0042 AT APR Instruction Manual Final 508

State Grants for Assistive Technology Program
Annual Progress Report (AT APR)
Instruction Manual and Definitions

Table of Contents
I. GENERAL INSTRUCTIONS
A. Reporting Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
B. Reporting Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
C. Non-responders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
D. Anecdotes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
E. Instructions for Determining Geographic Distribution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
F. Classification of Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
G. Classification of Individuals and Entities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
H. State Improvement Outcomes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
I. Performance Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
J. Customer Satisfaction Surveys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
II. GENERAL DEFINITIONS
A. Comparability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
B. State Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

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Instruction Manual and Definitions
State Grants for Assistive Technology Program
Annual Progress Report (AT APR)

This document contains information needed for completing the State Grants for AT Program
Annual Progress Report (AT APR). The AT APR is designed to provide the Administration for
Community Living (ACL) with the data necessary for program planning and reporting to
Congress, the Secretary of Health and Human Services and other entities. The AT APR is
organized by the state-level and state leadership activities outlined in the 21st Century Assistive
Technology Act (AT Act of 1998, as Amended). Lead agencies or implementing entities will
report on these state-level and state leadership activities and will provide data required by
Section 4(f) of the Act and other necessary data.
Information from individual states will be available to the public once the information is
complete and formally submitted. Questions regarding potential uses of the information
submitted by individual states should be directed to Robert Groenendaal, Program Specialist,
ACL, U.S. Department of Health and Human Services, 330 C Street SW, Switzer Building,
Room 1317B, Washington, DC 20201, Robert.Groenendaal@acl.hhs.gov, 202.795.7356.
This instruction manual is organized in the following manner:
I.
II.

General Instructions
General Definitions

I. General Instructions
A. Reporting Period
The reporting period is the federal fiscal year, which begins on October 1 of each year and
ends on the following September 30.
B. Reporting Data
Programs must collect and report data on activities that are supported using funds from their
State Grant for AT under section 4 of the 21st Century Assistive Technology 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 “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-21st Century Assistive Technology Act funds (e.g. the state
administers a telecommunications equipment distribution program that uses non-21st Century
Assistive Technology 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.
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General Instructions

C. Non-responders
The performance measures data elements and consumer satisfaction data include nonresponders. Reporting and use of nonresponse information is different for the performance
measure data as compared to consumer satisfaction data. A complete description of the reporting
and use of nonresponse data can be found in the subsequent sections on performance measures
and consumer satisfaction.
D. Anecdotes
For each of the state-level activities, you will be asked to provide anecdotal information
about consumers, or others that benefited from program activities, during the reporting period.
Generally, a consumer is an individual with a disability or his or her family, but in some cases it
may be appropriate to provide an anecdote about a professional. Please make these entries as
specific and concise as possible and include the following information:
•
•

What AT device, service or information did the consumer need?
How did your Statewide AT Program help the consumer obtain that device, service or
information?
• What barrier(s) did your Statewide AT Program help the consumer overcome?
• How did obtaining that device or service improve that consumer’s life?
• How did it improve the consumer’s access to education, employment, or community
living? You will be asked to check which of these outcome areas the anecdote addresses.
Other instructions to follow in providing anecdotes:
•
•

Limit each anecdote to 1800 characters or less.
Try to avoid using brand names for AT devices as those are not understandable to
readers; describe the AT device instead. For example, use “software that enlarges screen
display” instead of Zoom Text. Use language that is understandable to an uninformed
audience.
• Do not repeat the same anecdote in multiple sections.
• Do not identify any consumers by name or use other details that would allow a consumer
to be identified.
• Be sure that the example clearly fits within the appropriate activities supported by the 21st
Century Assistive Technology Act.
• Upload a good resolution picture for the anecdote if at all possible. Maximum picture
size for uploads is 5 MB.
Anecdotal information also is requested for some state leadership activities. Instructions on what
to include in anecdotes for these activities are provided in the reporting system.
E. Instructions for Determining Geographic Distribution
Section 4(f) of the 21st Century Assistive Technology 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.

