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State Financing Activities
Section Links
Background
What Makes a Good State Financing Activity
Ideas for State Financing Activities - Featured Programs
Cooperative Buying Program (Maryland)
Individual Development Accounts (Kansas)
Partnerships for Coordination of Agency Services (Nebraska)
Last Resort Fund (Illinois and Virginia)
Credit
Background
Section 4(e)(2)(A) of the Assistive Technology Act as Amended in
2004 states the following: “(A) STATE FINANCING ACTIVITIES - The State shall support State
financing activities to increase access to, and funding for,
assistive technology devices and assistive technology services
(which shall not include direct payment for such a device or service
for an individual with a disability but may include support and
administration of a program to provide such payment), including
development of systems to provide and pay for such devices and
services, for targeted individuals and entities described in section
3(16)(A), including--
(i) support for the development of systems for the purchase, lease,
or other acquisition of, or payment for, assistive technology
devices and assistive technology services; or
(ii) support for the development of State-financed or privately
financed alternative financing systems of subsidies (which may
include conducting an initial 1-year feasibility study of,
improving, administering, operating, providing capital for, or
collaborating with an entity with respect to, such a system) for the
provision of assistive technology devices, such as--
(I) a low-interest loan fund;
(II) an interest buy-down program;
(III) a revolving loan fund;
(IV) a loan guarantee or insurance program;
(V) a program providing for the purchase, lease, or other
acquisition of assistive technology devices or assistive technology
services; or
(VI) another mechanism that is approved by the Secretary.”
What Makes a Good State Financing Activity?
State financing activities directly assist individuals with the
acquisition of assistive technology devices or services (AT). This
often is done by reducing the cost of AT or developing alternative
sources of funding for AT. State financing activities should adopt a
systematic approach to assisting individuals with disabilities in
the acquisition of AT and should be activities that are sustained
over time. State financing activities should include the development
of systems that:
Provide for the purchase, lease, or other acquisition of, or payment
for AT devices and services using AT Act funds
Support the development of state-financed or privately-financed
alternative financing systems
Is statewide and serves individuals with disabilities of all ages
Can be measured (data can be collected on users)
Does not include direct payment for devices and services with AT Act
funds
Include support and administration of a program that provides
payment for, and acquisition of AT.
Ideas for State Financing Activities - Featured Programs
Cooperative Buying Program (Maryland)
Background
The Maryland A.T. Co-op is a program of AT:LAST, Inc. that provides
discounted purchasing and training opportunities to schools,
agencies, organizations, and families. With initial funding and
support from the Maryland Technology Assistance Program (Governor’s
Office for Individuals with Disabilities), the Maryland State
Department of Education (MSDE- Division of Special Education), and
the Maryland Developmental Disabilities Council (DDC), the Co-op
uses the combined purchasing power of Maryland’s schools to make
assistive technology (AT) more affordable.
Assistive Technology: Loans, Acquisitions, Services, and Training,
Inc. (AT:LAST, Inc.) was formed as a 501 (c)3 nonprofit organization
in 1998 by the Maryland Technology Assistance Program (MDTAP) in
response to several focus groups which sought to determine why
students were not receiving the assistive technologies to which they
were legally entitled under IDEA. The overwhelming focus group
response was “the high cost.” To tackle this issue, MDTAP provided
the seed money to establish this nonprofit organization, not
dependent on funding from the Assistive Technology Act and free to
operate without typical governmental bureaucratic delays and issues.
By March of 1999 AT:LAST had established the Maryland A.T.
Cooperative Buying Service to combine the purchasing power of
Maryland schools to reduce the high cost of AT. The rapid success of
this service has led to AT:LAST, Inc. being identified as the “MD
A.T. Co-op” although it performs many additional services, including
a comprehensive training program, short-term device loan program,
student evaluations on a limited basis, and public awareness
activities.
Goals of the program:
•
To see more product, properly used, in the hands of individuals with
disabilities.
•
To train parents and professionals shoulder-to-shoulder in the
appropriate use and integration of products.
•
To make individuals and institutions aware of the continuum of
assistive technologies available so that they can properly select
technologies that best support individual needs.
