Pennsylvania’s Assistive Technology Lending Library
Report on Progress: July 1, 2015 – June 30, 2016
Overview and Challenges
The Institute on Disabilities, Pennsylvania’s University Center of Excellence in De velopmental Disabilities at Temple University, has completed another successful year of operating Pennsylvania’s Assistive Technology Lending Library (ATLL), u nder the auspices of the Department of Labor and Industry, Office of Vocational Rehabilitation (OVR). In this capacity, the Institute on Disabilities has built on the infrastructure and accomplishments of Pennsylvania’s Initiative on Assistive Tech nology (PIAT), a federally-funded program of the Institute and the Commonwealt h’s program authorized by the Assistive Technology Act of 1998 as amended (th e “AT Act”). As state funds shrink, assistive technology (AT) device lending activities are increasingly supplemented with federal funds through PIAT.
Pennsylvania’s Assistive Technology Lending Library is designed to provide Pennsylvanians with disabilities, older Pennsylvanians, and those who support them with the opportunity to learn about and try assistive technology devices “before you buy” – so they can make an informed decision. The success of this program can be measured by the number of requests to borrow, the number of devices circulated, the number of borrowers who are served (including the number of new and the number of unique borrowers), consumers’ satisfaction with the program, and the outcome of device loans (e.g. decisions to purchase – or not purchase – specific assistive technology devices). Consumers also borrow devices while they wait for funding or while their device is “in the shop”; devices may also be borrowed as a temporary accommodation. Devices may be borrowed by other stakeholders to promote awareness of the range, scope, and potential of assistive technology or to train providers about the variety, benefit, and applications of AT.
The Institute on Disabilities implements its Interagency Agreement with the Penn sylvania Department of Labor and Industry, Office of Vocational Rehabilitation gu ided by the principles of consumer-responsiveness (e.g. through exemplary custo mer service) and consumer direction (e.g. increasing the informed involvement of persons with disabilities in the process of selecting their own assistive technolog y).
State funds for Pennsylvania's Assistive Technology Lending Library support a c entralized program designed to assure equal access to all Pennsylvanians with di sabilities by providing points of entry and information throughout the Commonwe alth, overcoming the barrier of transportation by using a “drop-ship” model of deli vering and returning the equipment at no cost to the borrower, and maintaining a n inventory of devices which are useful to individuals with physical, sensory, and/ or intellectual disabilities. In addition, items in the inventory are useful to infants
1 | P a g e and toddlers, young children, students (including post-secondary students), adult s, and/or older Pennsylvanians, and may be used in a variety of settings (home, community, school, or work). The needs of the constituents of the original five su pporting Departments—Aging, Education, Labor and Industry, Health, and Public Welfare—are considered and balanced against available resources as decisions are made in the implementation of the program.
Considering the decrease in appropriations over the last several years and the a dministrative fee levied by OVR, the Lending Library operates on a budget more than 60% lower than that in 07-08. State funds for the Lending Library buy fewer and fewer staff hours, for subcontractors as well as the Institute on Disabilities; outreach is most affected by this. We are hoping that the influx of funds received in the last month of the prior two fiscal years and used to revitalize the inventory, particularly in the area of devices for communication, will reverse the essentially flat demand for the program. We anticipate these items (and those contributed through other sources) will begin circulating in the first quarter 2016-17.
The impact of the Lending Library goes beyond mere numbers: Assistive technology has the ability to make a substantial difference to individuals with disabilities in working, learning, and living.
2 | P a g e Note: Data from the 14-15 program year appear throughout this report for the purpose of comparison, indicated in brackets.
Goal I: Maintain an inventory of assistive technology devices that meets th e needs of Pennsylvanians with disabilities and that addresses individuals of all ages, all disabilities, and the activities in which they seek to improve participation, independence, comfort and safety.
A. Circulate the devices in the inventory to Pennsylvanians with disabilities, family members, providers, and others who need to use or learn about assistive technology devices. Receive and process at least 850 requests for items from the centralized inventory at Hiram G. Andrews Center (HGAC) annually, reflecting more than 400 different borrowers. Reach at least 250 “new” customers, e.g. those who are “first time ever” borrowers from PA’s AT Lending Library. Report on utilization of the program.
