Data Collection Instrument

Rehabilitation Services Administration

Annual Report for

State Grant for Assistive Technology Programs

Public Reporting Burden

OMB # xxx-xxxx

Expires: xx/xx/xxxx

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is xxx-xxxx. The time required to complete this form is estimated to average 456 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Office of the Chief Financial Officer, U.S. Department of Education, 600 Independence Avenue SW, Washington, D.C. 20202-4248.

This document was prepared by RTI International and the Association of Assistive Technology Act Programs
under grants from the U.S. Department of Education
Grant Nos. H224B030001 and H224B060002

Table of Contents

General Information 3

State Financing 5

Reutilization 18

Device Loans 26

Device Demonstrations 31

Training 37

Technical Assistance 42

Public Awareness and Information and Assistance 46

Coordination and Collaboration Activities 49

State Improvement Outcomes 51

Additional and Leveraged Funds 53

Instructions for completion of this form and relevant definitions are contained
in a separate document, “Instruction Manual and Definitions for the Annual Report for the State Grant for Assistive Technology Program.”

Throughout the reporting form, terms for which a definition is available are indicated with an asterisk (*). Please refer to the “Instructions” for those definitions.

General Information

1. General Information
Statewide AT Program
State and Program Title
Lead Agency
Agency name
Mailing address
City
State
Zip code
Phone
Fax
Program URL
Program E-mail
Program toll-free number
Program TTY number
Implementing Entity
Check here if not applicable. If applicable, complete Items 14–24.
Name of implementing entity
Mailing address
City
State
Zip code
Phone
Fax
Program URL
Program E-mail
Program toll-free number
Program TTY number
Program director and other contacts
Program director(s)
Name of Program Director at Lead Agency (last, first)
Title
Phone
E-mail
Name of Program Director at Implementing Entity (last, first) – If applicable
Title
Phone
E-mail
Person responsible for completing this form If program director, check here. If different, complete Items 29–32.
Name (last, first)
Title
Phone
E-mail
Date form completed (mm/dd/yy)
Certifying representative
Name (last, first)
Title
Phone
E-mail

State Financing

Outline

1. General information

2. Financial loan programs*

1. Loan applications

2. Income of applicants to whom loans were made

3. Loan type

4. Interest rates

5. Types and dollar amounts of AT financed

6. Defaults*

3. State financing activities* that provide consumers with resources and services that result in the acquisition of AT devices and services

1. General information

2. Geographic Distribution, Number of Individuals Who Acquired AT Devices and Services and Number for whom Performance Measure Data are Collected

3. Types and dollar amounts of AT funded

4. Additional activities

4. State financing activities* that allow consumers to obtain AT at reduced cost

1. General information

2. Geographic Distribution and Number of Individuals Served

3. Savings to consumers, by type of AT device/service

4. Additional activities

5. Anecdote

6. Performance measures

7. Customer satisfaction

8. Notes

Section 4f requirements: (1) the type of State financing activities*…used by the State; (2) the amount and type of assistance, including the number of applications for assistance received, the number of applications approved and rejected, the default rate* for the financing activities, range and average interest rate for the financing activities, range and average income of approved applicants for the financing activities, and the types and dollar amounts of AT financed; (3) consumers of the State financing activities*, who shall be classified by type of AT device or service and geographical distribution

A state financing activity* is an activity approved as part of your State Plan for AT, such as the development of systems: to provide and pay for AT, for the purchase, lease, or other acquisition of, or payment for AT; or of State-financed or privately financed alternative financing systems of subsidies.

Examples of state financing activities* include, but are not limited to administering financial loan programs,* administering “last resort” funds* with non-AT Act dollars, administering cooperative buying programs,* administering telecommunications distribution programs,* administering non-financial loan programs that provide home modifications,* and other activities designed to provide consumers with resources and services that result in the acquisition of AT devices and services.

1. General Information

Did your statewide AT program conduct any state financing activities* during the reporting period?

Drop-down box: (1) yes; (2) no, statewide AT program exercised state flexibility;* (3) no, statewide AT program claimed comparability;* (4) no, statewide AT program is developing an activity not yet implemented (include feasibility studies* here)

(Respondents who choose “1” will receive balance of section.)

(If “2,” “3,” or “4” to Item 1) The state financing section of the reporting form includes the subsections listed below. If you would like to view a read-only version of the entire state financing section, or any of the subsections, please check the appropriate box(es). If, after reviewing the read-only version, you decide to enter data in any part of the state financing section, you will need to change your response in Item 1 to “Yes.”

□ View entire state financing section

□ View subsection—Financial loan programs

□ View subsection— State financing activities that provide consumers with resources and services that result in the acquisition of AT devices and services

□ View subsection—State financing activities that allow consumers to obtain AT at reduced cost

2. Financial Loan Programs*

Did the statewide AT program conduct a financial loan program* during the reporting period? (A financial loan program* is a program that provides loans for purchase of AT devices and services, for which the statewide AT program can report the number of applications received, approved, and rejected; the default rate*; the range and average interest rate; and the range and average income of approved applicants. Do not report Access to Telework funds* here; report that activity in Section C.

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will receive balance of section.)

1. Loan Applications

In this section, report on: (1) revolving loans* that are made directly by the Statewide AT Program; and (2) partnership loans* that use dollars from another source, usually a financial institution, in which the statewide AT program has an investment through loan guarantee, agreement with a financial institution based on an investment deposit, interest or principal buy-down, or other financial or administrative role. Do not include loans in which the statewide AT program had no financial or administrative role, such as loans for which you simply made a referral to a lending source.

In the table below, report information on loan applications made by Rural Urban Continuum Code (RUCC) of the applicant’s county of residence and the decisions made about those applications. Include all applications that were processed to one of the three decisions shown in the table below (i.e., approved—loan not made, approved—loan made, or rejected) during this reporting period, even if the application was received prior to the start of the reporting period. 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.

For guidance on how to classify the applicant’s area of residence as metro or non-metro, please see the “General Instructions.”

Number of Applications	Area of Residence		Total
	Metro RUCC 1-3	Non-Metro RUCC 4-9
Approved—loan made			System-generated
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
Rejected			System-generated
Total	System-generated	System-generated	System-generated

2. Income of Applicants to Whom Loans Were Made

This section collects data about the income of applicants to whom loans were made (i.e., those who were counted in row Aof the table in Section B, Item 1above). For purposes of this section, the income of these applicants is the gross annual income that the applicants reported on the loan applications (i.e., the amount upon which the decision about the loan was based). This may be the income of the individual, the family, and/or one or more co-borrowers.

1. Enter the lowest and highest income reported among all applicants to whom loans were made during the reporting period:

Lowest: $______________

Highest: $______________

2. Use the table below to calculate the average gross annual income of applicants to whom loans were made. In Column A, enter the sum of the incomes reported by all applicants to whom loans were made. The system will divide that amount by the number of applicants to whom loans were made (as reported in row Aof the table in Section B, Item 1above to calculate the average income.

   A	B	C
   Sum of Incomes	Number of Applicants to Whom Loans Were Made	Average Gross Annual Income
   $	System-generated	System-generated

3. In the table below, enter the number of loans made to applicants who reported incomes in each of the specified ranges. The total number of loans should match the number you reported in row Aof the table in Section B, Item 1above. The system will calculate the percentage of loans made to individuals in each income category.

	Number and Percentage of Loans Made to Applicants with Incomes of						Total
	$15,000 or Less	$15,001 to $20,000	$20,001 to $25,000	$25,001 to $30,000	$30,001 to $35,000	$35,001 or More
Number of loans							System-generated
Percentage of loans	System-generated	System-generated	System-generated	System-generated	System-generated	System-generated	System-generated

(System will generate an error message if total number of loans does not match number reported in row Aof the table in Section B, Item 1above.)

3. Loan Type

a. Enter the number of partnership loans* by loan type. Any row left blank will automatically count the number of loans as zero. The system will calculate the percentage of loans that fall into each category. For guidance on how to categorize partnership loans,* refer to the instructions. Report each loan in only one category.

Type of Loan	Number of Loans	Percentage of Loans
Revolving Loan		System-generated
Loan guarantee* (no special interest rate)		System-generated
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 buy-down* and loan guarantee*		System-generated
Other (specify)		System-generated
Total	System-generated	System-generated

(System will generate an error message if total number of loans does not match number reported in row A of the table in Section B, Item 1above.)

b. Enter the dollar value of both partnership loans* and revolving loans.* The number of loans in each category will automatically populate based on the table in 3(a). Report each loan in only one category.

Type of Loan	Number of Loans	Dollar Value of Loans
Revolving loans*	System-generated	$
Partnership loans*	System-generated	$
Total	System-generated	System-generated

4. Interest Rates

1. 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 you bought the loan down:

Lowest: ______________%

Highest: ______________%

2. Use the table below to calculate the average interest rate for all loans, including both revolving* and partnership loans.* Enter the sum of interest rates for all loans in Column A. The system will divide that amount by the number of loans made as previously reported and automatically populated in row A to calculate the average interest rate.

   A	B	C
   Sum of Interest Rates	Number of Loans Made	Average Interest Rate
   	System-generated	System-generated

3. In the table below, enter the number of loans made at interest rates in each of the specified ranges. The total number of loans should match the number you reported in row A of the table in Section B, Item 1above.

Number of Loans Made at Interest Rates of								Total Number of Loans
0-2.0%	2.1–4.0%	4.1–6.0%	6.1–8.0%	8.1-10%	10.1-12%	12.1-14%	14+%
								System-generated

(System will generate an error message if total number of loans does not match number automatically populated as the total based on previous reported data.)

5. Types and Dollar Amounts of AT Financed

Use the table below to provide information on the types of devices or services financed and the dollar value of loans made for each type of device or service. Report each device or service in only one category. For guidance on how to classify devices and services, and decision rules for devices and services that could be classified in more than one way, refer to the General Instructions.

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. However, the total dollar value of loans should be the same as reported previously. You previously reported a total dollar value of $ (system-generated).

For large building access projects, the numbers reported should reflect a logical access grouping (e.g., a bathroom modification or exterior ramping of a house would each be one home modification). Where an AT service (such as an evaluation) 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
Vehicle modification and transportation
Computers and related
Recreation, sports, and leisure
Other (specify)
Total	System-generated	$ System-generated

(System will generate an error message if total dollar value of loans does not match amount reported in the Total Dollar Value of Revolving Loans and Partnership Loans calculated in Item 3(b) above.)

6. Defaults* and Net Losses for Revolving and Guaranteed Financial Loans

The default rate* in the following tables is reported only for revolving and guaranty loans, those for which the loan administering organization can incur a financial loss in the case of default.

a. In the table below, enter the number of loans that were in default* during this reporting period. A loan is in default*, on or before, 120 days in which the borrower has not made the schedule payment for the balance still owed; or at which time the organization administering the loan paid the lending institution the remaining agreed upon balance of loan. Do not count any payments that may have been made by the loan administering organization on behalf of the borrower during that 120-day period as payments made by the borrower. (Rescue payments do not count as borrower payments and the 120 day clock continues). 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.

Number of Loans in Default	Number of Active Loans	Percentage of Loans in Default
		System-generated

b. In the table below, enter the net dollar loss on defaulted loans to determine the default rate. The default rate* is the net dollar loss on loans divided by the total dollar value of active loans. Net dollar loss on loans means the amount lost as a result of default* during this reporting period after subtracting 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 percentage of guaranty 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.

