[chap hd]State Financing Activities

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[chap hd]State Financing Activities ...

National Assistive Technology Technical Assistance Partnership

    Improving State Assistive Technology Programs

    Considerations for Effective Implementation

    State Financing Activities

    October 2006

    Providing Technical Assistance and Training to Programs

    funded under the Assistive Technology Act of 1998, as amended

    Improving State Assistive Technology Programs

    Considerations for Effective Implementation

    of State Financing Activities

    The Assistive Technology Act requires that (ii) support for the development of states support state financing activities either State-financed or privately financed directly or in collaboration with other entities. alternative financing systems of sub-Section 4(e)(2)(A) of the Assistive Technology sidies (which may include conducting Act as amended in 2004 states the following: an initial 1-year feasibility study of,

    improving, administering, operating,

    ―(A) STATE FINANCING ACTIVI-providing capital for, or collaborating

    with an entity with respect to, such a TIESThe State shall support State

    system) for the provision of assistive financing activities to increase access

    technology devices, such as to, and funding for, assistive technol-

    ogy devices and assistive technology

    services (which shall not include di-(I) a low-interest loan fund;

    rect payment for such a device or ser-(II) an interest buy-down program;

    vice for an individual with a disability (III) a revolving loan fund;

    but may include support and adminis-(IV) a loan guarantee or insurance

    tration of a program to provide such program;

    payment), including development of (V) a program providing for the pur-

    systems to provide and pay for such chase, lease, or other acquisition of as-

    devices and services, for targeted in-sistive technology devices or assistive

    dividuals and entities described in sec-technology services; or

    tion 3(16)(A), including (VI) another mechanism that is ap-

    proved by the Secretary.‖

     (i) support for the development of sys-

    Many states established Alternative Financing tems for the purchase, lease, or other

    Programs that meet the requirement for state acquisition of, or payment for, assis-

    financing activities. In addition, states have tive technology devices and assistive

    explored other activities that could address the technology services; or

    requirements of the act. This paper reports on National Assistive Technology Technical Assistance Partnership 1

    Considerations for Effective Implementation of State Financing Activities some of these activities as shared by states in a financing program (AFP). Descriptions of series to two conference calls hosted by the some of those programs are included. The list National Assistive Technology Technical As-is not inclusive of all activities being con-sistance Partnership (NATTAP) on April 14, ducted in all the states. Other than AFPs, some 2005, and April 27, 2005. of the activities highlighted by states included

     the following: Cooperative Buying Program Features of an Effective State (Maryland), Individual Development Ac-Financing Activity counts (Kansas), Partnerships for Coordina-

     tion of Agency Services (Nebraska), and Last State financing activities directly assist indi-Resort Fund (Illinois and Virginia). viduals with the acquisition of assistive tech- nology (AT) devices or services by reducing Other than AFPs, the inclusion of an activity the cost of AT or developing alternative on this list does not imply that the Rehabilita-sources of funding for AT. Good state financ-tion Services Administration has approved of ing activities approach funding is a systemat-this activity as a state financing activity that ic manner and are activities that are sustained meets the requirements of the AT Act. over time. State financing activities include the development of systems that do the fol-Cooperative Buying Program lowing: (Maryland)

    1. Provide for the purchase, lease, or other ac-Background quisition of, or payment for, AT devices and services using AT Act funds. The Maryland Assistive Technology Coopera-2. Support the development of state-financed or tive is a program of Assistive Technology: privately financed alternative financing systems. Loans, Acquisitions, Services, and Training, 3. Are statewide and serve individuals with Inc. (AT:LAST, Inc.), that provides dis-disabilities of all ages. counted purchasing and training opportunities 4. Can be measured (data can be collected on to schools, agencies, organizations and fami-users). lies. With initial funding and support from the 5. Do not include direct payment for devices Maryland Technology Assistance Program and services with AT Act funds. (Governor’s Office for Individuals with Dis-

    6. Include support and administration of a abilities), the Maryland State Department of program that provides payment for, and acqui-Education Division of Special Education, and sition of, AT. the Maryland Developmental Disabilities

     Council, the Cooperative uses the combined Descriptions of Ideas for State purchasing power of Maryland’s schools to Financing Activities make AT more affordable.