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General Instructions

In Training, there is an option for reporting participants as “Unknown” when the participant
county data cannot be gathered. This should happen rarely only in situations where there are
extenuating circumstances that prevent gathering county data (e.g. event registration was handled
by an outside organization and was supposed to collect county data but did not.) The
“Unknown” category should not be used to report international training participants as it is
recommended those participants not be included in the APR for a federal formula grant program.
Once you know the county where the individual resides or serves, you must determine the
Rural Urban Continuum Code (RUCC) for that county. The 2013 RUCCs form a classification
scheme that distinguishes metropolitan counties by size and non-metropolitan counties by degree
of urbanization and proximity to metro areas. The 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 as follows:
1. Go to: https://www.ers.usda.gov/data-products/rural-urban-continuum-codes/
2. Download the 2013 Rural-Urban Continuum Codes (excel spreadsheet)
3. Scroll to your state (list is alphabetical by state) and select your counties.
4. Column E provides the RUCC code for each county.
You will be responsible for tallying how many individuals fall into each grouping of RUCC and
then provide the final number in the appropriate area of the data collection instrument.
For example, through state financing activities you provide six loans during one reporting period
with one loan recipient living in a county with a RUCC of 2, one in a county with a RUCC of 4,
one in a county with a RUCC of 8, one in a county with a RUCC of 6, one in a county with a
RUCC of 9 and the last in a county with a RUCC of 3. The total for these six loan recipients
results in the following metro/non-metro data:
County of Residence
Metro (RUCC 1-3)
Non-Metro (RUCC 4-9)
Total

Number of Individuals
2
4
System-generated
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General Instructions

F. Classification of Devices
Throughout the reporting system you are asked to classify the devices provided. There are
ten categories for classifying devices.
•
•
•
•
•
•
•
•
•
•

Vision
Hearing
Speech communication
Learning, cognition, and developmental
Mobility, seating, and positioning
Daily living
Environmental adaptations
Vehicle modification and transportation
Computers and related
Recreation, sports, and leisure

You must choose one category where a device belongs. Devices must be reported in one of
these categories as there is no “Other” category. Many devices can fit into more than one
category depending on how they are used by a consumer. 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. Exception: If the device is designed to assist
someone who has a vision or hearing impairment, regardless of the function that is being served,
classify the device under vision or hearing. In the case of an individual who is deaf/blind, you
should classify the AT device in either vision or hearing. (For large amounts of deaf/blind
related AT device reporting associated with the I Can Connect program, you should establish a
process for making AT device type determinations so that your data is consistent over fiscal
years.)
You may not count a device more than once and devices that make up a system should be
reported as one device. A component of a larger system should be classified according to the
function or primary use of the entire system and reported as one device in that category. For
example, a switch and mounting system used to access a communication device would be
reported in communication as one device. Many sets of devices in Daily Living and Mobility,
Seating and Positioning should be reported as a system rather than individual devices when they
are providing an overall access purpose (such as bathroom access).
Services are classified according to the AT device category associated with the service.
Each category below includes a definition, decision rules, and examples that will assist you in
determining the appropriate classification.

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General Instructions
1. Vision

Definition: Products designed to assist with vision.
Decision rules: Products intended to facilitate access and participation for people who have
vision needs (i.e. blind, low-vision) are classified in this category, even if they are used for
activities of daily living, computer access, reading/learning, way finding/mobility,
recreation, etc. Products in this category characteristically provide output of information
through large print/display, speech and/or Braille/tactile alternatives to “regular” print or
text.
If the adaptation is for an individual who has vision and other disabilities, categorize
according to the primary functionality of the device (e.g. if the device is addressing a daily
living need due to a mobility disability in addition to the vision loss, then it would be
categorized as daily living). In the case of an individual who is deaf/blind, you should
classify the AT device in either vision or hearing. (For large amounts of deaf/blind related
AT device reporting associated with the I Can Connect program, you should establish a
process for making AT device type determinations so that your data is consistent over fiscal
years).

Examples:
▪

Manual magnifiers

▪

Video magnifiers

▪

Health related instruments (scales, blood pressure gauge, glucometer etc.) with
alternative input navigation control and output

▪

Household appliances with alternative input navigation control and output

▪

Daily living devices with alternative input navigation control and output

▪

Computers and mobile devices with alternate hardware and software options (e.g. text
scanning, audio navigation, speech output, screen magnifiers, Braille displays, etc.)