Only count loan balances in which the Statewide AT Program or their designated affiliate/partner provides direct loans such as revolving loans, or guaranteed loans for which the loan program could incur losses. Do not count loan balances in which the Statewide AT Program or their designated affiliate/partner 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 system will calculate the default rate* for your program.

Net Dollar Loss on Loans	Total Dollar Value of Active Loans*	Default rate*
		System-generated

3. State Financing Activities* that Provide Consumers with resources and services that result in the acquisition of AT devices and services

1. General Information

a. Did the statewide AT program conduct another state financing activity that provides consumers with access to funds for the purchase of AT devices and services?

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will receive balance of section.)

(If “Yes” to Item 1) Complete section (b) for that activity. If you have more than one activity to report, you will need to complete this section more than once. After you have completed your first entry, you will be given an opportunity to repeat this section in order to report additional activities.

b. Which of the following describes this state financing activity?

Drop-down box: (1) Access to Telework Funds;* (2)“last resort” activity;* (3) financing for home modifications;* (4) telecommunications distribution;* (5) other (specify)

2. Geographic Distribution, Number of Individuals Who Acquired AT Devices and Services and Number for whom Performance Measure Data are Collected

In this table, report the number of individuals who acquired AT devices and services through this activity, by the Rural Urban Continuum Code (RUCC) for the county in which they reside. For guidance on how to find a county’s RUCC, please see the “General Instructions.”

Of the recipients of AT devices and service, identify the number for whom performance measure data can be reported. This may be all of the recipients or may be fewer if the Statewide AT Program is administering a program (using external funding to purchase/provide the AT) on behalf of an entity that has responsibility for providing AT devices and services. The performance measure data questions are not answerable by such entities. While the number of individuals served by such programs should be reported here and in #3 below, performance measure data should not be collected for those individuals. See the instructions “Who To Survey” for more information.

County of Residence	Number of Individuals Served	Number of Individuals Included in Performance Measures (see required exclusion above)
A.Metro (RUCC 1-3)
B.Non-Metro (RUCC 4-9)
C. Total	i System-generated	ii

3. Types and Dollar Amounts of AT Funded

Use the table below to provide information on the number of devices or services funded and the amount of funding provided, by type of AT device/service. Report each device or service in only one category. For guidance on how to classify devices and services, and decision rules for devices and services that could be classified in more than one way, refer to the General Instructions.

For large building access projects, the numbers reported should reflect a logical access grouping (e.g., a bathroom modification or exterior ramping of a house would each be one home modification). Where funding was provided for an AT service (such as an evaluation), 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 Funded	Value of AT Provided
Vision		$
Hearing		$
Speech communication		$
Learning, cognition, and developmental		$
Mobility, seating and positioning equipment		$
Daily living		$
Environmental adaptations		$
Vehicle modification and transportation		$
Computers and related		$
Recreation, sports, and leisure		$
Other (specify)		$
Total	System-generated	$ System-generated

4. Additional Activities

Do you have additional activities to report in this section? If so, select “yes” and the system will repeat this section. If you select “no,” it will take you to the next section of the reporting form.

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will repeat this section.)

4. State Financing Activities* that Allow Consumers to Obtain AT at Reduced Cost

1. General Information

a. Did the statewide AT program conduct an activity that allows consumers to obtain AT at reduced cost?

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will receive balance of section.)

(If “Yes” to Item 1) Complete this section for that activity. If you have more than one activity to report, you will need to complete this section more than once. After you have completed your first entry, you will be given an opportunity to repeat this section in order to report additional activities.

b. Which of the following describes this state financing activity?

Drop-down box: (1) cooperative buying activity; (2) other (specify)

2. Geographic Distribution and Number of Individuals Served

In this table, report the number of individuals who acquired AT devices and services through this activity, by the Rural Urban Continuum Code (RUCC) for the county in which they reside. For guidance on how to find a county’s RUCC, please see the “General Instructions.”

Of the recipients of AT devices and service, identify the number for whom performance measure data can be reported. This may be all of the recipients or may be fewer if the recipients of the cost savings are entities that have responsibility for providing AT devices and services regardless of cost. The performance measure data questions are not answerable by such entities. While the number of individuals served by such programs should be reported here and in #3 below, performance measure data should not be collected for those individuals. See the instructions “Who To Survey” for more information.

County of Residence	Number of Individuals Served	Number of Individuals Included in Performance Measures (see required exclusion above)
A.Metro (RUCC 1-3)
B.Non-Metro (RUCC 4-9)
C.Total	i. System-generated	ii

3. Savings to Consumers, by Type of AT Device/Service

Use the table below to provide information on the number of devices or services provided to consumers and the savings to consumers resulting from this activity, by type of AT device or service. Report each device or service in only one category. For guidance on how to classify devices and services, and decision rules for devices and services that could be classified in more than one way, refer to the General Instructions.

For each type of AT device, enter the total estimated current purchase price of the devices and the total amount for which devices were sold. The system will calculate the resulting savings to consumers. Use the Manufacturer’s Suggested Retail Price (MSRP) to determine the current purchase price of the device. If you are unable to find the exact price for a particular item, use the value of a comparable device. Using estimates is acceptable when exact pricing is not available. If the device was given away, use a sale price of zero in your calculations.

For large building access projects, the numbers reported should reflect a logical access grouping (e.g., a bathroom modification or exterior ramping of a house would each be one home modification). Where funding was provided for an AT service (such as an evaluation), 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 Provided	Total Estimated Current Retail Purchase Price	Total Price for Which Devices Were Sold	Savings to Consumers
Vision				System-generated
Hearing				System-generated
Speech communication				System-generated
Learning, cognition, and developmental				System-generated
Mobility, seating and positioning				System-generated
Daily living				System-generated
Environmental adaptations				System-generated
Vehicle modification and transportation				System-generated
Computers and related				System-generated
Recreation, sports, and leisure				System-generated
Other (specify)				System-generated
Total	System-generated	System-generated	System-generated	System-generated

4. Additional Activities

Do you have additional activities to report in this section? If so, select “yes” and the system will repeat this section. If you select “no,” it will take you to the next section of the reporting form.

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will repeat this section.)

5. Anecdote

Provide at least one anecdote about an individual who benefited from a state financing activity.* For guidance on information to include in the anecdote, please see the “General Instructions.”

(Narrative item)

6. Performance Measures

State financing activities* are covered by the Acquisition Performance Measure. To collect data for this measure, statewide AT programs will collect follow-up information from consumers. Use data from those surveys to complete the table below. Refer to the “General Instructions” for guidance on how to categorize the primary purpose for which AT devices/service are needed.

The total number of customers surveyed should equal the sum of the following:

• the number of individuals to whom financial loans were made, as reported in Section B.1.A,

• the number of individuals served by other state financing activities who are included in performance measures as reported in Sections C.2.C.ii and D.2.C.ii.

Response	Primary Purpose for Which AT is Needed			Total
	Education	Employment	Community Living
1. Could only afford the AT through the statewide AT program (n,d)
2. AT was only available through the statewide AT program (n,d)
3. AT was available through other programs, but the system was too complex or the wait time was too long (n,d)
4. Subtotal	System-generated	System-generated	System-generated
5. None of the above (d)
6. Subtotal	System-generated	System-generated	System-generated
7. Nonrespondent (d)
8. Total	System-generated	System-generated	System-generated	System-generated
9. Performance on this measure	System-generated	System-generated	System-generated

NOTES: Items marked (n) are included in numerator. Items marked (d) are included in denominator.

Nonrespondents are included in the denominator for calculation of performance.

(System will generate an error message if total reported in column at far right does not equal total reported in Sections B.1.A plus C.2.C.ii plus D.2.C.ii )

7. Customer Satisfaction

Use data from customer surveys (which include an item about satisfaction) to complete the table below for all customers served by state financing activities.*

Customer Rating of Services	Number of Customers	Percent
Highly satisfied		System-generated
Satisfied		System-generated
Satisfied somewhat		System-generated
Not at all satisfied		System-generated
Nonrespondent		System-generated
Total	System-generated
Response rate	System-generated

(System will generate an error message if total does not equal total reported in Sections B.1.A plus C.2.C.i plus D.2.C.i )

8. Notes

Describe any unique issues that may affect your data in this section (e.g., types of devices/services that may not be financed because they are financed by other programs).

(Narrative item)

Reutilization

Outline

1. General information

2. Number of recipients of reutilized devices

3. Device exchange activities

4. Device Recycling/Refurbishment/Repair Activities

5. Open-ended loans

6. Anecdote

7. Performance measures

8. Customer satisfaction

9. Notes

Section 4f requirement: the number, type, estimated value, and scope of assistive technology devices exchanged, repaired, recycled, or reutilized (including redistributed through device sales, loans, rentals, or donations) through the device reutilization activities, and an analysis of the individuals with disabilities that have benefited from the device reutilization activities

Device reutilization includes device exchange activities* and device recycle/refurbish/repair activities.* It also includes open-ended device loans in which the borrower can keep the device for as long as it is needed, because these loans are considered a form of “acquisition.”

Device exchange activities* are those in which devices are listed in a “want ad”-type posting and consumers can contact and arrange to obtain the device (either by purchasing it or obtaining it for free) from the current owner. Exchange activities do not involve warehousing inventory and do not include repair, sanitation, or refurbishing of used devices. In some cases, a Statewide AT Program serves as an intermediary directly involved in making this exchange, in others the consumer and current owner make this exchange without the involvement of the Statewide AT Program. Data on device exchange may be difficult to gather if your program does not serve as an intermediary directly involved in the exchange.

Device recycle/refurbish/repair activities* are those in which devices are accepted (usually by donation) into an inventory; are repaired, sanitized, and/or refurbished as needed; and then offered for sale, loan, rental, or give away to consumers as recycled products. Repair of devices for an individual (without the ownership of the device changing hands) should be reported as device recycling.

1. General Information

Did your statewide AT program conduct device reutilization activities* during the reporting period?

Drop-down box: (1) yes; (2) no, statewide AT program exercised state flexibility;*
(3) no, statewide AT program claimed comparability;* (4) no, statewide AT program is developing activity not yet implemented

(Respondents who choose “1” will receive balance of section.)

(If “2,” “3,” or “4” to Item 1) If you would like to view a read-only version of the entire device reutilization section please check the box below. If, after reviewing the read-only version, you decide to enter data in any part of the device reutilization section, you will need to change your response in Item 1 to “Yes.”

□ View device reutilization section.

2. Number of Recipients of Reutilized Devices

In this table, report the number of recipients of devices through device exchange,* recycling/ refurbishment/repair activities,* and open-ended loans.

In the table below, report on the number of individuals who receive devices through a reutilization program. There are two reasons for which the number of individuals receiving devices through reutilization may not match the number included for Performance Measures.

1. Given the fact that many device exchange programs have little direct contact with device buyers, it may not be possible to collect information sufficient to include these individuals in the performance measures. Therefore, in the performance measures you only should count those individuals for whom you can collect sufficient follow-up information.

2. Some organizations that have an obligation to provide AT may provide it via reutilization. For example, a school has an obligation to provide an AT device identified in a child’s IEP- the school may obtain the device through the reutilization program. In these cases, the performance measure data questions are not answerable by such entities because the issue of affordability or availability are not allowable reasons to limit access to AT that has been identified as appropriate and needed to meet educational goals. You should exclude from the performance measures device recipients who acquire reutilized devices under these circumstances.

