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Accomplishment Series - 1996

The Tech Act
Accomplishments to Date

September 1996

by the RESNA Technical Assistance Project

Introduction

Assistive technology can play a powerful role in maximizing the independence of individuals with disabilities. Congress acknowledged this role by passing the Technology-Related Assistance For Individuals With Disabilities Act (Tech Act) in 1988 and amending it in 1994. This Act provides discretionary grants to states to assist them in developing and implementing consumer-responsive, comprehensive, statewide programs of technology-related assistance for individuals with disabilities of all ages. Currently, all fifty states plus the District of Columbia, Puerto Rico, American Samoa, Guam, Commonwealth of Northern Mariana Islands and US Virgin Islands are funded under this Act.

These grants to states are intended to be a catalyst for statewide systemic change to increase the availability and access to appropriate assistive technology (AT) devices and services. They are also intended to increase the availability of funding for these assistive devices and services.

The Tech Act as amended in 1994 requires states to perform systems change and advocacy activities that focus on changing laws, policies and practices in the state to increase access to assistive technology. States must also work to reach underrepresented and rural populations to increase their access to assistive technology. The legislation allows states flexibility on how they accomplish these activities.

The legislation also includes clear standards of accountability to ensure that states will meet the Tech Act goals within a ten-year funding period. During the last two years of this time period, federal grants to the states are reduced: 25 percent in the ninth year and 50 percent in the tenth year. The grants as stipulated in the 1994 Amendments, sunset after the ten-year federal funding period. Congress expects states to develop mechanism to replace federal funds within this ten-year period. The National Institute for Disability and Rehabilitation Research (NIDRR) administers the Tech Act program. It has developed regulatory language for the Tech Act and simultaneously developed uniform performance guidelines to report on project progress and outcome data for each state and territory.

According to the tech Act, the term "assistive technology device" means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities. (Tech Act)

The terms "assistive technology service" means any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology devices. (Tech Act)

Assistive technology includes adapted toys, computers, seating systems, powered mobility, augmentative communication devices, special switches, and thousands of commercially available or adapted solutions. These technology solutions improve an individual's ability to learn, compete, work, and interact with family and friends. (Enders, 1990)

Major Goals of the Tech Act Projects

The Tech Act Projects are fulfilling the objectives of the legislation. Listed here are the key objectives of the legislation and examples of how the projects are meeting these objectives. It should be noted that while some states are listed under the various objectives as engaging in certain activities, many others may also be conducting similar activities. For more information concerning a project's activities, you may contact the RESNA TA Project or the particular state. A list of projects is included at the end of this document.

Nationwide data on the experiences of people with disabilities has been systematically gathered since 1991. In the 1995 survey, results from 2,954 people with disabilities found that over half indicated that they needed AT but did not currently have it. The reasons were:

- lack of funding (65%),

- need for help in determining what is needed (40%), and

- lack of know to know where to go for help (33%).

(RESNA TA Project Consumer Satisfaction Survey)

GOAL: Access
Increase access and provision of assistive technology.

Over half of the Tech Act Projects have established equipment loan programs that act as equipment lending libraries to provide devices for infants and toddlers, school aged children, employed adults and retired citizens. As needs change, devices are returned and others loaned to fit the needs of the children and adults with disabilities of the states.

Many of the Tech Act Projects have developed equipment exchange programs that match individuals who need assistive technology devices with people who are selling or donating such devices. Eleven states (Arkansas, Georgia, Illinois, Kentucky, Mississippi, Missouri, Montana, Nevada, New Hampshire, New York, and Oklahoma) have programs that refurbish equipment so that people with disabilities can obtain new, used, and reconditioned assistive technology equipment at a reduced cost, thus decreasing medical expenses and improving the availability of products.

In Mississippi, a middle-aged man, quadriplegic from a diving accident at age 14, worked for many years as a school counselor. He had to retire due to a degenerative spinal cord disease. However, the Tech Act Project referred the man to its regional center for an AT assessment and loaned the gentleman a computer system with special switch access. While working with the computer, the man realized that he could work as a lumber broker, selling timber to the local furniture industry. The client is now employed as a broker.

