1



## Title III **Al ternativ**  **e Financing Program Data Collection**

**Instrument and Instructions**2 **Rehabilitation Services Administration**

**Annual Report for**  **Alternative Financing Programs Public Reporting Burden**  OMB # 1820 - 0662 Expires: 06/30/2011 Paperwork Burden Statement According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless su ch collection displays a valid OMB control number. Public reporting burden for th is collection of information is estimated to average 27 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 under Title III of the Assistive Technology Act of 1998 to retain benefit of the Alternative Financing Program. Send comments regarding the burden estimate or any other aspect of this collection of in formation, 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 - 0662. Note: Please do not return the completed Title III Alternative Financing Program Data Collection Instrument and Instructions application to this address. **This document was prepared by the A ssociation of Assistive Technology A**  **ct Programs ( AT**  **AP )** 

**unde r U.S. Department of Education**  **Grant No. H224B060002**3

Instructions for completion of this form and relevant definitions are contained in this document

**.** Throughout the reporting form, terms for which a definition is available are indicated with an ast erisk (*).4 

### Table of Contents
A. General Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 B. Background, General Instructions and Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 1. Reporting Period 2. Aggregate Data 3. L oan Activities That Occur Across More than One Reporting Period 4. Definitions C. AFP Required Data Elements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 1. Number, Result, And Geographic Distribution of L oan Applications 2. Information about Loans Made 3. Ty pe of Device Financed through the Program 4. Defaults and Net Losses 5. Classification of Consumers Receiving Assistance D. Anecdote . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0 E. Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 0 F. Classification of Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1 1. Vision 2. Hearing 3. Speech Communi cation 4. L earning, Cognition, and Developmental 5. Mobility , Seating and Positioning 6. Daily L iving 7. Environmental Adaptations and Home Modifications 8. Vehicle Modifications and Transportation 9. Computers and Related 10. Recreation, Sports, and Leisure Equipment5



## A. General Information **General Information : Alternative Financing Program (AFP)**  1. State and Name of AFP **Lead Agency** 1. Agency Name 2. Agency Contact 3. Mailing Address 4. Mailing Address (continued) 5. City 6. State 7. Zip Code 8. Phone 9. F ax 10. Program URL 11. Program E - mail 12. Program Toll - free Number 13. Program TTY Number **Community -**  **Based Organization (CBO)** 1. Name of Community - Based Organization 2. Name of AFP Director/Loan Fund Manager 3. Mailing Address 4. Mailing Address (continued) 5. City 6. S tate 7. Zip Code 8. Phone 9. Fax 10. Program URL 11. Program E - mail 12. Program Toll - free Number 13. Program TTY Number **Lending Institution** (see option below to add additional lending institution partners) 1. Name of Lending Institution 2. Contact at Lending Institut ion 3. Mailing Address 4. Mailing Address (continued) 5. City 6. State 7. Zip Code 8. Phone 9. Fax 10. Program URL **Report Submission** 1. Some or all of the data reported in this information 

### □ Yes6

collection instrument is also used as part of data on State Financing Activi ties in the Annual Report for State Grant for Assistive Technology Programs. 

### □ No 2. To the best of my knowledge and belief, by submitting this report we are attesting that all data in this performance report are true and correct and the report fully discloses all known weaknesses concerning accuracy, reliability, and c ompleteness of the data. 3. Date Form Submitted (mm/dd/yy) 4. Name of Lead Agency Representative Submitting Report 5. Mailing Address 6. City 7. State 8. Zip Code 9. Phone 10. Fax 11. Email 

### □ If the AFP has more than one lending institution as a partner click here to display additional forms to record the contact/general information for additional lending institutions/partners. You can add up to a total of 5 lending institutions/partners.7



## B. Background, General Instructions, and Definitions This document contai ns information needed for completing the AFP Annual Report required by the Rehabilitation Services Administration (RSA) under title III of the Assistive Technology Act of 1998 as in effect prior to the amendments of 2004 (AT Act of 1998). This annual repo rt is designed to provide RSA with the data necessary for program planning and reporting to Congress, the Secretary

of Education and other entities. In formation from individual states will be available to the public once the information is completed b y the state and submitted to and approved by RSA. Questions regarding potential uses of the information submitted by individual states should be directed to Robert Groenendaal, Program Specialist, RSA, U.S. Department of Education, 400 Mary land Avenue, SW, P CP Room 5019, Washington, DC 20202 - 2800, Robert.Groenendaal@ed.gov, 202 - 245 - 7393. Many individuals and organizations contributed to the development of this data collection sy stem, including a workgroup representing AFPs and Statewide Assistive Technolog y Programs, and the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). The workgroup’s discussions and input framed issues, developed solutions, provided perspective on implementation and refined this document. Working with RSA, the Association of Assistive Technology Act Programs (ATAP) developed this AFP data collection instrument under Grant No. H224B060002. 