Activity	Number of Individuals Receiving a Device from Activity	Number of Individuals Included in Performance Measure
Device exchange
Recycling/refurbishment/repair
Open-ended loans
Total	i System-generated	ii System generated

3. Device Exchange Activities

Indicate in column one (yes or no response) if devices in each category were made available to consumers of your program through your device exchange program during the reporting period. Enter the total number of devices exchanged (listed by one individual/entity and obtained by another) during the reporting period, by AT type. For each type of AT device, enter the total estimated current purchase price of the devices and the total amount for which the devices were exchanged. To report a device as “exchanged” you must have documentation of the price for which it was sold or exchanged. Use the Manufacturer’s Suggested Retail Price (MSRP) to determine the current purchase price of the device. If you are unable to find the exact price for a particular item, use the value of a comparable device. Using estimates is acceptable when exact pricing information is not available. If the device was given away, use a sale price of zero in your calculations. The system will calculate the resulting savings to consumers in the last column.

Type of AT Device	Are devices in this category included in your listing?	Number of Devices Exchanged	Total Estimated Current Purchase Price	Total Price for Which Device(s) Were Exchanged	Savings to Consumers
Vision	Y/N				System-generated
Hearing	Y/N				System-generated
Speech communication	Y/N				System-generated
Learning, cognition and developmental	Y/N				System-generated
Mobility, seating and positioning	Y/N				System-generated
Daily living	Y/N				System-generated
Environmental adaptations	Y/N				System-generated
Vehicle modification and transportation	Y/N				System-generated
Computers and related	Y/N				System-generated
Recreation, sports and leisure	Y/N				System-generated
Other (specify)					System-generated
Total		System-generated	System-generated	System-generated	System-generated

4. Device Recycling/Refurbishment/Repair Activities

Indicate in column one (yes or no response) if devices in each category were recycled, refurbished, repaired or otherwise made available to consumers of your program during the reporting period. Enter the total number of devices recycled/refurbished/repaired and acquired by an end user during the reporting period, by type. You will not report devices provided on open-ended loans here. For devices provided in open-ended loans, see section E.

For each type of AT device acquired by an end user, enter the total estimated current purchase price of the devices and the total price for which the devices were sold. The system will calculate the resulting savings to consumers. Use the Manufacturer’s Suggested Retail Price (MSRP) to determine the current purchase price of the device. If you are unable to find the exact price for a particular item, use the value of a comparable device. Using estimates is acceptable when exact pricing information is not available. If the device was given away, use a sale price of zero in your calculations.

Type of AT Device	Are devices in this category included in your program(s) ?	Number of Devices Recycled/ Refurbished/Repaired	Total Estimated Current Purchase Price	Total Price for Which Devices Were Sold	Savings to Consumers
Vision	Y/N				System-generated
Hearing	Y/N				System-generated
Speech communication	Y/N				System-generated
Learning, cognition and developmental	Y/N				System-generated
Mobility, seating and positioning	Y/N				System-generated
Daily living	Y/N				System-generated
Environmental adaptations	Y/N				System-generated
Vehicle modification and transportation	Y/N				System-generated
Computers and related	Y/N				System-generated
Recreation, sports and leisure	Y/N				System-generated
Other (specify)					System-generated
Total		System-generated	System-generated	System-generated	System-generated

5. Open-Ended Loans

Indicate in column one (yes or no response) if devices in each category were made available to consumers of your program through open-ended loans during the reporting period. Enter the total number of devices loaned in open-ended loans during the reporting period, by type. For each type of AT device, enter the total estimated current purchase price of the devices and the cost to the consumer for the loan, if applicable. If there was no charge to the consumer, use a cost to the consumer of zero in your calculations. The system will calculate the resulting savings to consumers. Use the Manufacturer’s Suggested Retail Price (MSRP) to determine the current purchase price of the device. If you are unable to find the exact price for a particular item, use the value of a comparable device. Using estimates is acceptable when exact pricing information is not available.

Type of AT Device	Are devices in this category included in your program(s) ?	Number of Devices on Long-Term Loan	Total Estimated Current Purchase Price	Cost to Consumer for the Loan	Savings to Consumers
Vision	Y/N				System-generated
Hearing	Y/N				System-generated
Speech communication	Y/N				System-generated
Learning, cognition and developmental	Y/N				System-generated
Mobility, seating and positioning	Y/N				System-generated
Daily living	Y/N				System-generated
Environmental adaptations	Y/N				System-generated
Vehicle modification and transportation	Y/N				System-generated
Computers and related	Y/N				System-generated
Recreation, sports and leisure	Y/N				System-generated
Other (specify)					System-generated
Total		System-generated	System-generated	System-generated	System-generated

6. Anecdote

Provide at least one anecdote about an individual who benefited from a reutilization activity.* For guidance on information to include in the anecdote, please see the “General Instructions.”

(Narrative item)

7. Performance Measures

Device reutilization activities* are covered by Performance Measure 2 (acquisition). To collect data for this measure, statewide AT programs will conduct customer surveys. Use data from those surveys to complete the tables below. Refer to the “General Instructions” for guidance on how to categorize the primary purpose for which AT devices/services are needed.

Performance measure for exchange, recycling/refurbishment/repair* and open-ended device loan activities should be reported in the table below. The number of customers surveyed should equal the total number reported in the second column (ii) of the table from Item B.

Response	Primary Purpose for Which AT is Needed			Total
	Education	Employment	Community Living
1. Could only afford the AT through the statewide AT program (n,d)
2. AT was only available through the statewide AT program (n,d)
3. AT was available through other programs, but the system was too complex or the wait time was too long (n,d)
4. Subtotal	System-generated	System-generated	System-generated
5. None of the above (d)
6. Subtotal	System-generated	System-generated	System-generated
7. Nonrespondent (d)
8. Total	System-generated	System-generated	System-generated	System-generated
9. Performance on this measure	System-generated	System-generated	System-generated

NOTES: Items marked (n) are included in numerator. Items marked (d) are included in denominator.

Nonrespondents are included in the denominator for calculation of performance.

8. Customer Satisfaction

Use data from customer surveys (which include an item about satisfaction) to complete the table below for all customers served by device reutilization activities.* Customer satisfaction surveys from sellers as well as buyers may be included here.

Customer Rating of Services	Number of Customers	Percent
Highly satisfied		System-generated
Satisfied		System-generated
Satisfied somewhat		System-generated
Not at all satisfied		System-generated
Nonrespondent		System-generated
Total surveyed	System-generated
Response rate	System-generated

(System will generate an error message if total surveyed is not equal to the number of device reutilization reported in Item B(i).

9. Notes

Describe any unique issues that may affect your data in this section (e.g., types of devices that are not reutilized because they are available from another source). If you have a device exchange program, please describe your data collection method, any challenges with collecting these data, and plans for overcoming those challenges.

(Narrative item)

Device Loans

Outline

1. General information

2. Short-Term Device Loans by Type of Purpose

3. Number of Device Loans by Type of Borrower

4. Length of short-term device loans

5. Types of devices loaned

6. Anecdote

7. Performance measures

8. Customer satisfaction

9. Notes

Section 4f requirement: the number, type, and length of time of loans of assistive technology devices provided to individuals with disabilities, employers, public agencies, or public accommodations through the device loan program…and an analysis of individuals with disabilities who have benefited from the device loan program

Statewide AT programs provide short-term loans of AT devices to individuals or entities. The purpose of the loan may be to assist in decision making, to serve as a loaner while the consumer is waiting for device repair or funding, to provide an accommodation on a short-term basis, 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 year begins); (2) self-education by an intermediary (e.g., a teacher) whose purpose is to become familiar with the device; and (3) training. Only loans for the purpose of decision-making should be included in the performance measures.

In this section, report only on short-term loans in which devices are loaned for a limited or prescribed amount of time that is determined by your statewide AT program.

In this section, do not report open-ended device loans, in which the device borrower* can keep the device for as long as it is needed. Report these loans under “Device Reutilization.”

1. General Information

Did your statewide AT program conduct short-term device loans* during the reporting period?

Drop-down box: (1) yes; (2) no, statewide AT program exercised state flexibility;*
(3) no, statewide AT program claimed comparability;* (4) statewide AT program is developing an activity not yet implemented

(Respondents who choose “1” will receive balance of section.)

(If “2,” “3,” or “4” to Item 1) If you would like to view a read-only version of the entire device loan section please check the box below. If, after reviewing the read-only version, you decide to enter data in any part of the device loan section, you will need to change your response in Item 1 to “Yes.”

□ View device loan section.

2. Short-Term Device Loans by Type of Purpose

In this section, report the total number of short-term device loans* made during the reporting period. A loan (counted as one) is defined as an occasion on which a device or devices were borrowed by an individual/entity who will use the device --

a) to make a decision (one decision) based on data, judgments, and other relevant information gained from trial use of the device in a natural environment,

b) as a loaner during device repair or while waiting for funding (no decision is involved),

c) to provide an accommodation (no decision is involved), or

d) for some other purpose that does not involve a decision.

The number of short-term device loans will equal the number of borrowers reported in C, as each individual or entity borrowing will be classified by type. The number of loans will NOT necessarily equal the number of devices borrowed as reported in E as there may be multiple devices borrowed within a single loan.

Use the following guidelines to determine the number of short-term device loans* made:

If the same individual or entity borrows devices on more than one occasion during the reporting period, count each occasion as a separate loan if a separate decision will be made.

If you extend the period of a short-term device loan, count that as a separate loan only if (1) the extension is for a different purpose than the original loan and a separate decision will be made; or (2) the borrower is an “intermediary” borrowing on behalf of others (e.g., a teacher), and the intermediary is requesting an extension to accommodate a second “end user” (i.e., an individual other than the one for whom the loan was initially made) and a second decision will be made.

Report the number of short-term device loans* made by primary purpose of the loan. Count each loan in only one category, even if the loan included multiple devices. If at least one device included in the loan was obtained for the purpose of decision-making, report the loan in Row A. Please see the instructions at the top of this section for what activities are included in “Other.”

Primary Purpose of Short-Term Device Loan	Number of Loans
A. Assist in decision making (device trial or evaluation)	Performance Measure
B. Serve as loaner during device repair or while waiting for funding
C. Provide an accommodation on a short-term basis
D. Other
Total	System-generated

3. Number of Device Loans by Type of Borrower

In this section, report the number of device loans by type of borrowers,* by type of individual or entity. The total number of device borrowers* should equal the total number of short-term device loans reported in Item B. You should minimize your use of “other” to the greatest extent possible.

Type of Individual or Entity	Number of Device Borrowers
Individuals with disabilities
Family members, guardians, and authorized representatives
Representatives of Education
Representatives of Employment
Representatives of Health, allied health, and rehabilitation
Representatives of Community Living
Representatives of Technology
Others
Total	System-generated

4. Length of Short-Term Device Loans

What is the usual length of a short-term device loan,* as established by your statewide AT program’s policies? If your program does not have an established policy, enter the average length of short-term device loans.* Please report the length in calendar days.