GOAL: Consumer Involvement
Involve persons with disabilities in project planning, development, implementation and evaluation.

All Tech Act Projects have advisory boards or councils composed of a majority of persons with disabilities or their family members. These advisory boards offer extensive input into project long range planning and direction, implementation of activities, and project evaluation.

During 1994, 6,298 persons with disabilities were directly and instrumentally involved with Tech Act Projects -- serving as staff, members of advisory boards, or as key consumer advisors.

In Nevada, an advisory board member stated, "Consumers (with disabilities) need to be involved because they know what the problems are, they lived through them. They can relate very well to what a person may need as opposed to what he may not need."

GOAL: Outreach
Reach underrepresented and rural populations.

Projects have conducted aggressive outreach to Hispanic populations, African Americans, Native Americans, the aging and also rural and urban populations. States have disseminated information about assistive technology to Hispanic consumers and service providers and developed comprehensive plans targeting Afican Americans to increase their acces to assistive technology. Outreach efforts to Native Americans are conducted using community liaisons located in the area in which they serve.

The elderly have been targeted by over half the Tech Act projects to enable them to live more independently through the use of assistive technology. Rural populations have been reached by almost all projects through various strategies, including mobile vans and regional centers located throughout each state.

In New Mexico, an 11-year old boy was unable to go outside his home without the help of family members who lifted him. The Tech Act project coordinated the building of a ramp for the boy, with help from the pueblo. His mother said, "They got the ramp done in no time. I'm really thankful for this ramp. It was hard to get him into the house, I use to carry him on my back."

GOAL: Public/Private Partnerships
Promote public/private partnerships.

Financial loan programs were established in 16 states to allow people with disabilities to purchase assistive technology through low interest loans (Alaska, Connecticut, Hawaii, Illinois, Kansas, Maine, Nevada, New Hampshire, New York, North Carolina, Rhode Island, South Carolina, South Dakota, Utah, Vermont, and Virginia). In 1994, $65,891 was loaned to 429 persons with disabilities and their family members in low-interest or no-interest loans to purchase assistive technology.

Nineteen states have begun to secure public and private funds to augment federal funding needed to carry out Tech Act Project activities (Alabama, Arkansas, Colorado, Connecticut, Delaware, Indiana, Kansas, Kentucky, Massachusetts, Nevada, New Hampshire, New Mexico, New York, North Carolina, Oregon, Tennessee, Utah, Virginia, and Wisconsin).

In Nevada, one woman received a low interest loan for a van with a lift so she could go to the doctor, bank, and grocery store. She commented, " I worked all my life in nursing and then I came down with multiple sclerosis (MS). I was almost like a prisoner in my own home...(The low interest loan) is the best thing that ever happened to me at this time in my life."

GOAL: Systems Change
Promote systemic change through legislation, policies and practice.

Lemon laws or consumer protection laws were passed in 16 states to protect consumers from defective wheelchairs and other assistive technology devices and equipment (California, Georgia, Louisiana, Maryland, Michigan, Minnesota, Missouri, Montana, New Jersey, New York, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Washington, Wisconsin). Additional laws were passed to ensure phone, building, and court access for people with all disabilities.

In some states, a permanent state council, division, or interagency body was created to ensure that the needs of individuals with disabilities with respect to assistive technology will continue to be addressed through the various service systems in the states.

A Missouri legislator who had successfully marshaled an assistive technology lemon law through his state legislature said, " It's tough because these wheelchairs can cost from $3,000 to $18,000, a major expense for these folks. If the chair doesn't work they can't just run out and buy another one. They're left for months trying to get it fixed or get a replacement...It isn't just an inconvenience to disabled citizens...It means that if they buy a motorized wheelchair and it breaks or malfunctions, they can not go to work, they can not get out to the grocery store, they can't live their lives."