•
To work closely with manufacturers to provide product development
feedback and to be sufficiently knowledgeable to answer questions
from consumers.
•
To support its members with accurate and up-to-date information
about products, strategies, professional development opportunities,
human and AT resources.
Operations
All discounted orders go through the MD A.T. Co-op at rates
published twice yearly.
The Co-op serves as a "reseller" to offer the best pricing on
certain product lines where margins are small. To bring consumers,
schools, and agencies discounted products, the Co-op keeps its
overhead low (paying minimal rent, advertising, etc.), and it gets
permission from numerous manufacturers to hold "statewide" versions
of "district" licenses, allowing small systems to benefit from the
purchase levels of large systems.
The Co-op realizes savings for its members by conducting competitive
bids, negotiating directly with manufacturers, and entering into a
limited number of reseller agreements. The Co-op attaches a small
percentage to the prices it obtains to sustain its operation. While
the Co-op occasionally receives grants from governmental agencies,
they are for the performance of particular, time-limited functions
and separate from the general operation of the purchasing Co-op.
The success of the cooperative buying function is the clear result
of cooperative and collaborative relationships with both its members
and with the AT community— manufacturers, vendors, academics,
consumers, and practitioners. It is also a reflection of the unique
bidding process.
Unlike most governmental or educational entities which seek
guaranteed pricing for a period of three to five years, the Co-op
seeks pricing for just a six month period. This protects the bidder
from unpredictable manufacturer cost increases and recognizes
factors unique to the technology market (i.e. short upgrade periods,
declining costs, and rapid new product introduction). Bids are
sought on a range of quantities to accommodate both large and small
members (typically <5, 5-24, and 25+). This yields good pricing for
members while protecting bidders from offering in anticipation of
quantities that may or may not materialize. A simple and transparent
process (bid and return only applicable sheets, no need to provide
pictures and product descriptions, no needless pages of
“boilerplate,”) reduces paperwork and valuable time completing and
returning bids. Processing is 98% completed the day after closing.
Results are known by winners within a week. (It takes only one
additional day to notify those without any winning bids.) Bids are
advertised in major local newspaper, by fax notification and on the
website. Bids are returned by fax, saving time and registered mail
expenses.
Although the easy process, quick notification, and policy of not
holding a bidder to a price if the bidder can document a
manufacturer’s price increase is reason enough to do business with
the Co-op, the Co-op’s position is that it needs to provide more to
the participating vendors in return for their offering discounts to
its members. Therefore the Co-op offers the following in return:
All orders are “pre-processed.” Clarification is sought about
platform, cable type, etc. BEFORE a Co-op PO leaves the office,
saving manufacturers/vendors the time and inconvenience of getting
additional required information
100% of invoices are paid within thirty days of receipt of
merchandise. This helps the collaborating merchant avoid cash flow
and collection issues since the Co-op waits for the more
historically slow-paying school systems
Product catalogs and demo disks are transported and distributed at
all Co-op events. The Co-op does NOT “promote” any product over
another; instead it seeks to make the public aware of the continuum
of devices and software programs available.
Sample products are displayed at all Co-op events. Some of these
have been purchased by the Co-op as sale or loan inventory. Many of
the display items have been donated to the Co-op for the purpose of
allowing the public to examine more closely before purchase. Items
are regularly made available by both large and small companies.
Laptop computers are available at Co-op events so participants can
try software programs for themselves. Similarly, the majority of
software programs have been donated by manufacturers or vendors.
The Co-op produces and distributes to EVERY Maryland public school,
each member of the Maryland Association of Non-Public Special
Education Facilities (MANSEF), and many organizations and agencies a
copy of its (now) twenty page Discounted Price List.
The Co-op exhibits at several statewide conferences each year to
make individuals and groups aware of the potential for assistive
technologies and of its service for acquiring them.
The Co-op supports the use of the products with trainings and
comparative product expos.
What the Co-op Does for Its Customers
The Co-op negotiates directly with and conducts semi-annual bids
with over 50 manufacturers and vendors of AT to get the best price.
The Co-op allows participants to put items from multiple
manufacturers on a single purchase order for efficiency and economy.