    The National Assistive Technology Technical AT:LAST, Inc., was formed as a 501(c)3 non-Assistance Partnership (NATTAP) conducted profit organization in 1998 by the Maryland a series of conference calls with state AT Act Technology Assistance Program (MDTAP) in programs to provide a forum for the exchange response to several focus groups that sought to of ideas on activities that might be considered determine why students were not receiving the state financing activities. States shared their assistive technologies to which they were legally ideas and offered potential state financing ac-entitled under IDEA. The overwhelming focus tivities other than the traditional alternative group response was ―the high cost.‖ To tackle National Assistive Technology Technical Assistance Partnership 2

    Considerations for Effective Implementation of State Financing Activities that issue, MDTAP provided the seed money to head low (paying minimal rent, advertising, etc.), establish a nonprofit organization that does not and it gets permission from numerous manufac-depend on funding from the Assistive Technol-turers to hold ―statewide‖ versions of ―district‖

    ogy Act and is free to operate without typical licenses, thus allowing small systems to benefit governmental bureaucratic delays and issues. from the purchase levels of large systems.

    By March 1999, AT:LAST had established the The Co-op realizes savings for its members by Maryland A.T. Cooperative buying service to conducting competitive bids, negotiating di-combine the purchasing power of Maryland rectly with manufacturers, and entering into a schools so it could reduce the high cost of AT. limited number of reseller agreements. The The rapid success of this service has led to Co-op attaches a small percentage to the pric-AT:LAST, Inc., being identified as the ―MD es it obtains to sustain its operation. While the A.T. Co-op,‖ although it performs many addi-Co-op occasionally receives grants from go-tional services, including a comprehensive vernmental agencies, those grants are for the training program, short-term device loan pro-performance of particular, time-limited func-gram, student evaluations on a limited basis, tions and are separate from the general opera-and public awareness activities. tion of the purchasing Co-op.

    The goals of the program are the following: The success of the cooperative buying function

     is the clear result of cooperative and collabora-1. To see more product, properly used, in the tive relationships with both its members and hands of individuals with disabilities. the AT communitymanufacturers, vendors,

    2. To train parents and professionals shoulder-academics, consumers, and practitioners. It is to-shoulder in the appropriate use and integra-also a reflection of the unique bidding process. tion of products. 3. To make individuals and institutions aware Unlike most governmental or educational enti-of the continuum of assistive technologies that ties that seek guaranteed pricing for a period are available so that they can properly select of 3 to 5 years, the Co-op seeks pricing for a technologies to best support individual needs. 6-month period. This timing protects the bid-4. To work closely with manufacturers to pro-der from unpredictable manufacturer cost in-vide product development feedback and to be creases and recognizes factors that are unique sufficiently knowledgeable to answer ques-to the technology market (i.e., short upgrade tions from consumers. periods, declining costs, and rapid new-5. To support its members with accurate and product introduction). Bids are sought on a up-to-date information about products, strate-range of quantities to accommodate both large gies, professional development opportunities, and small members (typically, less than 5, be-and human and AT resources. tween 5 and 24, and 25 and more). This strat-

     egy yields good pricing for members while it

    protects bidders from offering in anticipation Operations

    of quantities that may or may not materialize.

    All discounted orders go through the MD A.T. Co-op at rates published twice yearly. The Co-op A simple and transparent process (the bidder serves as a ―reseller‖ to offer the best pricing on bids and returns only applicable sheets; certain product lines where margins are small. there is no need to provide pictures and To bring discounted products to consumers, product descriptions, and there are no need-schools, and agencies, the Co-op keeps its over-less pages of ―boilerplate‖), the Co-op’s me-