▪

Navigation and mobility aids with alternative input navigation control and output

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General Instructions
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 in this category characteristically provide amplified auditory output
and/or output in another format (e.g. text or sign language).
If the adaptation is for an individual who has hearing and other disabilities, categorize
according to the primary functionality of the device (e.g. if the device is addressing a daily
living need due to a mobility disability in addition to the hearing loss, then it would be
categorized as daily living). In the case of an individual who is deaf/blind, you should
classify the AT device in either vision or hearing. (For large amounts of deaf/blind related
AT device reporting associated with the I Can Connect program, you should establish a
process for making AT device type determinations so that your data is consistent over fiscal
years).

Examples:
▪

Personal amplification systems including medical device hearing aids, over-the-counter
(OTC) hearing aids, and personal sound amplification products (PSAP)

▪

Assistive Listening Systems designed to improve signal to noise ratio (FM, loop,
infrared, sound-field)

▪

Daily living aids with enhanced auditory, visual and/or tactile output (e.g. vibrating alarm
clock; smoke alarm with strobe light; etc.)

▪

Amplified or text telecommunication devices (including captioned telephones and
associated signaling devices)

▪

Captioning systems and apps (including speech to text) for computers or mobile devices

▪

Video systems and apps that support visual communication (sign language, speech
reading, etc.) for computers or mobile devices

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General Instructions
3. Speech Communication

Definition: Products designed to assist with communication for individuals with speech
limitations.
Decision rules: Products intended to facilitate face-to-face and virtual communication for
people with speech disabilities are classified in this category, even if they are also used for
other functions (e.g. a speech generating device that can also serve as an alternate keyboard
for computer input). These products may produce speech and/or text output, or may be those
that rely on interpretation by the communication partner (e.g. “low tech” symbol and/or
alphabet-based communication boards). Products that amplify voice are classified here if
used by an individual with a communication disability, in order for his/her speech to be
audible to others. Peripherals designed to facilitate access to 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. Software that provides symbol sets used
in creating “low tech” systems or overlays for speech generating systems are counted in this
category.
Examples:
▪

“Dedicated” or purpose-built speech generating devices

▪

“Talking” switches (if used for communication)

▪

Communication boards/books

▪

Software and apps that support speech communication on a computer or mobile device

▪

Artificial larynx

▪ Voice clarifiers
▪ Voice amplifiers
▪ Stuttering aids

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General Instructions
4.

Learning, Cognition, and Developmental

Definition: Products that assist with learning, development and cognitive processes for
people with disabilities of all ages.
Common subcategories:
Cognitive aids
Early intervention aids
Instructional materials
Reading and writing
Memory aids
General personal organization tools
Decision rules: Products intended to augment, mitigate or compensate for learning or
cognitive process limitations such as memory, organization, reading, writing, etc. regardless
of the environment used should be classified here. This includes products that provide access
to educational materials and instruction in school or other learning environments. Products
designed to assist people with vision disabilities with reading, organization, learning,
computer access, or other functions are classified under vision. Toys are reported under
Recreation, Sports and Leisure even if used to teach cause and effect.
Examples:
▪

Calculators

▪

Clocks/timers/alarms

▪

Calendar/reminder systems including apps

▪

Memory aids including apps

▪

Educational/instructional software including apps

▪

Audio recorders

▪

Text-to-speech systems

▪

Speech-to-text systems

▪

Devices for enhancing signal to noise ratio or blocking extraneous noise

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General Instructions
5. Mobility, Seating, and Positioning

Definition: Products whose main focus is addressing the functional limitations of a mobility
disability and/or improving seating and positioning for health, safety and control.
Decision rules: Wheelchair components associated with seating and positioning (shoulder or
safety belts) are classified in this category. Wheelchair restraints (e.g. tie downs and docking
or lock systems) which allow a power chair user to drive and/or be transported safely in a car
or van are classified under Vehicle Modification and Transportation. Devices that position
other equipment (e.g. communication device mounts) are classified in the category of the
device they are supporting.

Examples:
▪

Ambulatory aids such as canes (not canes used by people with vision disabilities for
wayfinding), walkers or crutches

▪

Orthotics and prosthetics

▪

Non-motorized wheeled mobility products including strollers, transport chairs and
manual wheelchairs

▪

Power mobility products including scooters and power wheelchairs

▪

Seating and positioning aids including foam wedges, cushions and specially designed
seating systems

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General Instructions
6.