Usual length of short-term device loan,* in days: (Numeric field)

5. Types of Devices Loaned

Enter the number of devices that were loaned, by type of device, and indicate whether devices in each category were included in your inventory. For guidance on how to categorize devices, refer to the “General Instructions.”

The number of devices loaned may exceed the number of loans reported above in Item B, since a loan may include more than one device.

Type of AT Device	Are devices in this category included in your loan pool?	Number
Vision	Y/N
Hearing	Y/N
Speech communication	Y/N
Learning, cognition, and developmental	Y/N
Mobility, seating and positioning	Y/N
Daily living	Y/N
Environmental adaptations	Y/N
Vehicle modification and transportation	Y/N
Computers and related	Y/N
Recreation, sports, and leisure	Y/N
Other (specify)	Y/N
Total		System-generated

6. Anecdote

Provide at least one anecdote about an individual who benefited from a device loan* activity. For guidance on information to include in the anecdote, please see the “General Instructions.”

(Narrative item)

7. Performance Measures

Device loan* activities are covered by the Performance Measure 1 (access). To collect data for this measure, statewide AT programs will conduct surveys of all customers who obtained device loans* for the purpose of decision-making (i.e., the number reported in Item B. Row A). Use data from those surveys to complete the table below. Refer to the “General Instructions” for guidance on how to categorize the primary purpose for which AT devices/services are needed.

Response	Primary Purpose for Which AT is Needed				Total
	Education	Employment	Community Living	IT/ Tele-communi-cations
1. Decided that an AT device/service will meet needs (n,d)
2. Decided that an AT device/service will not meet needs (n,d)
3. Subtotal	System-generated	System-generated	System-generated	System-generated
4. Have not made a decision (d)
5. Subtotal	System-generated	System-generated	System-generated	System-generated
6. Nonrespondent (d, if > 35%)
7. Total	System-generated	System-generated	System-generated	System-generated	System-generated
8. Performance on this measure	System-generated	System-generated	System-generated	System-generated

NOTES: Items marked (n) are included in numerator. Items marked (d) are included in denominator.

Nonrespondents in excess of 35% are included in the denominator for calculation of performance.

(System will generate an error message if total reported in column on far right does not equal total reported in Item B, Row A.)

8. Customer Satisfaction

Use data from customer surveys (which include an item about satisfaction) to complete the table below for all customers served by device loans.*

Customer Rating of Services	Number of Customers	Percent
Highly satisfied		System-generated
Satisfied		System-generated
Satisfied somewhat		System-generated
Not at all satisfied		System-generated
Nonrespondent		System-generated
Total	System-generated
Response rate	System-generated

9. Notes

Describe any unique issues that may affect your data in this section (e.g., types of devices that are not loaned because those loans are available from another source, or types of devices that are not loaned because your inventory does not include those devices, difficulty obtaining data from intermediaries, etc.)

(Narrative item)

Device Demonstrations

Outline

1. General information

2. Number of Device Demonstrations by Device Type

3. Types of participants

4. Number of referrals

5. Anecdote

6. Performance measures

7. Customer satisfaction

8. Notes

Section 4f requirement: the number and type of device demonstrations and referrals provided and an analysis of individuals with disabilities who have benefited from the demonstrations and referrals

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

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

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

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

As noted in the instructions for this section, a device demonstration referral* is provision of information about a specific source where the customer may obtain additional information or services related to AT. A referral* must provide a consumer with information on how to contact that source directly. Referrals* may be made to funding sources, service providers, vendors, or repair services. Do not include referrals* to other components of your statewide AT program. Report only on referrals* that result from demonstration activities, not referrals made through an information and assistance activities.

1. General Information

Did your statewide AT program conduct device demonstrations* during the reporting period?

Drop-down box: (1) yes; (2) no, statewide AT program exercised state flexibility;*
(3) no, statewide AT program claimed comparability;* (4) no, statewide AT program is developing activity not yet implemented

(Respondents who choose “1” will receive balance of section.)

(If “2,” “3,” or “4” to Item 1) If you would like to view a read-only version of the entire device demonstration section please check the box below. If, after reviewing the read-only version, you decide to enter data in any part of the device demonstration section, you will need to change your response in Item 1 to “Yes.”

□ View device demonstration section.

2. Number of Device Demonstrations by Device Type

In this section, report the number of device demonstrations by type of device/service demonstrated during this reporting period. For guidance on how to categorize devices and services, refer to the “General Instructions.” A device demonstration (counted as one) is defined as an occasion in which one or more devices within a category are demonstrated to an individual or small group who will make a decision (one decision) based on data, judgments, comparisons and other relevant information gained from the interaction with the equipment and demonstrator. The number of device demonstrations will NOT necessarily equal the number of demonstration participants reported in C as there may be multiple participants in a demonstration even though only one decision will be made.

Type of AT Device/Service	Number of Demonstrations of this Type of AT Device/Service
Vision
Hearing
Speech communication
Learning, cognition, and developmental
Mobility, seating and positioning
Daily living
Environmental adaptations
Vehicle modification and transportation
Computers and related
Recreation, sports, and leisure
Other (specify)
Total	System-generated

3. Types of Participants

In the table below, enter the number of individuals who participated in device demonstrations, by type of participant. Include all individuals participating in demonstrations, not just those who are making a decision (or for whom a decision is being made). For guidance on how to categorize participants, refer to the “General Instructions.” Note that the table includes a row for any participants whom you are unable to categorize.

Type of Participant	Number of Participants in Device Demonstrations
Individuals with disabilities
Family members, guardians, and authorized representatives
Representatives of Education
Representatives of Employment
Representatives of Health, allied health, and rehabilitation
Representatives of Community Living
Representatives of Technology
Others
Total	System-generated

D. Number of Referrals

In this section, report the number of referrals* made to each type of entity. Since participants in a demonstration may receive more than one referral,* or may not be referred at all, the number of referrals will may be greater or less than the number of participants and number of demonstrations. Do not include referrals* to other components of your statewide AT program. You should minimize your use of “other” to the greatest extent possible.

Type of Entity	Number of Referrals
Funding source (non-AT program)
Service provider
Vendor
Repair service
Others

5. Anecdote

Provide at least one anecdote about an individual who benefited from a device demonstration activity.* For guidance on information to include in the anecdote, please see the “General Instructions.”

(Narrative item)

5. Performance Measures

Device demonstrations are covered by the Performance Measure 1 (access). To collect data for this measure, statewide AT programs will conduct surveys of the identified decision-maker who participated in demonstrations (as reported in Item B). Use data from those surveys to complete the table below. Refer to the “General Instructions” for guidance on how to categorize the primary purpose for which AT devices/services are needed.

Response	Primary Purpose for Which AT is Needed				Total
	Education	Employment	Community Living	IT/ Telecommuni-cations
1. Decided that an AT device/service will meet needs (n,d)
2. Decided that an AT device/service will not meet needs (n,d)
3. Subtotal	System-generated	System-generated	System-generated	System-generated
4. Have not made a decision (d)
5. Subtotal	System-generated	System-generated	System-generated	System-generated
6. Nonrespondent (d)
7. Total	System-generated	System-generated	System-generated	System-generated
8. Performance on this measure	System-generated	System-generated	System-generated	System-generated

NOTES: Items marked (n) are included in numerator. Items marked (d) are included in denominator.

Nonrespondents are included in the denominator for calculation of performance.

(System will generate an error message if total reported in column on far right does not equal total reported in Item C)

G. Customer Satisfaction

Use data from customer surveys (which include an item about satisfaction) to complete the table below for all customers served by device demonstration.*

Customer Rating of Services	Number of Customers	Percent
Highly satisfied		System-generated
Satisfied		System-generated
Satisfied somewhat		System-generated
Not satisfied		System-generated
Nonrespondent		System-generated
Total	System-generated
Response rate	System-generated

(System will generate an error message if total does not equal total reported in Section F.)

H. Notes

Describe any unique issues that may affect your data in this section (e.g., types of participants that may appear to be underrepresented because they receive demonstration services from another organization, types of devices/services that are not demonstrated because those demonstrations are available from another source, issues related to use of distance education mechanisms to deliver demonstrations, or issues related to dissatisfaction (e.g.; consumer may be dissatisfied because they assumed the AT Program could purchase the device for them)

(Narrative item)

Training

Outline

1. Training participants: Number and types of participants; geographical distribution

2. Training topics

3. Description of training activities

4. Notes

Section 4f requirements:

Training

1. “the number and general characteristics of individuals who participated in training…(such as individuals with disabilities, parents, educators, employers, providers of employment services, health care workers, counselors, other service providers, or vendors)”

2. ”the topics of such training”

3. “to the extent practicable, the geographic distribution of individuals who participated in the training.”

Transition: No explicit reporting requirement in Section 4f, but Section 4e includes requirement that statewide AT programs provide training and technical assistance to assist students with disabilities who receive transition services under IDEA and adults with disabilities maintaining or transitioning to community living. Section e also requires that at least 5% of the money allocated for State Leadership activities be used for transition activities.

The AT Act of 1998, as amended provides a combined description of training* and technical assistance* (see Section-Specific Definitions). Following is guidance on what activities to report in this section and how to distinguish training* activities from public awareness* or technical assistance* activities. Report each activity only once, in the appropriate section.

This section of the reporting form also collects information on training* activities that are related to transition. Information on technical assistance* activities related to transition should be reported in that section of the form. Reminder- each Statewide AT Program must report on at least one transition activity related to school transition (e.g., secondary school to post-school) AND one transition activity related to community living transition (e.g. congregate living to community living). The activity reported may be either a training event or a technical assistance initiative.

Training* activities are instructional events, usually planned in advance for a specific purpose or 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, participants in training* can be individually identified and could complete an evaluation of the training.* Examples of training* include classes, workshops, and presentations that have a goal of increasing skills, knowledge, and competency, as opposed to training intended only to increase general awareness of AT.

Distinguishing Training Activities from Public Awareness Activities

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

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

Distinguishing Training from Technical Assistance

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

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

1. Training Participants: Number and Types of Participants; Geographical Distribution

   1. Enter the number of training participants by type. The participant may self-determine the appropriate descriptor for themselves or such information may be derived from other training event records. Use unable to categorize when no data can be obtained on type of participant.

Type of Participant	Number
Individuals with disabilities
Family members, guardians, and authorized representatives
Representative of Education
Representative of Employment.
Representative of Health, allied health, and rehabilitation
Representative of Community Living
Representative of Technology
Others
Unable to categorize
Total

2. Enter the number of individuals who participated in training,* by the Rural Urban Continuum Code (RUCC) of the participant’s county. For a consumer, you determine the RUCC by the county in which he or she resides. For a representative, you determine the RUCC by the county in which they generally provide services. Those training participants for whom you cannot determine a county should be counted in “Unknown.” For additional guidance on how to find the RUCC for an individual’s county, refer to the “General Instructions.”

Metro (RUCC 1-3)	Non Metro (RUCC 4-9)	Unknown	TOTAL

[The Total in A(2)column four above should equal the Total from the final row of the table in A(1)]

2. Training Topics

Enter the number of participants by the primary purpose of the training.*

Training* topics are organized into categories:

1. AT products and services, which includes subcategories of AT types.

2. AT funding, policy and practice, which includes subcategories of common topics in this category, and space to specify other topics.

3. Information Technology/Telecommunications which includes subcategories of related uses of information technology and telecommunications products.