    National Assistive Technology Technical Assistance Partnership 3

    Considerations for Effective Implementation of State Financing Activities thod reduces paperwork and valuable time 5. Laptop computers are available at Co-op used for completing and returning bids. events so participants can try software pro-Processing is 98% completed the day after grams for themselves. Similarly, the majority

    closing. Results are known by winners with-of software programs have been donated by in a week. (It takes only one additional day manufacturers or vendors. to notify those without any winning bids.) 6. The Co-op produces and distributes a copy Bids are advertised in a major local newspa-of its "Discounted Price List" to every Mary-per, by fax notification, and on the Web site. land public school, to each member of the Bids are returned by fax, thereby saving Maryland Association of Non-Public Special time and registered mail expenses. Education Facilities, and to many organiza-

     tions and agencies. The easy process, quick notification, and poli-7. The Co-op exhibits at several statewide cy of not holding a bidder to a price if the bid-conferences each year to make individuals and der can document a manufacturer’s price groups aware of the potential for assistive increase is reason enough to do business with technologies and of its service for acquiring the Co-op. But the Co-op’s position is that it them. needs to provide more to the participating 8. The Co-op supports the use of the products vendors in return for the discounts they offer with training sessions and comparative prod-to its members. Therefore, the Co-op offers uct expos. the following in return:

     What the Co-op Does for Its Customers 1. All orders are ―pre-processed.‖ Clarification is sought about platform, cable type, and so The Co-op provides several services to its forth, before a Co-op purchase order leaves customers: the office, thus saving manufacturers or ven- dors the time and inconvenience of providing 1. The Co-op negotiates directly with and con-additional required information. ducts semi-annual bids with more than 50 manu-2. Within 30 days of receipt of merchandise, facturers and vendors of AT to get the best price. 100% of invoices are paid. This practice helps 2. The Co-op allows participants to put items the collaborating merchant avoid cash flow and from multiple manufacturers on a single pur-collection issues because the Co-op waits for the chase order for efficiency and economy. more historically slow-paying school systems. 3. Parents and individuals with disabilities can 3. Product catalogs and demonstration disks participate in cooperative purchasing of AT are transported and distributed at all Co-op software or devices needed at home or in the events. The Co-op does not ―promote‖ any community. The Co-op works closely with the product over another; instead it seeks to make Maryland AT Guaranteed Loan Fund so that the public aware of the continuum of devices individuals can get the lowest possible cost and software programs available. plus the lowest possible interest rate when fi-4. Sample products are displayed at all Co-op nancing the purchase of AT. events. Some of the samples have been pur-4. The Co-op displays and distributes manu-chased by the Co-op as sale or loan inventory. facturer’s catalogs, demonstration disks, and Many of the display items have been donated so forth, at training events open to the public. to the Co-op for the purpose of allowing the 5. The Co-op brings nationally renowned public to examine them more closely before speakers to Maryland for quality professional purchase. Items are regularly made available development activities, many of which pro-by both large and small companies. vide professional continuing education units, National Assistive Technology Technical Assistance Partnership 4

    Considerations for Effective Implementation of State Financing Activities from the Maryland State Department of Edu-Easter Seals, Head Start, Garrett Spe-cation and other organizations. cial Needs Children, Lion’s Club, 6. The Co-op assists local school systems in Maryland Disability in Higher Educa-writing and implementing grants to improve tion Network members, Mikel Founda-the achievement of students with disabilities tion, United Cerebral Palsy, through the use of AT. ? Parent groups and individuals

    ? Teachers and therapists

     Types of AT Products Currently Available

    Purchasing Procedures

     The Co-op offers a variety of AT products,

    Directions for purchasing are slightly different which include the following items:

    for parents than they are for agencies and

    school districts, which already have estab-? Education software

    lished relationships with the Co-op. Parents ? Communication devices

    are directed to first work with their child’s ? Adapted computer access

    therapist or teacher to get guidance regarding ? Aids for daily living

    the selection of appropriate AT. The Co-op ? Visual supports software

    does not provide recommendations regarding ? Sensory aids

    which AT should be purchased. Next, the par-? Therapeutic supplies

    ent completes a quote form. The Co-op ? Adapted recreation supplies

    searches for the best price and then informs ? Seating and positioning equipment

    the parent. The parent next submits payment ? Accessible information technology

    to the Co-op by check or money order.

