs all costs of administering the LRF. Staff time is dedicated to reviewing applications, working with the vendors who provide the AT, processing all of the funds, and following

- up with the recipient once a device is obtained. Addition al resources are used to make and disseminate promotional materials about the LRF.1820

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46 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section C: State Financing Activities Last resort program**  These programs provide AT, or funds to p urchase AT, to consumers when all other options have been exhausted. These may be earmarked for particular t yp es of consumers (such as children) or particular t ypes of AT (such as home modification) or they may be for any

group or ty pe of AT. States may

n ot 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.
**1. Enter the year when the program began conducting this activity.**  **2. Who conduc ts this activity? Check all that apply.**  **The Statewide AT Program Other entities (e.g. contractors)**  **3. The Statewide AT Program provides and/or receives the following support (choose all that apply).**  **Provides financial support to other entities via an a greement with the Statewide AT**  **Program. Provides in**  **- kind support to other entities via an agreement with the Statewide AT**  **Program. Receives financial support from the state.**  **Receives in -**  **kind support from the state. Receives financial support from private**  **entities. Receives in**  **- kind support from private entities.**  **Coordinates and collaborates with other entities for the purpose of establishing a new program or service.**  **Coordinates and collaborates with other entities for the purpose of expanding an existing p**  **rogram or service. Coordinates and collaborates with other entities for the purpose of reducing**  **duplication of programs or services. 4. If you conduct this activity by providing financial or in**  **- kind support to other entities,**  **identify the kinds of entit ies you support in column (a) of the following table.**  **If you receive financial or in -**  **kind support from the state to conduct this activity, identify the state entities that provide this support in column (b) of the following table.**  **If you receive financial or in**  **- kind support from private entities, identify the private**  **entities that provide this support in column (c) of the following table. If you coordinate and collaborate with other entities in conducting this activity,**  **identify those entities in column (d) of the following table.** 1820

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47 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the state**  **c.**

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution**  **Community Living agency Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher**  **Education Non**  **- categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing**  **Organization that primar ily serves**  **individuals with developmental disabilities**  **Organization that primarily serves individuals with physical disabilities**  **Organization focused specifically on providing AT**  **Protection and Advocacy Organization Technology agency**  **UCP Other**  **5. Select the option that best describes from where this activity is conducted. One central location**  **Regional sites A combination of a central location and regional sites**  **6. If you indicated the use of regional sites, from ho w many regional sites is the activity**  **conducted? [Number field] 7. This activity is available (choose all that apply).**  **By website By phone**  **By e -**  **mail By mail**  **In person**1820

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48 **8. Describe the activity. [Text box]** Instructions: Explain in the simplest ter ms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. This explanation should make it clear how this activity is related to the pur

poses of the AT Act. Italso should describe who the activity is intended to serve, specificall y if only particular populations of individuals are served by the activity or if there are qualifications for participation in the activity . The role of the St atewide AT Program in carrying out the activity should be explained clearly . The example below is an example of the style with which the entry should be written, not an example of what a last resort fund must be. Example: Our Statewide AT Program suppor ts a Last Resort Fund (LRF). The state Department of Community L iving placed $500,000 in an interest

- bearing account in 2006. The interest generated from this account is used to purchase AT devices for individuals with disabilities in need who apply to the LRF. The LRF can be accessed by an individual of any age with any

disability . However, onl y individuals with disabilities who can clearl y establish a need for AT but who do not qualify for AT through other s ys tems such as Medicaid, VR, or special educ ation, and cannot pay for a device on their own can receive a device paid for through this fund. Once an individual is determined qualified to receive a device through the LRF, he or she generall y is referred to our device loan or device demonstration pro gram or to other qualified parties for assistance in determining the appropriate AT. The LRF also checks with reuse programs to see if the device is available used before making a new purchase. Once the AT has been selected, the LRF works with the vendor of that AT and the funds are paid directly to that vendor, who then provides the device to the consumer. While no AT Act funds are used to purchase devices (all purchases are paid for with interest from the account started by the community

living agency) , the Statewide AT Program incurs all costs of administering the LRF. Staff time is dedicated to reviewing applications, working with the vendors who provide the AT, processing all of the funds, and following

- up with the recipient once a device is obtaine d. Additional resources are used to make and disseminate promotional materials about the LRF.1820

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49 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section C: State Financing Activities Other program**  This is any

state financing activi ty

not covered in a previous section of this state plan. Feasibility

studies would be described here. **1. Enter the year when the program began conducting this activity. 2. Who conducts this activity? Check all that apply.**  **The Statewide AT Program Other entities (e.g. contractors)**  **3. The Statewide AT Program provides and/or receives the following support (choose all that apply).**  **Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT**  **Program. Receives financial support from the state.**  **Receives in -**  **kind support from the state. Receives financial support from private entities.**  **Receives in -**  **kind support from private entities. Coordin**  **ates and collaborates with other entities for the purpose of establishing a new program or service.**  **Coordinates and collaborates with other entities for the purpose of expanding an existing program or service.**  **Coordinates and collaborates with other entiti es for the purpose of reducing**  **duplication of programs or services. 4. If you conduct this activity by providing financial or in**  **- kind support to other entities,**  **identify the kinds of entities you support in column (a) of the following table. If you rece**  **ive financial or in -**  **kind support from the state to conduct this activity, identify the state entities that provide this support in column (b) of the following table.**  **If you receive financial or in -**  **kind support from private entities, identify the private en**  **tities that provide this support in column (c) of the following table. If you coordinate and collaborate with other entities in conducting this activity,**  **identify those entities in column (d) of the following table.**1820

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50 **Organization or Activity a. You**  **provi de**  **support b.** 

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agency**  **Ea ster Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organization Orga**  **nization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing Organization that primarily serves**  **individuals with developmental disabilities Organ**  **ization that primarily serves individuals with physical disabilities**  **Organization focused specifically on providing AT**  **Protection and Advocacy Organization Technology agency**  **UCP Other**  **5. Select the option that best describe s from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central location and regional sites 6. If you indicated the use of regional sites, from how many regional sites is the activity**  **conducted? [Number field] 7. This activity is available (choose all that apply).**  **By website By phone**  **By e -**  **mail By mail**  **In person**1820

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51 **8. Describe the activity. [Text box]** Instructions: Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. This explanation should make it clear how this activity is related to the purposes of the AT Act. Italso should describe who the activity is intended to serve, specificall y if only particular populations of individuals are served by the activity or if there are qualifications for participation in the activity . The role of the Statewide AT Program in carrying out the activity should be expla ined clearly . The example provided below is for a Last Resort Fund, but a similar concept should be applied here. Example: Our Statewide AT Program supports a Last Resort Fund (LRF). The state Department of Community L iving placed $500,000 in an inte rest

- bearing account in 2006. The interest generated from this account is used to purchase AT devices for individuals with disabilities in need who apply to the LRF. The LRF can be accessed by an individual of any age with any

disability . However, onl y individuals with disabilities who can clearl y establish a need for AT but who do not qualify for AT through other s ys tems such as Medicaid, VR, or special education, and cannot pay for a device on their own can receive a device paid for through this fund. Once an individual is determined qualified to receive a device through the LRF, he or she generall y is referred to our device loan or device demonstration program or to other qualified parties for assistance in determining the appropriate AT. The LRF als o checks with reuse programs to see if the device is available used before making a new purchase. Once the AT has been selected, the LRF works with the vendor of that AT and the funds are paid directly to that vendor, who then provides the device to the c onsumer. While no AT Act funds are used to purchase devices (all purchases are paid for with interest from the account started by the community

living agency), the Statewide AT Program incurs all costs of administering the LRF. Staff time is dedicated to reviewing applications, working with the vendors who provide the AT, processing all of the funds, and following

- up with the recipient once a device is obtained. Additional resources are used to make and disseminate promotional materials about the LRF.1820

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52 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section D: Device Reutilization Activities**
The AT Act describes the State

- level activity of device reutilization as follows: “DEVICE REUTILIZATION PROGRAMS.

— The State shall directl y , or in collaboration with public or private entities, carry out assistive technology

device reutilization programs that provide for the exchange, repair, recycling, or other reutilization of assistive technology devices, which may

include redistribution through device sales, loans, rentals, or donations.” For the purposes of this State Plan, device reutilization activities are categorized as either device exchange activities or device reassignment activities. Device exchange activities are those in which the Statewide AT Program facilitates the transfer of a device from a consumer who does not need the device to a consumer who could use the device without the organization taking possession of the device at an y time. Devices are listed in a “want ad” or o ther t ype of 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, sanitization 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. Sect ion 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan in clude a description of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activities among public and priv ate entities. The following items are items intended to meet these requirements for device exchange activities. If you indicated that you conduct two or more device exchanges, you will repeat the items below once for each device exchange you indicated.1820

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53 **1. Select the option that best describes the type of exchange. [Drop -**  **down menu]** Instructions : The drop down box offers the following selections, use the definitions below to determine which t ype of device exchange to select (choose one):

o General device exchange o Device exchange for targeted agencies or entities General device exchange

– This is an exchange available to the public for use. These include websites, want

- ads in newsletters or other formats that can be accessed by any kind of consumer or professional Device exchange for targeted individuals or entities

– This is an exchange that is not open to the public and does not directly serve consumers; instead, the exchange was created and is used only

by a specific agency

or entity . For ex ample, a statewide AT program may have developed and maintains an exchange that tracks used devices in a school system and allows school sy stem employ ees to exchange these devices online.
**2. If you indicated this is a general exchange, describe it. If**  **this exchange is part of a collaborative among states, identify the states and how the collaborative works as part of**  **your description.**
Instructions : Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the pro gram should be able to read this explanation and understand what the Statewide AT Program is “doing”. The role of the Statewide AT Program in carrying out the activity

should be explained clearly . Describe the format or formats used for the exchange (e.g ., website, want ads), how the format works (i.e., how a consumer makes a device available for exchange and how a consumer can receive a used device from the exchange) and how you collect data. Some Statewide AT programs support their device exchange sp ecifically for their own state (though occasionall y consumers in bordering states may be served). Other Statewide AT Programs work together and share their exchange sites within a region or make their devices available nationall y. Provide the names of th e other states participating in the collaborative exchange (abbreviations can be used) and how the collaboration “works.” If it is a national exchange and you do not know the other states participating, indicate that it is a national exchange. **3. If you indicated that your device exchange serves a particular entity or agency, identify**  **the entity or agency and describe the purpose of the exchange: [Text box]** Instructions : Explain in the simplest terms possible how this activity is conducted; a person un familiar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing.” This explanation should make it clear how this activity is related to the purposes of the AT Act. It also should describe who the ac tivity is intended to serve, and how it is of benefit to the given agency . The role of the Statewide AT Program in carrying out the activity should be explained clearly . If you support more than one such exchange for more than one agency , each should be counted separately when answering1820

