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TAP Bulletin - August 1997


COLLABORATIVE ACTIVITIES OF THE TECH ACT PROJECTS

A history of collaboration exists in the Tech Act community due to a shared vision, common goals, and a means to share resources.

Title I of the Technology-Related Assistance for Individuals with Disabilities Act of 1988, as amended, promotes collaboration among grantees. It also promotes partnerships with public and private sectors to facilitate linkages for public access to information regarding assistive technology (AT). The Tech Act legislation specifies that information systems may be organized on an interstate basis or as part of a regional consortium to facilitate the establishment of compatible, linked information systems. States may enter into cooperative agreements with other states (interstate activities) to expand their capacity to assist individuals with disabilities of all ages to learn about and acquire AT devices and services that individuals with disabilities need at home, school, work, or in other environments that are part of daily living. The Act encourages states to electronically communicate with other states to gain technical assistance in a timely fashion and to avoid the duplication of efforts already undertaken in other states. It also supports partnerships and cooperative initiatives to promote greater participation between public and private sectors.

This issue of the TAP Bulletin highlights some of the collaborative efforts among the 56 Tech Act grantees.

Interstate Activities

One of the earliest collaborative efforts between states is a joint information and referral system established between the Iowa (IPAT) and Minnesota (STAR) Tech Act Projects. When the Tech Act grant awards were made to Minnesota (1989) and Iowa (1990), an AT information network was already in existence at the University Affiliated Program in the Iowa University Hospital School. The two state Tech Act projects, IPAT and STAR, contracted with the existing InfoTech to expand and enhance services to provide comprehensive information to consumers, families, and service providers related to AT. InfoTech operates a toll-free number and produces a bi-monthly publication containing news items on AT and advertisements of AT devices available through the Used Equipment Referral Services for residents of both states. Systems change efforts are driven by data gathered through this information and referral service, including identification of issues, patterns and regional barriers regarding access to AT. Since its inception more than seven years ago, InfoTech has continued to adapt to advances in assistive technologies, information and advocacy needs of persons with disabilities. The Minnesota STAR program now publishes its own newsletter with AT information related specifically to Minnesotans. InfoTech continues to provide information services and used equipment referrals to residents of Iowa, Minnesota and many other states through a national toll-free number, quarterly publication of a newsletter and posting the Used Equipment Referral Service on IPAT's internet home page for public access.

Recent efforts to provide services to remote rural areas with sparse populations led to the creation of the Wyobraska Project, a collaborative activity between Wyoming's New Options in Technology (WYNOT) and the Nebraska Assistive Technology Project. Both state Tech Act projects recognized the need to provide outreach and access to AT to underserved populations. Funds were pooled to establish a mobile demonstration unit designed to serve the rural border communities and eliminate state-line barriers. A comprehensive array of services was developed by linking existing programs, and sharing personnel and equipment resources. The mobile unit carries a variety of AT devices and is used for equipment demonstration, presentations, training and evaluations. Nearly 800 individuals have been provided with necessary AT information, training or evaluations in less than a year of operation. Jointly, the Wyoming and Nebraska projects developed a Request for Proposals and an award was made to an organization committed to continuing to serve this area beyond the one year start-up grant. An advisory task force of consumers with disabilities, parents of consumers and agency personnel from the rural areas of western NE and southern WY was formed to monitor the contract services, assess the needs of consumers on a monthly basis, and assist the projects to determine the regional impact of this activity. Prospects for long-term funding or self-sustainment are being considered. As a result of this joint venture a discussion has begun comparing the two states' regulations regarding AT and how they affect the provision of services across arbitrary borders. Community members have started to develop strategies to continue to provide awareness, information and access to AT through other means such as health fairs and to involve key leaders.

Partnerships

A supplemental grant award from the National Institute on Disability and Rehabilitation Research (NIDRR) was made to the New York State Technology-Related Assistance for Individuals with Disabilities Project (TRAID), in collaboration with the New Hampshire Alliance for Assistive Technology, to study the feasibility of a national model of reclamation and recycling equipment. This study serves as a resource guide and model for use by states interested in replicating existing recycling programs to expand access to AT in a timely and cost effective manner. Equipment loan programs are designed to allow individuals to obtain necessary AT devices; to aid in the selection of appropriate devices; and to provide temporary replacement devices to consumers whose own personal devices are on order or being repaired. The study (completed in March 1997) outlines existing recycling, loan and equipment exchange programs for persons with disabilities, focusing on computers and durable medical equipment. Program strengths and weaknesses are identified and recommendations are set forth to improve different aspects of recycling programs, overcome operational impediments and make such programs more functional and replicable.

A partnership between the American Medical Association and the Nebraska Assistive Technology Project in collaboration with Tech Act projects in Arkansas, Iowa, Maine and Minnesota resulted in a unique capacity-building program to educate physicians and other health care providers about primary care for persons with disabilities and the resources available to assist them. An interdisciplinary team developed Guidelines for the Use of Assistive Technology: Evaluation, Referral, Prescription, a 58 page booklet published in 1994 and revised in 1996. The team also developed a curriculum and training materials; conducted physician workshops and clinical education seminars; developed outreach and publicity materials; and conducted surveys to evaluate changes in physician attitudes, knowledge and practices as a result of the seminars. The program has been effective. As a result of the training, nearly half of the attendees reported implementing changes in their practices to better accommodate their patients with disabilities, including: screening functional assessments; referral of patients for AT evaluations; use of community resources; and the ability to plan for and deliver care to persons with disabilities. Partnering with the AMA provided important visibility and legitimacy for the Tech Act Projects. Subsequently, DakotaLink (South Dakota's Tech Act project) and the Texas Assistive Technology Partnership successfully adapted the AMA seminar to utilize distance learning and reach a large number of rural physicians.