     Population Served


     The Maryland Co-op serves a number of cus-

    Although the Maryland A.T. Co-op initially tomers, including the following:

    charged a membership fee to school districts,

    it no longer does, partly because the school ? 23 of Maryland’s 24 public school

    districts were not used to paying a member-systems

    ship fee and did not want to pay one. Instead, ? 14 private schools

    the Co-op now attaches a small percentage to ? Government agencies: County Health

    the prices it obtains so it sustains its operation. Departments, Developmental Disabili-

    Consequently, schools, state agencies, and ties Administration, Developmental Dis-

    consumers can get good prices on AT without abilities Council, MDTAP Guaranteed

    paying membership fees. Loan Program, Maryland State Depart-

     ment of Education, U.S. Veterans Af-

    In addition to providing access to affordable fairs Office for Western Maryland

    AT, it is essential that training on the use of ? Colleges and Universities: Bowie State

    the AT be provided. University, Frostburg State University,

     Johns Hopkins University, Loyola Col-

    Establishing a cooperative buying program is lege in Maryland, Towson University

    time and labor intensive. It also requires a fi-? Organizations: Abilities Network,

    nancial ―slush fund‖ (approximately $20,000 Amerigroup Maryland, Inc., ARCs,

    when the Co-op first began and now almost Community Services for Autistic

    $100,000) to cover the expenses of the AT Adults and Children, Day Care Centers,

    National Assistive Technology Technical Assistance Partnership 5

    Considerations for Effective Implementation of State Financing Activities while the Co-op awaits payment from school eligibility of IDAs to include non-TANF reci-districts and other customers. pients and provided federal funding to expand

     the availability of IDA programs. AT:LAST, Inc., moved into public space in May 2005 to establish a demonstra-IDAs are managed by community organiza-tion/resource room and training center in order tions, and accounts are held at local financial to support use of the products handled. It is institutions. Contributions from low-income highly recommended that such a facility be participants are matched using both private part of a cooperative purchasing plan. and public sources. Money set aside in IDAs

     is disregarded in determining individual assets. Susan Garber, executive director of the Money provided as a match by private sources Maryland A.T. Co-op, suggests that states can often be claimed as a tax credit. Employ-consider partnering with an existing pro-ers who contribute to the IDA match may re-gram, such as the Maryland A.T. Co-op, ceive wage subsidies. rather than having each state establish its own program. IDAs are used to help individuals save for

     education and job training, home ownership,

    and micro-enterprise. Individuals save a Contacts and References

     monthly amount that is matched 1:1 or 2:1 or For more information, visit the Co-op’s Web more so that after a time, the amount available site at or contact: for education, home ownership, or starting a

     business is larger than the individual would Susan Garber, Executive Director, (410) 381-have been able to save by himself or herself. COOP, For example, if an individual saves $50 a Amanda Cheong, Purchasing Director, (410) month that is matched 2:1, at the end of a year, 290-1327, instead of saving $600, the person will have Sarah Poundstone, Communications Coordi-accumulated $1,800 in the account. nator, (410) 381-COOP, communications@ Operations

    Individual Development Accounts IDAs have been linked to the purchase of assis-(Kansas) tive technology. Kansas passed a law in 2001

     (Senate Bill 332) that allowed for the creation of

    IDAs to purchase assistive technology. The in-Background

     dividual or family must have an income of less Individual Development Accounts (IDAs) are than or equal to 300% of the federal poverty dedicated matched-savings accounts that pro-level. Individuals can contribute up to $5,000 vide incentives for low-income individuals to per year; the total in the account cannot exceed build investment assets. $50,000. A match of 1:1 to 5:1 is allowed. Cur-

     rently, Kansas is seeking matching funds for the The Personal Responsibility and Work Oppor-program. No AT accounts have been started. tunity Reconciliation Act of 1996 allows states to create community-based IDA pro-Considerations grams with Temporary Assistance for Needy Families (TANF) block grant funds. The 1998 More than 500 IDAs exist nationwide, with Assets for Independence Act broadened the more than 10,000 people participating. Pro-National Assistive Technology Technical Assistance Partnership 6