### 1. **Reporting Period** The reporting period is the federal fiscal year, which begins on October 1 of each ye ar and ends on the following September 30. 

### 2. Aggregate Data You do not provide data on individual loans. Individual loan data and records should be retained at the program level and will not be requested by RSA for the purposes of this data collection. All data is provided in the aggregate and represents the total for the reporting period. 

### 3. Loan Activities That Occur Across More than One Reporting Period It is possible for an AFP to receive a loan application during one reporting period, but no t process that application to a conclusion until the following reporting period. Do not split yo ur data across reporting periods. If an application is received during reporting period “A” but the decision about that application is not made until the foll owing reporting period “B,”8

report **all** data related to that application during reporting period “B” onl y. The same logic should be applied to data on any activities that can cross two reporting periods. 

### 4 **. Definitions** On subsequent pages, many terms w ith meanings specific to this instrument are used. Definitions for these terms are provided throughout these instructions. Once defined in this document, the term retains the same meaning throughout. Key terms to know before proceeding are: a. 

### Partnersh **ip loan:** A loan administered b y and using dollars from a source other than the AFP, usuall y a financial entity, for which the AFP has an investment through interest or principal bu y - down, loan guarantee (see next definition), agreement with a financial ins titution based on an investment deposit, or other financial/administrative role. b. 

### Loan guarantee or insurance: The AFP uses its funds to guarantee all or a portion of loans for AT. A guaranteed loan is a partnership loan in which the AFP guarantees that th e loan to a consumer is secure and will be repaid in the event of a default, thus increasing the lender’s willingness to loan funds.

c. 

### Revolving loan fund (or revolving loan): A loan fund that directly uses funds from the “permanent separate account” ( ti tle III funds plus match dollars plus interest paid/ accrued) for loans. The AFP directly provides the funds that are to be loaned out and retains full control over to whom and at what terms the funds are loaned. As loans are repaid, the money is lent out again to other AT consumers

— that is, the same money

“revolves” out to other borrowers as earlier borrowers return it to the program.9



## C **. AFP Required Data Elements All AFPs are**  **required to**  **provide the data requested in C items 1**  **- 8 and E. See**  **General Instructions in Section B for information on reporting on activities that**  **cross over reporting periods.** 

### 1. **Num ber, Result, and Geographic Distribution of Loan Applications**  **Number and Result of Loan Application of Loan Applications** Here you will provide data on the number of applications y ou received, what resulted from those applications and the geographic distribution of the applicants. In this section, report on all loan applications that were processed to one of the three decisions shown in the table belo w (i.e., approved

— loan made, approved

— loan not made, or loan application rejected) during this reporting period. **“** Approved - loan not made” includes loan applications that were approved but not accepted by the consumer and loans that were withdrawn b y the consumer after review. “Loan application rejected” does not mean that the AFP did not process and review the application; it means that the application was fully processed and reviewed but a loan was denied to the consumer. Report on all loan application s including (1) revolving loans* that are made directl y b y the AFP; and (2) partnership loans* that use dollars from another source, usually a financial institution, in which the AFP has an investment through loan guarantee, agreement with a financial ins titution based on an investment deposit, interest or principal buy - down, or other financial or administrative role . Do not include loans in which the AFP had no financial or administrative role, such as loans for which you simply made a referral to anothe r funding or lending source. Do not include applications that were not reviewed because they were not complete, were withdrawn before a final decision was made, or were still pending at the end of the reporting period. As explained in the general instruct ions, report on applications even if the application was received prior to the start of the reporting period, but was processed to a decision or approved during this reporting period. **Geographic Distribution of Loan Applications** In this section, report on geographic distribution of the applicant for a loan during the reporting period. Report only one applicant per loan. Choose the primary applicant in the event of multiple applicants for a loan. States have various methods for classifying an applicant by

the area of the state where he or she resides. For the purposes of national data collection, a single method for designating the area where an applicant resides must be used by all grantees. This data collection will classify applicants by