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54 how many

device exchanges you support and y ou should respond to items about each separately

. Example: Under subcontract, our Statewide AT Program developed an online database of AT that is purchased for the Big City Scho ol Sy stem. When the Big City School Sy stem purchases AT it is barcoded and scanned into an inventory s ys tem that tracks information about the equipment and the school and class in which it is being used. The AT continues to be tracked until the student t o whom it originally was assigned no longer needs it. It then is flagged as available for exchange and can be sent to any other school or class in the sy stem that needs it. Before purchasing new AT, staff access a password protected website to view the i nventory

of devices available for exchange within the sy stem. If there is a match, they

request the device online and it is sent to them via the school’s interoffice mail. The Statewide AT Program is responsible for ongoing maintenance, quality control, and training on use of this site for the Big City School sy stem. All barcoding and other data entry activities are done at the school level. **4. Enter the year when the program began conducting this activity. [Number field] 5. Who conducts this activ**  **ity? Check all that apply. The Statewide AT Program**  **Other entities (e.g. contractors) 6. The Statewide AT Program provides and/or receives the following support (choose all**  **that apply). Provides financial support to other entities via an agreement wit**  **h the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives in**  **- kind support from the state.**  **Receives financial support from private entities. Re**  **ceives in -**  **kind support from private entities. Coordinates and collaborates with other entities for the purpose of establishing a new**  **program or service. Coordinates and collaborates with other entities for the purpose of expanding an**  **existing program or se rvice.**  **Coordinates and collaborates with other entities for the purpose of reducing duplication of programs or services.**  **7. If you conduct this activity by providing financial or in -**  **kind support to other entities, identify the kinds of entities you supp**  **ort in column (a) of the following table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table. If you receive financial or in**  **- kind s**  **upport from private entities, identify the private entities that provide this support in column (c) of the following table.**  **If you coordinate and collaborate with other entities in conducting this activity, identify those entities in column (d) of the foll**  **owing table.**1820

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55 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabo rate**  **with AgrAbility Program**  **Alliance for Technology Access Center Bank or other fi**  **nancial institution Community Living agency**  **Easter Seals Education**  **- related agency**  **Employment -**  **related agency Health, allied health, and rehabilitation**  **** **related agency Independent Living Center**  **Institution of Higher Educatio n**  **Non -**  **categorical disability organization Organization that primarily serves**  **individuals who are blind or visually impaired**  **Organization that primarily serves individuals who are deaf or hard of hearing**  **Organization that primarily serve s**  **individuals with developmental disabilities Organization that primarily serves**  **individuals with physical disabilities Organization focused specifically on**  **providing AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other 8. Select the option that best describes from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central location and regional sites 9. If you indicated the use of regional sites, from how many regi**  **onal sites is the activity conducted? [Number field]**  **10. This activity is available (choose all that apply). By website**  **By phone By e**  **- mail**  **By mail In person**  **11. The online page for this activity can be found at: [Text box]** Instructions : Enter the website address for this exchange, or enter N/A if the exchange is not online or the website cannot be accessed b y the public.1820

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56 **12. Select the option that best describes what happens when a device is exchanged. [Drop**  **- down menu]**  Instructions : The drop do wn offers the following selections (choose one):

o the transaction is direct consumer

- to

- consumer o the Statewide AT Program is involved in the transaction Use the following to determine how to respond: The transaction is direct consumer

- to

- consumer - The exchange is set up so that the person who wants the device directly contacts the person who has the device and the two of them work out the details of the exchange without the involvement of the Statewide AT Program. Occasionally , an individual may not want to post contact information on the exchange and requests that the Statewide AT Program be the contact. In these cases, the Statewide AT Program’s only responsibility

is providing the contact information to those who ask. The Statewide AT Program is in volved in the transaction

- A consumer who wants a device **must** go through the Statewide AT Program to connect with the person who has the device. The role of the Statewide AT Program may vary once this connection has been made, but the Statewide AT Program undertakes some level of control over the exchanges made through its program. **13. Select the option that best describes the policy of the program for charging individuals with disabilities for a device. [Drop**  **- down menu]**  Instructions: The drop down o ffers the following selections (choose one):

o Nothing o A flat fee for posting a device on the site o A flat fee when a device is exchanged o A percentage of the price when a device is exchanged o Combination o Multiple subcontractors are used and they set their own policies o Other Many programs support their activities by charging some kind of fee. Here y ou will identify whether you charge a fee and if so what that fee is based upon. Even though exceptions may

be made in particular cases, choose the answer that is closest to y our policy . When selecting the answer, if you use a hierarch y to determine the fee, indicate which option begins the hierarch y. Example: I f it is your policy to charge a flat fee, but a consumer indicates that he or she cannot pay the fee and you then would charge a percentage when the device is exchanged, select “flat fee” because it is y our policy default. A flat fee for posting

– You charge onl y those who are offering devices for exchange, regardless of whether the device actually is e xchanged.1820

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57 A flat fee when an exchange is made

– You do not charge for offering a device for exchange, but you charge a set amount when an exchange happens. Select this whether yo u charge the person giving the device, the person receiving the device, or b oth. A percentage of the price when the device is exchanged

– Unlike a flat fee charged when an exchange takes place, you collect a percentage of the “sale price” of the device. Select this whether you charge the person giving the device, the person rece iving the device, or both. Combination

– Your policy may be to charge more than once. For example, you may charge a fee for someone to offer the device and a fee to the recipient when the exchange is made. Multiple subcontractors are used and they set their own policies

- If the charging of fees is at the discretion of subcontractors and those subcontractors set their own policies, there is an option to indicate this. If you use subcontractors but your subcontracts stipulate if/how fees are to be char ged for all subcontractors, do not select this and instead reflect the policy you appl y to all. If you use only one subcontractor, do not select this and respond to the item based on that one subcontractor’s policy.
**14. Provide any additional informat**  **ion about this activity you wish to share [Text box].**1820

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58 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section D: Device Reutilization Activities**
The AT Act describes the State

- level activity of device reutilization as foll ows: “DEVICE REUTILIZATION PROGRAMS.

— The State shall directl y, or in collaboration with public or private entities, carry out assistive technology

device reutilization programs that provide for the exchange, repair, recycling, or other reutilization of a ssistive technology devices, which may

include redistribution through device sales, loans, rentals, or donations.” For the purposes of this State Plan, device reutilization activities are categorized as either device exchange activities or device reassignment activities. Device reassignment activities are those in which the Statewide AT Program accepts devices from donors and stores them until they can be given or sold to new owners. Some programs repair, sanitize, and/or refurbish the devices as needed, and then offer them for sale, loan, rental, or give away to consumers. The prox y for device reassignment under NISAT is device recycling/refurbishment/repair activities. Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activit ies, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a description of the State

- level and State L eadership Activities the s tate will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activities among public and private entities. The following items are items intended to meet these requirem ents for device reassignment activities. If you indicated that you conduct two or more device reassignment programs, y ou will repeat the items below once for each device reassignment program y ou indicated. **1. Select the option that best describes the type of reassignment program. [Drop**  **- down**  **menu]** Instructions : The drop down box offers the following selections, use the definitions below to determine which t ype of device exchange to select (choose one):

o Reassigns computers only o Reassigns general AT o O pen - ended loan program1820

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59 Computer

- only reassignment

– A program that reutilizes computers exclusively and the only AT devices reutilized are part of the computer. AT reassignment

– A programs that reassigns an y kind of AT (including durable medical equipm ent). A program that occasionall y reassigns computers if they are donated would be included here rather than a computer

- onl y program. Open

- ended loan program

– A program in which the device borrower can keep the device for as long as it is needed but i t the policy of the program to require the device be returned. Do not select this if the intent of the program really is as a reassignment program and the choice to call it an open

- ended loan is for legal or administrative reasons only

. **2. Enter the ye ar when the program began conducting this activity. [Number field]**  **3. Who conducts this activity? Check all that apply. The Statewide AT Program**  **Other entities (e.g. contractors) 4. The Statewide AT Program provides and/or receives the following sup**  **port (choose all that apply).**  **Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the stat e.**  **Receives in -**  **kind support from the state. Receives financial support from private entities.**  **Receives in -**  **kind support from private entities. Coordinates and collaborates with other entities for the purpose of establishing a new**  **program or service. Coordin**  **ates and collaborates with other entities for the purpose of expanding an existing program or service.**  **Coordinates and collaborates with other entities for the purpose of reducing duplication of programs or services.**  **5. If you conduct this activity by p roviding financial or in**  **- kind support to other entities,**  **identify the kinds of entities you support in column (a) of the following table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table.**  **If you receive financial or in -**  **kind support from private entities, identify the private entities that provide this support in column (c) of the following table.**  **If you coordinate and collaborate wi th other entities in conducting this activity,**  **identify those entities in column (d) of the following table.**1820

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60 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Co llabo**  **rate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agency**  **Easter Seals Education**  **- related agency**  **Employment -**  **related agency Health, allied health,**  **and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organization Organization that primarily serves**  **individuals who are blind or visually impaired**  **Organization that primarily serves**  **individuals who are deaf or hard of hearing Organization that primarily serves**  **individuals with developmental disabilities Organization that primarily serves**  **individuals with physical disabilities Organization focused speci**  **fically on providing AT**  **Protection and Advocacy Organization Technology agency**  **UCP Other**  **6. Select the option that best describes from where this activity is conducted. One central location**  **Regional sites A combination of a cen**  **tral location and regional sites 7. If you indicated the use of regional sites, from how many regional sites is the activity**  **conducted? [Number field] 8. This activity is available (choose all that apply).**  **By website By phone**  **By e -**  **mail By mail**  **In per son**  **9. Select the option that best describes the policy of the program for charging individuals with disabilities for a reutilized device. [Drop**  **- down menu]** 1820

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61 **10. Select the option that best describes the policy of the program for charging professional**  **s for a reutilized device. [Drop -**  **down menu] 11. How do you get the device to the consumer? [Drop**  **- down menu]**  Instructions: The drop