    Considerations for Effective Implementation of State Financing Activities grams take time to start up. Additional time is IDA Network

    needed to market the programs to individuals This Web site, sponsored by the Corporation who might be interested in participating in them. for Economic Development, is a clearinghouse The advantage of an IDA is that an individual for IDA information. It has links to IDA confe-can actually save and realize a tremendous in-rences and training sessions, a directory of IDA crease in his or her investmentespecially programs, and an IDA toolkit. It also has links when the match ratio is high. The disadvantage to the IDA technical assistance provider. of an IDA is that the individual must have the disposable income to allow him or her to save a Washington University, St. Louis, MO

    set amount each month. If forced to choose be- tween purchasing food for the month and paying The site provides a brief overview of what into an IDA account, an individual might not IDAs are and the prevalence of IDAs across contribute to his or her IDA account that month. the country, as well as summaries of research

     into IDA effectiveness. States may not need to have specific legislation that allows for the purchase of assistive technol-Partnerships for Coordination of ogy with IDAs. If the IDA is for employment, Agency Services (Nebraska) the AT purchase could be seen as falling within job training. AT for education could fall under Background the education category, and home modifications could fall under the housing category. The Nebraska Assistive Technology Partner-

     ship (ATP) was formed in 1997, and today it

    includes nine state agencies (see Table 1 on Contacts and References

    page 9). The ATP administers some of the AT

    Flacke, T., Grossman, B., & Jennings, S. ―In-related services of the other eight state agen-dividual Development Account Program De-cies. It works with clients of these state agen-sign Handbook: A Step-by-Step Guide to cies and ensures that they receive the Designing an IDA Program‖ (1999). Corpora-technology or home modifications that they tion for Enterprise Development, 777 North need under the guidelines of the particular Capitol Street, NE, Suite 410, Washington, agency's programs. The ATP is able to leve-DC 20002, (202) 408-9788. rage funds from many funding sources and

     provides a comprehensive approach to meet Sherraden, M., Page-Adams, D., & Johnson, L. an individual’s needs. Staff members identify ―Downpayments on the American Dream Pol-appropriate services and then see that they are icy Demonstration: A National Demonstration delivered in a timely manner. Consumers par-of Individual Development Accounts, Start-up ticipate in the process of identifying their Evaluation Report‖ (1999). St. Louis, MO: needs and solutions. Center for Social Development at Washington University. Operations See also idas.htm. Partnership services include the following:

    Kansas Senate Bill 332, from the 2001 Session 1. Home purchase and remodeling for accessi-establishing individual development accounts bility for assistive technology available at http:// 2. Identification of accessibility and affordable homes and rentals National Assistive Technology Technical Assistance Partnership 7

    Considerations for Effective Implementation of State Financing Activities 3. Information on available funding sources, which an elderly person is living in a rental including eligibility guidelines and policies for property, the ATP will recommend an alumi-various programs num modular ramp rather than a wooden ramp. 4. On-site assessments for home modifications The modular ramps are more expensive initially, 5. On-site assessments for work-site modifica-but they can be recycled by removing them and tions using them in another location. 6. Information on specialized or adapted ve- hicles and mobility devices Another advantage of the partnership is its 7. Information on technology solutions, costs, ability to recycle equipment purchased by one availability, and manufacturers system and to make it available to a consumer 8. Provision of technology adaptations and who is eligible for another system. The cost of repairs assistive technology and home modifications 9. Web site assessments for accessibility for an individual can be recaptured in two 10. Training for accessible Web site design months by preventing institutionalization. 11. Recycle used equipment 12. Training on the use of assistive technology Considerations including demonstrations 13. Free, short-term loans of AT devices Advantages

     1. The ATP is able to leverage funds from Funding for the cost of home modifications, many funding sources. technology, or services needed by consum-2. The system provides a comprehensive ap-ers who experience a disability are provided proach to meet an individual’s needs.