Parents and individuals with disabilities can participate in
cooperative purchasing of AT software or devices needed at home or
in the community. The Co-op works closely with the Maryland AT
Guaranteed Loan Fund so that individuals can get the lowest possible
cost plus the lowest possible interest rate when financing the
purchase of AT.
The Co-op displays/ distributes manufacturers catalogs/ demo disks,
etc. at training events open to the public.
The Co-op brings nationally renowned speakers to Maryland for
quality professional development activities, many of which provide
professional CEU's from the Maryland State Department of Education
and other organizations.
The Co-op assists local school systems write and implement grants to
improve the achievement of students with disabilities through the
use of AT.
Types of A.T. Products Currently Available:
•
Educational Software
•
Communication Devices
•
Adapted Computer Access
•
Aides for Daily Living
•
Visual Supports Software
•
Sensory Aids
•
Therapeutic Supplies
•
Adapted Recreation Supplies
•
Seating and Positioning Equipment
•
Accessible Information Technology
Populations Served:
•
23 of Maryland's 24 public school systems
•
14 private schools
•
Government agencies: County Health Departments, Developmental
Disabilities Administration (DDA), Developmental • Disabilities
Council (DDC), MDTAP Guaranteed Loan Program, Maryland State
Department of Education, US Veterans Affairs Office for Western MD
•
Colleges and Universities: Johns Hopkins, Loyola, Towson, Frostburg,
Bowie
•
Organizations: UCP; ARCs; Easter Seals, Head Start, Garrett Special
Needs Children, Abilities Network, Day Care Centers, Amerigroup MD
Inc. Community Services for Autistic Adults and Children (CSAAC),
Lion's Club, Mikel Foundation, MD Disability in Higher Education
Network members
•
Parent groups and individuals
•
Teachers and Therapists
•
Purchasing Procedures
Directions for purchasing are slightly different for parents than
they are for agencies and school districts—who already have
established relationships with the Co-op. Parents are directed to
first work with their child’s therapist or teacher to get guidance
regarding the selection of appropriate AT. The Co-op does not
provide recommendations regarding which AT should be purchased.
Next, the parent completes a quote form. The Co-op searches for the
best price and then informs the parent. The parent then submits
payment to the Co-op via check or money order.
Considerations
While the Maryland A.T. Co-op initially charged a membership fee to
school districts, it no longer does this, due in part to the fact
that school districts weren’t used to and didn’t want to pay a
membership fee. Instead, the Co-op attaches a small percentage to
the prices it obtains to sustain its operation. Consequently,
schools, state agencies, and consumers can get good prices on AT
without paying membership fees.
In addition to providing access to affordable AT, it is essential
that training on the use of the AT be provided.
Establishing a cooperative buying program is time and labor
intensive. It also requires a financial “slush fund” (approximately
$20,000 when the Co-op first began and now almost $100,000) to cover
the expenses of the AT while the Co-op awaits payment from school
districts and other customers.
AT:LAST, Inc has just moved into public space in May of 2005 to
establish a demonstration/resource room and training center in order
to support use of the products handled. It is highly recommended
that such a facility be part of a cooperative purchasing plan.
Susan Garber, Executive Director of the Maryland A.T. Co-op,
suggests considering partnering with an existing program, such as
the Maryland A.T. Co-op, rather than each state establishing their
own program.
Contacts/References:
For more information, visit the following website:
http://www.matcoop.org/ or contact:
Susan Garber, Executive Director 410-381- COOP, info@matcoop.org
Amanda Cheong, Purchasing Director 410-290-1327 purchasing
@matcoop.org
Sarah Poundstone, Communications Coordinator, 410-381-COOP,
communications@matcoop.org
Individual Development Accounts (Kansas)
Background
Individual Development Accounts (IDAs) are dedicated matched-savings
accounts that provide incentives for low income individuals to build
investment assets.
The Personal Responsibility and Work Opportunity Reconciliation Act
of 1996 (PRWORA) allows states to create community-based IDA
programs with TANF block grant funds. The 1998 Assets for
Independence Act broaden the eligibility of IDAs to non TANF
recipients as well as provided federal funding to expand the
availability of IDA programs.
IDAs are managed by community organizations and accounts are held at
local financial institutions. Contributions from low income
participants are matched using both private and public sources.