Note: Data in this section refers to activity related to borrowers that requested devices that circulate from the “centralized inventory” located at Hiram G. Andrews Center. Information about borrowers and equipment loaned from the “onsite” lending programs of the Assistive Technology Resource Centers (ATRCs) is noted in Goal I, Objective B.
As of June 30, 2016, there are 3078 [3641] items (including 1681 [1902] different kinds of items) in the AT Lending Library housed at the Hiram G. Andrews Center (HGAC), the subcontractor for the maintenance and circulation of the centralized inventory. There were 1062 [1068] separate requests for device loans received by regional Assistive Technology Resource Centers (ATRC), reviewed, and forwarded to HGAC for processing, exceeding this year’s modest target and representing a flat level of activity. Almost all of these requests (1056 [1018]) were fulfilled, and more devices (1704 [1338) were sent out to borrowers; the remaining borrowers are waiting for the requested product or group of products.
There were 540 unique borrowers (unduplicated count), exceeding the modest target for this year (400) and essentially level from last year [542]. Four hundred fifty-one [450] were first-time borrowers, substantially exceeding the target (250), and again, essentially level from the prior year. The lack of growth in reaching new borrowers reflects a lack of investment in outreach.
Borrowers came from 57 [55] of the Commonwealth’s 67 counties (all except Adams, Cameron, Clarion, Clinton, Forest, McKean, Perry, Sullivan, Snyder and Tioga counties). Of the ten counties with no borrowers this year, all but two (Adams and Perry) are “non-metro” (according to www.ers.usda.gov Rural Urban Continuum Codes).
3 | P a g e Who is making the request? Data on the borrowers of Pennsylvania’s Assistive Technology Lending Library is obtained each time a separate request form to borrow item(s) is submitted (altho ugh more than one device may be requested on each form). For each loan application submitted, borrowers identify their role. Requests for devices come from individuals with disabilities (or family members on their behalf) and service providers (for use with an individual with a disability). During the 2015-16 program year, 71 [71] requests came from borrowers who identified themselves as “education” (including representatives from higher education), 11 [2] as “family members”, 187 [124] as “service providers”, 7 [2] as “employer”, and 28 [56] as “other”. The vast majority of loan requests (758 [812]) or about 71% [76%]) were made by people with disabilities.
What are the ages of borrowers? Customers of Pennsylvania’s Assistive Technology Lending Library included persons of all ages. Data on age is available for about two-thirds of the borrowers, reflected in the following chart.
Age of Recipients Age Number Category birth to 2 64 [93] 3 to 5 92 [62] 6 to 21 111 [182] 22 to 64 286 [250] 65 and older 186 [175] Unknown 323 [306] TOTAL 1062 [1038] There is continuing demand for a program that serves Pennsylvanians of all ages. Of those for whom age data was known, approximately 36% [44%] of borrowers were 21 or younger, 39% [33%] were adults 22 to 64, and 25% [23%]. were older adults (65+).
What is the purpose of the AT? Why borrow a device?
Seven hundred forty-one [755] borrowers indicated the equipment would help the m “at home or in the community”; 164 [229] requests were for loans for equipment that would help them “at school”, 142 [52] borrowers reported the devi ce would be for “work”, and 15 [31] borrowers reported the device would assist wi th using the phone or the computer. A more than 150 % increase in borrowers reporting the device would be for work is especially notable. Nine hundred thirty-
4 | P a g e nine [921] loans were for consumer device trial, 98 [82] loans to professionals (e. g. faculty, service providers) for professional development, 28 [27] uses as an ac commodation (e.g. for employment or public access), 40 [29] uses as “loaners” (e. g. while the individual’s device was being repaired), and 22[11] “other” uses. Note more than one reason for borrowing could be identified; clearly, the ability to “try before you buy” is the overarching function filled by this program.
What is the racial/ethnic demographic of borrowers? Although it is often uncomfortable to ask for and obtain information on a device recipient’s race, efforts continue to be made to collect this information in order to determine the extent to which the Lending Library reaches all Pennsylvanians with disabilities. More than 67% [80%] of the records included information on the race/ethnicity of borrowers. Based on the number of records of borrowers for whom race/ethnicity of the borrower was known and specified, almost 23% [19%] of borrowers identified their race/ethnicity as other than Caucasian.