4. Combination of AT products and services, AT funding, policy and practice and/or IT/Telecommunications. (Use this category only when absolutely necessary.)

5. Transition, including transition from school to work or postsecondary education and transition to community living.

6. Other training topics not included above. Please specify the topics.

Primary Topic of Training	Number of Training Participants
AT Products/Services Training focused on AT: such as instruction to increase skills and competency in using AT, and integrating AT into different settings
2.AT Funding/Policy/ Practice Training focused on funding sources and related laws, policies, and procedures required to implement and deliver access to AT devices/services and related.
3.Information Technology/Telecommunication Access Training focused on accessible information technology and telecommunications including web access, software accessibility, procurement of accessible IT and telecommunications, etc.
4 Combination of any/all of the above -- AT Products/Services, AT Funding/ Policy/Practice and/or IT/Telecommunications Access
5.Transition Training focused on education transition (school to work or post-secondary education and Part C to Part B), community transition (institution to community living) and other transitions.
6 Other Topic (specify)
Total	System generated

[The Total Number of Training Participants above should equal the Total in A(1)and the Total in A(2)]

3. Description of Training Activities

In Item 1 below, describe an innovative or high-impact training* activity that is not related to transition. In Item 2 below, describe a training activity that is related to transition.

1. Briefly describe one innovative or high-impact training* activity conducted during this reporting period. Note who conducted the training* (e.g., type of expertise of staff) and characteristics of the audience (including number that attended). In one sentence, describe the topic, content, and/or approach of the training.* In one sentence, summarize the positive result or intended impact of the training.* Do not include overall descriptions of conferences held, unless the conference had a unique purpose and outcome.

(Narrative item)

2. Briefly describe a training* activity related to transition conducted during this reporting period. Note who conducted the training* (e.g., type of expertise of staff) and characteristics of the audience (including number that attended). In one sentence, describe the topic, content, and/or approach of the training.* In one sentence, summarize the positive result or intended impact of the training.* Do not include overall descriptions of conferences held, unless the conference had a unique purpose and outcome.

(Narrative item)

4. Notes

Describe any unique issues that may affect the data in this section, (e.g., reasons why particular topics or audiences were emphasized or were not included during this reporting period).

(Narrative item)

Technical Assistance

Outline

1. Frequency and nature of technical assistance

2. Description of technical assistance activities

3. Notes

Section 4f requirements:

Technical Assistance

“the frequency of provision and nature of technical assistance provided to State and local agencies and other entities.”

Transition: No explicit reporting requirement in Section 4f, but Section 4e includes requirement that AT programs provide training and technical assistance to assist students with disabilities who receive transition services under IDEA and adults with disabilities maintaining or transitioning to community living. Section e also requires that at least 5% of the money allocated for State Leadership activities be used for transition activities.

The AT Act of 1998, as amended provides a combined description of training* and technical assistance* (see “General Definitions”). Additional descriptions of technical assistance* activities are provided below, along with guidance for distinguishing technical assistance* activities from public awareness* activities and training* activities.

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

Mandatory transition activities that are technical assistance* are reported in this section; mandatory transition activities that are training* are reported in the training* section. Reminder- each Statewide AT Program must report on at least one transition activity related to school transition (e.g., secondary school to post-school) AND one transition activity related to community living transition (e.g. congregate living to community living). The activity reported may be either a training event or a technical assistance initiative.

Distinguishing Technical Assistance from Public Awareness

Technical assistance* may include multiple contacts/interactions over an extended period of time. Less intensive support services, including single-contact requests for information or limited assistance, should be reported under public awareness.* For example, assisting an individual in troubleshooting problems with an AT device should be reported under public awareness.*

Distinguishing Technical Assistance from Training

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

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

Distinguishing Technical Assistance from Information and Assistance

Technical assistance is provided to agencies or other organizations, not to individuals. Intensive support provided to an individual, for example assistance with a particular AT device or policy issue, is reported in Information and Assistance under Public Awareness.

A. Frequency and Nature of Technical Assistance

Complete this section for each major technical assistance* activity that you conducted. If you have more than one activity to report, you will need to complete this section more than once. After you have completed your first entry, you will be given an opportunity to repeat this section in order to report additional activities.

1. Primary description of program or agency receiving technical assistance:* (check one):

Education

Employment

Health, Allied Health, Rehabilitation

Community Living

Technology (Information Technology, Telecommunications, Assistive Technology)

2. For this technical assistance* activity, identify the policy expertise areas and product/service expertise areas that were addressed. If the technical assistance* activity included both policy and product/service expertise, select both.

Note that mandatory transition activities that are technical assistance activities are reported here under product/service expertise. Mandatory transition activities that are training activities are reported in the training section.

Radio buttons for “check all that apply”: (1) policy area; (2) product/service area

(If policy area) Identify the policy areas on which the technical assistance* focused. Choose all that apply.

Radio buttons: (1) ADA/504; (2) IDEA Part C; (3) IDEA Part B; (4) Section 508 and Section 255; (5) WIA/Rehabilitation Act/VR; (6) Medicaid; (7) Medicare; (8) Private insurance; (9) HAVA; (10) Older Americans Act; (11) SSI/SSDI/Work Incentives; (12) Olmstead (13) other (specify)

(If product/service area) Identify the product/service areas on which the technical assistance* focused. Choose all that apply.

Radio buttons: (1) Web accessibility; (2) accessible IT procurement; (3) AT purchasing (cost-effective options);(4) accessible voting systems; (5) AT eligibility determinations; (6) AT personnel development; (7) AT resource allocation; (8) AT service delivery options; (8) AT legislation/policy development; (9) specific AT device assistance; (10) transition–education; (11) transition–community living; (12) other (specify)

3. Duration of technical assistance* during this reporting period:

Drop-down box: (1) less than 3 months; (2) 3 to 5 months; (3) 6 to 8 months;
(4) 9 to 12 months

4. Approximate number of person hours expended by AT program staff to deliver the technical assistance:* (Numeric field)

5. Do you have additional activities to report? If so, select “Yes” and the system will repeat this section. If you select “no,” it will take you to the next section of the reporting form.

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will repeat Items 1 through 5.)

B. Description of Technical Assistance Activities

In Item 1 below, describe an innovative or high-impact technical assistance* activity that is not related to transition. For this item, choose a technical assistance* activity that had an outcome. In Item 2 below, describe a technical assistance* activity that is related to transition. The transition technical assistance activity is not required to have an outcome.

1. Describe in detail one innovative or high-impact technical assistance* activity conducted during this reporting period. Note who provided the technical assistance* (e.g., type of expertise of staff) and characteristics of the recipient agency. In two sentences: (1) describe the topic, content, and/or approach of the technical assistance;* and (2) summarize the positive result or impact of the technical assistance.*

   (Narrative item)

   
   

   
   

   
   

   
   

2. Briefly describe one technical assistance* activity related to transition conducted during this reporting period. Note who provided the technical assistance* (e.g., type of expertise of staff) and characteristics of the recipient agency. In two sentences: (1) describe the topic, content, and/or approach of the technical assistance;* and (2) summarize the positive result or impact of the technical assistance.*

(Narrative item)

C. Notes

Describe any unique issues with data in this section (e.g., reasons why particular topics or audiences were emphasized or were not included during this reporting period).

(Narrative item)

Public Awareness and Information and Assistance

Outline

1. Public awareness activities

2. Information and Assistance

3. Notes

Section 4f requirement: “the number of individuals assisted through the public awareness activities and statewide information and referral system”

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. Actual numbers of information recipients are often difficult to know for certain, but should be reported when known, and in other cases estimated as accurately as possible. Public awareness* activities should be described, as accurately as possible, in Part A of this section.

Information and assistance includes provision of information and supports to individuals and provision of referrals to other entities. All of these activities may be provided in person, over the telephone, via email, or other effective communication mechanism

Distinguishing Information and Assistance from Device Demonstration Referral

In this section, report only on referrals resulting from information dissemination activities, such as calls to a 1-800 number or e-mails. Referrals resulting from device demonstrations* should be reported under device demonstrations.*

Distinguishing Public Awareness from Training

The intended outcome of an activity should determine whether it is reported under public awareness* or training.* Include presentations made for the purpose of general awareness under public awareness.* Do not include training* sessions with the intended outcome of participants applying new knowledge or skills in addressing AT device/service issues (which should be reported under training).*

1. Public Awareness Activities

In this section report on public awareness* activities intended to reach a wide audience. In the table below enter the known or estimated number of individuals reached during the reporting period by each type of public awareness* activity.

Public Awareness Activity	Estimated Number of Individuals Reached
Newsletters
Other print materials
Listservs
Internet information
PSA/radio/TV
Presentations/expos/conferences*
Other
Total

*Include only presentations made for the purpose of general awareness. Training sessions with the intended outcome of participants applying new knowledge or skills in addressing AT device/service issues should be counted as a training activity.

2. Information and Assistance

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

In the table below report the number of individuals to whom you provided information and assistance services by type of individual or entity (see instructions for classification system explanation) and by the content of the information and assistance provided. For the content of the I&A provided, differentiate between

• Information and assistance about specific AT products, devices, or services, or selecting an AT product, device, or service;

• Information and assistance for assistance in obtaining funding for AT; and

• Information and assistance for other related disability topics, such as: locating an interpreter; responding to questions about IDEA that are not AT related or assisting an individual access personal attendant services when no AT is involved.

To the extent practicable each unique request for information and assistance should be counted only once.

Types of Recipients of Information and Assistance	AT Device/ Service	AT Funding	Related Disability Topics	Total
Individuals with disabilities				System-generated
Family members, guardians, and authorized representatives				System-generated
Representative of Education				System-generated
Representative of Employment				System-generated
Representative of Health, Allied Health, and Rehabilitation				System-generated
Representative of Community Living				System-generated
Representative of Technology				System-generated
Others				System-generated
Total	System-generated	System-generated	System-generated	System-generated

3. Notes

Describe any unique issues with your data in this section.

(Narrative item)

Coordination and Collaboration Activities

Outline

1. State Level

2. State Leadership

Section 4f requirements: None

Section (4)(e)(3)(B)(iii) requires that “The State shall coordinate activities described in paragraph (2) and this paragraph, among public and private entities that are responsible for policies, procedures, or funding for the provision of assistive technology devices and assistive technology services to individuals with disabilities, service providers, and others to improve access to assistive technology devices and assistive technology services for individuals with disabilities of all ages in the State.”

Provide the following information on your most significant coordination and collaboration as related to AT LEAST one state level activity and AT LEAST one state leadership activity. You may report on coordination and collaboration for every state level and state leadership activity if you so desire. If you have a Title III grant for an alternative financing program, do NOT report the mandatory roles of your community based organization or financial institution in operation of your financial loan program as coordination and collaboration. If you opted for comparability for one of the state-level activities, but work with the administering entity of the “Comparable Program” do NOT report such efforts under Coordination and Collaboration.

A. State Level

1. Identify the State Level activity for which you are reporting coordination and collaboration. (check one)

Ο State Financing

Ο Reutilization

Ο Demonstration

Ο Device Loan

2. What was the intended result of the coordination and collaboration? (check one)

Ο Establish a new program or service

Ο Expand a program or service to serve more individuals

(e.g. expand geographically or include a group not previously served)

Ο Eliminate duplicative programs or services

3. With whom did you primarily coordinate and collaborate? (check one entity type)

Ο Education

Ο Employment

Ο Health, Allied Health, Rehabilitation

Ο Community Living

Ο Technology (Information Technology, Telecommunications, Assistive Technology)

4. In three or four sentences, describe the collaboration and coordination including whether you achieved the result intended. (Narrative)

5. Do you want to report on coordination and collaboration for another State Level activity?

Yes/No (If yes, you will be given the opportunity to repeat this section but the already selected state level activity will not be available in the pick list in A.)