Rural Urb an Continuum Codes (RUCCs).10

To use RUCCs, y ou must ascertain the count y of residence of the applicant. Once you know the county

where the applicant resides, y ou can determine the RUCC for that county . The 2003 RUCCs form a classification scheme that dis tinguishes metropolitan counties by size and non - metropolitan counties by degree of urbanization and proximity to metro areas. 1 The standard Office of Management and Budget (OMB) metro and non - metro categories have been subdivided into three metro and si x non - metro categories, resulting in a nine part count y codification as follows:
 1 - Counties in metro areas of one million population or more  2 - Counties in metro areas of 250,000 to one million population  3 - Counties in metro areas of fewer than 250 ,000 population  4 - Urban population of 20,000 or more, adjacent to a metro area  5 - Urban population of 20,000 or more, not adjacent to a metro area  6 - Urban population of 2,500 to 19,999, adjacent to a metro area  7 - Urban population of 2,500 to 19, 999, not adjacent to a metro area  8 - Completely

rural or less than 2,500 urban population, adjacent to a metro area  9 - Completely

rural or less than 2,500 urban population, not adjacent to a metro area For purposes of this data collection, these ni ne codes are combined into two levels:
 Codes 1 - 3 are considered “metro”  Codes 4 - 9 are considered “non - metro” When required b y this instrument, AFPs will categorize individuals into one of these two groups based on the RUCC for their county . Finding the RUCC for an y county is done in the following manner: 1) Go to the following Web site: US Department of Agriculture, Economic Research Service Site : http://www.ers.usda.gov/Data/Rural UrbanContinuumCodes/2003/ This site allows y ou to view all the counties in yo ur state, at the same time, in a table format. In addition, the USDA provides a link to a downloadable version of the county codes in excel format which will enable you to pull the information and manipulate it for your use. http://www.ers.usda.gov/data/RuralUrbanContinuumCodes/ Scroll down to the Data Files Section and click on the option “ Download the 2003 codes in an Excel file ” 2) Select the appropriate state from the map or listing of states that appears below the map. 1 For complete information about Rural Urban Continuum Codes, visit the following Web site: http://www.ers.usda.gov/briefing/Rurality/RuralUrbCon/11 3) A list of all counties in the selected state will appear. The 2003 RUCC is the fourth column from the left. AFPs are responsible for tallying how man y direct users fall into each grouping of RUCC and providing the final number in the appropriate area of the data collection instrument. **EXAMPLE** : For the program that had six loan applications during the reporting period:

 Person A lives in a county with a RUCC of 2  Person B lives in a county with a RUCC of 4  Pers on C lives in a county with a RUCC of 8  Person D lives in a county with a RUCC of 6  Person E lives in a county with a RUCC of 9  Person F lives in a county with a RUCC of 3 **The Geographic Distribution totals for the six loan applications depicted in the ex** **ample result in the following example:**

**Number of A pplications**  **Area of Residence Total**  **Me tro**  **RUCC 1 -**  **3** In the example, persons A &F would be included in this RUCC **Non -**  **Me tro**  **RUCC 4 -**  **9** In the example, persons B,C,D, & E would be included in this RUCC A. Appr oved

— loan made 1 (person A) 2 (persons B and C) System - generated B. Approved

— loan not ma de* (i.e., the application was withdrawn after the loan was approved, or the loan was approved but not accepted by the consumer) 0 1 (person D) System - generated

C. Re jected 1 (person F) 1 (person E) System - generated D. Total System - generated System - generated System - generated **Number, Result, and Geographic Distribution of Loan Applications**

**Number of A pplications**  **Area of Residence Total**  **Me tro**  **RUCC 1 -**  **3 Non**  **- Me**  **tro RUCC**  **4 -**  **9** A. Approved

— loan made System - generated B. Approved

— loan not made* (i.e., the application was withdrawn after the loan was approved, or the loan was approved but not accepted by the consumer) System - generated
C. Rejected System - generated D. Total System - generated System - generated System - generated12



### 2. Inform **ation about Loans Made** Nationally , man y different kinds of alternative financing mechanisms are available because AFPs offer different t ypes of loans to consumers; some individual AFPs m ay offer several ty pes of loans. Here y ou will provide data on the ty pes of loans y ou offer and the number of loans of each ty

pe y ou provided during this reporting period. The difference between partnership loans and revolving loans was previously explai ned. Within partnership loans and revolving loans, other ty pes of loans include: 

### Loan guarantee or insurance: A partnership loan in which the AFP uses its funds to guarantee all or a portion of a loan for AT. A guaranteed loan is a partnership loan in which the AFP guarantees that the loan to a consumer is secure and will be repaid in the event of a default, thus increasing the lender’s willingness to loan funds. 

