Although the AT Act does not include a formal definition of device reutilization programs, the Act describes reutilization programs as programs that provide for the exchange, repair, recycling or other reutilization of assistive technology devices, which may include redistribution through device sales, loans, rentals or donations, carried out either directly or in collaboration with public or private entities (Section 4(e)(2)(B)).
The terms reutilization and reuse are used synonymously. The following definitions are to be used for the Annual Progress Report (APR) and will also be used for the new state plan that will be submitted in spring of 2018.
Device Exchange Activities
These encompass activities in which devices are listed in a “want ad”-type posting and consumers can contact and arrange to obtain the device (either by purchasing it or obtaining it for free) from the current owner. Exchange activities do not involve warehousing inventory and do not include sanitation or refurbishing of used devices. In some cases, a State AT Program serves as an intermediary directly involved in making this exchange; in others the consumer and current owner make this exchange without the involvement of the State AT Program. Data on device exchange may be difficult to gather if your program does not serve as an intermediary directly involved in the exchange.
Device Reassignment/Refurbishment and Repair Activities
Device reassignment and refurbishment activities are those in which devices are accepted (usually by donation) into an inventory; are sanitized and/or refurbished as needed; and then offered for sale, loan, rental, or given away to consumers as redistributed products. The consumer becomes the permanent owner of the device.
Repair activities are those in which device(s) are repaired for an individual (without the ownership of the device changing hands) thus avoiding the owner’s need to purchase a new device.
Devices in a reuse inventory can be reassigned on a permanent basis to a new “owner” or provided as an open-ended loan to a borrower. Open-ended device loans are generally distinguishable from short-term device loans by the length of the loan period. Open-ended loans are generally long term (at least several months) with the device provided to the consumer for as long as s/he needs it; ownership usually does not transfer to the consumer.
Devices produced as a result of AT “maker” or fabrication activities can be included in reutilization if the fabricated devices are provided as open-ended loans, with the expectation that the devices will be returned to the program’s inventory when no longer needed. In general, however, AT fabrication should be considered as an “other” type of state financing as devices fabricated are typically made specifically for an individual. In any case, devices produced through maker or fabrication activities must be counted in only one acquisition activity area. More information is provided in the AT Maker Efforts and Reporting (word) document.
Performance Measures and Required Data Collection Elements
Device reuse activities are covered by the Acquisition Performance Measure. To report data for this measure, state AT programs must collect follow-up information from consumers regarding the primary purpose for which AT was needed and customer satisfaction. Data elements include the number, type, estimated value, and scope of assistive technology devices exchanged, repaired, recycled, or reutilized (including redistributed through device sales, loans, rentals, or donations) through the device reutilization activities. Programs must also provide one anecdote about an individual who benefited from the activity. Programs are required to meet a minimum performance measure of 75% for acquisition activities. Detailed information on performance measures and the required data collection elements can be found in the instructions for the Annual Progress Report (APR) and the APR reporting instrument.
Using Data for Program Improvement
Developing the new state plan is an opportunity to review definitions (found in State Plan and Instructions 2018-20 and Instruction Manual for the State AT APR OMB Approved Dec 2017) with staff and subcontractors to insure fidelity in your data collection and reporting. In particular, the definitions of device refurbishment and reassignment and/or open ended loan, as well as the categorization of devices, should be reviewed. If you operate an exchange program as well as a refurbishment/reassignment/open-ended loan program, consider whether or not you exclude device recipients from performance measures. Review instructions about counting the number of recipients and devices, especially when recipients acquire more than one item through the reuse program.
Number of Reused Devices over Time
Is your total number of reused devices provided changing over time? You can generate a report that compares this activity by year (e.g. FFY 2015, 2016, and 2017). You can also compare your state’s trend (e.g. increase or decrease) with the national trend data.
Ask: How can we explain the increase/decrease in numbers of devices provided through device reuse? e.g., we had an equipment drive this year; we added two subcontractors; we lost a reuse partner; we discontinued our device exchange. Is the change (increase or decrease) similar in degree and direction to that in the national trend data?
Decide: Do we want to increase the overall number of devices provided to consumers through our reuse activities? What changes in resource allocation or program operations would we need to accomplish this?
Device Reuse and Device Type
Are you able to provide reused devices representing the full taxonomy of AT devices? You can generate a report that compares this activity by year, exploring the percentage of reused devices by device category. You can also compare your state’s activity by device type with national data.
Ask: Why does our reuse program have so many devices in some of the categories, and so few in the others? Is our data substantially different than the national data? For example, nationally, 10% of reused devices are in the category of environmental adaptations, yet in our state that category accounts for more than 25%. How can we explain changes over time, and differences among the device categories? Are we having difficulty obtaining sufficient inventories of devices that are in demand?
Decide: Do we need to expand our inventory in one or more device type areas? How can we do this?
Dollar Amount Program Saved Consumers
Review the instructions for calculating the estimated value of devices that were refurbished and/or repaired and reassigned or placed on open-ended loan (page 25, Instruction Manual for the State AT APR OMB Approved Dec 2017.