Daily Living

Definition: Devices that enhance the capacity of people with disabilities to live
independently, especially AT that assists with Instrumental and other Activities of Daily
Living, (ADLs, IADLs) such as dressing, personal hygiene, bathing, home maintenance,
cooking, eating, sleeping, breathing, shopping and managing money.
Common Subcategories:
Personal care and hygiene
Medical equipment for life and safety
Smart home hub
Clothing and dressing aids
Housekeeping, cleaning, maintenance
Meal preparation and eating
Handling, reaching, manipulating
Alerting and signaling
Household management, bill paying (not cognitive, vision, or hearing AT)
Telephony equipment
Decision rules: Durable medical equipment for life and safety that do not involve home
modifications are categorized here, e.g. respiratory equipment. Smart home hubs are
classified according to their primary use. Those that control small appliances may be
classified here; if they control semi-permanent or permanently installed home devices they
are categorized as Environmental Adaptations; if they are primarily used for entertainment
they should be categorized as Recreation, Sports and Leisure. Devices intended to
accommodate hearing or vision, including telephony, are assigned to those categories.
Devices that assist with personal organization are classified as Learning, Cognition and
Developmental AT. Devices that assist persons with motor impairments not categorized
elsewhere are included here. Switches controlling daily living aids or unknown devices are
reported here, otherwise switches are reported with the category of devices controlled.
Examples:
▪

Writing guides, adapted writing implements

▪

Modified or large-handled tools and utensils

▪

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

▪

Zipper pulls, button hooks, needle thread

▪

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

▪

Wheelchair desks/trays

▪

Reacher

▪

Wheelchair/walker bag

▪

Switch-adapted food processor

▪

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

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General Instructions
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/or 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
Modification and Transportation. Adaptations to furniture such as chairs, couches, beds, etc.,
would generally be classified under Mobility, Seating, and Positioning. Items or structures
that are portable or temporary, rather than permanent or semi-permanent, are generally
classified in another related category to address a functional limitation. For example, shower
chairs, commodes, raised toilet seats, temporary/portable ramps 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

▪

Alarm and security systems

▪

Cabinetry and storage equipment

▪

Door/gate openers including farm and ranch gates/latches

▪

Environmental controls and switches that control them permanently or semi-permanently
installed or non-mobile items (i.e., electronic systems that enable people to control
various appliances, lights, window coverings, security systems, etc.)

▪

Flooring and surface materials/detectable warning surfaces

▪

General environmental access products

▪

Lifts

▪

Ramps

▪

Signage/signaling products

▪

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

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General Instructions
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. Multi-purpose portable ramps would be classified under
Daily Living.
Examples:
▪

Adaptive shoulder and seat safety belts

▪

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

▪

Hand controls

▪

Extended directional mirrors.

▪

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

▪

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

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General Instructions
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, proprietary software, and/or
operating system accessibility options.
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 limitations as those will be reported in Vision or
Learning/Cognition and Developmental.
Examples:
▪

Standard software

▪

Standard hardware

▪

Computer accessories

▪

Alternative keyboards and pointing devices

▪

Switches and scanning software used for computer access

▪

Touchscreens

▪

Voice recognition systems

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General Instructions
10. Recreation, Sports, and Leisure Equipment

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

Toys and games
Sports equipment
Fitness equipment
Specialized wheelchairs and recreational mobility equipment
Musical instruments and related devices
Arts, crafts and photography equipment
Gardening and horticultural equipment
Hunting, fishing, shooting equipment
Camping, hiking and other outdoor recreational equipment
Audio and video entertainment equipment

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

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

▪

Tennis wheelchairs; beach wheelchairs

▪

Skiing equipment; sled/sledge hockey equipment

▪

Gardening tools and equipment

▪

Playing card shuffler

▪

Adapted camera and other photography equipment

▪

Adaptive exercise equipment (not used in a rehabilitation setting)

▪

Adaptive equipment for wildlife viewing, 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