Money set aside in IDAs is disregarded in determining individual
assets. Money provided as match by private sources can often be
claimed as a tax credit. Employers who contribute to the IDA match
may receive wage subsidies.
IDAs are used to help individuals save for
•
education, and job training
•
home ownership, and
•
micro-enterprise.
Individuals save a monthly amount that is matched 1:1 or 2:1 or more
so that after a time, the amount available for education, home
ownership and starting a business is larger than the individual
would have been able to save by himself/herself. For example, if an
individual saves $50 a month that is matched 2:1, then at the end of
a year, instead of saving $600, the person has accumulated $1800 in
the account.
Operations
IDAs have been linked to the purchase of assistive technology.
Kansas. Kansas passed a law in 2001 (Senate Bill 332) that allowed
for the creation of IDAs to purchase assistive technology. The
individual/family must have an income of less than or equal to 300%
of the federal poverty level. Individuals can contribute up to
$5,000 per year, the total in the account cannot exceed $50,000.
Match is allowed from 1:1 to 5:1. Currently Kansas is seeking match
funds to fund the program. No AT accounts have been started.
Considerations
Over 500 IDAs exist nationwide, with over 10,000 people
participating. Programs take time to start up; it takes additional
time to market the programs to individuals who might be interested
in participating in the program. The advantages of the IDA is that
an individual can actually save and get a tremendous increase in
his/her investment - especially when the match ratio is high. The
disadvantages of an IDA is that the individual has to have the
disposable income to allow him/her to actually save a set amount
each month. Given the choice between purchasing food for the month
and paying into an IDA account, an individual might not contribute
to his/her IDA account that month.
States may not need to have specific legislation that allows for the
purchase of assistive technology with IDAs. If the IDA is for
employment - then the AT purchase could be seen as falling under job
training. Likewise AT for education could fall under the education
category and home modifications could fall under the housing
category.
References (provided by Sara Sack)
Flacke, T., Grossman, B., & Jennings, S. "Individual Development
Account Program Design Handbook: A Step-by-Step Guide to Designing
an IDA Program," (1999). Corporation for Enterprise Development, 777
North Capitol Street, NE, Suite 410, Washington, D.C. 20002, (202)
408-9788/
Sherraden, M., Page-Adams, D., Johnson, L. (1999). Down payments on
the American Dream Policy Demonstration: A National Demonstration of
Individual Development Accounts, Start-up Evaluation Report. St.
Louis, MO: Center for Social Development at Washington University.
See also gwbweb.wustl.edu/csd/asset/idas.htm
Additional References
Kansas Senate Bill 332, from the 2001 Session establishing
Individual Development Accounts for Assistive technology available
at http://www.kslegislature.org/bills/2002/332.pdf
IDA Network Web site - http://www.idanetwork.org
This web site sponsored by the Corporation for Economic Development
is a clearing house for IDA information. It links to IDA conferences
and training sessions, directory of IDA programs, and an IDA
toolkit. It also has links to the IDA technical assistance provider.
Washington University, St. Louis, Missouri -
gwbweb.wustl.edu/csd/asset/idas.htm
Provides a brief overview of what IDAs are and the prevalence of
IDAs across the country as well as summaries of research into IDA
effectiveness.
Partnerships for Coordination of Agency Services (Nebraska)
Background
The Nebraska Assistive Technology Partnership was formed in 1997 and
today includes nine agencies (see Table 1). The program was started
under the direction of Mark Schultz who directs the federally funded
state grant on assistive technology. The original state grant on
assistive technology (AT) was written by the state’s Department of
Vocational Rehabilitation in 1989. Vocational Rehabilitation began
assigning some of their technology-related activities to the
assistive technology project because of the expertise of the staff.
The Department of Health and Human Services (HHS) became aware of
the cost savings with Vocational Rehabilitation and partnered with
the Assistive Technology Project, earmarking $540,000 for assessment
services in addition to paying for devices needed by Health and
Human Service consumers. Thus the Partnership was born.