Ask: Are we seeing an increase or decrease in the dollar amount saved by consumers? Can we explain unexpected findings, e.g. even though there were fewer reused devices provided, there was a greater savings to consumers. Can we identify the kinds of devices that provide the greatest savings for consumers? Does data related to dollar amount the program saved consumers have implications for our program?
Decide: Should we change our focus on devices for reuse in order to increase the dollar amount the program saved consumers?
Are recipients of reused devices satisfied with the program? You will want to be sure you are asking about satisfaction with your service, not the degree to which participants are satisfied with the reused device(s). Note this is the only data report available through CATADA that provides insight into the number of people served by reuse (versus the number of devices).
Ask: Based on the numbers of individuals reporting satisfaction, are you serving more or fewer consumers than in prior years? If satisfaction is declining over time (e.g. movement from “highly satisfied” to “satisfied”), what factors might account for that trend? Are we asking the satisfaction questions the “right way”? Are satisfaction data for our program in alignment with national trends?
Decide: If necessary, how can we get more information from participants about the reasons why they are less than “highly satisfied”? What would it take for them to become “highly satisfied”?
2017 APR Reuse Data Collection Updates
Begining in 2017, the APR has only two reporting categories: 1) device exchange and 2) device reassignment and/or open-ended loan. A program may choose to track subcategories of device refurbishment/repair but will only report the aggregate data in the APR.
Frequently Asked Questions
Must a program perform reutilization activities?
No. Section 4(e)(6) of the AT Act allows a state to carry out any two or more of the required state-level activities, meaning a state can choose not to conduct up to two activities. However, in order for a program to not do any reutilization activities it must claim either comparability or flexibility in its State Plan for Assistive Technology.
If a program does perform reutilization activities must it to do all of the activities?
No. A program can choose to do only one type of reutilization activity or numerous activities.
What if we have an exchange program but have difficulty obtaining performance measures because we have no direct contact with the buyer or seller?
You can choose not to report this data but should only do so if your program has data from other acquisition activities. To avoid lacking data related to acquisition, states that solely administer a device exchange program and do not have data from state financing (e.g. because they have claimed comparability or flexibility) or other forms of device reutilization are strongly encouraged to collect performance measure data on their device exchange activities.
Can we modify or change the Performance Measure questions?
No. The performance measure questions have been approved by the Office of Management and Budget (OMB) and they cannot be modified. Programs should make the documents available in accessible formats and can translate them into other languages as long as the questions remain consistent with the OMB approved language.
What if individuals served do not respond to the questions?
For state financing, reutilization, device demonstration, and device loan all non-respondents (individuals who are included in the performance measure data collection but for whom you are unable to obtain data) will be included in the calculation of the performance measure. Missing data results in a lower performance outcome and therefore every effort should be made to obtain the data. Only device loan activities have an exception as to how non-respondents are calculated. For more information refer to the APR instructions.
Do programs always maintain ownership of devices in open ended loan inventories?
No. It is a programmatic decision as to who maintains ownership of a device in open-ended loans. Ownership of the device does not affect data elements related to the APR.
Why would programs choose to distinguish between the activities of reassignment and open-ended loan by ownership?
The primary reasons programs distinguish ownership include:
- Policies (federal, state, and/or agency restrictions on how to dispose of devices and equipment)
- Liability/risk (e.g. if the consumer is harmed by a used item whose title is retained by the program)
- Inventory was purchased with the intent of use as open-ended loans
Can reutilization activities include emergency management?
Yes. While not specifically mentioned in the AT Act, equipment reuse is a critical component of emergency management. AT Act programs have a statewide infrastructure that can be useful in meeting the needs of its citizens during an emergency or disaster, including providing equipment to survivors while they wait for replacement devices or providing AT to help make shelters accessible.
What technical assistance is available through AT3?
The AT3 Center can assist AT Act programs and their affiliates and subcontractors with all aspects of reutilization that support quality implementation, best practices, partnerships, and policy driven initiatives. The AT3 Center provides training and technical assistance for AT Reuse activities and facilitates the Reuse Community of Practice.
Reuse Community of Practice
A schedule of upcoming Reuse calls and webinars can be found on this website under AT3 Events – Calls/Webinars.
View the Reuse CoP page for related information and resources.
The goal of the AT Reuse CoP is to provide technical assistance and training to the Assistive Technology Act Programs in the area of AT Reuse so they can conduct safe, appropriate and effective reuse activities. The community of AT Act programs and their affiliated partners are critical team members of the CoP. Other interested programs that engage in reutilization activities are welcome to participate. To join, email email@example.com.
Sanitization practices relating to COVID-19
Sanitization practices particularly relating to COVID-19, but useful at any time, can be found at https://www.at3center.net/Emergency-Management, scroll down to the heading, Sanitization/cleaning.
Pass It On Center Knowledge Base
Pass It On Center collects and curates national and state resources to foster the safe, effective and appropriate reuse of assistive technology. This site contains a large repository on numerous topics related to reuse activities.