B. State Leadership

1. Identify the State Leadership activity for which you are reporting coordination and collaboration. (check one)

Ο Training

Ο Technical Assistance

Ο Public Awareness and Information and Assistance

2. What was the intended result of the coordination and collaboration? (check one)

Ο Establish a new program or service

Ο Expand a program or service to serve more individuals (e.g. expand geographically or include a group not previously served)

Ο Eliminate duplicative programs or services

3. With whom did you primarily coordinate and collaborate? (check one entity type)

Ο Education

Ο Employment

Ο Health, Allied Health, Rehabilitation

Ο Community Living

Ο Technology (Information Technology, Telecommunications, Assistive Technology)

4. In three or four sentences, describe the collaboration and coordination including whether you achieved the result intended. (Narrative)

5. Do you want to report on coordination and collaboration for another State Leadership activity?

Yes/No (If yes, you will be given the opportunity to repeat this section but the already selected state leadership activity will not be available in the pick list in A.)

State Improvement Outcomes

Outline

1. General information

2. State improvement outcomes

It is understood and expected that AT Programs will coordinate and collaborate with other public and private entities in terms of receiving referrals, sharing information, serving on advisory board, etc. and will provide technical assistance to a variety of agencies and entities throughout the reporting period. Outcomes of state improvements initiatives include policy, practice or procedure improvements beyond those associated with or already reported in previous state-level and state leadership coordination and collaboration sections.

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

1. General Information

Do you have state improvement outcomes* to report? (For example, you may have worked with your state Information Technology Office to implement an Executive Order related to web accessibility or may have worked with your Medicaid office to streamline procedures for obtaining wheeled mobility devices.)

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will receive balance of section.)

(If “2” to Item 1) If you would like to view a read-only version of the entire “additional outcomes of state improvement initiatives” section please check the box below. If, after reviewing the read-only version, you decide to enter data in any part of the device reutilization section, you will need to change your response in Item 1 to “Yes.”

□ View “additional outcomes of state improvement initiatives” section

2. State Improvement Outcomes

(If “Yes” to Item 1) Complete this section for the first state improvement outcome you want to report. If you have more than one outcome to report, you will need to complete this section more than once. After you have completed your first entry, you will be given an opportunity to repeat this section in order to report additional outcomes.

1. In one or two sentences, describe the outcome. Be as specific as possible about exactly what changed during this reporting period as a result of the AT program’s initiative. (Narrative field)

2. In one or two sentences, describe the written policies, practices, and procedures that have been developed and implemented as a result of the AT program’s initiative. Include information about how to obtain the full documents, such as a Web site address or e-mail address of a contact person, but do not include the full documents here. (If there are no written policies, practices, and procedures, explain why.) (Narrative field)

3. Was the primary outcome of the state improvement initiative outcome* in a policy area? Drop-down box: (1) yes; (2) no

4. (If yes) Identify the policy area in which the state improvement outcome* had its primary impact. Example of how to determine primary impact area: If an improvement initiative resulted in coverage of hearing aids for adults under Medicaid, Medicaid would be the policy impact area. Choose only one policy area for each outcome.

Drop-down box: (1) ADA/504; (2) IDEA Part C; (3) IDEA Part B; (4) Section 508 and Section 255; (5) WIA/Rehabilitation Act/VR; (6) Medicaid; (7) Medicare; (8) Private insurance; (9) HAVA; (10) Older Americans Act; (11) SSI/SSDI/Work Incentives; (12) Olmstead; (13) other (specify)

5. What was the role of the statewide AT program in achieving the outcome (e.g., primary leader, partner, participant) and means (e.g., technical assistance) were used to achieve the outcome? (Narrative field)

6. Do you have additional outcomes to report in this section? If so, select “yes” and the system will repeat this section. If you select “no,” it will take you to the next section of the reporting form.

Drop-down box: (1) yes; (2) no

(Respondents who choose “1” will repeat this section.)

Additional and Leveraged Funds

Outline

1. Leveraged Funding for State Plan Activities (Previously Reported)

2. Leveraged Funding for Activities Not in State Plan (not previously reported)

3. Notes

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

In this section, provide information on funding that has been leveraged to support statewide AT Program activities. Report only actual dollars leveraged; do NOT report in-kind contributions. The additional and leveraged funding reported in this section is NOT necessarily considered program income under federal guidelines.

1. Leveraged Funding for State Plan Activities (Previously Reported)

Statewide AT Programs often establish partnerships and leverage funds to support state implementation of required AT Act activities as described in your State Plan. These funds should be reported by entering the sources and amounts of non-AT Act funds that you received during this reporting period to support your State Plan activities. Report each source and amount in the reporting period that it was received, even if not all of the funds were expended in that reporting period. Do not report AFP endowments or matching funds. Identify which state level or leadership activity the funds were allocated to support. If funds were received to support more than one activity, report an amount for each activity according to funding allocations. The number of individuals served by those funds or other outcomes should have already been reported in the appropriate previous sections.

Fund Source	Amount	Use of Funds (select one)
		Ο State Financing Ο Training Ο Reutilization Ο Technical Assistance Ο Demonstration Ο Public Awareness, I&A Ο Device Loan

B. Leveraged Funding for Activities Not in State Plan (not previously reported)

Statewide AT Programs may also leverage funds to support activities not required by the AT Act or other activities not included in a State Plan. Examples of such activities might be conducting evaluations or assessments under contract with your state Vocational Rehabilitation Agency or developing a training curriculum for an agency on a non-AT topic. If an activity is approved as part of your state plan, it should NOT be reported here but should be reported in the appropriate previous section. This section is limited to only non-State Plan approved activities that do not have information on individuals served or other outcome data reported in previous sections.

Funds used to support these activities should be reported by entering the sources and amounts of non-AT Act funds that you received during this reporting period. Report each source and amount in the reporting period that it was received, even if not all of the funds were expended in that reporting period. Do not report AFP endowments or matching funds. Identify which activities those funds were allocated to support. Report the number of individuals served by each funding source identified or describe other outcomes if individuals served is not an appropriate measure. Using the examples, you would report the number of individuals provided with evaluations or assessments or would describe the end product developed for training.

Fund Source	Amount	Use of Funds – select one	Individuals Served or Other Outcome
		Ο State Financing Ο Reutilization Ο Demonstration Ο Device Loan Ο Training Ο Technical Assistance Ο Public Awareness, I&A Ο Non-AT Act (describe the activity)	(enter the number of individuals served or describe the outcome)

C. Notes

Describe any unique issues with your data in this section (e.g., the reason why you were unable to report the number of individuals served with additional or leveraged funds).

(Narrative item)

Instruction Manual and Definitions
for the Annual Report
for the State Grant for Assistive Technology Program

This document was prepared by RTI International and the Association of Assistive Technology Act Programs
under grants from the U.S. Department of Education
Grant Nos. H224B030001 and H224B060002

Table of Contents

I. General Instructions 1

A. Reporting Period 1

B. Reporting Data 2

C. Missing Data 2

D. Nonresponders 2

E. Anecdotes 2

F. Instructions for Determining Geographic Distribution 3

G. Classification of Devices 5

1. Vision 6

2. Hearing 7

3. Speech Communication 8

4. Learning, Cognition, and Developmental 9

5. Mobility, Seating, and Positioning 10

6. Daily Living 11

7. Environmental Adaptations 12

8. Vehicle Modification and Transportation 13

9. Computers and Related 14

10. Recreation, Sports, and Leisure Equipment 15

H. Classification of Individuals and Entities 16

I. Coordination and Collaboration Activities 17

J. State Improvement Outcomes 18

K. Performance Measures Surveys 19

L. Customer Satisfaction Surveys 22

II. General Definitions 24

A. Comparability 24

B. State Flexibility 24

III. Section-Specific Instructions and Definitions 25

A. General Information 25

B. State Financing 25

C. Reutilization 28

D. Device Loans 30

E. Device Demonstrations 30

F. Training 31

G. Technical Assistance 32

H. Public Awareness and Information and Assistance 33

I. Additional and Leveraged Funds 34

Instruction Manual and Definitions
for the Annual Report for the State Grant
for Assistive Technology (AT) Program

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

Information from individual states will be available to the public once the information is complete and formally submitted to RSA. Questions regarding potential uses of the information submitted by individual states should be directed to Jeremy Buzzell, program specialist, RSA, U.S. Department of Education, 400 Maryland Avenue, SW, PCP Room 5025, Washington, DC 20202-2800, Jeremy.Buzzell@ed.gov, 202-245-7319.

Many individuals and organizations contributed to the development of this data collection system, including the Association of Assistive Technology Act Programs (ATAP), a workgroup representing Statewide AT Programs and Alternative Financing Programs funded under the AT Act (workgroup), and the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). The voluntary data collection system developed by ATAP served as the foundation of this document. The workgroup’s discussions and input framed issues, developed solutions, provided perspective on implementation and refined this document. Beth Greenland also made an important contribution to the workgroup’s efforts. RESNA provided analyses of State Plans for AT and other information. Working with RSA, RTI and its subcontractor InfoUse developed this document from these sources and made original contributions (under Grant No. H224B030001). ATAP worked with RSA on final revisions to this document (under Grant No. H224B060002). This instruction manual is organized in the following manner:

I. General Instructions

II. General Definitions

III. Section-Specific Instructions and Definitions

I. General Instructions

A. Reporting Period

The reporting period is the federal fiscal year, which begins on October 1 of each year and ends on the following September 30. The first reporting period will begin concurrent with OMB approval of this data collection system and continue through the end of FY 2007 on September 30, 2007. The second reporting period is FY 2008 (October 1, 2007, through September 30, 2008). The third reporting period is FY 2009 (October 1, 2008, through September 30, 2009).

B. Reporting Data

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

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

There may be additional non AT Act activities that are implemented by your program, but are not described in your State Plan and not supported with AT Act dollars. If these activities are AT related and you wish to report data on such activities, do so in the second table in the section on “Additional and Leveraged Funding.”

C. Missing Data

Enter “MD” (missing data) for any data you are unable to provide due to circumstances beyond the control of the entity submitting the data. MD should be used only in rare circumstances. You must explain any missing data under “Notes” at the end of the section in which the MD appears.

D. Nonresponders

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

E. Anecdotes

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

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

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

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

• If applicable, how did your Statewide AT Program collaborate with other entities in providing this help?

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

• How did it improve the consumer’s access to education, employment, community living or telecommunications/information technology?

Other instructions to follow in providing anecdotes:

• Limit each anecdote to 500 words or less.

• Include examples that are understandable to an uninformed audience.

• Do not repeat the same anecdote in multiple sections.