- down menu offers the following options (choose one):

o The device is shipped via mail or other commercial delivery o The dev ice is delivered to the consumer by staff o The consumer picks up the device at a designated site o Other Statewide AT Programs use many methods for getting devices (or computers) to consumers under their device loan and device reuse programs. Here you will indicate the primary method you use. Your primary method should be your preferred or most frequentl y used method. Please note that in the option “the device is delivered to the consumer b y staff,” your program determines who is designated as staff. This could include subcontractors and volunteers. **12. In the following table, select by device type how the device is reassigned. Select the top two used by the program.** 

**Type of device Based on** 

**consumer choice**  **and/or request**  **A professional**

**recommendation is**  **required Qualified**  **program staff**  **match it to the**  **consumer Qualified** 

**consultants and/or**  **volunteers match it to**  **the consumer**  **The**

**device is provided**  **through a**  **qualified third**  **** **party Not** 

**applicable**

**- this**  **type of device is**  **not made available**  **Vision Hea**  **ring Speech**  **Communication Learning,**  **Cognition, and Developmental**  **Mobility, Seating, and**  **Positioning Daily Living**  **Environmental Adaptations**  **Vehicle Modification**  **and Transportation**  **Recreation, Sports, and**  **Leis ure**  **Equipment**1820

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62 **Computer and Associated**  **Equipment** Instructions: Statewide AT Programs emplo y different strategies to ensure that reused devices will meet the needs of recipients. As the policy may change depending on a particular device with in a larger device t ype, provide the two strategies most used by the program. Your program may employ a hierarchy

of strategies or use different strategies depending on the individual’s need. Example: You first request that a consumer bring a professiona l recommendation. If the consumer cannot provide a professional recommendation, you then have qualified program staff work with the consumer. These would be the “top two” for the program. Another option is to select the two methods most frequentl y used. For example, the category of “mobility , seating, and positioning” includes both wheelchairs and walkers. These may be the most frequentl y reassigned devices but you may have very different policies for them (e.g., professional recommendation for a wheel chair but consumer choice for walker). In this case, you would select the strategy

the corresponds to each because they would be the strategies most frequently

used. Definitions and decision rules for each t ype of device are consistent with NISAT and are included as an appendix. If the answer is the same regardless of the device ty pe, you need to repeat this information. If your program conducts a device reassignment program for computers only, you need answer this question only for the category of computers and associated equipment and select not applicable for the rest of the categories. Use the following to help make your selections: Based on consumer choice/request

– Select this if you rely on the consumer’s assessment of his or her own need s. Professional recommendation

– Select this if you require that a medical, educational, allied health, or other professional recommend a device before you will provide it. Your program defines whom it considers a professional and what constitutes a rec ommendation. Qualified program staff match it to the consumer

– Select this if your staff gather information from the consumer and use their expertise to determine what device they believe may

best meet the consumer’s need. Your program defines what it me ans to be qualified. Qualified consultants/volunteers match it to the consumer

– Select this if others outside yo ur organization assist with matching on a regular or as

- needed basis. Examples include: a retired rehabilitation engineer who volunteers once a week or an occupational therapist who you pa y on a case - by

- case basis to consult. Your program defines what it means to be qualified.1820

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63 The device is provided through a qualified third party

– Select this if you provide the device onl y when a qualified i ndividual or agency requests it on behalf of someone and that individual or agency

has done the work of determining the appropriate match. Example: An independent living center requests used devices on behalf of consumers. Your program defines what it me ans to be qualified. Not applicable

– this type of device is not made available

- Your program may choose not to accept certain categories of devices. If you do not accept certain categories, choose this. Choosing not to accept a category of devices is different from having never received a device in that category , however. If you have not received a device in a given category, but would accept and reassign a device in it if available, provide the response for what yo u most likely

would do under the cir cumstances. **13. If applicable, describe how consumers demonstrate the need for devices. [Text box]** Instructions: If a consumer must in some way qualify for a device from yo ur reassignment program, describe how they qualify and the qualifications. Addi tionally , you may want to describe if your program assists the consumer with accessing appropriate funding streams to pay for a device before using the reassignment program. Explain in the simplest terms possible; a person unfamiliar with the program shou ld be able to read this explanation and understand what the Statewide AT Program is “doing”. If consumers do not need to qualify or you do not provide assistance, simply state that they

do not. Example: To receive a device from our reuse program, a con sumer must (a) attest to having a disability , (b) lack or be denied public pay ment or private insurance coverage for the device, and (c) prove that the household income is not sufficient to purchase or to take out a financial loan to purchase the device. Before providing a device we work with the consumer to determine their eligibility for Medicaid, VR, or other s ys tems that cover AT. If they prove ineligible, we then work with our AFP to see if he or she could obtain a loan for the purchase. During the period of looking at funding options, we provide a used device on a temporary

basis. I f he or she does not qualify for any funding options to purchase a new device, he or she can keep the used device permanentl y. If he or she qualifies for other funding, he or she returns the used device once he or she has obtained the new one. **14. Describe any supports provided to the consumer to ensure successful use of the device. [Text box]**  Instructions: Describe any work you do with a consumer either before or af ter he or she obtains a device in order to ensure that the device is successfully used, such as: training the consumer or family members in use and maintenance of the device or requiring that the consumer receive training elsewhere; or following up with th e consumer after they

have received the device to see how it is working out and answer an y questions. Explain in the simplest terms possible; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. If you do provide supports, simply state that you do not.1820

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64 Example: Before a consumer receives a device, we provide on

- site training on how to use and maintain it. A family member or friend must attend with the consumer so there i s a back

- up. A month after the consumer has taken the device, we call the consumer to see how the device is being used in the community and provide an y assistance or troubleshooting. If this follow

- up call shows it to be necessary , we will visit the cons umer at home or work for further training. **15. Describe the activity. [Text box]** Instructions: Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and under stand what the Statewide AT Program is “doing”. Describe the process for obtaining, refurbishing (if applicable), and reassigning devices. If the program is for a particular agency or entity , identify that agency or entity and the purpose and population served. Example: The MS society subcontracts with us to operate an open

- ended loan program for individuals with MS in the state. We have a pool of communication and adaptive daily

living devices set aside for this program. When the MS society identifie s an individual in need, they contact and inform us of the t ypes of devices that could assist him or her. We arrange to provide the devices, and support for their use, to the individual. We track all devices as they come in and out of the program, and co ntact the individual with the device on a regular basis to determine if he or she still is benefiting from it. When the device no longer can be used b y the individual, we collect it and take care of an y necessary sanitization and maintenance of the item i n preparation for another open

- ended loan.1820

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65 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section E: Device Loan Activity** The AT Act say s that Statewide AT Programs are to “directl y or in collaboration with public or private entities, carry

out device loan programs that provide short

- term loans of assistive technology

devices to individuals, employ ers, public agencies, or others seeking to meet the needs of targeted individuals and entities, including others seekin g to comply with IDEA, ADA and Section 504.” The purpose of a device 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 or for other purposes. “Other” purposes include: (1) self

- education by

a consumer for the purpose of later decision making (e.g., when the school y ear begins); (2) self

- education by

an intermediary

(e.g., a teacher) whose purpose is to become familiar with the device ; and (3) training. Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan d escribe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requ ires that the State Plan include a description of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activ ities among public and private entities. The following items are items intended to meet these requirements for device loan activities. If you indicated that you conduct two or more device loan activities, you will repeat the items below once for each d evice loan activity you indicated. **1. Select the option that best describes the type of program. [Drop -**  **down menu]** Instructions : The drop

- down menu offers the following options (choose one):

o General program o Program for targeted consumers o Program for targeted agencies or entities o Other1820

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66 Some Statewide AT Programs have a pool of devices available for loan to anyone for any purpose, while others maintain several pools of devices, some for the public and some for specific audiences or purposes. Use the definitions below to determine the best description of the ty pes of device loan activities you conduct. You will repeat these questions again if yo u have more than one ty pe of loan activities, so select only one descriptor here. Note that yo u are require d to provide annual data for any activity claimed in this State Plan. General device loan program

– Devices in the loan inventory are available to most targeted individuals and entities for most purposes. Device loan program for targeted consumers

- Devi ces in the loan inventory are reserved for the use of certain consumers. The t ype of consumer can be defined b y age, disability , intended purpose, or other characteristic. If they are reserved for the use of particular professionals, you should answer th at it is for targeted agencies or entities. If the ty pe of consumer is linked to an agency or entity , you also would answer targeted agency or entity (e.g., the pool is reserved for children being served by earl y intervention agencies is different from a pool reserved for infants and toddlers). Device loan program for targeted agencies or entities

– Devices in the loan inventory are reserved for the use of a certain agency or entity (e.g., you have a pool of communication devices specificall y set aside f or the use of a nearby

school district). This can appl y to both consumers and professionals who receive the loan through the agency in question. Other

– The device loan inventory is not available like a general loan inventory , but the exclusions are not related to a ty pe of consumer or entity

. **2. If you indicated that you have a device loan program for targeted consumers or devices, describe the specific types of consumers or devices for whom the loan program is**  **intended and why. [Text box]** Instru ctions : Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. It also should describe to whom the activ ity is intended to serve, and how it is of benefit to the consumer. The role of the Statewide AT Program in carryi ng out the activity

should be explained clearly

. Example: We maintain an inventory of augmentative communication devices specifically for children with autism. We purchased the devices in this inventory specifically

with children with autism in mind because their needs are distinct and our program received so many requests for assistance from their families. There are duplicates of some o f the devices in our general loan inventory , but if the person requesting a device identifies that it is for an autistic child, the device comes from this specific pool before we loan it to him or her from the general pool. A staff member with expertise i n autism is assigned to assist all those who receive devices from this inventory

. **3. If you indicated that you have a device loan program for targeted agencies or entities, identify the entity or agency and describe the purpose of the program. [Text box**  **]**1820

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67 Instructions : Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. It also should describe who the activit y is intended to serve, and how it is of benefit to the consumer. The role of the Statewide AT Program in carryi ng out the activity

should be explained clearly

. Example: We have a partnership to provide device loans to vocational rehabilitation counselors serving students in transition. All requests for device loans for students in transition come to us from the VR agency and are fulfilled from a pool of devices set aside for this purpose. The devices were purchased using funds provided by the VR agency , but the Statewide AT Program provides the management of the pool and staff expertise related to the devices at no cost to the agency

. **4. If you selected other, describe. [Text box]** Instructions : Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. It also should describe who the activit y is intended to serve, and how it is of benefit. Th e role of the Statewide AT Program in carrying out the activity should be explained clearly

. **5. Enter the year when the program began conducting this activity. [Number field] 6. Who conducts this activity? Check all that apply.**  **The Statewide AT Pr ogram**  **Other entities (e.g. contractors) 7. The Statewide AT Program provides and/or receives the following support (choose all**  **that apply).**

**Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind s upport to other entities via an agreement with the Statewide AT**  **Program. Receives financial support from the state.**  **Receives in -**  **kind support from the state. Receives financial support from private entities.**  **Receives in -**  **kind support from private entities. C**  **oordinates and collaborates with other entities for the purpose of establishing a new program or service.**  **Coordinates and collaborates with other entities for the purpose of expanding an existing program or service.**  **Coordinates and collaborates with other entities for the purpose of reducing**  **duplication of programs or services.**1820

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68 **8. If you conduct this activity by providing financial or in**  **- kind support to other**  **entities, identify the kinds of entities you support in column (a) of the following table.**  **If you receive financial or in -**  **kind support from the state to conduct this activity, identify the state entities that provide this support in column (b) of the following**  **table. If you receive financial or in**  **- kind support from private entities, identify th**  **e private entities that provide this support in column (c) of the following table.**  **If you coordinate and collaborate with other entities in conducting this activity, identify those entities in column (d) of the following table.** 

**Organization or Activity a**  **. You provide**  **support b.** 

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living age**  **ncy Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organizatio n**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing Organization that primarily serves**  **individuals with developmental disabilities Organization that primarily serves**  **individuals with physical disabilities Organization focused specifically on**  **providing AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other 9. Select the option that be**  **st describes from where this activity is conducted. One central location**  **Regional sites A combination of a central location and regional sites**  **10. If you indicated the use of regional sites, from how many regional sites is the activity conducted? [Num**  **ber field]**1820

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69 **11. This activity is available (choose all that apply).**  **By website By phone**  **By e -**  **mail By mail**  **In person 12.**  **Select the option that best describes the policy of the program for charging individuals with disabilities for a loan. [Drop**  **- down**  **menu] 13.**  **Select the option that best describes the policy of the program for charging professionals for a loan. [Text box]**  **14. Describe any supports provided to the consumer to ensure a successful loan. [Text box]**  Instructions: Some loan programs provide support to consumers on multiple levels at multiple times to improve the loan experience. Describe the typ es of supports y ou provide, if an y. Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. Example: Every

device sent out from our loan inventory comes both with the manufacturer’s instructions and a “cheat sheet” of basic instructions. Prio r to sending the device, we ensure that at least one adult in the household receiving the device is able to read the instructions that are sent. A week after a device has been sent, we place a follow

up call to the recipient to ask (a) if the device has arrived and (b) if they need any assistance with setting it up. If it has not been set up, we call back in another week. If it alread y has been set up, we ask them a series of questions to probe how successfull y/ correctl y the device is being used. If it appears that the consumer is having difficulty , we troubleshoot the situation or offer a different device. **15. Devices in the loan pool also are made available for the following (choose all that apply). [Check boxes]** 

**Device demonstrations Evaluations an**  **d assessments Training**  **Public awareness** Instructions : Indicate other purposes for which you allow y our device loan devices to be used, whether the other use is internal to your program only or if you allow others to receive a loan for the given purpose. This includes if you allow a professional not affiliated with your program to check out a device for the purpose of evaluating a consumer or conducting a training.1820

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70 **16. How do you get the device to the consumer? [Drop -**  **down menu]** Instructions: The drop

- down menu offers the following options (choose one):

o The device is shipped via mail or other commercial delivery o The device is delivered to the consumer b y staff o The consumer picks up the device at a designated site o Other Statewide AT Programs use many methods for getting devices to consumers under their device loan and device reuse programs. Here you will indicate the primary method you use. Your primary

method should be your preferred or most frequently used method. Please note that in the opti on “the device is delivered to the consumer b y staff,” your program determines who is designated as staff. This could include subcontractors and volunteers. **17. Provide any additional information about this activity you wish to share. [Text box]**1820

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71 

# As **sistive Technology State Grant Program**  **State Plan for FY 2009 -**  **2011 Section F: Device Demonstration Activity** 
The AT Act describes device demonstrations as activities to “directly , or in collaboration with public and private entities, such as one

- stop partners, as defined in section 101 of the Workforce Investment Act of 1998 (29 U.S.C. 2801), demonstrate a variety of assistive technology

devices and assistive technology services (including assisting individuals in making informed choices regarding, and pro viding experiences with, the devices and services), using personnel who are familiar with such devices and services and their applications.” Section 4(e)(2)(D) In a device demonstration for an individual, guided experience with the device(s) is provided t o 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 detail s 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 d emonstration 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 adequatel y explored to enable decision

- making. Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan describe how various public and private enti ties will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a descript ion of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activities among public and private entities. T he following items are items intended to meet these requirements for device demonstration activities.1820

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72 If you indicated that you conduct two or more device demonstration activities, you will repeat the items below once for each device demonstration activ ity you indicated. **1. Select the option that best describes the type of program. [Drop -**  **down menu]** Instructions : The drop

- down menu offers the following options (choose one):

o General device demonstration program o Device demonstration program for targe ted consumers o Device demonstration program for targeted agencies or entities o Other Some Statewide AT Programs have a pool of devices available to demonstration to any one for an y purpose, while others maintain several pools of devices, some for the public and some for specific audiences or purposes. Use the definitions below to determine the best description of the t ypes of device demonstration activities y ou conduct. You will repeat these questions again if you have more than one t ype of demonstration a ctivities, so select only one descriptor here. Note that y ou are required to provide annual data for any activity claimed in this State Plan. General device demonstration program

– Devices in the demonstration inventory are available to most targeted ind ividuals and entities for most purposes. Device demonstration program for targeted consumers

- Devices in the demonstration inventory are reserved for the use of certain consumers. The t ype of consumer can be defined b y age, disability, intended purpose, or other characteristic. If they are reserved for the use of particular professionals, you should answer that it is for targeted agencies or entities. I f the ty

pe of consumer is linked to an agency or entit y, you also would answer targeted agency

or ent ity (e.g., the pool is reserved for children being served by earl y intervention agencies is different from a pool reserved for infants and toddlers). Device demonstration program for targeted agencies or entities

– Devices in the demonstration inventory are reserved for the use of a certain agency or entity (e.g., you have a pool of communication devices specificall y set aside for the use of a nearby school district). This can appl y to both consumers and professionals who receive the demonstration through the agency in question. Other

– The device demonstration inventory is not available like a general demonstration inventory , but the exclusions are not related to a t ype of consumer or entit y. **2. If you indicated that you have a device demonstrati on program for targeted consumers**  **or devices, describe the specific types of consumers or devices for whom this demonstration program is intended and why. [Text box]**  Instructions : Explain in the simplest terms possible how this activity is conducted; a p erson unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing”. It also should describe who the activit y is intended to1820

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73 serve, and how it is of benefit to the consumer. The role of the St atewide AT Program in carryi ng out the activity

should be explained clearly

. Example: Under an agreement with AARP, we have a special demonstration program for senior citizens. The inventory for this program consists of the most popular and affordable AT for the elderl y who live on their own or in nursing homes. Twice a month, all of the devices in this program are taken to locations such as nursing homes, senior centers, and hospitals. Staff spend a full day at the location providing one

- on - one demo nstrations to those being served there. **3. If you indicated that you have a device demonstration program for targeted agencies or entities, identify the entity or agency and describe the purpose of the program. [Text box]**  Instructions: See instruction s for item 2. **4. If you selected other, describe. [Text box]** Instructions : Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Stat ewide AT Program is “doing”. It also should describe whom the activity is intended to serve, and how it is of benefit. The role of the Statewide AT Program in carrying out the activity should be explained clearly

. **5. Enter the year when the program began conducting this activity.**  **6. Who conducts this activity? Check all that apply. The Statewide AT Program**  **Other entities (e.g. contractors) 7. The Statewide AT Program provides and/or receives the following support (choose all**  **that apply).**

**Prov ides financial support to other entities via an agreement with the Statewide AT**  **Program. Provides in**  **- kind support to other entities via an agreement with the Statewide AT**  **Program. Receives financial support from the state.**  **Receives in -**  **kind support from th e state.**  **Receives financial support from private entities. Receives in**  **- kind support from private entities.**  **Coordinates and collaborates with other entities for the purpose of establishing a new program or service.**  **Coordinates and collaborates with other en tities for the purpose of expanding an**  **existing program or service. Coordinates and collaborates with other entities for the purpose of reducing**  **duplication of programs or services.**1820

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74 **8. If you conduct this activity by providing financial or in**  **- kind**  **support to other entities, identify the kinds of entities you support in column (a) of the following**  **table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following**  **table. If you receive financial or in**  **- kind support from private entities, identify the private**  **entities that provide this support in column (c) of the following table. If you coordinate and collaborate with other entities in conductin**  **g this activity, identify those entities in column (d) of the following table.** 

**Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agency**  **Easter Seals Education**  **- related agency**  **Employment -**  **related agency Health, allied health, and rehabilitation**  **** **related agency Independent Living Center**  **Institution of Higher Education Non**  **- categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of**  **hearing Organization that primarily serves**  **individuals with developmental disabilities Organization that primarily serves**  **individuals with physical disabilities Organization focused specifically on**  **providing AT Protectio**  **n and Advocacy Organization Technology agency**  **UCP Other** 
**9. Select the option that best describes from where this activity is conducted. One central location**  **Regional sites A combination of a central location and regional sites**  **1 0. If you indicated the use of regional sites, from how many regional sites is the activity**  **conducted? [Number field]**1820

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75 **11. This activity is available (choose all that apply). By website**  **By phone By e**  **- mail**  **By mail In person** 
**12. Select the option th at best describes the primary type of demonstrations provided by**  **the program. [Drop -**  **down menu]** Instructions : The drop

- down menu offers the following selections (choose one):

o In

- person demonstrations from one fixed location o In

- person demonstrations at fi xed regional sites o In

- person demonstrations that move to multiple sites o In

- person demonstrations from a mobile unit(s) o Virtual demonstrations via technology For this item, you identify the primary

method. The next item allows you to identify a secondary method. The primary method should be your preferred or most frequentl y used method, and secondary

the next in your hierarchy. Use the following definitions when determining the t yp e of method: In

- person demonstrations from one fixed location

– You have a central location that houses all employ ees and resources engaged in the activity . If you have a central location and use other strategies described here, remember you can choose a primary and secondary . It is assumed that there is a correlation betwee n your response to this item and yo ur response to the general item about the use of central locations vs. regional sites. In