Race/Ethnicity of Borrowers Category Number Caucasian 616[705] Hispanic/ 45 [31] Latino African- 106 [85] American Asian 22 [39] other 9[1] unknown 264 [207] TOTAL 1062 [1068]
What “systems” serve the borrowers? Many borrowers are served by publicly-funded service “systems”. To the extent that the “system” is identified, we can infer that benefits accrue to that system (e.g. assistive technology that has been tried is less likely to be subsequently “abandoned”, therefore public monies are more wisely utilized; consumers of that system are better served). As the Lending Library is a primarily a state-funded program, it is of particular interest to see where state-funded systems are affected. Conversely, where borrowers are not “connected” to a service system, it may be more difficult for them to find funding to acquire their own devices and other supports for assistive technology. Borrowers are asked on the loan request form to select all systems from which they receive services (e.g. they may select more than one). Borrowers reported being served by the following systems:
5 | P a g e “Systems” Serving Borrowers Category Number Early 134 [139] Intervention Public School 64 [100] Private 11 [28] School Mental Health 23 [17] Office of 28 [38] Developmen tal Programs Office of 60 [47] Vocational Rehabilitation BVS 63 [55] Area 38 [44] Agencies on Aging/Senior Centers None 538 [519] Other 103 [93] TOTAL# 1062 [1081] responses The number of borrowers served by the Office of Developmental Programs continues to be lower than expected and declining. We do understand that, in at least some cases, a barrier may be the reluctance on the part of residential service providers to assume responsibility for devices borrowed by people with intellectual developmental disabilities who live in community living arrangements or larger congregate settings. Conversely, it is gratifying to see the increase of borrowing by or on behalf of BBVS consumers. We continue to serve students with disabilities (either because PaTTAN has a waiting list for the desired item, does not have the desired item, OR because other requirements were not met for that program [e.g. request was not made by “authorized” personnel), although these numbers have substantially declined. The number of borrowers who report being served by none of the listed service systems continues to surprise.
B. Circulate devices from regional Assistive Technology Resource Centers (ATRCs), including arrangements for delivery and pick up. Track and report on usage of ATRC on-site loans.
6 | P a g e On-site loans remain an option to reduce shipping costs, as long as the borrower is able to go to the ATRC location and the ATRC has the desired product. Although on-site lending is NOT supported with state ATLL funds, this activity compliments the role of the ATRC as a key resource for device loans. Some ATRCs, including the Institute on Disabilities, have augmented their collection of devices for onsite lending through other funding sources, where available. For items represented in both the centralized inventory and an ATRC’s onsite loan program, the ATRC adheres to its established policies and procedures for determining the source of the loan. ATRCs are permitted to use their state or federal funds (if needed) to support lending, e.g. mileage or postage to deliver/pick up loaned equipment.
Counting all sources of devices, a total of 290 [331] on-site loans were made from July 1, 2015 through June 30, 2016, as follows: PIAT – 198 [220]; Three Rivers Center for Independent Living (7/1/2015 – 9/30/2015) – 2 [12]; CLASS (11); Roads to Freedom – 4 [66]; Tri-County Patriots for Independent Living – 16 [8]; United Cerebral Palsy of Northeastern PA – 25 [16]; United Cerebral Palsy of Central PA – 28 [1]; Community Resources for Independence – 3 [7], and Good Shepherd Rehabilitation Hospital – 3 [1]. The differences in loan activity may be accounted for by the increasing availability of current devices through the centralized inventory. C. Implement mechanisms for reutilization or other re-distribution of outdated or irreparable items, in order to reduce the amount of space required at HGAC. Track disposition of items in the centralized inventory purchased with state funds, e.g. distributed to individuals with disabilities or programs serving individuals with disabilities; or items beyond repair that are discarded.
Removing outdated or irreparable equipment from the centralized inventory reduces the needed space at the Hiram G. Andrews Center (with the potential of reducing space-associated costs). Review of items also assures an up-to-date program that does not have consumers borrowing and making decisions about equipment that is not currently sold.
During the reporting period July 2015-June 2016, 40 [20] devices in working condition and meeting the criteria of no longer sold and no longer supported by the manufacturer were taken out of inventory, listed in the Reused and Exchanged Equipment Program online classifieds (REEP) and subsequently matched with consumers who needed the AT and had no other resource for obtaining the devices. Eighteen additional speech generating devices have been distributed to the ALS Association of Western Pennsylvania and are pending a match to consumers in need. This activity saved consumers almost $30,000 [$13,223] (if they had to buy similar devices “new”). Devices were provided at no cost, except for the cost of shipping, when applicable.