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General Instructions

G. Classification of Individuals and Entities
Throughout the reporting system you are asked to classify the individuals and entities that
participate in a program or receive services based on who they represent and/or the purpose of
their interaction. There are seven categories for classifying individuals and entities as follows.
Individuals with disabilities: As defined in the 21st Century Assistive Technology Act, an
“individual with a disability” means any individual of any age, race or ethnicity who has a
disability; and who is or would be enabled by an AT device or an AT service to minimize
deterioration in functioning, to maintain a level of functioning, or to achieve a greater level of
functioning in any major life activity.
Family members, guardians and authorized representatives: A person who is related to
an individual with a disability, who is the legal guardian of an individual with a disability, or
who is authorized by an individual with a disability to act on that individual’s behalf or who
participate in an activity with an individual with a disability such as friends and advocates.
Representatives of Education: This category includes individuals and entities whose
primary purpose is education and/or those who interacted with the AT program primarily for
purposes related to education. This category can include any type of educational entity such as
early childhood, elementary, secondary, special education, remedial education, adult basic
education, continuing education, and post-secondary programs. It includes both public and
private educational agencies and organizations and federal, state, and local governmental entities
who primarily provide or regulate educational services (e.g. State Education Agency). This
category also includes interactions focused on training of graduate students and undergraduate
students.
Representatives of Employment: This category includes individuals and entities whose
primary purpose is employment and/or those who interacted with the AT program primarily for
purposes related to employment. This category includes seeking employment, maintaining
current employment or expanding employment options. It includes participating in employment
training programs, vocational rehabilitation programs and other programs related to employment.
It can include employers, or firms that employ workers or assist them in becoming employed,
and providers of employment and/or training services to enable individuals with disabilities to
become employed, include those representing public and private agencies and organizations that
provide or regulate employment services, such as state employment agencies, one-stop career
centers, state vocational rehabilitation agencies, community rehabilitation programs, vocational
training programs, training providers approved under the Workforce Investment Act, and
apprenticeship programs.
Representatives of Health, Allied Health and Rehabilitation: This category includes
individuals and entities whose primary purpose is health care, allied health and health related
rehabilitation services, and/or those who interacted with the AT program primarily for purposes
related to health care, allied health and rehabilitation. It includes those from hospitals, health
clinics, mental health agencies and organizations, and managed care providers. This category
can also include employees of such organizations, such as physicians, physicians’ assistants,
nurses, nurse practitioners, psychologists, psychiatrists, occupational therapists, physical
therapists, speech pathologists, audiologists, rehabilitation counselors, hospital discharge
planners and other hospital employees.

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General Instructions

Representatives of Community Living: This category includes individuals and entities
whose primary purpose is to support community living and/or those who interacted with the AT
program primarily for purposes related to community living. This category includes carrying out
daily activities, participating in community activities (e.g., social and recreational activities),
using community services (e.g., public transportation and libraries), and living independently. It
can include individuals representing community living issues but who are employed by
independent living centers, disability-related nonprofits, agencies that provide services for
seniors, and other related social service and community organizations. This category can also
include both public and private organizations and federal, state, and local government entities
that primarily provide or regulate community living and related services (e.g. a State Department
of Aging, Public Utilities Commission, and State Housing Authority).
Representatives of Technology: This category includes individuals and entities whose
primary purpose is delivery of technology devices or services and/or those who interacted with
the AT program primarily for purposes related to technology. This category includes using
computers, software, Web sites, telecommunications, office equipment, and media. This
category can include technology experts such as computer programmers, web and application
developers, information technology professionals and procurement officials along with
manufacturers and vendors of information technology, telecommunications products, and
assistive technology devices.
Sometimes an individual or entity could fit into more than one category depending on the
program or service utilized and who they represent via their participation. You must choose one
category in which to classify each individual or entity and may not count them in multiple
categories. In addition, the name or type of organization that employs the individual may or may
not reflect how they should be categorized. A professional or other representative of an entity
may be classified differently depending upon who they primarily represent in their interaction
with the program or service. For example:
1) An individual with a disability might work for a technology vendor, but they are
accessing the device loan program to obtain a loaner while their personal AT is being
repaired. That person should be classified as an individual with a disability as he/she
accessed the loan program representing himself/herself as a consumer.
2) An occupational therapist (OT) employed by a hospital who participates in a device
demonstration as part of an IEP team would be reported under “Representative of
Education.” That same OT might borrow devices to use in an evaluation as part of her work
at the hospital and would be classified as “Health, Allied Health, Rehabilitation” under type
of borrower.
3) Representatives of State Early Intervention Programs (IDEA Part C) should be reported
in the category that best fits the lead agency for Part C or the agency delivering the Part C
services, most typically Health or Education.
In most sections, individuals and entities must be reported in a category as “other” is not an
option. In some sections “unable to categorize” or “unknown” is an option when the program
contact with the participant or recipient is limited and it is acceptable for the participant or
recipient to not provide such information.