- person demonstrations at fixed regional sites

– You have at least two sites that operate relativel y independently and house their own employ ees and separate resources. If one of these sites is considered the central site or “headquarters,” that site most likely should be identified as either your primary or secondary

“one fixed location.” Regional sites can be directly managed by the Lead Agency /Implementing Entity

or can be subcontractors. Sites that simply

serve as referral sources or provide minimal assistance to a central location are not considered regional sites. In

- person demonstrations that move to multiple sites

– You us e community

- based sites on a temporary

basis, and staff and equipment move from site to site. For example, a staff member travels from independent living center to independent living center across the state with a vehicle full of devices. The staff membe r spends a week at each independent living center performing demonstrations. If the staff members and equipment are sent out from a primary

site, that site most likely should be identified as either your primary or secondary “one fixed location.” This op tion is not to be confused with a mobile unit, wherein the vehicle transporting devices serves as a demonstration in and of itself. It also is not to be confused with regional sites, which are fixed locations.1820

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76 In

- person demonstrations from a mobile uni t(s)

– Unlike demonstrations that move to multiple sites, a mobile unit is designed to be a demonstration in and of itself. This is different from a vehicle in which devices are transported. Virtual demonstrations via technology

– You deliver a demonstr ation using the Internet or some other distance learning technology rather than in

- person, regardless of whether the recipient of the demonstration has hands

- on access to the device. **Select the option that best describes the secondary type of demonstrat ions provided**  **by the program. [Drop -**  **down menu]** Instructions : Same instructions for primary t ype. **13. Select the option that best describes the policy of the program for charging individuals with disabilities for a demonstration. [Drop**  **- down menu]**  **14. Select the option that best describes the policy of the program for charging**  **professionals for a demonstration. [Drop -**  **down menu] 15. Devices in the demonstration pool also are made available for the following (choose**  **all that apply). [Check boxes]**

**D evice loans**  **Evaluations and assessments Training**  **Public awareness** Instructions : Indicate other purposes for which you allow y our device demonstration devices to be used, whether the other use is internal to your program onl y or if you allow others to re ceive a loan for the given purpose. This includes if you allow a professional not affiliated with your program to check out a device for the purpose of evaluating a consumer or conducting training. **17. Select the option that best describes what is share d with the device loan program.**  **[Drop -**  **down menu]** Instructions: The drop

- down menu offers the following selections:

o Staff o Space o Not applicable Many Statewide AT Programs share resources between their device demonstration and device loan programs. Ident ify here the resources shared between y our programs. If you share devices, this already should have been identified. **18. Provide any additional information about this activity you wish to share. [Text box]**1820

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77 

# Assistive Technology State Grant **Progra m**  **State Plan for FY 2009 -**  **2011 Section G1: State Leadership Activities**  **Training Activities**
The AT Act describes training as follows: “(i) TRAINING AND TECHNI CALASSI STANCE.

— (I) IN GENERAL.

— The State shall directl y, or provide support to public or private entities with demonstrated expertise in collaborating with public or private agencies that serve individuals with disabilities, to develop and disseminate training materials, conduct training, and provide technical assistance, for individuals from lo cal settings statewide, including representatives of State and local educational agencies, other State and local agencies, earl y intervention programs, adult service programs, hospitals and other health care facilities, institutions of higher education, an d businesses. (II) AUTHORIZED ACTIVITIES.

— In carrying out activities under subclause (I), the State shall carry

out activities that enhance the knowledge, skills, and competencies of individuals from local settings described in subclause (I), which may in clude

— (aa) general awareness training on the benefits of assistive technology and the Federal, State, and private funding sources available to assist targeted individuals and entities in acquiring assistive technology ; (bb) skills

- development training in assessing the need for assistive technology devices and assistive technology

services; (cc) training to ensure the appropriate application and use of assistive technology devices, assistive technology

services, and accessible technology for e

- government functions; (dd) training in the importance of multiple approaches to assessment and implementation necessary to meet the individualized needs of individuals with disabilities; and (ee) technical training on integrating assistive technology into the developme nt and implementation of service plans, including an y education, health, discharge, Olmstead, employ ment, or other plan required under Federal or State law.” Training activities are instructional events, usuall y planned in advance for a specific purpose o r audience, that are 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, parti cipants in training can be individuall y 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 trainin g intended onl y to increase general1820

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78 awareness of AT. Training activities have more depth and breadth than public awareness activities and are focused on skill building and competency development. Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a description of the State

- level and State L ead ership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activities among public and private entities. The following items are items intended to meet these requirements for training activities. **1. Who conducts this activity? Check all that apply. The Statewide AT Program**  **Other entities (e.g. contractors) 2. The Statewide AT Program provides and/or receives the following support (choose**  **all that apply).** 

**Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives**  **in -**  **kind support from the state. Receives financial support from private entities.**  **Receives in -**  **kind support from private entities. Coordinates and collaborates with other entities for the purpose of establishing a**  **new program or service. Coordinates and col**  **laborates with other entities for the purpose of expanding an existing program or service.**  **Coordinates and collaborates with other entities for the purpose of reducing duplication of programs or services.**  **3. If you conduct this activity by providing fina**  **ncial or in -**  **kind support to other entities, identify the kinds of entities you support in column (a) of the following**  **table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following**  **table. If you receive financial or in**  **- kind support from private entities, identify the private**  **entities that provide this support in column (c) of the following table. If you coordinate and collaborate with other enti**  **ties in conducting this activity, identify those entities in column (d) of the following table.** 1820

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79 **Organization or Activity a. You**  **provide support**  **b.**

**Receive support**  **from the state**  **c.**

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate wit**  **h AgrAbility Program**  **Alliance for Technology Access Center Bank or other financial institution**  **Community Living agency Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilit ation**  **** **related agency Independent Living Center**  **Institution of Higher Education Non**  **- categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily se**  **rves individuals who are deaf or hard of**  **hearing Organization that primarily serves**  **individuals with developmental disabilities**  **Organization that primarily serves individuals with physical disabilities**  **Organization focused specifically on pr**  **oviding AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other 4. Select the option that best describes from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central locat ion and regional sites**  **5. If you indicated the use of regional sites, from how many regional sites is the activity conducted? [Number field]**  **6. This activity is available (choose all that apply).**

**By website By phone**  **By e -**  **mail By mail**  **In person**1820

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80 **7 . Select the option that best describes how training is primarily provided.**  Instructions : The drop

- down menu offers the following selections (choose one):

o At fixed sites supported by the Statewide AT Program. o At sites arranged b y those receiving the tr aining. o Via distance learning technology

. While it is likely

you deliver training in many situations, you will identify the primary method you use to deliver training. Choose the answer that is y our policy or your preferred or most frequentl y used method. Use the following definitions when determining the ty pe of method: At fixed sites supported by the Statewide AT Program

– Whether you have a central location or use regional sites, you ask that trainees come to one of your facilities to receive training

. At sites arranged by those receiving the training

– When training is requested, you go to one of the trainee’s facilities to provide it. Via distance learning technology

- Trainings are not provided on

- site. **8. Select the option that best describes the policy of the program for charging individuals**  **with disabilities for training. [Drop -**  **down menu] 9. Select the option that best describes the policy of the program for charging**  **professionals for training. [Drop -**  **down menu] 10. Provide any addition**  **al information about this activity you wish to share**1820

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81 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section G2: State Leadership Activities Technical Assistance Activities**  The AT Act describes training as follows: “(i) TRAININ G AND TECHNI CALASSI STANCE.

— (I) IN GENERAL.

— The State shall directl y, or provide support to public or private entities with demonstrated expertise in collaborating with public or private agencies that serve individuals with disabilities, to develop and disseminate training materials, conduct training, and provide technical assistance, for individuals from local settings statewide, including representatives of State and local educational agencies, other State and local agencies, earl y intervention program s, adult service programs, hospitals and other health care facilities, institutions of higher education, and businesses. (II) AUTHORIZED ACTIVITIES.

— In carrying out activities under subclause (I), the State shall carry

out activities that enhance the know ledge, skills, and competencies of individuals from local settings described in subclause (I), which may include

— (aa) general awareness training on the benefits of assistive technology and the Federal, State, and private funding sources available to assis t targeted individuals and entities in acquiring assistive technology ; (bb) skills

- development training in assessing the need for assistive technology devices and assistive technology

services; (cc) training to ensure the appropriate application and use of assistive technology devices, assistive technology

services, and accessible technology for e

- government functions; (dd) training in the importance of multiple approaches to assessment and implementation necessary to meet the individualized needs of indivi duals with disabilities; and (ee) technical training on integrating assistive technology into the development and implementation of service plans, including an y education, health, discharge, Olmstead, employ ment, or other plan required under Federal or State law.” Technical Assistance (TA) is direct problem

- solving services 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, b y electronic me dia 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.1820

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82 Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, section 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a description of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and col laborate their State

- level and State Leadership activities among public and private entities. The following items are items intended to meet these requirements for technical assistance activities. **1. Who conducts this activity? Check all that apply. T**  **he Statewide AT Program Other entities (e.g. contractors)**  **2. The Statewide AT Program provides and/or receives the following support (choose all that apply).** 

**Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives in**  **- kind support from the state.**  **Receives financial support from private entities. Receives in**  **- kind support from p**  **rivate entities. Coordinates and collaborates with other entities for the purpose of establishing a**  **new program or service. Coordinates and collaborates with other entities for the purpose of expanding an**  **existing program or service. Coordinates and collab**  **orates with other entities for the purpose of reducing duplication of programs or services.**  **3. If you conduct this activity by providing financial or in**  **- kind support to other**  **entities, identify the kinds of entities you support in column (a) of the follo wing**  **table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table.**  **If you receive financial or in -**  **kind support from private entities, identify the private**  **entities that provide this support in column (c) of the following table. If you coordinate and collaborate with other entities in conducting this activity,**  **identify those entities in column (d) of the following table.**1820

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83 **Or ganization or Activity**  **a. You provide**  **support b.** 

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabo rate**  **with AgrAbility Program**  **Alliance for Technology Access Center Bank or other financial institution**  **Community Living agency Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categoric al disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing Organization that primarily serves**  **individuals with d evelopmental disabilities**  **Organization that primarily serves individuals with physical disabilities**  **Organization focused specifically on providing AT**  **Protection and Advocacy Organization Technology agency**  **UCP Other**  **4. S elect the option that best describes from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central location and regional sites 5. If you indicated the use of regional sites, from how many regional sites is the a**  **ctivity conducted? [Number field]**  **6. This activity is available (choose all that apply).**