7 | P a g e An additional 69 items have been identified for reuse and removed from the circulating inventory (and from the online equipment catalog) but have not yet been listed in the REEP Classifieds or otherwise redistributed. Forty-nine (49) devices that were beyond repair or so antiquated they were not usable were appropriated discarded. In collaboration with HGAC staff, considerable progress has been made this year in identifying items that have not circulated in the past year and determining their suitability for reuse or surplus.
The following stories illustrate the “new life” AT Lending Library equipment can have, even when it is no longer suitable for a “try before you buy” program:
A 73-year-old woman with MS contacted PIAT about a phone that had been a part of the Lending Library inventory but placed in REEP. She was able to obtain the adapted phone (Fortissimo) at no cost, and now has a telephone she can use in an emergency. A consumer with cerebral palsy was in process of obtaining a new device but the appeals process was delaying his acquisition. In the meantime, he needed a way to communicate at his sister’s wedding, and a system for communicating during a business training program he was set to attend. These needs were met through his receipt of a Pathfinder, formerly a part of the Lending Library inventory, with ownership transferred to him through REEP.
D. Identify items (current; in good operating condition) that are housed at HGAC that can be re-deployed to ATRCs; develop mechanisms for re- distributing these items for on-site lending, as per ATRCs’ request and for which they have capacity to store and circulate.
In September, 2015, 53 software titles valued at approximately $1500 were redistributed to ATRCs for demonstration or on-site lending.
Goal II: Provide referral services to borrowers who require additional supports in order to have a meaningful trial with the loaned device.
For items that require support, ATRCs may identify people with disabilities in need of help in setting up or using devices as they assist them in completing a loan application or during the review and processing of the application to borrow “high tech” devices. ATRCs typically explain the complexity or other characteristics (e.g. weight) of the identified devices, why, and what kind of support will be needed during the loan period in order to make an “informed decision”.
A. Provide an interim contact to borrowers of complex devices to see if they have the supports they need for a meaningful trial.
8 | P a g e Each month, ATRCs call or otherwise contact people with disabilities or family members who have borrowed devices which require support to make sure the supports needed for a meaningful loan period have been obtained. This interim contact may result in the identification of borrowers who had listed a support person on the application but for whatever reason, that individual has been unable to provide the necessary supports or services. In some cases, the borrower will contact the ATRC (or HGAC) when s/he is experiencing problems in using the device.
B. Provide borrowers who require additional supports with referrals to qualified providers; provide information on potential funding sources for those services, including but not limited to the Griswold Scholarship Fund.
Although the numbers of consumers requesting support declined, the amount of support provided increased dramatically. Twenty-eight [40] individuals received almost 187 [148] hours of support on 31 [71] devices, arranged or provided by ATRCs. Some borrowers received support on more than one item. Items requiring supports (where specified) were those for vision (10 [6]), hearing (10 [24]), speech communication (4 [18]), mobility, seating and position (1[12]), computer access (1 [6]).
Recipients of support services provided (or arranged) by ATRCs are asked to complete a support satisfaction survey upon conclusion of the service. Based on a 57% [54%] response rate to satisfaction follow-up with borrowers who received support services, 100%[100%] indicated satisfaction with the service (61% [61%] highly satisfied, 31% [30%] satisfied, and 4% [9%] somewhat satisfied).
There was one referral to the Griswold Scholarship Fund for financial support for needed services, however, the applicant must first identify service goals, who the service provider will be and the provider’s usually and customary fees before the application can be considered.
The following story illustrates the value of support services as a critical component for consumers who are borrowing a device to make a decision about what AT might work: In April 2016, a consumer borrowed a TV Ears Listening System from the Lending Library. An ATRC staff member responded to the consumer’s request for assistance and went to his home. One and a half hours of device support was provided. At the end of the loan period, the consumer was able to determine that this device did not meet his needs, but he was highly satisfied with our service. The opportunity to borrow – and the support from the ATRC – helped this consumer decide what would – and wouldn’t - work for him.