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

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

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

F. Instructions for Determining Geographic Distribution

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

Once you know the county where the individual resides or serves, you must determine the Rural Urban Continuum Code (RUCC) for that county. The 2003 RUCCs form a classification scheme that distinguishes 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 six non-metro categories, resulting in a nine-part county codification as follows:

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

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

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

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

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

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

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

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

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

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

• Codes 1-3 are considered “metro”

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

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

1. Go to the following Web site:

2. http://rtc.ruralinstitute.umt.edu/geography/countydisability.asp

(Note: You will not have to exit the data collection instrument to do this – all the information necessary will be part of the data collection Web site).

3. Select the appropriate state from the map or drop down menu (if using the drop down menu, you must hit “Go” after your selection).

4. Select the appropriate county from the drop down menu and hit “Go.”

5. “County Information” should appear. Under “County Characteristics” the RUCC is the third line.

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

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

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

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

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

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

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

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

So, the totals for these seven result in:

County of Residence	Number of Individuals
Metro (RUCC 1-3)	2
Non-Metro (RUCC 4-9)	4
Total	System-generated

G. Classification of Devices

Throughout the reporting system you are asked to classify the devices provided. There are 10 categories for classifying devices.

• Vision

• Hearing

• Speech communication

• Learning, cognition, and developmental

• Mobility, seating, and positioning

• Daily living

• Environmental adaptations

• Vehicle modification and transportation

• Computers and related

• Recreation, sports, and leisure

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

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

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

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

Each category below includes a description, decision rules, and examples that will assist you in deciding whether a device should go into a particular category.

1. Vision

Definition: Products designed to assist with vision

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

Examples:

• Magnifiers including CCTV systems;

• talking scales, blood pressure gauge, glucometer etc.;

• screen readers, screen magnifiers and Braille displays;

• Daisy or Victor Readers;

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

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

• OCR reading systems; talking thermostats, household appliances etc.

2. Hearing

Definition: Products designed to assist with hearing

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

Examples:

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

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

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

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

• Instant messaging devices (used as portable TTY)

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

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

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

• Classroom Captioning System

• iCommunicator (Voice to text system)

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

• InterpreType dual keyboard system

3. Speech Communication

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

Decision rules: Products intended to facilitate computer access and usage for written communication 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. If the purpose of the amplifier is to enhance the volume of speech produced by an individual without a disability, in order for his/her speech to be heard by persons who are deaf or hard of hearing, the device is classified under hearing. Peripherals designed to facilitate access or otherwise support the use of a device for speech communication (e.g. mounting systems; carrying cases, switch or mouth stick used for access) are counted in this category.

Examples:

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

• Communication boards/books

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

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

• Artificial larynx

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

  • Voice clarifiers (e.g. Speech Enhancer)

  • Voice amplifiers (e.g. Falck amplifier)

  • Stuttering aids

4. Learning, Cognition, and Developmental

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

Common subcategories:

Cognitive aids

Early intervention aids

Instructional materials

Memory Aids

General Personal Organization Tools

Sensory/Developmental Stimulation Products

Decision rules: Products intended to mitigate, compensate, or address learning or cognitive limitations should be classified here along with products used to facilitate computer access for individuals with learning/cognitive limitations. Products designed to assist people who are blind or visually impaired with reading, organization, learning, computer access, etc. are classified under vision.

Examples:

• Calculators and measurement tools

• Clocks/Timers/Wake-up Systems

• 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/Instructional 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 systems (WYNN, Read and Write Gold, etc. – not related to vision)

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

5. Mobility, Seating, and Positioning

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

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

Examples:

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

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

• Scooters and power chairs: Functionally matched motorized independent power mobility bases

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

6. Daily Living

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

Common Subcategories:

Personal hygiene, care and toileting

Dressing and apparel, and aids to dressing

Housekeeping, cleaning, maintenance

Cooking and eating

Handling, reaching, manipulating

Alerting and signaling

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

Telephony equipment

Decision rules: Architectural/home adaptations or modifications are classified under Environmental adaptations. Life safety devices and systems that do not involve home modifications are categorized here. Devices intended to accommodate specific disabilities, such as hearing or vision, are assigned to those categories. Devices that assist with personal organization are classified as Learning, Cognition and Developmental AT. Devices used to accommodate multiple disabilities are categorized here. Devices that assist persons with motor impairments not categorized elsewhere are included here. EADLs that also function as environmental controls are classified according to their primary use. Telephony equipment not intended to accommodate other categories of disabilities is listed here.

Examples:

• Writing guides, adapted 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/trays

• reacher

• wheelchair/walker bag

• switch-adapted food processor or other appliance

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

7. Environmental Adaptations

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

Decision rules: Adaptations or modifications to vehicles are classified under Vehicle modifications. Adaptations to furniture such as chairs, couches, beds, etc., would be generally 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 daily living category where as a roll in shower, wall or floor mounted grab bars, installed ramps, etc would be classified here because they become part of the building structure.

Examples:

• Accessible HVAC controls, accessible plumbing fixtures and controls

• Adapted playground equipment and structures

• Alarm and Security Systems

• Cabinetry and Storage equipment

• Door/Gate Openers

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

• Flooring and Surface materials/Detectable warning surfaces

• General Environmental Access Products

• Lifts

• Lighting/lighting controls

• Ramps

• Signage/signaling products

• Workstations/Desks/Tables, Home-workplace adaptations

8. Vehicle Modification and Transportation

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

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

Examples:

• Adaptive shoulder and seat safety belts

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

• Hand controls

• Extended directional mirrors.

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

9. Computers and Related

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

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 keyboards and pointing devices

• Switches and scanning software used for computer access

• Touchscreens

• Voice recognition systems

10. Recreation, Sports, and Leisure Equipment

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

Common subcategories:

• Toys and games

• Sports equipment

• Fitness equipment

• Specialized wheelchairs and recreational mobility equipment

• Musical instruments and related devices

• Arts, crafts and photography equipment

• Gardening and horticultural equipment

• Hunting, fishing, shooting equipment

• Camping, hiking and other outdoor recreational equipment

• Audio and video entertainment equipment

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

Examples:

• Switch-adapted toys and games;

• Tennis wheelchairs; beach wheelchairs

• Skiing equipment; sled/sledge hockey equipment

• Gardening tools and equipment;

• Playing card shuffler;

• Adapted camera and other photography equipment;

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

• Adaptive equipment for fishing, hunting, and camping;

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

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

H. Classification of Individuals and Entities

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

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

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

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

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

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

Representatives of Community Living: This category includes individuals and entities whose primary purpose is to support community living and/or those who interacted with the AT program primarily for purposes related to community living. This category includes carrying out daily activities, participating in community activities (e.g., social and recreational activities), using community services (e.g., public transportation and libraries) and living independently. It can include individuals representing community living issues but who are employed by independent living centers, disability-related nonprofits, agencies 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.)

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

Others: This category includes individuals and entities whose primary purpose is not otherwise classified above. Includes all individuals and entities/organizations who primarily provide or regulate an area not described above and/or interact with an AT program for a purpose not classified above.

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

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

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

I. Coordination and Collaboration Activities

States are asked to report on coordination and collaboration activities. Coordination and collaboration involves working with other entities to improve access to AT devices and services through the provision of state-level and state leadership activities. You should report on at least one example of coordination and collaboration for your state- level activities (state financing, reutilization, demonstration, device loan) and at least one example of coordination and collaboration for state leadership activities (training, technical assistance, public awareness and Information and Assistance). You are not limited in the number of coordination and collaboration activities you report; however, you cannot report multiple coordinations and collaborations on the same activity. For example, if a state reports on coordination and collaboration related to reutilization, it has satisfied the requirement to provide at least one example of coordination and collaboration of state-level activities. If the state chooses to report other examples of coordination and collaboration of state-level activities, the additional coordination and collaboration must relate to one or more of the remaining state-level activities such as state financing, demonstration or device loan.

Coordination 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 Statewide AT Program and other entities must be working together for a specific purpose. You will be asked to identify the intended result of the coordination and collaboration and the entity with whom you coordinated (e.g., education, employment). Coordination and collaboration activities include activities that enable the Statewide AT Program to establish a service that did not exist previously; enable expansion of an activity geographically; enable the expansion of an activity to groups not previously served; and, eliminate duplicative services. 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. Lastly, you will be asked to describe the coordination and collaboration and whether you achieved the result intended.

However, not all activities in which a Statewide 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 and the results would be reported in the State Improvement Outcomes section. In addition, if the Statewide AT Program has a contract with an entity to provide a specific service, that interaction would not typically be reported under coordination and collaboration, rather the recipients of the contracted service would be reported in the appropriate section (device demonstration, device loan, etc.)

J. State Improvement Outcomes

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

You are asked to report state improvement initiative outcomes (i.e., the results of your Statewide AT Program activities that have produced improved policies, practices, procedures or funding of AT at the state or local level) in the “State Improvement Outcomes” section of the data collection system. Such improvements may result from coordination and collaboration activities, technical assistance activities or other improvement initiatives involving the Statewide AT Program and those public and private agencies that are responsible for policies, practices and procedures that deliver or fund AT.

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

K. Performance Measures Surveys

Instructions

For device demonstration, device loan, device reutilization and state financing, states must use the performance measure questions provided by RSA to collect data for the seven performance measures identified in their State Plan for AT, which are listed below.

Access Goals

1. An increase in the percentage of appropriate targeted individuals and entities who accessed device demonstration programs and/or device loan programs and made a decision about an AT device or service for educational purposes as a result of the assistance they received.

2. An increase in the percentage of appropriate targeted individuals and entities who accessed device demonstration programs and/or device loan programs and made a decision about an AT device or service for employment purposes as a result of the assistance they received.

3. An increase in the percentage of appropriate targeted individuals and entities who accessed device demonstration programs and/or device loan programs and made a decision about an AT device or service for community living as a result of the assistance they received.

4. An increase in the percentage of appropriate targeted individuals and entities who accessed device demonstration programs and/or device loan programs and made a decision about an AT device or service that meets an information technology/ telecommunications need as a result of the assistance they received.

Acquisition Goals

1. An increase in the percentage of appropriate targeted individuals and entities who obtained devices or services from state financing activities or reutilization programs for educational purposes who would not have obtained the AT device or service.

2. An increase in the percentage of appropriate targeted individuals and entities who obtained devices or services from state financing activities or reutilization programs for employment purposes who would not have obtained the AT device or service.

3. An increase in the percentage of appropriate targeted individuals and entities who obtained devices or services from state financing activities or reutilization programs for community living purposes who would not have obtained the AT device or service.

Use of Performance Measure Questions

Two documents are provided to gather performance measure data: one for the “access” measure, and one for the “acquisition” measure. Because the performance measure questions have been approved by the Office of Management and Budget (OMB), they cannot be modified. Programs should make the documents available in accessible formats and can translate them into other languages as long as the questions remain consistent with the OMB approved language.

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

Who Must Provide Performance Measure Data

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

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

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

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

For device loan, states will collect performance measure data only from customers who obtained device loans for decision-making purposes. Device loans that served as “loaners” while another device was repaired or while the customer waited for funding and device loans made to provide a short-term accommodation will not be included in the performance measures.

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

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

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

How and When to Collect Performance Measure Data

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

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

How to Record Nonrespondents

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

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

Determining Primary Purpose for Which AT Devices or Services Are Needed

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

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

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

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

Information technology/telecommunications: The individual or entity requested services from the AT program primarily for purposes related to information technology/ telecommunications. This category includes using computers, software, Web sites, telephones, office equipment, and media. (Note that this category is not applicable to the acquisition measure.)