One of the advantages of the Partnership is that it has a broad
mission and purpose that can encompass assistive technology from all
environments, including employment, education, independent living,
housing, and information technology. The Partnership is able to
leverage funds from many funding sources and provides a
comprehensive approach to meet an individual’s needs. The expertise
of staff ensures needed and appropriate services that are delivered
in a timely manner (inappropriate solutions are not purchased or
need to be replaced resulting in a cost savings) and consumers
participate in the process of identifying their needs and solutions.
Operations
Partnership services include:
•
Home purchase and remodeling for accessibility
• Identification of accessibility and affordable homes and rentals
• Available funding sources, including eligibility guidelines and
policies for various programs
• Onsite assessments for home modifications
• Onsite assessments for worksite modifications
• Information on specialized or adapted vehicles and mobility devices
• Technology solutions, costs, availability, and manufacturers
• Technology adaptations and repairs
• Web site assessments for accessibility
• Training for accessible website design
• Used equipment
• Use of assistive technology including demonstrations
• Equipment available or for free, short-term loans
Funding for the cost of home modifications, technology, or services
needed by consumers who experience a disability are provided by
numerous programs. The guidelines and eligibility requirements of
programs vary widely and would be overlooked by those who are
unfamiliar with how to access them. To maximize resources, the
Partnership worked with various agencies in Nebraska to develop a
Service and Device Application Form. The information provided by
consumers includes their technology and home modification requests
and their financial status. This information is used to coordinate
funding between 19 agencies and organizations. The application
includes a release that allows the agencies to share the
information.
Technology Specialists average 120 assessments per year. A
Technology Specialist does an on-site assessment, identifies
solutions and a contractor to do the modifications, and monitors the
project to make sure it is done correctly. Resources are maximized
by identifying solutions that will meet the needs of the consumer
and are cost effective. For example, in situations in where an
elderly person is living in a rental property the Partnership will
recommend an aluminum modular ramp, instead of building a wooden
ramp. The modular ramps are more expensive initially, however, they
can be recycled by removing them and using in another location.
Another advantage of the Partnership is the ability to recycle
equipment purchased by one system and make it available to a
consumer who is eligible for another system. The cost of assistive
technology and home modifications for an individual can be
recaptured in two months by preventing institutionalization.
Considerations
Advantages
The Partnership is able to leverage funds from many funding sources.
The system provides a comprehensive approach to meet an individual’s
needs.
The process saves cost because of the AT expertise available to
ensure appropriate services are needed and delivered.
Consumers participate in the process by identifying their needs and
solutions.
Disadvantages
The need and demand for AT are greater than the dollars available to
support the staff.
Contacts/References
For more information on the Partnership, call 402.471.0734 or visit
its web site at: www.nde.state.ne.us/ATP/
Last Resort Fund (Virginia and Illinois)
Background
Virginia: In 1992, the Virginia Disability Commission, a General
Assembly appointed bi-partisan commission representing individuals
with physical and sensory disabilities, made a recommendation to
create a “last resort” fund of grants for persons with physical or
sensory disabilities. The Consumer Service Fund (CSF), which
receives an annual appropriation of approximately $500,000 from the
State, is administered by the Assistive Technology Loan Fund
Authority (ATLFA). The CSF is used to help consumers achieve
specific planned goals (obtain employment, live more independently
at home, or eliminate a move to a nursing home). Examples include
special equipment or supplies, assistive technology, short term
PT/OT services, and home or vehicle modifications; however, the
majority of the CSF funds is used for the purchase of assistive
technology (AT).
Illinois: About three years ago, Illinois’ alternative financing and
telework programs, TechConnect Low Interest Loan Program, submitted
a grant application to the Illinois Office of the Attorney General
for monies to support a Fund of Last Resort for individuals with
disabilities who need assistive technology (AT). The State Office of
the Attorney General had received funds from an anti-trust
settlement. Of these monies, the program was awarded $470,000 which
could be spent over a period of three years. The funds run out on
June 30, 2005. The program is currently in the process of securing
funding from other sources so that the Fund of Last Resort will
continue beyond June 2005.
Operations
Virginia: Any individual with a physical or sensory disability can
apply to the fund and any state agency or disability organization in
the state can refer individuals with physical or sensory
disabilities to the program. Applicants must live in Virginia, have
a demonstrated physical or sensory disability, and must demonstrate
that their disability-related needs cannot be met by other agencies.