Regional Conferences

The development of a regional perspective of common goals and integration among communities has also facilitated collaborative efforts. Regional conferences can promote networking and exchange of information, get information out to consumers, parents, families or representatives and service providers, and provide a forum for sharing strategies to address common issues.

The Tri-State Conference, Assistive Technology: Across the Lifespan, was a unique collaborative effort among three regional Tech Act Projects-- the District of Columbia, Maryland and Virginia-- conducted in May 1996 in Alexandria, Virginia. The partnership among these Tech Act projects was an opportunity to build interstate networks to assist both end users (consumers) and providers of assistive technology. Each state highlighted innovative approaches it was using to increase access to AT for individuals with disabilities and build state capacity. The three projects also presented examples of how policy had been changed through legislative and advocacy initiatives. National and local vendors were assembled to create a massive hands-on exhibit hall.

Access Midwest, held this past April in Omaha, Nebraska, was the midwest's largest ADA, Employment and Assistive Technology Conference & Expo for individuals with disabilities, their families, teachers, service providers and employers. This regional conference was a cooperative effort among four Tech Act Projects (Iowa, Kansas, Missouri and Nebraska) and select state public and private agencies and organizations. More than 1600 people attended the event. Workshops and vendor exhibits provided the opportunity for everyone to obtain the latest information on technology, services, and programs that impact the lives of people with disabilities. Representatives from funding agencies were able to learn more about the assistive technology devices that they are being asked to fund. Organizers hope to expand the next conference to encompass a larger region; continue to foster the establishment of networks of information exchange and support; enhance problem solving and search for solutions beyond state boundaries. They also intend to utilize expertise among neighboring Tech Act projects to provide training and build a wide base of support-constituencies. Past midwest regional conferences have focused on practical applications of AT in learning and transitions and lifelong learning and productivity. These conferences, held in Sioux City, attracted approximately 500 people from Iowa, Minnesota, Nebraska and South Dakota.

Replication of Model Policies, Practices and Services

Technical assistance is provided by Tech Act projects to other grantees through the development of model policy and programs. When grantees share their efforts, it enables other projects to adopt and implement successful programs in a timely manner and without duplication of effort. The Iowa Program for Assistive Technology (IPAT) developed a train-the- trainer program to increase awareness of, and access to AT in the elder community. "small changes, BIG DIFFERENCES" has been generously shared by IPAT since its inception in 1993 through workshop presentations. Alabama STAR and many other Tech Act projects have now adopted this program. LATAN, Louisiana's Tech Act project, provided legislative language for an assistive technology consumer protection law in 1993. This model legislation is commonly referred to as the AT "lemon law" and since its passage has been widely shared with other Tech Act projects for reference and adoption in their states. The Virginia Assistive Technology Project (VATS) conducted a study of state financial loan programs in 1993 in an effort to develop options for the creation of a loan assistance program that would provide long-term, low-interest loans to individuals for the purchase of assistive technology devices or services. This study, National Research of Loan Financing Practices: Model Approaches, Implementation Strategies, and Funding (1993), updated in 1997, was intended to provide guidance to Tech Act projects on alternative approaches to the development of loan financing programs. This comprehensive report was shared and utilized widely among the Tech Act grantees and has been a valuable resource in the development of AT financial loan programs in many states. Purchasing educational technology has been made easier by Access Considerations for Technology Purchases, a technical assistance packet developed by the Missouri Assistive Technology Project to assist school districts in purchasing technology that is or can be fully accessible to students with disabilities. The packet includes a series of questions, called a QuickList, that school districts need to consider regarding system access capabilities. It is intended for use by educational technology and special education staff to gather necessary information to assist in making purchasing decisions. The computer technology access QuickList has been disseminated to all Tech Act projects for use in their states and related public agencies.

Cooperative Initiatives

Another supplemental grant was awarded by NIDRR to facilitate collaborative activities among grantees to promote systems change and advocacy. The Louisiana Assistive Technology Access Network (LATAN) led 16 state Tech Act projects in a coordinated effort to remove Medicaid funding barriers for augmentative and alternative communication (AAC) devices and services. Alabama, Delaware, Georgia, Indiana, Kentucky, Louisiana, Maryland, Michigan, Mississippi, North Dakota, Oklahoma, Pennsylvania, South Dakota, Tennessee, Utah, and West Virginia participated in the implementation of strategies to eliminate funding barriers to AAC for Medicaid eligible individuals with disabilities of all ages. The multi-state collaboration award of $80,000 was designed to achieve systems change and increase access to AT. In addition to the supplemental grant funds, several states contributed money or in-kind consultations to enhance the initiative through policy development and dissemination efforts. Significant changes and positive outcomes were made throughout the 16 participating states. A model policy was developed entitled "Medicaid Coverage Policy for Augmentative & Alternative Communication Devices and Services." A videotape was produced to demonstrate how AAC intervention is treatment for individuals of all ages who have severe expressive communication disabilities. Overall, systems were changed-- existing coverage barriers were reduced or eliminated. States with complete AAC coverage exclusions acknowledged their duty to cover and now provide these AT devices. For those states that limited scope of AAC coverage to children, some did eliminate the age-based distinction; others continue to pursue efforts to eliminate this distinction. Tech Act projects are writing AAC device decision-making criteria for adoption by their state Medicaid agencies. Unique coverage and funding barriers that projects worked on included: refusal to cover computer based AAC devices (SD); uncertainty regarding managed care organization's duty to cover AAC devices for nursing facility residents (TN); and unwarranted delays in Medicaid payments to vendors (IN). All these barriers were eliminated.

These are just a few of the many possible examples of collaboration among Tech Act projects.