GOAL: Collaboration
Promote interagency coordination and collaboration.

State special education agencies are partners with Tech Act Projects in many of the states. Collaboration has centered on writing state policy regarding AT, training, coordinating transition services, establishing equipment loan programs and services, and planning school services.

State Tech Act Projects have collaborated with vocational rehabilitation agencies to train case managers, plan transition services, and provide assistance to identify job accommodations.

All projects have contracts or grants with their state protection and advocacy agency. Through these some states have worked to increase access and availability of assistive technology devices and services. In 1994, 1,450 persons with disabilities and their family members were referred by Tech Act Projects to protection and advocacy organizations in their states to obtain advocacy services and legal representation in gaining access to AT and funding for AT devices and services.

Some Tech Act Projects have worked with other state agencies to streamline state AT equipment procurement procedures to ensure more timely delivery of equipment.

Tech Act Projects have also collaborated with other agencies such as Developmental Disabilities Councils, Departments of Health, and Area Agencies on Aging, as well as the American Medical Association.

The Georgia Tech Act Project has recycled 215 computers, with assistance from volunteers. The Department of Administrative Services now sends its surplus 286, 386 computers, and even some useable laptop computers to one of the Tech Act Project's regional centers instead of the state warehouses. Recycled computers have been placed with children and adults with disabilities who can use them. The Tech Act Project was also instrumental in getting the Department of Medical Assistance to launch a six month pilot to recycle 500 hospital beds, patient lifts, and wheelchairs with Friends of the Disabled, a private group.

GOAL: Training
Enhance skills and competencies through training.

In 1994, Projects provided training to 54,625 persons with disabilities and their family members and 75,934 providers working with persons with disabilities and their family members.

Training and staff development topics included: proven methods to access funding; ways to decrease time it takes to get devices and services delivered; and ways to use AT devices and services to improve employability, increase self sufficiency and independence, and improve access to schooling opportunities.

After participating in a workshop on using assistive technology in the schools, a coordinator of school services in Indiana put his new knowledge to work with dramatic results. He said: " We're seeing kids produce written work through assistive devices (and) participating in the classrooms much more fully with the use of assistive devices than what we would ever have dreamed."

GOAL: Information
Increase awareness and knowledge about assistive technology.

Almost all Tech Act projects have established in-state information and referral systems, usually with a toll free number where individuals and family members can call to get information on assistive technology.

In 1994, 124,535 persons with disabilities or their family members have received information from the projects. 77,297 service providers (therapists, teachers, nurses, others) working with persons with disabilities or their family members also received information.

Examples of information provided includes how to obtain AT devices and services, funding options, and where to go for additional information. Most states have demonstration sites where persons with disabilities may try out the assistive technology to see if it works for them before they purchase it. This helps the potential technology user make an informed buying decision.

One woman from New York who received a recycled computer, as well as computer training and access to the Internet, said, "I cannot express how very much (Tech Act project staff) have changed my life from one of desolation and despair to one of hope and aspirations. Being connected to the Internet has enabled me to resume a writing career, although sporadically. Being able to do research at home is an immeasurable help."

Ongoing Challenges for Tech Act Projects
Funding remains a barrier to the acquisition and use of assistive technology.

According to a 1992 study cosponsored by the Centers for Health Statistics and NIDRR, 13.1 million people or approximately 5.3% of the population in the U.S. were using assistive technology devices to accommodate physical disabilities. Approximately half of the persons with assistive technology devices and over three fourths of those with home accessibility features, paid for them out of pocket without the assistance of third-party payers. Over 2.5 million Americans claimed they were in need of assistive technology devices that they did not have mainly because they could not afford them. (LaPlante, Hendershot, Moss, 1992, p.1)

The need for systemic change continues.

Changing economic, social, and political realities have contributed to this need. For example, some Tech Act projects have found that gains they had made with third party payers providing funding for assistive technology were lost as managed care has become more prevalent.