### Low**- interest loans:**  In a low - interest loan, the AFP establishes an agreement with a lend ing institution to provide loans for AT at “preferred” interest rates. Preferred interest rates are highly

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 by which AFPs arrange for lending institutions to provide low - interest loans for AT are variable, but t ypically include a requirement that the AFP deposit its funds with the lending institution. The interest that the AFP’s fund s would normally generate is then used by

the lending institution to supplement the interest it charges consumers on loans for AT, thus resulting in lower interest rates paid by the consumers. The reporting form collects data on two ty pes of low - interest loans: (a) low interest loans at or below prime rate and (b) preferred interest loans. For both loan ty pes, use the prime rate at the time the loan was provided. Both loans are defined as follows: **a. Low -**  **interest loan (at or below prime rate*):** 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 bel ow for a definition of prime rate. 

### Interest buy**- down loan:**  A partnership loan in which AFP funds are used to buy down the interest rate of a loan. The AFP uses funds to reduce the interest rate that lending institutions offer to consumers for loans to p urchase AT. The AFP pay s the lending institution for a portion of the interest on the loan, resulting in lower interest pay ments for the consumer over the term of the loan. 

### Prim **e Rate:** The prime rate is the average majority prime rate charged by banks on short - term loans to business, quoted on an investment basis. The Federal Reserve defines a bank prime loan as follows: “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 rates13

used by banks to price short - term business loans." To determine whether a loan was made above, at, or below prime rate, check the U.S. prime rate at the following website for the date on which the loan was closed: http://www.federalreserve.gov/releases/h15/update/ **a) Type of Loans, Number, and Percentage** Enter the number of loans made in this reporting period, by loan ty pe. The sy stem will calculate the percentage of loans that fall into each category . The total number of loans must match the number of applications “approved

– loan made” in the previous table, so report each loan in onl y one category .

**Type of Loan Number**  **of Loans Percentage** 

**of Loans Revolving Loan**  ***** Revolving Loan: Low Interest (prime or less) System -generated Revolving Loan: Preferred Interest (greater than prime) System -generated **Total Revolving Loans** System -generated System -generated **Partnersh ip Loan** * **Low Interest (prime or less)*** Without interest buy - down* or loan guarantee* System -generated With interest buy - down* only System -generated With loan guarantee* only System -generated With both interest buy - down* and loan guarantee* System -generated **Preferred Interest (greater than prime)** * Without interest buy - down* or loan guarantee* System -generated With interest buy - down* only System -generated With loan guarantee* only System -generated With both interest b uy - down* and loan guarantee* System -generated **Total Partnership Loans** System -generated System -generated **Total All Loans** System -generated System -generated **b) Type of Loans and Amount Financed** Enter the dollar value of both Revolving Lo ans* and Partnership Loans*. **Type of Loan Number of Loans**  **Dollar Value of Loans** Revolving Loans* System -generated Partnership Loans* System -generated Total System -generated System -generated14

**c) Range of Dollar Amounts of Loans Provided** In the tabl e below, enter how many loans were made within the range of dollar amounts shown below. This is the dollar amount of the entire loan, not the dollar amount divided among different devices if more than one device was purchased. The total number of loans must match the number of loans in the “Total” row of the preceding table. The s ys tem will calculate the percentage of the amount of the loans made to individuals.

**d) Highest and Lowest Loan Amounts** Unlike the data you may have reported under the option section at the beginning of this instrument, these are the actual highest and lowest loan amounts provided for the reporting period, not a description of y our policies. Enter the highest and lowest dollar amounts of loans provided during this reporting period: Highest $_________ Lowest $ _________ **e) Highest and Lowest Interest Rates**  Enter the lowest and highest interest rates among all loans made, including both revolving* and partnership loans.* For interest buy - downs,* report the interest rate to which y ou bought the loan down: Lowest: ______________% Highest: ______________%

**Number and Percentage of Loans Made to Applicants in the Amount of**  **$1,000 or**  **L ess**  **$1,001**

**to $5,000**  **$5,001**

**to $10,000**  **$10,001**

**to $15,000**  **$15,001**

**to $20,000**  **$20,001**

**to $25,000**  **$25,001**

**to $50,000**  **$50,001**

**or More Total**  **Number of loans**  System generated **Percent of**  **Loans** System generated System generated System generated System generated System generated System generated System generated System generated System generated15