**By website By phone**  **By e -**  **mail By mail**  **In person 7. Select the option that best describes the policy of the program for charging for**  **technical assistance. [Drop -**  **down menu] 8. Provide any additional information about this activity you wish to share [Text box].** 1820

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84 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section G3: State Leadership Activities Public Awareness Activities**  The AT Act say s the following about Public Awareness “The State shall conduct public

- awareness activities designed to provide information to targeted individuals and entities relating to the availability , benefits, appropriateness, and costs of assistive technology

devi ces and assistive technology services, including

— (aa) the development of procedures for providing direct communication between providers of assistive technology

and targeted individuals and entities, which may include partnerships with entities in the statewide and local workforce investment sy stems established under the Workforce Investment Act of 1998 (29 U.S.C. 2801 et seq.), State vocational rehabilitation centers, public and private employ ers, or elementary and secondary

public schools; (bb) the devel opment and dissemination, to targeted individuals and entities, of information about State efforts related to assistive technology ; and (cc) the distribution of materials to appropriate public and private agencies that provide social, medical, educational, employ ment, and transportation services to individuals with disabilities.” Public awareness activities are designed to reach large numbers of people, including activities such as public service announcements, radio talks shows and news reports, newspaper stories and columns, newsletters, brochures, and public forums. Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, se ction 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a description of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate their State

- level and State Leadership activities among public and private entities. The following items are items intended to meet these requirements for public awareness activities. **1. Who conducts this activity? Check all that apply. The Statewide**  **AT Program Other entities (e.g. contractors)** 1820

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85 **2. The Statewide AT Program provides and/or receives the following support (choose all that apply).** 

**Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives in**  **- kind support from the state.**  **Receives financial support from private entities. Receives in**  **- kind support from private entit**  **ies. Coordinates and collaborates with other entities for the purpose of establishing a**  **new program or service. Coordinates and collaborates with other entities for the purpose of expanding an**  **existing program or service. Coordinates and collaborates with**  **other entities for the purpose of reducing duplication of programs or services.**  **3. If you conduct this activity by providing financial or in**  **- kind support to other**  **entities, identify the kinds of entities you support in column (a) of the following table.**  **If you receive financial or in -**  **kind support from the state to conduct this activity, identify the state entities that provide this support in column (b) of the following**  **table. If you receive financial or in**  **- kind support from private entities, identify the**  **private entities that provide this support in column (c) of the following table.**  **If you coordinate and collaborate with other entities in conducting this activity, identify those entities in column (d) of the following table.** 

**Organization or Activity a.**  **You provide**  **support b.** 

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community Living agen**  **cy Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organization Organization that primarily serves**  **individuals who are blind or visually impaired**  **Organization that primarily serves individuals who are deaf or hard of**  **hearing Organization that primarily serves**  **individuals with developmental disabilities Organization that primarily serves** 1820

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86 **individuals with physical disabilities Organization focused specifically on**  **providing AT Protection and Advocacy Organization**  **Technology agency UCP**  **Other 4. Select the option that bes**  **t describes from where this activity is conducted. One central location**  **Regional sites A combination of a central location and regional sites**  **5. If you indicated the use of regional sites, from how many regional sites is the activity conducted? [Numbe**  **r field] 6. This activity is available (choose all that apply).** 

**By website By phone**  **By e -**  **mail By mail**  **In person 7. Describe the activity. [Text box]**  Instructions: This should include a description of the major activities that occur on an ongoing b asis. Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing.” Example: Our statewide AT Program conduc ts 3 major public awareness activities on an annual basis. (1) We sponsor the state’s annual AT awareness day . On AT awareness day , stakeholders in the field of AT gather in the state capitol for a small festival featuring events and a device pavilion. As sponsor, we are responsible for arranging the facilities, logistics, and publicit y for the event, though other agencies and organizations contribute funds. (2) We have a booth at 3

- 5 conferences/expos every y ear, such as education conferences and health expos. Depending on the theme and attendees of the conference, the booth features various devices and staff with appropriate expertise. We also distribute material to promote the program and general information about AT. (3) In partnership with the state chapter o f AARP, we do a once

- a - ye ar mailing to all AARP members in the state that includes information about AT and the services available through our program.1820

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87 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section G4: State Leadership Act ivities**  **Information and Assistance Activities** The AT Act say s the following about information and referral activities, which for the purpose of this State Plan are called information and assistance activities: “(aa) IN GENERAL.

— The State shall directl y , or in collaboration with public or private (such as nonprofit) entities, provide for the continuation and enhancement of a statewide information and referral sy stem designed to meet the needs of targeted individuals and entities. (bb) CONTENT.

— The sy st em shall deliver information on assistive technology devices, assistive technology

services (with specific data regarding provider availability within the State), and the availability of resources, including funding through public and private sources, to o btain assistive technology devices and assistive technology services. The sy stem shall also deliver information on the benefits of assistive technology devices and assistive technology services with respect to enhancing the capacit y of individuals with dis abilities of all ages to perform activities of daily living.” Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the Statewide AT Program will implement its State

- level and State Leadership activities. Further, sect ion 4(d)(4) requires that the State Plan describe how various public and private entities will be involved in the implementation of those activities, including a description of the nature and extent of resources that will be committed by public and private collaborators. Section 4(d)(7) also requires that the State Plan include a description of the State

- level and State L eadership Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and collaborate th eir State

- level and State Leadership activities among public and private entities. The following items are items intended to meet these requirements for information and assistance activities. **1. Who conducts this activity? Check all that apply. The Sta**  **tewide AT Program Other entities (e.g. contractors)** 1820

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88 **2. The Statewide AT Program provides and/or receives the following support (choose all that apply).** 

**Provides financial support to other entities via an agreement with the Statewide AT Program.**  **Provides in -**  **kind support to other entities via an agreement with the Statewide AT Program.**  **Receives financial support from the state. Receives in**  **- kind support from the state.**  **Receives financial support from private entities. Receives in**  **- kind support from p**  **rivate entities. Coordinates and collaborates with other entities for the purpose of establishing a**  **new program or service. Coordinates and collaborates with other entities for the purpose of expanding an**  **existing program or service. Coordinates and collab**  **orates with other entities for the purpose of reducing duplication of programs or services.**  **3. If you conduct this activity by providing financial or in**  **- kind support to other**  **entities, identify the kinds of entities you support in column (a) of the follo wing**  **table. If you receive financial or in**  **- kind support from the state to conduct this activity,**  **identify the state entities that provide this support in column (b) of the following table.**  **If you receive financial or in -**  **kind support from private entities, identify the private**  **entities that provide this support in column (c) of the following table. If you coordinate and collaborate with other entities in conducting this activity,**  **identify those entities in column (d) of the following table.**

**Organization or Activity**  **a. You provide**  **support b.** 

**Receive support**  **from the**  **state c.** 

**Receive support**  **from these**  **private entities**  **d.**

**Collabor ate with**  **AgrAbility Program Alliance for Technology Access Center**  **Bank or other financial institution Community**  **Living agency Easter Seals**  **Education -**  **related agency Employment**  **- related agency**  **Health, allied health, and rehabilitation**   ** related agency** **Independent Living Center Institution of Higher Education**  **Non -**  **categorical disability organization**  **Organization that primarily serves individuals who are blind or visually**  **impaired Organization that primarily serves**  **individuals who are deaf or hard of hearing Organization that primarily serves**  **individuals with developmental d isabilities**  **Organization that primarily serves individuals with physical disabilities** 1820

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89 **Organization focused specifically on providing AT**  **Protection and Advocacy Organization Technology agency**  **UCP Other**  **4. Select the opt ion that best describes from where this activity is conducted.**  **One central location Regional sites**  **A combination of a central location and regional sites 5. If you indicated the use of regional sites, from how many regional sites is the activity**  **condu cted? [Number field]**  **6. This activity is available (choose all that apply).**

**By website By phone**  **By e -**  **mail By mail**  **In person 7. Describe the activity. [Text box]**  Instructions : This should include a description of how a consumer in need of informati on and assistance can contact your program and how y our program would provide assistance to him or her. Explain in the simplest terms possible how this activity is conducted; a person unfamiliar with the program should be able to read this explanation and understand what the Statewide AT Program is “doing.” Example: Our Statewide AT Program has four regional sites. Each site has a half

- time person devoted to answering information and assistance calls and e

- mails and this person receives extensive and on going training. A consumer can call an y of the four sites (usually he or she is directed to the one closest to where he or she lives) and either speak to the staff or leave a message via voicemail. E

- mail inquiries are handled similarl y, except that they all go to a general account and then are forwarded to the appropriate staff member. Our policy is to respond to all inquiries within one business day . When contacting a consumer, the staff has a routine of questions to ask to ensure that we have all of the information necessary to connect the consumer with appropriate resources. The expertise of the staff about AT

- related resources in the state is backed up by several three

- ring binders full of topical information for quick reference. If staff is not a ble to respond to a request for assistance alone, the request is brought to the weekly staff meeting to problem

- solve.1820

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90 

# Assistive Technology State Grant **Program State Plan for FY 2009**  **- 2011**  **Section H: Assurances, Measurable Goals, and Signature** 

S ection 4(d) of the AT Act prescribes the duties of the Lead Agency receiving a grant under section 4 of the AT Act and requires the State to provide a number of assurances in its application for funds. 34 CFR part 76 also requires that any State Plan incl ude certain assurances. Your certifying representative will attest to these assurances and other requirements below and will sign the State Plan, indicating that to the best of his or her knowledge and belief all information provided in the State Plan is true and correct and the State Plan fully discloses all known weaknesses concerning the accuracy , reliability , and completeness of the information.
**1. As Certifying Representative of the Lead Agency for the State of [state name will**  **automatically populate ], I hereby assure the following:**  **2. The Lead Agency prepared and submitted this State Plan on behalf of the State of** 

**[state name will automatically populate]. 3.**  **The Lead Agency submitting this plan is the State agency that is eligible to submit thi**  **s plan. 4.**  **The State agency has authority under State law to perform the functions of the**

**State under this program. 5.**  **The State legally may carry out each provision of this plan. 6.**  **All provisions of this plan are consistent with State law. 7.**  **A S tate officer, specified by title in this certification, has authority under State law**  **to receive, hold, and disburse Federal funds made available under the plan. 8.**  **The State officer who submits this plan, specified by title in this certification, has au**  **thority to submit this plan. 9.**  **The agency that submits this plan has adopted or otherwise formally approved this**

**plan. 10.**  **The plan is the basis for State operation and administration of the program. 11.**  **The Lead Agency will maintain and evaluate th e program under this State Plan.** 1820