The survey instrument asks customers to identify a single primary purpose for which AT devices/services are needed. For example:

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

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

L. Customer Satisfaction Surveys

Instructions

Use of Survey Instruments

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

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

Who to Survey

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

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

How and When to Survey

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

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

How to Record Nonrespondents

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

II. General Definitions

Throughout the reporting system, terms for which definitions are available are identified by an asterisk (*). This General Definitions section contains definitions that appear throughout the reporting system. Section-specific instructions and definitions are included in the next section.

A. Comparability

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

B. State Flexibility

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

III. Section-Specific Instructions and Definitions

A. General Information

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

B. State Financing

Instructions

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

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

Definitions

State financing activities: Although the AT Act does not include a formal definition of state financing activities, the act describes state financing activities as activities to increase:

“access to, and funding for, assistive technology devices and assistive technology services (which shall not include direct payment for such a device or service for an individual with a disability but may include support and administration of a program to provide such payment), including development of systems 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 systems for the purchase, lease, or other acquisition of, or payment for, assistive technology devices and assistive technology services; or

(ii) support for the development of State-financed or privately financed alternative financing systems of subsidies (which may include conducting an initial 1-year feasibility study of, improving, administering, operating, providing capital for, or collaborating with an entity with respect to, such a system) for the provision of assistive technology devices, such as—

(I) a low-interest loan fund;

(II) an interest buy-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 by the Secretary.” Section 4(e)(2)(A)

Access to Telework funds: Many AT programs offer an alternative financing program that provides funds for telework. Telework loans allow individuals with disabilities to purchase computers or other equipment (including adaptive equipment) to use for teleworking. In some instances, a consumer may use a telework loan to purchase AT. Only telework loans provided for the purchase of AT can be counted under state financing. Telework loans that purchase computers and other equipment that are not AT cannot be counted. In some instances, a loan may include the purchase of AT and other devices. Only the portion of the loan used for the purchase of AT can be counted.

Active loan – a loan for which a borrower owns money and is still actively making payments (i.e. the loan has not been paid in full by the borrowers or otherwise “closed” due to default). For purposes of calculating default rate, an active loan means the unpaid percentage of guaranty 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.

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

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

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

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

Default rate: The default rate is the net dollar loss on loans divided by the total dollar value of active loans. Net dollar loss on loans means the amount lost as a result of default during this reporting period after subtracting 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 percentage of guaranty 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.

Feasibility study: An initial one-year study of improving, administering, operating, providing capital for, or collaborating with another entity with respect to the development of state-financed or privately financed alternative financing systems of subsidies for AT devices and services.

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

Financing for home modifications: A state financing activity to finance 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.

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

“Last resort” activities: Programs that provide AT, or funds to purchase AT, to consumers when all other options have been exhausted. These may be earmarked for particular types of consumers (such as children) or particular types of AT (such as home modification) or they may be for any group or type of AT. States may not use AT Act dollars to provide funds or devices directly to individuals. AT Act dollars may be used to administer a last resort fund comprised of non-AT Act dollars.

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

Low-interest loan fund: In a low-interest loan fund, a Statewide AT Program establishes an agreement with a lending 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 states arrange for lending institutions to provide low-interest loans for AT are variable, but typically 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 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 types of low-interest loans: (1) low-interest loans at or below prime rate and (2) preferred interest loans. Both loans are defined as follows:

1. Low-interest loan (at or below prime rate): A partnership loan* at interest rates that are at or below the prime rate. The prime rate, which fluctuates over time, is the interest rate charged by commercial banks for large loans to their most creditworthy business and industrial customers.

2. Preferred interest loan: A partnership loan* offered at an interest rate that is lower than the consumer would normally pay, but not as low as the prime rate.

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

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

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

C. Reutilization

Instructions

For recycling/refurbishment/repair activities, you will be asked to report the total estimated value of devices that were recycled, refurbished or repaired.

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

Instructions for Data Collection on Device Exchange

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

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

If you operate a device exchange you have options for collecting data. You may: (1) Choose to report only the number and type of devices exchanged through your program and not collect and report estimated current price and amount devices were sold and performance measure data on your exchange activity and report data on other reutilization activities only; (2) Choose to report data by collecting information from the current owner of the device; collecting information from the recipient of the device; or collecting information from a combination of the recipient and current owner.

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

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

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

You will be required to provide a narrative explanation of how you are collecting data for your exchange program, any challenges experienced in using this method, and plans for overcoming those challenges.

Regardless of the source of the data, all programs that operate a device exchange service supported by AT grant dollars must report the number of individuals served through device exchange (this is the number who received used devices) and the number of devices exchanged by category.

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

Definitions

Device reutilization programs: Although the AT Act does not include a formal definition of device reutilization programs, the Act describes reutilization programs as 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, carried out either directly or in collaboration with public or private entities (Section 4(e)(2)(B)).

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

Device recycling/refurbishment/repair activities: Activities in which devices are accepted (usually by donation) into an inventory are repaired, sanitized, and/or refurbished as needed, and then offered for sale, loan, rental or give away to consumers as recycled products. Repair of devices for an individual (without the ownership of the device changing hands) should be reported as device recycling. Open-ended device loans, in which the device borrower can keep the device for as long as it is needed, are a form of device reutilization and should be reported as device recycling.

D. Device Loans

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 year begins); (2) self-education by an intermediary (e.g., a teacher) whose purpose is to become familiar with the device; and (3) training. Only loans for the purpose of decision making should be included in the performance measures.

Definitions

Device loans: Although the AT Act does not include a formal definition of device loan programs, it states that states are to “directly or in collaboration with public or private entities, carry out device loan programs that provide short-term loans of assistive technology devices to individuals, employers, public agencies, or others seeking to meet the needs of targeted individuals and entities, including others seeking to comply with IDEA, ADA and Section 504” (Section 4(e)(2)(C)).

Device borrower: An individual, group of individuals, or entity that receives a short-term device loan for the purpose of making a decision, serving as loaner, providing an accommodation or for another short-term use purpose.

Short-term device loans: An occasion on which a device or devices are borrowed by an individual/entity who will use the device to make a decision (one decision) based on data, judgments, and other relevant information gained from trial use of the device in a natural environment, as a loaner during device repair or while waiting for funding (no decision is involved), to provide an accommodation (no decision is involved), or for some other purpose that does not involve a decision.

Usual length of short-term device loans: The standard length of loan established by each grantee’s policies or practices. If your program does not have an established policy, enter the average length of short-term loans. Please report the length in calendar days. Open-ended device loans, in which the device borrower can keep the device for as long as it is needed, are a form of device reutilization and should be reported under that activity rather than device loans.

E. Device Demonstrations

Instructions

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

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

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

Definitions

Device demonstrations: Although the AT Act does not include a formal definition of device demonstrations, the 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 providing experiences with, the devices and services), using personnel who are familiar with such devices and services and their applications.

(ii) COMPREHENSIVE INFORMATION. — The State shall directly, or through referrals, provide to individuals, to the extent practicable, comprehensive information about State and local assistive technology venders, providers, and repair services.” Section 4(e)(2)(D)

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

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

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

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

F. Training

Definitions

Training: Although the AT Act does not include a formal definition of training, the Act describes training as.

“activities that enhance the knowledge, skills, and competencies of individuals…(from entities described above) which may include—

(aa) general awareness training on the benefits of assistive technology and the … 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 development and implementation of service plans, including any education, health, discharge, Olmstead, employment, or other plan required under Federal or State law” (Section 4 (b)(i)(II)).

Training activities are instructional events, usually planned in advance for a specific purpose or 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, participants in training can be individually identified and could complete an evaluation of the training. Examples of training include classes, workshops, and presentations that have a goal of increasing skills, knowledge, and competency, as opposed to training intended only to increase general awareness of AT.

Distinguishing Training Activities from Public Awareness Activities

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

Working with individual consumers on how to use a particular AT device or troubleshooting problems with devices should be reported under Public Awareness as “Individual Assistance.”

Distinguishing Training from Technical Assistance

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

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

G. Technical Assistance

Definitions

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

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

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

Distinguishing Technical Assistance from Public Awareness

Technical assistance may include multiple contacts/interactions over an extended period of time. Less intensive support services, including single-contact requests for information or limited assistance, should be reported under public awareness. For example, assisting an individual in troubleshooting problems with an AT device should be reported under public awareness.

Distinguishing Technical Assistance from Training

Technical assistance is focused on providing extensive assistance to state or local agencies or other entities (rather than individuals) and generally involves problem solving to achieve a mutually agreed upon goal. Technical assistance may involve multiple contacts and interactions over an extended period of time. Training is designed to teach, present or guide participants in order to impart knowledge, skills and competencies to individuals, while technical assistance may be designed to help entities (not individuals) improve their policies, practices and procedures and generally involves problem solving.

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

Distinguishing Technical Assistance from Information and Referral

Technical assistance is provided to agencies or other organizations, not to individuals. Intensive support provided to an individual, for example assistance with a particular AT device or policy issue, is reported in Information and Referral under Public Awareness.

H. Public Awareness and Information and Assistance

Definitions

Public awareness: Although the AT Act does not include a formal definition of public awareness, the Act describes public awareness activities as activities:

“to provide information to targeted individuals and entities relating to the availability, benefits, appropriateness, and costs of assistive technology devices 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 systems established under the Workforce Investment Act of 1998 (29 U.S.C. 2801 et seq.), State vocational rehabilitation centers, public and private employers, or elementary and secondary public schools;

(bb) the development 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, employment, and transportation services to individuals with disabilities” (Section 4(e)(3)(B)(ii)(I)).

Statewide Information and Referral System: Although the AT Act does not include a formal definition of a statewide information referral system, the Act describes such a system as follows:

“(aa) IN GENERAL. — The State shall directly, or in collaboration with public or private (such as nonprofit) entities, provide for the continuation and enhancement of a statewide information and referral system designed to meet the needs of targeted individuals and entities.

(bb) CONTENT. — The system 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 obtain assistive technology devices and assistive technology services. The system shall also deliver information on the benefits of assistive technology devices and assistive technology services with respect to enhancing the capacity of individuals with disabilities of all ages to perform activities of daily living” (4(e)(3)(B)(ii)(III)).

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. Actual numbers of information recipients are often difficult to know for certain, but should be reported when known, and in other cases estimated as accurately as possible.

Information and Assistance:

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

Distinguishing Public Awareness from Training

Note: Activities should be counted in only one category. The intended outcome of an activity should determine whether it is reported under public awareness or training. Include presentations made for the purpose of general awareness under public awareness. Do not include training sessions with the intended outcome of participants applying new knowledge or skills in addressing AT device/service issues (which should be reported under training).

I. Additional and Leveraged Funds

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

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

A state may receive telecommunications funding to provide adaptive telephone equipment to eligible individuals in their state. This activity could be a state financing activity if so reported in the State Plan. The recipients of this service would be reported under state financing and the amount and source of funds reported in the Leveraged Funds section.

A state may receive funds from its Department of Vocational Rehabilitation to conduct evaluations of clients. Since are evaluations are not part of either state-level or state leadership activities, the recipients of this service would be reported in the Leveraged Funds section along with the amount and source of the funding.

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

1 For complete information about Rural Urban Continuum Codes, visit the following Web site:

http://www.ers.usda.gov/briefing/Rurality/RuralUrbCon/

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