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General Instructions

H. State Improvement Outcomes
The 21st Century Assistive Technology 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 egovernment” (Section 4(f)(2)(B)(ix)).
You are asked to report no more than two MAJOR state improvement initiative outcomes
(i.e., the results of your Statewide AT Program activities that have produced improved policies,
practices, procedures or funding of AT at the state or local level) in the “State Improvement
Outcomes” section of the data collection system. Such improvements may result from
coordination and collaboration activities, technical assistance activities or other improvement
initiatives involving the Statewide AT Program and those public and private agencies that are
responsible for policies, practices and procedures that deliver or fund AT.
Only report improvement initiatives that are funded, at least in part, by AT Act funds.
Types of improvements include obtaining new or expanded AT funding, protecting AT funding,
reducing AT cost to consumers, increasing AT expertise in service delivery systems, expanding
or protecting system eligibility to obtain AT, establishing new or expanded access requirements,
protecting access requirements, and increasing cost effectiveness and cost-savings in systems.

I.

Performance Measures

Instructions

For training, device demonstration, device loan, device reutilization and state financing,
states must use the performance measure questions provided by ACL to collect data for the
performance measures identified in their State Plan for AT.
Use of Performance Measure Questions
Four documents are provided to gather performance measure data: one for the decisionmaking access measure (device demonstration and one of the device loan purposes), two for
acquisition measures (state financing, reuse and three of the device loan purposes) and one for
IT/Telecommunications (training). Because the performance measure questions have been
approved by the Office of Management and Budget (OMB), they cannot be modified. Programs
should make the documents available in accessible formats and can translate them into other
languages as long as the questions remain consistent with the OMB approved language.
Programs may elect to incorporate the performance measure questions into their own data
collection system, so long as the language is not modified. For example, programs may include
the questions in application forms or may ask the questions of program participants as part of
their interaction with the program or service. Programs may also add items or questions that do
not in any way change the performance measure questions.

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General Instructions

Who Must Provide Performance Measure Data
Consumers who acquire AT through state financing activities and recipients of reutilized
devices who are identified as those included in the performance measure (see Reutilization,
section A table) must provide a response to the acquisition questions with one exception. Some
organizations have a legal obligation to provide AT and will be unable to legitimately 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 a cooperative buying
program (other state financing activity). 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. In these situations, the recipients can be
excluded from the performance measure with appropriate justification (narrative text is entered
to describe the rational for the exclusion).
For device loan, states will collect access performance measure data only from customers
who obtained device loans for decision-making purposes. Device loans made for the other three
purposes will have an acquisition performance measure collected.
When device loans or device demonstrations are provided to multiple participants:
(a) If the end user is directly involved, performance measure data is collected from/on
behalf of 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 10 different devices on behalf of 3
students. You may collect performance information related to the speech pathologist’s
borrowing experience alone and overall decision-making (reported as one loan event), or you
may collect performance measure data on all 5 students separately which would be reported as 5
separate device loans with multiple devices each and unique device decision-making for each.
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, the response to the
performance measure questions must be documented as provided directly by the consumer at the
appropriate time for each activity. While some information can be obtained during intake,
response to the performance measure questions 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. For state financing and reuse, service delivery is complete
with acquisition of the AT.
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