9 | P a g e Goal III: Evaluate customer satisfaction and outcomes associated with equipment loans and supports through Pennsylvania’s Assistive Technology Lending Library. Utilize findings to continuously improve the program (ongoing and as funds allow). A. Measure overall satisfaction with the program, maintaining at least a 90% satisfaction rate. More than 97% (N=749 [558]) of the Lending Library’s customers responding to the follow up survey conducted by ATRCs are satisfied with the service. Of these, 85% [74%] % are highly satisfied, 13% [26%] are satisfied, and less than 2% are somewhat satisfied (with only one borrower reporting s/he was not at all satisfied. This benchmark was exceeded. Increase in satisfaction is attributed to improvements in the currency of the inventory. B. Report on the ability of the borrower to make a decision as a result the program, with at least 90% of program users who borrow in order to make a decision reporting they were able to determine AT would (or would not) work for them. One of the best measures of efficacy of the program is an examination of program outcomes. As per the following chart, 94% [96%] of respondents were able to make a decision that the AT whose hands-on experience dissuaded them from pursuing the AT they tried – a potential cost savings if they had purchased said device. This benchmark was exceeded. As a result of borrowing Education Employment Community Total the device, I Living Decided that an 127 [107] 24 [16] 446 [345] 597 AT [489] device/service will meet needs
Decided that an 2 [1] 1 [1] 12 [18] 15 [14] AT device/service will not meet needs Have not made 44 [8] 2 [4] 18 [20] 64 [34] a decision
No response 0 [5] 0 [2] 5 [3] 5 [11]
Total 173 [121] 27 [23] 481 [380] 681[548]
10 | P a g e The following stories illustrate the value of being able to borrow a device to make a decision: Nancy is a consumer with low vision who works in an office where she has to view many documents. In November 2015, she realized she needed equipment that would help her view her work more easily. So, she decided to borrow from PA’s Assistive Technology Lending Library and, with assistance from her local ATRC decided to borrow the monocular 4x12 magnifying device to help assist her during work. After her two week loan period, she realized this device would work for her. She asked for (and received) a loan extension and notified her ATRC that after the device was returned she planned to purchase the device. Bill C. is a young man who, as a result of traumatic brain injury, is disoriented to month, date and time of day. His therapist called to inquire about a wearable device that might be able to assist him. Upon the ATRC’s recommendation, his therapist borrowed the Talking Watch for him to try. Now he is routinely oriented to the date and uses the hourly alert feature as well. The ability to borrow the device gave him a chance to gain skill and confidence; he was able to purchase one on his own and is now less reliant on his family. While the primary purpose of the Lending Library is to assist consumers in making a decision about whether or not to purchase an item, use of the program while an owned device is being repaired continues to be a valuable service. A blind consumer who relies on his Braille Note for communication owns one, but it often requires repairs. Every time his device needs repairs he needs to borrow a device in order to continue his work and complete his communication needs until he gets his back. He is thankful for the Lending Library because he would have trouble communicating without it. In addition, consumers may borrow a device when they are waiting for funding for their own device to be approved, for the device to be delivered. A consumer met with her BBVS counselor to reopen her case and obtain a new CCTV (VisioBook). Subsequently, her home CCTV stopped working, and she was able to borrow a VisioBook to use at home and at work until her new device was delivered. The Lending Library also provides a way for professionals or pre-service students to learn about, see, and try assistive devices. This year, 94 borrowers who accessed the Lending Library for purposes other than to make a decision responded to a follow up survey. Almost half (47%) said they could only afford to borrow from the Lending Library (e.g. free); more than 40% (42%) said the item was only available from the Lending Library; and others reported they could borrow from other resources but the system was too complex or the waiting list too long.
11 | P a g e Goal IV : Review, revise, and/or develop policies for the operation of a statewide program that is efficient, consumer-responsive, cross-age (with some exceptions), and cross-disability. A. Continue to develop and implement new policies that create additional cost efficiencies while attempting to maintain a program that meets the needs of consumers who wish to borrow and trial assistive devices, including but not limited to procedures to reduce shipping costs, generate fees and increase loans of devices from de-centralized points.