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91 **12. The State will annually collect data related to the required activities implemented**  **by the State under this section in order to prepare the progress reports required under subsection 4(f) of the Act.**  **13. The Lead A**  **gency will submit the progress report on behalf of the State. 14.**  **The State will prepare reports to the Secretary in such form and containing such information as the Secretary may require to carry out the Secretary's functions**  **under this Act and keep su ch records and allow access to such records as the**  **Secretary may require to ensure the correctness and verification of information provided to the Secretary.**  **15. The Lead Agency will control and administer the funds received through the grant.**  **16. The**  **Lead Agency will make programmatic and resource allocation decisions necessary to implement the State Plan.**  **17. Funds received through the grant will be expended in accordance with Section 4 of**  **the Act, and will be used to supplement, and not supplant, funds available from**  **other sources for technology -**  **related assistance, including the provision of assistive technology devices and assistive technology services.**  **18. The Lead Agency will ensure conformance with Federal and State accounting**  **requirements. 19.**  **The State will adopt such fiscal control and accounting procedures as may be necessary to ensure proper disbursement of and accounting for the funds received**  **through the grant. 20.**  **Funds made available through a grant to a State under this Act wil l not be used for**  **direct payment for an assistive technology device for an individual with a disability. 21.**  **A public agency or an individual with a disability holds title to any property purchased with funds received under the grant and administers tha**  **t property. 22.**  **The physical facility of the Lead Agency and Implementing Entity, if any, meets the requirements of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et**  **seq.) regarding accessibility for individuals with disabilities. Section 4(d)(6)(E)**  **23. Activities carried out in the State that are authorized under this Act, and supported**  **by Federal funds received under this Act, will comply with the standards established by the Architectural and Transportation Barriers Compliance Board**  **un der section 508 of the Rehabilitation Act of 1973 (20 U.S.C. 794d). Section**  **4(d)(6)(G) 24.**  **The Lead Agency will coordinate the activities of the State Plan among public and private entities, including coordinating efforts related to entering into interag**  **ency agreements.**  **25. The Lead Agency will coordinate efforts related to the active, timely, and**  **meaningful participation by individuals with disabilities and their family members, guardians, advocates, or authorized representatives, and other appropriate**  **individuals, with respect to activities carried out through the grant. 26.**  **Describe how your program will conform to section 427 of General Education**

**Provisions Act by describing the steps you propose to take to ensure equitable access to, and participa**  **tion in, your program for students, teachers, and other program beneficiaries with special needs. [Text box]** 1820

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92 To complete item 26, refer to the instructions for the **“** General Education Provisions Act (GEPA) Requirements

- Section 427” form found at the follo wing website: http://www.ed.gov/fund/grant/apply /appforms/appforms.html **General Instructions for Measurable Goals:**  Section 4(d)(3) of the AT Act requires that the State include information on the measurable goals, and a timeline for meeting those goals , that the State, with the advice of the Advisory Council required in section 4(c)(2), has addressed the assistive technology needs of individuals with disabilities in the State in the domains of education, employ ment, community

living, and telecommunicati ons and information technology (IT).

 Section 4(d)(3)(A)(i) of the AT Act states that education goals include goals involving the provision of assistive technology to individuals who receive services under the Individuals with Disabilities Education Improv ement Act (20 U.S.C. 1400 et seq.). This includes infants and toddlers receiving early intervention services under Part C.

 Education also includes the provision of assistive technology to individuals who receive services under section 504 of the Rehabili tation Act of 1973 (29 U.S.C. 720 et seq.) and individuals in institutions of higher education and vocational education, including community

colleges.

 Section 4(d)(3)(A)(ii) of the AT Act states that employ ment goals include goals involving the State vocational rehabilitation program carried out under title I of the Rehabilitation Act of 1973 (29 U.S.C. 720 et seq.). RSA has established two ty pes of measurable goals: access goals and acquisition goals.
 Access goals relate to the activities of device loan and device demonstration. The State will show that it has improved access to AT b y increasing the percentage of appropriate targeted individuals and entities who accessed device demonstration programs or device loan programs and made a decision about an AT device or service as a result of the assistance they

received.

 Acquisition goals relate to the activities of state financing and device reutilization. The State will show that it has improved acquisition by increasing the percentage of appropriat e targeted individuals and entities who obtained devices or services from State financing activities or reutilization programs who would not have obtained that AT device or service.1820

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93 **Access Goal and Table** RSA set s one goal for improving access to assistive technology for individuals with disabilities in each of the domains of education, employ ment, community

living, and telecommunications and IT. 3 The State will show that it has improved access by increasing the percentage of appropriate targete d individuals and entities who accessed device demonstration programs and device loan programs and made a decision about an AT device or service as a result of the assistance they received. Long

- term and annual short

- term measurable goals are based on the combined performance measure data for both device demonstration and device loan activities claimed in the State Plan and reported in the state’s Annual Report. RSA set s a long

- term goal (the desired percentage of appropriate targeted individuals and e ntities who accessed device demonstration programs and device loan programs that are able to make an informed decision about an AT device or service as a result of the assistance they received) to be achieved by the end of the third y ear of the State Plan for AT. A long

- term goal is the desired optimal level of performance at the end of three years. The Statewide AT Program should work with its advisory council to address this optimal level of performance based on its own data and knowledge of the state. RSA set s annual short

- term goals that may show progress from the first y ear of the State Plan for AT toward the long

- term goal. The long

- term and short

- term measurable goals should be both ambitious and attainable. Short

- term goals may represent incr eases that lead to a long

term goal. If a program reaches it s long

- term goal or its first y ear annual data proves to be optimal, the goal should be maintenance of that performance. The long

- term and short

- term goals are a percentage not a number of peop le served. The calculation is the percentage of those who were served b y the Statewide AT Program who also had a particular outcome. Example: Under the access performance measure, those who receive a device loan or demonstration will complete a follow

- up survey (the survey

and its instructions are included in the annual report). Those who respond to the survey will indicate whether they were able to make a decision about an AT device or service as a result of the loan or demonstration.

3 A State is unable to meet a goal for access if it performs neither device loans nor device demonstrations due to claiming comparability or flexib ility. However, a goal will be set if either activity is undertaken. If both activities are undertaken the performance measure in your annual report is bas ed on the combined performance measure of both activities. This combined performance measure is used to determine your performance status and must be tak en into consideration as you address your long

- term and short

- term

access goals.1820

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94 The table in item 27 below wil l be used to report the long

- term goal, short

- term goals, and actual performance. See below for detailed instructions on completing the table.
**27. Access Goal Table** 

**Access Education**  **Employment Community**  **Living IT/Telecomm** 
**a. Lon g**  **- term**  **Goal System**  ****

**generated System**  ****

**generated System**  ****

**generated System**  ****

**generated b. Long**  **- term**  **Goal Status System**  ****

**generated System**  ****

**generated System**  ****

**generated System**  ****

**generated c. FY 20**  **11 Performance**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **System**  

** generated** **d. FY 20 12**  **Short -**  **term goal**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **System**  

** generated** **e. FY 20 12**  **Performance System**  ****

**generated System**  ****

**generated System**  ****

**generated System**  ****

**generated f. FY 20**  **12 Status**  **System**  

** generated** **System**  

** generated** **Syste m**  ****

**generated System**  ****

**generated g. FY 20**  **13 Short**  **- term**  **goal System**  ****

**generated System**  ****

**generated System**  ****

**generated System**  ****

**generated h. FY 20**  **13 Performance**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **System**  

** generated** **i. FY 201 3**  **Status System**  ****

**generated Sys**  **tem**  

** generated** **System**  

** generated** **System**  

** generated** **j. FY 201 4**  **Short -**  **term goal**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **System**  

** generated** **k. FY 201 4**  **Performance System**  ****

**generated System**  ****

**generated System**  ****

**generated System**  ****

**generated l. FY 201**  **4 Status**  **S ystem**  ****

**generated System**  ****

**generated System**  ****

**generated System**  ****

**generated**1820

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95 **Acquisition Goal and Table** RSA set s one goal for improving acquisition of assistive technology for individuals with disabilities in each of the domains of education, e mploy ment, and community living. 4 The State will show that it has improved acquisition by increasing the percentage of appropriate targeted individuals and entities who obtained devices and/or services from all State financing activities and reutilizati on programs who would not have obtained that AT device or service. Long

- term and annual short

- term measurable goals are based on the combined performance measure data for an y State Financing Activities (including Financial Loan Programs; State financing activities that provide consumers with resources and services that result in the acquisition of AT devices and services; and, State financing activities that allow consumers to obtain AT at reduced costs) and an y Reutilization activities (including Device Exchange, Recycling/Refurbishment/Repair and Open

- ended loans) claimed in the State Plan and reported in the state’s Annual Report. RSA set s a long

- term goal (the desired percentage of appropriate targeted individuals and entities who obtained devices or services from State financing activities or reutilization programs who would not have obtained that AT device or service) to be achieved by the end of the third y ear of the State Plan for AT. A long

- term goal is the desired optimal level of performance at the end of three ye ars. The Statewide AT Program should work with i ts advisory council to address this optimal level of performance based on its own data and knowledge of the state. RSA set s annual short

- term goals that may show progress from the first ye ar of the State Plan toward the long

- term goal. The long

- term and short

- term measurable goals should be both ambitious an d attainable. Short

- term goals may represent increases that lead to a long

- term goal. If a program reaches its long

- term goal or its first y ear annual data proves to be optimal , the goal should be maintenance of that performance.

4 A State is unable to m eet a goal for acquisition if it performs neither state financing nor device reutilization due to claiming comparability or flexibility. How ever, a goal must be set if either activity is undertaken. If both activities are undertaken the performance m easure in your annual report is based on the combined performance measure of both activities. This combined performance measure is used to determine your performance status must be tak en into consideration as you address yo ur long

- t erm and short

- term acqu isition goals.1820

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96 The table in item 28 below wil l be used to report the long

- term goal, short

- term goals, and actual performance. See below for detailed instruction s on completing the table.