Applicants are also screened to assure that all appropriate
resources have been explored, including a guaranteed loan from the
ATLFA, if feasible. Applicants must provide persuasive justification
of their need by conveying the difference this will make in all
aspects of their lives. The Assistive Technology Loan Fund Authority
recommends that a human services advocate, case manager, counselor
or social worker assist the consumer with completing the application
and submitting the request. If an applicant has been previously
funded through the CSF, the waiting period is two years before
he/she can reapply.
Applications are reviewed quarterly by a panel of consumers and
interagency representatives. Applicants must demonstrate that all
appropriate financial resources have been exhausted (Medicare,
Medicaid, private insurance, vocational rehabilitation or special
education.) Funding is based on demonstration of critical need, CSF
priorities, and provision of supporting documentation.
Unfortunately, many requests are not approved as the CSF receives
many more requests for devices than it can purchase with its limited
funds.
Because the amount appropriated by the State has varied from year to
year and because some years have been leaner than others,
modifications have been made at times to what can be funded by the
Consumer Service Fund. Assistive technology devices and home
modifications can generally be funded; however resource limitations
often prevent awards for consumers to obtain vehicles with
modifications.
Illinois: The Fund of Last Resort is not advertised or marketed.
Information about it does not even appear on the TechConnect
website. TechConnect staff refer applicants who do not qualify for
the low interest loan program and/or the telework program to the
Fund of Last Resort. Willie Gunther, the Illinois Assistive
Technology Program’s Executive Director, and her staff review each
application and make the final decision on whether an applicant
should be funded by the Fund of Last Resort. The cap for each
applicant is $40,000. Applicants are required to demonstrate that
they have exhausted all other funding options. Fund of Last Resort
monies are distributed on a first come, first served basis.
The Application
Virginia: The application requires the following:
Documentation of a physical or sensory disability.
The request must be for a disability specific service, device, or
product and must include proof of disability from the applicant’s
physician.
Documentation demonstrating that all resources have been exhausted.
Consumers awarded funding are required to pay towards the cost of
requested services based on their ability to pay.
The request should be facilitated by a Human Services Advocate.
For vehicle requests (which cannot exceed $15,000), the consumer
must provide documentation regarding the need for the vehicle,
documentation that the individual is legally permitted to drive (if
he/she will be operating the vehicle), a copy of the Vocational
Rehabilitation Transportation Assessment if applicable, a PT/OT
assessment, and specific detail as to how the individual will pay
for the daily upkeep and insurance on the vehicle.
For home modification requests (which cannot exceed $20,000), funds
can only be used for accessibility modifications that are within the
existing square footage of the dwelling. A conceptual plan or
drawing and a corresponding bid must be submitted. ATLFA generally
arranges for a rehabilitation engineering consult prior to making
modifications.
For special equipment requests, an assessment by a physical or
occupational therapist must be submitted along with physician
reports or prescriptions or therapist recommendations.
Illinois: The Fund of Last Resort used the same application that is
used for the low interest loan program.
Population Served
Virginia: People of any age living in Virginia who have a
demonstrated physical or sensory disability are eligible for funding
if their disability-related needs cannot be met by other agencies.
Illinois: The fund covers all disabilities and is statewide.
Considerations
This fund was established and receives continued support from the
state legislature due, in part, to the testimony of individuals who
have benefited from the fund.
For states that wish to establish a “last resort fund” like the ones
described, it is advised that a diverse group of public and private
entities partner to demonstrate the need for such a fund, and
present hard data that can be tracked once the fund is operational.
Contacts/References
Virginia: For more information on Virginia’s program, including the
application form, visit the following website: http://www.atlfa.org/csf.htm
Illinois: For more information on Illinois’ TechConnect Low Interest
Loan Program, visit the following website: https://www.techconnect.iltech.org/Home.aspx
Credit:
This section is indebted to information from the Rehabilitation Engineering & Assistive
Technology Society of North American (RESNA), especially for their April, 2005,
Survey of State AT Act Projects (The RESNA Technical Assistance Project, Grant #H224B020001,
funded by the Rehabilitation Services Administration, U.S. Department
of Education, under the Assistive Technology Act of 1998).
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