Delays in returning equipment, for any reason, negatively impact customer service by creating waiting lists. The more time that elapses past the due date for equipment return, the less likely it is that equipment (and all related components including instruction manuals, cables, etc.) will be returned intact— or at all. In addition, each call tag issued is an added expense to the program. Most late returns necessitate only a second call tag. For example, in the fourth quarter of the 2015-2016 program year, of 376 [278] devices that were returned that quarter there were 11 [12] devices requiring a second call tag; 8 [2] loans three call tags and 6 devices more than three call tags before they were successfully returned via UPS. Although as per this sample only 7% of loans required two or more call tags, policies and procedures regarding ATRC responsibilities to control the number of call tags and increase on-time equipment returns will be reviewed in the 2016-2017 program year.
During this program year, the following policies were developed, revised, and/or reviewed: NEW: Loans of Internet Protocol Captioned Phones Managing IOS Devices via Teltex, Inc. Protecting “Unlocked” Electronic Devices from Tampering Requesting Loan Extensions
REVISED/REVIEWED: Removing Equipment from the Inventory Lending AAC to Children with Disabilities Missing/Damaged/Overdue Equipment - $50 or Less Missing/Damaged/Overdue Equipment - $51 or More Device Loans to Pre-Service Professionals and University Faculty Software Loans from the AT Lending Library Reducing Waiting Lists Suspending Agencies
B. Maintain acceptable levels of loss, at or below the number of items/cost of items not returned in 2014-15. Review and revise (if necessary) policies that prevent/minimize loss.
12 | P a g e Some borrowers find the equipment so helpful they don’t want to return it! Procedures regarding late and missing items continue to be implemented, resulting in many items recovered by the ATRCs and successfully returned to the circulating inventory.
During this program year, 15 [18] devices valued at $14,309 [$29,806] were recovered or paid for by the borrower, thanks to the efforts of the ATRCs. Ten [4] devices with a value of approximately $926 [$430] and representing less than half of one percent of the total number of items shipped were determined a “loss”. Approximately $700 of that was accounted for by one case (containing multiple items) that was lost by UPS (compensation capped at $100).
The level of loss (number of items lost, value of items lost) continues to be remarkably low given the total value of the inventory that circulated during the year.
The following story illustrates the important role of ATRCs in retrieving devices:
A consumer who had borrowed a one message communication device did not return the device as scheduled. The speech therapist supporting the borrower was notified by e-mail, and she contacted the family about the device. When we did not hear back from the family, the ATRC made arrangements for UPS to pick up the device at the home. When that didn’t work, the family was told to bring the device to the ATRC office, at which point arrangements were made for UPS to pick up the device from the ATRC office and return it to HGA.
Goal V: Maintain the infrastructure of Pennsylvania’s Assistive Technology Lending Library. A. Coordinate, monitor, and evaluate Lending Library-related activities of Assistive Technology Resource Centers (7 ATRC subcontractors, staff at Institute on Disabilities) and the Inventory Subcontractor. Institute on Disabilities at Temple University The Institute on Disabilities maintains overall coordination and provides direction for the implementation of Pennsylvania’s Assistive Technology Lending Library. In addition to positions funded directly through the Interagency Agreement with th e Department of Labor and Industry, the Institute on Disabilities contributes other resources towards this program. The Institute strives to maximize available reso urces from multiple funding sources (e.g. Pennsylvania’s Telecommunication De vice Distribution Program, as well as federal support through Pennsylvania’s Initi ative on Assistive Technology, and iCanConnectPA) to develop a seamless syste m of assistive technology services in Pennsylvania, while at the same time assuri ng that funding from any given source is supplemented, but not supplanted.
13 | P a g e The Institute serves as the Assistive Technology Resource Center for southeaste rn Pennsylvania, coordinates the network of ATRCs, oversees the work of the ce ntralized inventory subcontractor Hiram G. Andrews Center (HGAC), facilitates c ommunication between the ATRCs and HGAC, establishes and implements polic ies and procedures for the operation of the program, and provides overall coordin ation and direction to the statewide infrastructure for assistive technology.
Objective 1: Process subcontracts as per acceptable responses to noncompetitive “RFPs”; monitor subcontracted activities; facilitate payment of invoices (ongoing).