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General Instructions

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 Non-respondents
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, non-respondents 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 non-respondents. 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 measure data must be categorized by the primary purpose for which AT
devices or services are needed. Brief descriptions of these categories are as follows:
Employment: The individual or entity requested services from the AT program primarily for
purposes related to employment. This category includes seeking employment, maintaining
current employment or expanding employment options. It includes participating in employment
training programs, vocational rehabilitation programs and other programs related to employment.
Education: The individual or entity requested services from the AT program primarily for
purposes related to education. This category includes participating in any type of educational
program, including early childhood, elementary, secondary, special education, remedial
education, adult basic education, continuing education, and post-secondary programs.
Community living: The individual or entity requested services from the AT program
primarily for purposes related to community living. This category includes carrying out daily
activities, participating in community activities (e.g., social and recreational activities), using
community services (e.g., public transportation and libraries), accessing health care services
including mental health and substance use disorder services in-person or via telehealth, and
living independently.
This categorization may be done by the consumer, by the State AT Program based on their
interaction with the consumer, or a combination of both. Since State AT Programs must
categorize non-respondent data and to ensure data consistency it is advisable for the State AT
Program to either at least review this data to ensure all performance measures have been
appropriately categorized by area. Each performance measure must be categorized by a single
primary purpose for which AT devices/services are needed.
For example, a consumer uses her computer in almost all aspects of life, including general email with friends, homework for a class she is taking and in her work. Through demonstration
activities, she tries out different kinds of voice recognition and makes a choice about software to
purchase. The demonstration performance measure could fit into any of the areas (Employment,
Education, or Community Living). In a conversation with staff the consumer notes that the class

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General Instructions

she is taking is related to advancing in her job. A decision is made that employment is the
primary purpose at this time.
J. Customer Satisfaction Surveys
Instructions

Use of Survey Instruments
States must use the survey instrument provided by ACL to collect customer satisfaction data
with direct and documented responses from consumers. 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 and direct responses from consumers are
obtained (not assumed). 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 Non-respondents
Non-respondents 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.

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General Definitions

II. General Definitions
This General Definitions section contains definitions that apply throughout the reporting
system. Section-specific instructions and definitions are included in the next section.
A. Comparability
As described in Section 4 (e)(1)(B) of the 21st Century Assistive Technology 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. You are required to
report data for any state-level activities for which your state claimed comparability.
B. State Flexibility
As described in Section 4(e)(5)(A) of the 21st Century Assistive Technology 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 are not conducting an activity for which you have
claimed flexibility. 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.

Paperwork Reduction Act Public Burden Statement:
According to the Paperwork Reduction Act of 1995 5 CFR § 1320.8(b)(3), no persons are
required to respond to a collection of information unless such collection displays a valid OMB
control number (OMB 0985-0042). Public reporting burden for this collection of information is
estimated to average 404 hours per response, including time for gathering, maintaining the data
needed, completing, and reviewing the collection of information. The obligation to respond to
this collection is required to maintain or retain benefits under the 21st Century Assistive
Technology Act (AT Act of 1998, as Amended), applicable to Section 4 formula funded grantees
for the State Grant for Assistive Technology Program. This Information Collection (IC) contains
data needed for completion of the State Grants for AT Program Annual Progress Report (AT
APR). The AT APR IC is designed to provide the Administration for Community Living (ACL)
with information necessary for program planning and reporting data on required state-level and
state leadership activities to Congress, the Secretary of Health and Human Services and
additional entities. The AT APR is organized by the state-level and state leadership activities
outlined in the 21st Century Assistive Technology Act (AT Act of 1998, as Amended). State
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
information. Annual data and information from individual states will be available to the public
once the information is complete, formally submitted, reviewed, and published. Data will be kept
private to the extent allowed by law, there are no assurances of confidentiality. The states will
not report information that identifies individual consumers. States will provide anecdotes about

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the effect of their programs on individual consumers, but states are instructed to write anecdotes
in a manner that ensures their anonymity. All other data provided is reported in the aggregate.
The web-based system used for this instrument will not allow public access to the reporting
instrument for data entry, and states will have access to their data only. They will not be able to
see or manipulate data of other states. Individual state reports will be kept confidential until they
have been finalized by the state and accepted by ACL. Once a report has been finalized by the
state and accepted by ACL, access to the aggregated state-specific and national data will be
available to the public via the Internet. However, while the public will be able to view the data,
they will not be able to alter the data. States will be advised that their data will be available to
the public in this manner. Send comments regarding the burden estimate or any other aspect of
this collection of information, including suggestions for reducing this burden to Robert
Groenendaal, Administration for Community Living, 330 C Street, SW, Washington, DC 20201
or via E-Mail Robert.Groenendaal@acl.hhs.gov.

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