### 3. Type of Device Financed through the Program Loans are provided for many different kinds of AT devices. Here y ou will report on how many devices were funded by

y our loans during the reporting period, what categories of devic es were funded, and how much funding was provided for devices in those categories. There are a total of 1 0 categories for classifying devices:  Vision  Hearing  Speech communication  Learning, cognition, and developmental  Mobility , seating, and positioning  Da ily living  Environmental adaptations  Vehicle modification and transportation  Computers and related  Recreation, sports, and leisure Definitions for each of the Categories of AT can be found in Section G: Classification of Devices. The Classification of Dev ices includes a description, decision rules, and examples that will assist you in deciding whether a device should go into a particular category . Many devices can fit into more than one category depending on how they

are used b y a consumer. You must ch oose one category where a device belongs in each instance you are reporting and may

not count a device more than once. For example, y our AFP may provide one loan to one consumer for one computer. Though this computer may be classified in many of the ten categories, it must be counted only once and placed in one category in this circumstance. This does not mean a computer must alway s go into the same category every time a loan for a computer is provided, however. When it is not immediately obvious in whi ch category

y ou should classify

a device, y ou should classify it based on the functional need that is served b y the “assistive” aspect of the device. For example, while telephones are used for communication, not all telephones are immediately

categorize d in speech communication. A telephone could be classified in different categories, depending on the functional needs of the user. When the primary challenge is seeing the dial, a large button phone would be classified under Vision. When the primary cha llenge is hearing another person on the phone, an amplified phone would be classified under Hearing. When the primary challenge is having one’s speech understood on the phone, an adapted phone would be classified under Speech Communication. When the prim ary challenge involves another function (or multiple functions) the phone would be classified under Dail y Li ving. A component of a larger sy stem should be classified according to the function or primary use of the larger s ys tem. For example, a mouth st ick that is used to provide access to a communication sy stem such as Pathfinder would be classified under Speech Communication. A mouth stick that is used to ty pe papers would be classified under Computer Access. A mouth stick that is used generically as an aid to daily

living would be classified as Dail y Living.16

Services are classified according to the AT category associated with the service. For example, an audiological evaluation would be classified under Hearing. **a) Types and Dollar Amounts of AT Fi nanced**  Use the table below to provide information on the ty pes of devices or services financed and the **dollar value of loans made for each type of device or service** . Because a single loan may pay for more than one device or service, the number of devices and services reported in this table may exceed the number of loans. The total number of devices financed may be different than the total number of direct users of AT as reported in the Tables on Age, Gender and Underrepresented. When multiple devices fa ll into different categories of Ty pe of AT Device or Service are acquired with a single loan, the number of devices or services should be reflected in the appropriate “Number of Devices Financed” Category and an approximation of the loan amount used to acq

uire that Device or Service should be recorded in the associated category for “Dollar Value of Loans.” For large building access projects, the numbers reported should reflect a logical access grouping (e.g., a bathroom modification or exterior ramping o f a house would each be one Environmental Adaptation/Home Modification). Where an AT service (such as an evaluation or training) was part of a financial loan, include that dollar amount in the appropriate AT category

associated with the service (e.g., an audiological evaluation would go in the “hearing” category). **Type of AT Device/Service Number of**  **Devices Financed Dollar Value** 

**of Loans** Vision* Hearing* Speech communication* Learning, cognition, and developmental* Mobility , seating and positioning* Daily living* Environmental adaptations and home modifications* Vehicle modification and transportation* Computers and related* Recreation, sports, and leisure* **Total** System -generated System -generated17



### 4. Defaults and Net **Losses** Most AFPs have their own policies for when they declare a loan to be in default. For the purposes of national data collection, one definition of default must be applied to all programs. An AFP can continue to use its own definition of default f or its own purposes, but under the AFP data collection instrument, a default is defined as follows: 

### Default: A loan is in default, on or before 120 days in which the borrower has not made the scheduled payment for the balance still owed; or at which time the organization administering the loan paid the lending institution the remaining agreed upon balance of loan. Do not count an y payments that may have been made b y the loan administering organization on behalf of the borrower during that 120 - day period. All loans that meet the above definition must be reported in this data collection. Here you will report on y our default rate and net dollar losses for the reporting period. To do so, you must include y our active loans, which are defined as follows: 