The noncompetitive Requests for Proposals (RFP) for 15-16 were reviewed, amended as necessary, and incorporated as the statement of work for the 15-16 subcontracts for our Assistive Technology Resource Centers (ATRCs) as well as Hiram G. Andrews Center. Subcontracts were executed once the state budget was passed. One region changed implementing agency (from Three Rivers Center for Independent Living to Community Living and Support Services [CLASS]) as of October 1, 2016. Institute on Disabilities staff (McNally) monitored contract compliance and performance and provided technical assistance throughout the year, especially to Good Shepherd Rehabilitation Hospital and Roads to Freedom to address performance concerns. The noncompetitive RFP for 16-17 and award amounts (based on level funding) was developed and communicated to incumbent ATRCs; all responses have been received. A noncompetitive RFP was also invited from Life and Independence for Today (LIFT), representing a re-districting of counties to establish an additional ATRC to better serve rural Pennsylvanians. LIFT will initiate services as an ATRC, including the ATLL subcontracted activities, on October 1, 2016, allowing for a period of transition from the affected counties currently served by Community Resources for Independence (CRI) (Elk, Jefferson and McKean counties) and Roads to Freedom (RTF) (Cameron, Clearfield, and Potter counties). This is possible due to an increase in federal funding to Pennsylvania’s Initiative on Assistive Technology that comprises the base funding for each ATRC. Due to continued performance concerns with Good Shepherd, they will receive a six month contract (July 1, 2016 – December 30, 2016) and their region will be re-competed this fall.
Assistive Technology Resource Centers (ATRCs)
The ATRCs provide the link between borrowers and the “circulating department” of the Lending Library at the Hiram G. Andrews Center (HGAC). The ATRCs facilitate the borrowing process by providing assistance to consumers as follows: identify the equipment to be borrowed (which may involve referral for evaluation); identify and refer to service providers when the device requires support for use during the loan period; assure completeness of the application (including original signature);
14 | P a g e track the loan request; communicate with the borrower regarding (a) the status of the request; (b) anticipated shipment date; (c) for those on waiting list, information about alternative sources for trying, borrowing, renting the desired device OR possible substitutions; (d) whether or not there is a need for additional supports in order to have a meaningful trial period, and arranging for or providing up to two hours of such support if needed; (e) reminder of the impending end of the loan period; and (e) follow up on items that are late being returned or which are returned damaged or with missing pieces; and assist borrowers in “next steps” regarding the purchase/funding of equipment that has been found to be useful and appropriate.
The relationship between the ATRC and the borrower figures significantly in the success of the program. On-going communication improves the consumer- responsiveness of the program, keeping borrowers informed and providing opportunities for the ATRC to intervene when there are problems. The contact between ATRC and borrower increases the likelihood that the loan period will meet its goal (rule in or rule out a particular device, for example) while minimizing losses that might be expected with the circulation of thousands of pieces of equipment. ATRCs receive status reports from the “circulation department” of the Lending Library at Hiram G. Andrews Center (HGAC) enumerating incomplete and overdue loans. The ATRCs implement procedures for following up with late (beyond 30 days past due date), missing, and/or damaged items in accordance with Lending Library policy. Close communication between HGAC and the ATRCs helps to contain the extent and cost of losses incurred by the program as a result of incomplete returns, lost devices and damaged items.
As the AT Lending Library centralized inventory “ages”, ATRCs play an increasingly important role in identifying other resources through which individuals may borrow more current technologies, including but not limited to the ATRC’s on-site loan program. Hiram G. Andrews Center (HGAC) The Lending Library staff at the Hiram G. Andrews Center is responsible for moving the equipment to and from borrowers, in a timely way, and with all components in working order. During the 15-16 program year, a full staffing complement at HGAC facilitated the timely introduction of new devices into the inventory, review of older devices to determine their disposition, and overall improvements in customer service. The routine activities of the “circulating department” at HGAC include: intake and processing of requests to borrow equipment, including communication with Assistive Technology Resource Centers (confirmations to ATRCs with estimated shipment dates; notice of waiting list status if applicable); 15 | P a g e packing and shipping of devices, components, and peripherals; coordinating with UPS, including resolving problems with shipping; checking in devices returned (inventorying all items returned, checking condition e.g. need for batteries to be charged or replaced); maintaining the inventory so that all devices are in good condition and in working order; responding to inquiries and maintaining and reporting data regarding inventory and loan activity. In addition, HGAC staff promote the Lending Library within their facility (including the Center for Assistive and Rehabilitation Technology), throughout the Office of Vocational Rehabilitation system, and when other opportunities arise. HGAC Lending Library staff also assists borrowers who are in residence at HGAC, and provide follow-up activities (e.g. retrieving components to devices borrowed but not returned by HGAC clients).