    by numerous programs. The guidelines and 3. The process reduces costs because of the eligibility requirements of programs vary AT expertise available to ensure the appropri-widely and would be overlooked by those ate services are needed and delivered. who are unfamiliar with how to access them. 4. Consumers participate in the process by To maximize resources, the ATP worked identifying their needs and solutions. with various agencies in Nebraska to devel- op a Service and Device Application Form. Disadvantage The information provided by consumers in-1. The need and demand for AT are greater cludes their technology and home modifica-than the dollars available to support the staff. tion requests and their financial status. That information is used to coordinate funding Contacts and References between 19 agencies and organizations. The application includes a release that allows For more information on the Partnership, call the agencies to share the information. (402) 471-0734 or visit its Web site at Technology specialists average 120 assessments per year. A technology specialist conducts an on-site assessment, identifies solutions and a contractor to do the modifications, and monitors the project to make sure it is done correctly. Re- sources are maximized by identifying solutions that will meet the needs of the consumer and are cost-effective. For example, in situations in

    Table 1. Agency Partnerships in Nebraska

    National Assistive Technology Technical Assistance Partnership 8

Considerations for Effective Implementation of State Financing Activities

    AGENCY AMOUNT PURPOSE DESCRIPTION Nebraska $540,000 In-home as-This is a collaboration of a number of Health and Human

    Health and sessments for Services programs including the Home and Community

    Human AT and home Based Waiver, Medically Handicapped Children’s Pro-Services modifications gram, Disabled Children’s Program, Disabled Persons

     and Family Support Program, Economic Assistance, Sub-

    sidized Adoption, Child Protective Services, and Adult

    Protective Services. ATP provides assessments and au-

    thorizes work to be done as recommended. The program

    is focused on providing appropriate assistive technology

    and home modification solutions to help keep an individu-

    al with a disability in his or her home, living independently,

    thus avoiding institutionalization.

    ATP provides 8001,000 assessments per year and au-

    thorizes just under $2 million per year of Aged and Dis-

    abled Medicaid Waiver funds for the purchase of assistive

    technology and home modifications. The ATP contract is

    based on a fee of $850 per assessment. ATP bills

    monthly, in advance, adjusting each billing to reflect the

    difference between that month’s actual expenditures and

    the previous advance. The contract amount is currently

    capped at $540,220.

    Vocational $200,000 Financial as-Funds provide direct financial assistance for the purchase of

     Rehabilitation sistance to assistive technology and home modifications for 80100 (VR)-Part B purchase AT persons each year to allow individuals to live more indepen-

    and home dently. The funds are primarily used as gap financing when

    modifications no other resources are available. Authorized purchases are

    direct billed to VR. The entire amount of $200,000 was used

    for direct purchases of AT and home modifications for con-


    Vocational $235,000 Work-site as-Vocational Rehabilitation Title I evaluations are funded

    Rehabilitation sessments for through Solutions On Site for employment-related needs

    AT and modifi-of Vocational Rehabilitation (VR) consumers with a disa-

    cations for bility. This funding can include work-site modifications,

    employment computer equipment, and software and hardware adapta-

    tions, as well as home modifications necessary to allow a

    person to get out of his or her home to get to work. Work-

    site assessments are provided for 125160 persons each

    year. Actual expenses for the provision of services (in-

    cluding salaries, benefits, rents, operating costs, phone,

    etc.) are direct billed to VR. ATP provides the recommen-

    dations to VR staff members who then authorize the pur-

    chase of services and equipment. VR reports spending

    $647,333 for rehabilitation technology services (purchas-

    es of equipment and services) in the last fiscal year. Educational $30,000 To provide for ATP collaborates with Nebraska Educational Assistive Service Unit recycling of AT Technology to operate the eastern Nebraska recycling site #10 and computers and to assist with the implementation of TechConnectors

    through Tech-recycling or equipment loan on-line database. Funding pro-

    Connectors vides for .5 full-time equivalency. The entire amount of

    funding is drawn down and available for use upon approval

    of the contract.

    Housing Devel-$12,750 To conduct Assessments are conducted in support of Making Homes

    National Assistive Technology Technical Assistance Partnership 9

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