### A **ctive loan:** A loan for which a borrower owes money and is still actively making pay ments (i.e., the loan has not been paid in full by the borrower or otherwise “closed” due to default) no matter when they originated. For the purposes of providing data on defaults and net losses, active loans are only those loans in which the AFP or their designated affiliate/partner could incur direct losses, such as revolving loans or guaranteed loans. Do not count loans in which the AFP or their designated affiliate/par

tner does not have a financial responsibility to pay the bank in case of default, such as loan balances for low interest loans, preferred interest loans, or buy - down interest rate loans that are not guaranteed. The default rate* in the following tables i s reported only for revolving and guarant y loans, those for which the organization administering the loan can incur a financial loss in the case of default. **a) Number of Loans in Default and Default Rate** In the table below, enter the number of loans that w ere in default* during this reporting period. In the second column, enter the number of active loans* as of the last day of this reporting period. The system will calculate the percentage of loans in default for your program, which is your default rate. **Number of Loans in Default Number of**  **Active Loans Default Rate**  System - generated When a loan defaults, there often (but not alway s) is a net dollar loss. For this data collection, a net dollar loss is defined as: 

### Net Dollar Loss: The amount lost as a result of default during this reporting period after subtracting an y funds that were recovered. It includes the amount that is unpaid on18

any loans in default and any

loan guarantee pay out amounts minus the amount of collateral recovered. Total dollar value of active loans means the unpaid amount of guarant y or revolving loan balance the loan administering organization is responsible for paying in case of a default at the end of the reporting period of all active loans, no matter when they

originated. **b) Net Dollar Loss on Defaulted Loans** In the table below, enter the net dollar loss on loans that were in default during this reporting period. Net dollar loss on loans means the amount lost as a result of default* during this reporting period after sub tracting any funds that were recovered. It includes the amount that is unpaid on any loans in default* and any loan guarantee payout amounts minus the amount of collateral recovered. Total dollar value of active loans means the unpaid amount of guarant y or revolving loan balance the organization administering the loan is responsible for paying in case of a default at the end of the reporting period of all active loans*, no matter when they originated. The sy stem will calculate the net loss rate* for your program. **Net Dollar Loss on Loans Total Dollar Value of**  **Active Loans*** **Net Loss Rate** System - generated 

### 5. Classification of Consum **ers Receiving Assistance** Here you will provide data about the consumers who received loans from your AFP during th is reporting period. The data should be provided only for the direct user of the AT, not the individual to whom the loan was provided (in some cases these are the same person, but often they are not). 

### Direct User: A direct user is an individual that uses an AT Device or Service that provides a direct benefit or impact to the individual. A secondary user or beneficiary

is a person who benefits from the user having an AT Device or Service. For example, if a family acquired a modified van for two children th at are wheelchair users, both children would be considered direct users, but the parents of the children would be considered the secondary users or beneficiaries. Although a secondary user or beneficiary may benefit from the direct user having an AT devic e or service, for the data below, yo u must report on the direct user onl y. **a) Gender** Enter the total number of direct users * of AT benefiting from a loan for a device or service by gender - female or male. If multiple persons are direct users* of the AT p rovided b y a single loan, the gender for each direct user* should be reported.19 **Gender of Direct User(s)** * **Number** Female Male Total System - generated **b) Age** Enter the total number of direct users * of AT benefiting from a loan for a device or service by

the age range distribution. If multiple persons are direct users* of the AT provided b y a single loan, the age for each direct user* should be reported. Programs should report the actual age of the direct user(s) at the time the loan was made. **Age of Direct Users**  *** of AT Number**  0 - 9 10 - 17 18 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80+ Total System - generated* **c) Type of Disability** In this section, report on which of the AT user’s abilities will be affected by the AT they are purchasing d

uring this reporting period. An AT user may be affected in more than one area, therefore the data reported for each user may reflect multiple areas or “Ty pe of Abilities” affected. **Type of Ability Number**  Seeing Hearing Talking/communicating Gett ing around/mobility Handling objects, reaching Learning new information Remembering Interacting with others/socializing **Total** System - generated *The total number of areas affected may exceed the total number of loans and the totals reported for age, gender, and geographic distribution/underrepresented population.20



## D **. Anecdote**  Provide at least one anecdote about a direct user or secondary user or beneficiary

who benefited f

rom an AFP loan.* Please make these entries as specific as possible, and include the following information:

 What AT devic e or service did the user need?  How did y our AFP help the user obtain that device or service?  What barrier(s) did your AFP help the user overcome?  If applicable, how did yo ur AFP collaborate with other e ntities in providing this help?  How did obtaining that device or service improve that user’s life ? Other instructions to follow in providing anecdotes:

 Limit each anecdote to 500 words or less.  In clude examples that are understandable to an uninformed aud ience.  Do not identify

an y users by name or use other details that would allow a user to be identified. Be sure that the example clearl y fits within the appropriate activities supported by the AFP. (Narrative item)



## E **. Notes** Describe an y unique issues that may affect y our data during this reporting period (e.g., if you are unable to provide data due to circumstances beyond the control of the entity submitting the data, you must explain). L imit notes to 500 words or less. (Narrative item)21



## F **. Classification of Devices 1. V**  **ision Definition:**  Products designed to assist with vision. **Decision rules :**  Products intended to facilitate access and participation for people who are blind or visually

impaired are classified in this category , even if they are used for activities of daily living, computer access, reading/learning, way finding/travel, recreation, etc. Products in this category

characteristically

provide output of information through large print/display , sy nthetic speech or Braille/tact ile. 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.22



### 2. Hearing **Definition:** Products designed to assist with hearing. **Decision rules:** Products intended to facilitate access and participation for people who are deaf o r hard of hearing are classified in this category , even if they are used for activities of daily living or could have another application for people with other disabilities or for other functions. Products intended to facilitate telephone usage for indivi duals with hearing disabilities are categorized here, rather than as aids to daily living. If the telephone adaptation is for an individual who is both visually impaired and hearing impaired, categorize under **either** vision or hearing. Products that ampli fy voice are classified here if the purpose is to enhance the volume of speech produced b y an individual without a disability , in order for his/her speech to be heard b y persons who are deaf or hard of hearing. This category also includes sy stems that pro vide for text communication, both via telecommunication (text messaging; TTY) and face to face (Interpret yp e). Peripherals designed to facilitate access or otherwise support the use of a device for hearing (e.g. neck loop induction coils; TeleL ink phone c ouplers; conference microphone; telephone signalers) are counted in this category . **Examples:**  Personal amplification s ystems (hearing 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 d evices (used as portable TTY)  Daily living aids with enhanced audible signals (Sonic Boom Alarm Clock)  Amplified Telephones, in - line amplifiers for telephones, cell phone amplifiers  Text telephones (TTYs), Voice carry over (including CapTel) and Hearing car ry over 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) 

###  Interpr eTy pe dual key

board s ys tem23



### 3. Speech Comm **unication 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 communications 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 i s 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 b y an individual with a disability , in order for his/her speech to be audibl e b y persons without disabilities. I f the purpose of the amplifier is to enhance the volume of speech produced b y an individual without a disability , in order for his/her speech to be heard b y persons who are deaf or hard of hearing, the device is classif ied 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” communicat ion 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 aids24



### 4. Learning, Cognition, and Developm **ental Definition:**  Products to provide people with disabilities with access to educational materials and instruction in academic or other environments; products that assist with learning an d cognition. **Common subcategories:** Cognitive aids Earl y intervention aids Instructional materials Memory Aids General Personal Organization Tools Sensory /Developmental Stimulation Products **Decision rules:** Products intended to mitigate, compensate, or address learning or cognitive limitations should be classified here along with products used to facilitate computer access for individuals with learning/cognitive limitations. Products designed to assist people who are blind or visuall y 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 Notetakers, Portable Wor d Processers, and Recording Devices  Electronic Organizers/Personal Digital Assistants  Scientific Equipment  Educational/Instructional Software ( computer based instructional applications used to teach cause and effect, readin g, language, spelling, math, writ ing, 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, etc.

– not related to vision)  FM sy stems (to support auditory processing - not related to hearing loss)25



### 5. Mobility, Seating, and Positioning **Definition:** Products whose main focus is on augmenting or replacing the functional limitations of an individual’s mobility . **Decision rules:** Wheelchair restraints associated with seat ing & 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, which allow a power chair user to drive and/or be transported safel y is cl assified under “Vehicle Modification and Transportation.” **Examples:**  Ambulatory

aids: low tech aids such as canes, walkers or crutches  O rthotics & prosthetics  Wheelchairs: dependent (such as strollers & transport chairs) & independent manual mobility

(4 - wheels propelled independently)  Scooters and power chairs: Functionally matched motorized independent power mobility bases  Seating and positioning

– considerations based on postural control & deformity management, pressure & postural management, and/or co mfort & postural accommodation. (such as pelvic guides, contoured seating s ys tems, head supports)26