**28. Acquisition Goal Table**  **Acquisition Education**  **Employment Community**  **Living a. Long**  **- term**  **Goal System**  ****

**generated System**  ****

**generated System**  ****

**generated b. Long**  **- term**  **Goal Status System**  ****

**generated System**  ****

**generated System**  ****

**gene rated**  **c. FY 20**  **11 Performance**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **d. FY 20 12**  **Short -**  **term goal**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **e. FY 20 12**  **Performance System**  ****

**generated System**  ****

**generated System**  ****

**generated f. FY 20**  **12 Status**  **Sy stem**  ****

**generated System**  ****

**generated System**  ****

**generated g. FY 20**  **13 Short**  **- term**  **goal System**  ****

**generated System**  ****

**generated System**  ****

**generated h. FY 20**  **13 Performance**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **i. FY 20 13**  **Status System**  ****

**generated System**  ****

**generated System**  ****

**generated j. FY 201**  **4 Short**  **- term**  **goal System**  ****

**generated System**  ****

**generated System**  ****

**generated k. FY 201**  **4 Performance**  **System**  

** generated** **System**  

** generated** **System**  

** generated** **l. FY 201 4**  **Status System**  ****

**generated System**  ****

**generated System**  ****

**generated** Instructions : The two tables in items 27 and 28 correspond to the access and acquisition goals. The majority of the data needed to complete these tables is derived from the State’s “Annual Report for State Grant for Assistive Technology Programs” (OMB #1820

- 0572). The instructions for calculating the State’s progress toward measurable goals are included in the instruction manual accompan yi ng the annual report. This annual report is also entered into RSA’s MI S. Once the State has entered its annual report data into the MIS, many items will cross

- populate into tables 27 and 28 (as indicated by use of “sy stem

- generated”). In row “a” (Long

- Term goal) of tables 27 and 28, RSA enter s the long

- term goal for each domain as a percentage. This goal is a fixed, cumulativ e goal not tied to any particular ye ar, but it reflect s what is hoped to be achieved by the end of the third y ear of the approved State Plan for AT. Once RSA sets the long

- term goal, this row of the tables is locked. The long

- term1820

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97 goal can be modified on ly if an appeal is made to RSA. Such requests must be based on events or circumstances that have or are expected to impact a State’s ability to make progress towards the long

- term goal , such as a natural disaster

. Row “b” (Long

- term goal status) of both tables automatically wil l show whether you have met the lon g - term goal. The status of the long

- term goal is automatically generated and progress in meeting the long

- term goal is designated by either a “met” or “not met” designation. This determination w ill be based on the State’s performance for the fiscal y ear most re centl y entered (e.g., in FY 2012 the number entered into row “e” will be used, in FY 2013 the number entered into row “h” will be used). The data in row “b” will change accordingl y when annual report data is entered for subsequent y ears. In row “c” of both tables, your FY 2010 performance will be entered for each domain. This data serves as your baseline and is reflected as a percentage. In rows “d,” “g,” and “j” of both tables, the sh ort

- term goals may reflect incremental progress from this baseline toward the long

- term goal, or maintenance of that level of performance if the State alread y has reached its long

- term goal. RSA enter s the short

- term goals into rows “d,” “g,” and “j” in e ach table. 1 This is the annual go al developed based upon the 2010 Performance data. In rows “e,” “h,” and “k” of both tables, the State’s actual performance on each short

- term goal (rows “e,” “h,” and “k”) will be sy stem generated based on the performance data entered in the annual report.
In rows “f,” “i,” and “l” of each table, the actual performance data from rows e, h, and k will be used to determine the State’s goal status. The status determination will be based on data from the most recent FY and the sy stem will automatically generate “met” goal or goal “not met.” For example, if in row “d” the FY 2012 goal is 87%, and in row “e” the actual performance for FY 2008 is 85%, row “f” will reflect that the goal was “not met”. RSA will provide instructions and deadl ines for addressing measurable goal information on an annual b asis. Once entered, the long

- term and short

- term goals onl y can be modified upon appeal to RSA.
**29 .**  **Name of Certifying Representative for the Lead Agency. 30**  **. Title of Cer**  **tifying Representative for the Lead Agency. 31**  **. Signed.**  **32 .**  **Date Signed.**1820

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98 

### Appendix Classification of Devices (Adapted from Annual Report Instructions)

**1. Vision** 
**Definition:** Products designed to assist with vision **Decision rules:** Products int ended 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. Produ cts in this category

characteristicall y provide output of information through large print/display , sy

nthetic 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 s ys tems to accommodate vision are classified here while similar sy stems to accommodate learning are classified accordingl y. A TTY with Braille output is classified as hearing. A telephone with both a large print key pad and amplification for listening may be classified in either vision or hearing. **Examples:**

 Magnifiers including CCTV sy stems

 Talking scales, blood pressure gauge, glucometer etc.

 Screen readers, screen magnifiers and Braille display s

 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 sy stems; talking thermostats, household appliances etc.1820

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99 

### 2. **Hearing Definition:**  Products designed t o 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 applicat ion 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 indi vidual 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 orde r for his/her speech to be heard b y persons who are deaf or hard of hearing. This category

also includes sy stems that provide for text communication, both via telecommunication (text messaging; TTY) and face to face (Interpret ype). Peripherals designed t o 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 s ystems (heari ng aids, PocketTalker Pro, etc.)

 Assistive L istening S ys tems (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

- l ine 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 Sy stem

 iCommunicator (Voice to text sy stem)

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

 InterpreTy

pe dual key

board s ys tem1820

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100 

### 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 are 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. I f the purpose of the amplifier is to enhance the volume of speech produced b y an individual w ithout 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 s ys tems; carrying cases, switch or mouth stick used for access) are counted in this category

. **Examples:**

 Speech generating devices such as BIGMack, DV4, ChatPC, Dy naWrite, Pathfinder, talking photo album

 Communication boards/books

 Software with speech output (e.g. Speaking Dy namically Pro)

 Software that provides s ymbol sets for use in developing “low tech” communication boards/books or “high tech” overlay s (e.g., BoardMaker, Picture This!)

 Artificial lary

nx

 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 aids1820

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101 

### 4. **Learning, Cognition, and Developmental Definition:**  Products to provide people with disabil ities with access to educational materials and instruction in school or other environments; products that assist with learning, and cognition. **Common subcategories:** Cognitive aids Earl y intervention aids Instructional materials Memory Aids General Persona l 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 i ndividuals 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. **Examples:**

 Calculators and measurement tools

 Clocks/Timers/Wake

- up Sy stems

 Electronic Reference Tools and Money Management Tools

 Memory

Aids

 Electronic Notakers, Portable Word Processers, and Recording Devices

 Electronic Organizers/Personal Digital Assistants

 Scientific Equipment

 Educational/Instruc tional Software (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 s ys tems (WYNN, Read and Write Gold, e tc.

– not related to vision)

 FM sy stems (to support auditory processing

- not related to hearing loss)1820

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102 

### 5. Mobility **, Seating, and Positioning Definition:**  Products whose main focus is on augmenting or replacing the functional limitations of an individu al’s mobility **Decision rules:** Wheelchair restraints associated with seating & positioning (shoulder or safet y belts) are classified in this category

. Wheelchair restraints (tie downs: 4

- belt & docking or lock downs: trailer

hitch) associated van locks that allow a power chair user to drive and/or be transported safel y is classified under “Vehicle Modification and Transportation.” **Examples:**

 Ambulatory

aids: low tech aids such as canes, walkers or crutches; also includes orthotics & prosthetics

 Wheel chairs: 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 b ased on postural control & deformity management, pressure & postural management, and/or comfort & postural accommodation (such as pelvic guides, contoured seating s ys tems, head supports)1820

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103 

### 6. **Dail y**  **Liv ing**  **Definition:** Devices that enhance the capacit y of p eople with disabilities to live independentl y, especially AT that assists with Instrumental and other Activities of Daily

L iving, (ADLs, IADLs) such as dressing, personal hygiene, bathing, home maintenance, cooking, eating, shopping and managing money

. **Co mmon 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 cognit ive, vision, or hearing AT) Telephon y equipment
**Decision rules:** Architectural/home adaptations or modifications are classified under Environmental adaptations. L ife safet y devices and sy stems that do not involve home modifications are categorized here. D evices 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 multip le 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. **Examples:**

 Writing guides, adapted writing implements

 Modified or large

- handled tools and utensils

 Eating/feeding equipment, spiked cutting board, jar opener

 Zipper pulls, button h ooks, needle threader

 Personal pager, multi

- sensing/multi

- sensory alerting devices

 Wheelchair desks/tray s

 Reacher

 Wheelchair/walker bag

 Switch

- adapted food processor or other appliance

 Large

- button telephone (not for vision or cognitive accommodation).1820

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104 

### 7
**. Environmental A**  **daptations Definition:**  Environmental and structural adaptations to the built environment that remove or reduce barriers and promote access to and within the built home, employ ment and community

facilities for individuals with disabilitie s. 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 t yp icall y 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 be gener ally be classified under Mobility , Seating, and Positioning. Items or structures that are portable or temporary , rather than permanent or semi

- permanent, would generally be classified in another category related to the functional limitation address. For example, shower chairs, commodes, raised toilet seats and similar portable items should be classified in the dail y 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

S ys tems

 Cabinetry

and Storage equipment

 Door/Gate Openers

 Environmental controls and switches (i.e., electronic sy stems that enable people to control various appliances, lights, telephones, securit y s ys tems etc.)

 Flooring and Surface materials/Detectable warning surfaces

 General Environmental Access Products

 Lifts

 Li ghting/light ing controls

 Ramps

 Signage/signaling products

 Workstations/Desks/Tables, Home

- workplace adaptations1820

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105 

### 8. **Vehicle Modification and Transportation Definition:**  Products that give people with disabilities independence and enhance safety

in transportation thro ugh 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. **Examp les:** 

 Adaptive shoulder and seat safet y 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.1820

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106 

### 9. **Computers and Rela ted**  **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 key boards, switches activated by pressure, touch screens, special software, voice to text software **Common subcategories: 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 key

boards and pointing devices

 S witches and scanning software used for computer access

 Touchscreens

 Voice recognition sy stems1820

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107 

### 10. **Recreation, Sports, and Leisure Equipment Definition:**  Products not alread y classified in other categories that help persons with disabilities to participate in sport, health, phy sical education, recreation, leisure, and dance events. **Common subcategories:**

 Toy s 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 specificall y 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 sy stem controls (e.g. television remote) are classified according to their primary use. **Examples:**

 Switch

- adapted to ys and games

 Te nnis wheelchairs; beach wheelchairs

 Skiing equipment; sled/sledge hockey equipment

 Gardening tools and equipment

 Playing card shuffler

 Adapted camera and other photograph y equipment

 Adaptive exercise equipment (not used in a rehabilitation setting)

 Ada ptive equipment for fishing, hunting, and camping

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

 Entertainment sy stem remote control not used for lights, heat or other environmental control