Providing AT devices and services is cost effective.

The cost effectiveness of providing appropriate assistive technology devices and services to people with disabilities can be demonstrated. In Chicago a cost/benefit analysis of assistive technology was conducted with dramatic results. The study evaluated 150 people with disabilities receiving Meals-on-Wheels or homemaker services paid for by the city of Chicago. A preliminary analysis of the first 50 people receiving assistive technology devices and services through this project demonstrated that 90% were able to reduce or eliminate their need for these services. For the 45 clients that were able to eliminate or reduce their need for Meals-on-Wheels or homemaker services, the city was projected to save $867,531 in services. (Hedman, 1996 pps. 50, 51)

In 1993, the National Council on Disability studied 136 individuals in seven states to evaluate the costs and benefits associated with assistive technology services and devices. They found that 62% of working age persons in the study were able to reduce dependence on family members, 58% were able to reduce dependence on paid assistance, and 37% were able to increase earnings by using assistive technology. With respect to elderly persons in the study, 80% were able to reduce their dependence on others, half were able to reduce dependence on paid assistance, and half were able to avoid moving into a nursing home. (National Council on Disability, 1993, p. 50, 51)

Population needs are ever changing.

The number of persons over 65 represents a growing proportion of the total population in the U.S. Currently, approximately 13% of the total population is over 65. By the year 2030 the U.S. Census Bureau predicts that persons 65 or older will represent 25% of the population in the U.S. (Vitaliti, Bourland, 1995). According to a Centers for Health Statistics and NIDRR report, older people are more likely than younger people to use assistive technology devices. 52% of people who use assistive technology devices are over 65. (LaPlante et al. 1992, p. 3.)

References

Enders, A. (1990). Assistive technology sourcebook. Washington, DC: RESNAPRESS.

Hedman, G. (1996). The assistive technology - Chicago project: preliminary cost / benefit results. In A. Langton (Ed.), Proceedings of the RESNA '96 Annual Conference (pp. 35-37). Arlington, Virginia: RESNAPRESS.

LaPlante, M.P., Hendershot, G.E., Moss, A.J. (1992). Assistive technology devices and home accessibility features: prevalence, payment, need, and trends. Advance data from vital and health statistics; no 217. Hyattsville, Maryland: National Center for Health Statistics.

National Council on Disability. (1993). Study on the financing of assistive technology devices and services for individuals with disabilities: a report to the President and the Congress of the United States; March 4 1993. Washington, DC: National Council on Disability.

Vitaliti, L.T., Bourland E. (Eds.). (1995). Project reaching out: Proceedings of forum on human diversity. Arlington, Virginia: RESNA.

The purpose of this report is to share the accomplishments and dramatic gains made by the projects funded under the Technology-Related Assistance for Individuals with Disabilities Act Amendments of 1994 (P.L. 103-218). The program initially began in 1989 as P.L. 100-407.

RESNA Technical Assistance Project Staff

Jim Geletka - RESNA Executive Director
M. Nell Bailey - Project Director
Barbara Crowl - Project Associate
Marka Hayes - Project Associate
Nancy Meidenbauer - Project Associate
Todd H. Miller - Information Coordinator
Sharon Scott - Project Assistant

This publication is available upon request in alternative formats

The RESNA Technical Assistance Project, Grant #H224A50006, is an activity funded by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Department of Education (ED) under the Technology-Related Assistance for Individuals with Disabilities Act Amendments of 1994. The amount of the grant award for 1995-96 ins $749,925.00. The information contained herein does not necessarily reflect the position or policy of NIDRR/ED or RESNA and no official endorsement of the material should be inferred.

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The National Assistive Technology Technical Assistance Partnership is a cooperative agreement between the U.S. Department of Education and RESNA. The grant (Grant #H224B050003; CFDA 84.224B) is funded under the Assistive Technology Act of 1998, as amended and administered by the Rehabilitation Services Administration, Office of Special Education and Rehabilitative Services at the U.S. Department of Education.

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