### 6. Daily Living **Definition:** Devices that enhance the capacit y of people with disabilities to live independentl y, especially AT that assists with Instrum ental and other Activities of Daily Living, (ADL s, IADLs) such as dressing, personal hygiene, bathing, home maintenance, cooking, eating, sleeping, breathing, shopping and managing money . **Common Subcategories:** Personal hygiene, care and toileting Dressing and apparel, and aids to dressing Housekeeping, cleaning, maintenance Cooking and eating Handling, reaching, manipulating Alerting and signaling Household management, bill paying (not cognitive, vision, or hearing AT) Telephon y equipment **Decision rules:** Architectural/home adaptations or modifications are classified under Environmental adaptations. L ife safet y and life support devices and s ys tems that do not involve home modifications are categorized here including medical and respiratory equipment . Device s intended to accommodate specific disabilities, such as hearing or vision, are assigned to those categories. Devices that assist with personal organization are classified as Learning, Cognition and Developmental AT. Devices used to accommodate multiple di sabilities 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 inten ded to accommodate other categories of disabilities is listed here. Switches controlling daily living aids or unknown devices are reported here. Otherwise switches are reported with the category of devices controlled. **Examples:**  Writing guides, adapte d writing implements  Modified or large - handled tools and utensils  Eating/feeding equipment, spiked cutting board, jar opener  Zipper pulls, button hooks, needle threader  Personal pager, multi - sensing/multi - sensory alerting devices  Wheelchair desks/tray s  Re acher  Wheelchair/walker bag  Switch - adapted food processor or other appliance  Large - button telephone (not for vision or cognitive accommodation).27



### 7. Environm **ental Adaptations and Home Modifications 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 disabilities. Environmental adaptations usually involve building construction, engineering, and architecture, but also include environmental controls and switches that can control a large portion of or an entire living environment. Environmental adaptations are t ypicall y permanent or semi permanent structures, modifications or additions. **Decision r ules:**  Adaptations or modifications to vehicles are classified under Vehicle modifications. Adaptations to furniture such as chairs, couches, beds, etc., would generall y be classified under Mobility , Seating, and Positioning. Items or structures that are portable or temporary , rather than permanent or semi - permanent, would generall y be classified in another category

related to the functional limitation addressed. For example, shower chairs, commodes, raised toilet seats and similar portable items should be classified in the daily living category

where as a roll in shower, wall or floor mounted grab bars, installed ramps, etc. would be classified here because they become part of the building structure. **Examples:**  Accessible HVAC controls, accessible pl umbing fixtures and controls  Adapted playground equipment and structures  Alarm and Security

S ys tems  Cabinetry

and Storage equipment  Door/Gate Openers including farm and ranch gates/latches  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/lighting controls  Ramps  Signage/signaling products  Work stations/Desks/Tables, Home - workplace adaptations  Adapted farm equipment that is not reported as Vehicle Modification and Transportation such as spray ers, seeding s ys tems, augers, etc.)28



### 8. V **ehicle Modification and Transportation Definition:**  Products that give people with disabilities independence and enhance safet y in transportation through adaptation of vehicles. **Decision rules:** Vehicle ramps are classified in this category . Versatile/portable ramps (temporary

adaptation) and wheelchair lifts (permanently installed in buildings) are classified under Environmental adaptations. **Examples:**  Adaptive shoulder and seat safet y belts  Tie downs and lock downs that secure the wheelchair to the vehicle floor  Hand controls  Extended directional mirrors.

 Vehi cles and vans modified with lifts, ramps, raised roofs, etc.  Adapted farm vehicles such as tractors and other self - propelled vehicles modified with hand controls, GPS, lifts and ramp sy stems.29



### 9. Com **puters and Related Definition:**  Hardware and software products that enable people with disabilities to access, interact with, and use computers at home, work, or school. Includes modified or alternate key boards, switches activated by pressure, touch screens, special software, voice to text software. **D ecision rules:**  Classify standard computers and computer - related devices (those that will be used without an y adaptations) in this category, along with input adaptations used to mitigate, compensate or address motor limitations. Do not include computer ada ptations used to address vision or learning, cognitive or developmental limitations. **Examples:**  Standard software  Standard hardware  Computer accessories

 Alternative key

boards and pointing devices

 Switches and scanning software used for computer access

 Touchscreens

 Voice recognition sy stems30



### 10. Recreation, Sports, and Leisure Equipm **ent 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 ho rticultural 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:**  T oy s and games (includes toy s used for developmental purposes such as teaching cause an d effect.) ;  Tennis 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 rehabilit ation setting);  Adaptive 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.