Objective 2: Maintain communication among ATRC subcontractors, the Institute on Disabilities, and the Centralized Inventory Subcontractor via telecommunications or other cost-effective methods.
Oversight and technical assistance to ATRCs are provided by Institute on Disabilities’ staff, and include ongoing monitoring of monthly progress reports and database entries. A listserv and other forms of communication (e.g. periodic teleconferences and an in-person meeting supported through federal funds) have engaged ATRCs as well as HGAC staff.
Goal VI: Maintain electronic resources. A. Provide and maintain an accessible website including current inventory information, borrowing procedures, application forms, and electronic versions of other relevant print materials.
Materials are available to assist Pennsylvanians in learning about the Lending Library inventory and its operation. The website reflects new additions to the inventory and is updated as items are removed from circulation. Alternate formats (electronic, audiotape, Braille) and Spanish language information are available upon request.
Informational and captioned videos to describe the Lending Library and borrowing processes were created and posted on the website (disaibities.temple.edu). The accessible, interactive PDF device loan application has been updated. All new items acquired in the last month of the prior program year were entered in the online equipment catalog. As items are removed from circulation, they are removed from the equipment catalog.
This year, the number of page views for the equipment catalog was similar to last year’s (65, 739 [65, 983]. The number of views of pages with supporting
16 | P a g e information (FAQ, application, ATRC detail) substantially decreased, perhaps because return visitors navigated directly to the equipment catalog. (16,554 [33,968]). There were 1146 page views for downloaded documents (e.g. printable loan request forms [including large print and Spanish versions] and “how to borrow” in Spanish).
New additions to the inventory are also announced via social media (Facebook page of Pennsylvania’s Initiative on Assistive Technology).
Goal VII: Seek sources of private support from vendors, manufacturers, foundations, individuals and other sources to enhance the program.
A. Identify and respond to public and private funding opportunities that may support additions to the equipment inventory.
The Institute on Disabilities provides support to the AT Lending Library by allocating a portion of its federal funds received through Pennsylvania’s Initiative on Assistive Technology (PIAT), the Commonwealth’s program under the Assistive Technology Act. This year, more than $100,000 in federal funds through PIAT supplemented the state funding, including partial support for a student worker and a graduate assistant, partial funding for other designated Institute staff, travel on Lending Library-related business, development of the previously described instructional videos, targeted outreach to OVR and BBVS offices to promote the Lending Library resources, and additional equipment purchases exceeding $32,000 [$35,000]. Eleven [22] telecommunications devices valued at over $4200 [$600] were added to the equipment inventory through the Telecommunication Device Distribution Program (funded through the PUC). Three devices valued at almost $5000 were provided through the federally-funded iCanConnectPA program.
Temple University provides in-kind support by accepting the state’s limitation of 15% on “indirect” charged by the University for similar activities (usually at 26%).
Almost $45,000 in supplemental funding provided by OVR in June, 2016, as well as almost $10,000 unspent by an ATRC and re-budgeted, enabled the purchase of additional equipment to refresh and update the inventory. It is anticipated these devices will begin to circulate in the first quarter of the 16-17 program year. Priority was given to purchasing those items for which there is documented demand (as per waiting lists) and/or which are not represented in the inventory of current technologies.
B. Contact at least fifty vendors/manufacturers requesting they consider product donations and/or open-ended/long-term loans of equipment in order to augment the centralized equipment inventory with current technologies.
17 | P a g e In response to more than fifty letters sent this year to technology and assistive technology vendors and manufacturers, 15 devices valued at $7125 were donated by seven different companies.
C. When requesting a quote prior to ordering equipment (as funds allow), request consideration of a discount or contribution (e.g. no charge for shipping, extra warranty) in order to augment the centralized equipment inventory and maximize expenditures.
As part of standard operating procedure when purchasing equipment, vendors/manufacturers are asked to provide discounts wherever possible. Leveraged discounts and contributions tend to be are generally modest (5%-15% off the Manufacturer’s Suggested Retail Price, free shipping, extended warrantees); approximately $6500 was leveraged this year.
18 | P a g e