The AT Act describes state financing activities as activities that 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”.
There are several different types of state financing activities that states and territories may perform, including:
Financial Loan Programs
Support for the development of state-financed or privately financed alternative financing systems of subsidies for the provision of assistive technology devices, such as:
- an interest buy-down program
- a revolving loan fund
- a loan guarantee or insurance program
A financial loan program provides financial loans for purchase of AT devices and services. A financial loan program may make loans directly (revolving loans) or may make partnership loans using dollars from another source, usually a financial institution.
Other State Financing Activities that Directly Provide AT
Development and administration of systems that provides for the payment or other acquisition of assistive technology. Examples of such programs can include:
Last Resort Funds: These programs provide AT, or funds to purchase AT, to consumers when other options have been exhausted or are unavailable. These may be earmarked for particular types of consumers (such as children or seniors) or particular types of AT or they may be for any group or type of AT. Programs may not use AT Act dollars to provide funds or devices directly to individuals. AT Act dollars may be used to administer a last resort fund comprised of non-AT Act dollars.
Home Modification Program: A home modification program provides home modifications, including the addition of wheelchair ramps. Programs may not use AT Act dollars to provide funds or devices directly to individuals. AT Act dollars may be used to administer a home modification program comprising non-AT Act dollars.
Telecommunications Equipment Distribution Program (State): These are state program to distribute telecommunications equipment that serves the needs of people with disabilities, including safety needs during emergencies. (This is not the federally funded NDBEDP or iCanConnect). Programs may not use AT Act dollars to provide funds or devices directly to individuals. AT Act dollars may be used to administer a telecommunications distribution program comprising non-AT Act dollars.
Deaf/Blind Telecommunications Equipment Distribution Program (Federal): This is the National Deaf/Blind Equipment Distribution Program funded by the Federal Communications Commission also known as iCanConnect. This program provides telecommunications equipment for individuals who are deaf/blind. Programs may not use AT Act dollars to provide funds or devices directly to individuals. AT Act dollars may be used to administer a telecommunications distribution program comprising non-AT Act dollars.
Other State Financing Activities That Create AT Savings
Examples of these types of activities can include:
Cooperative Buying Program: Cooperative buying programs procure AT in bulk at a discount from AT suppliers and then pass the savings on to consumers/beneficiary recipients.
AT Lease Program: These programs provide AT to consumers on a leased arrangement which provides savings over a direct purchase. Typically there is external funding used to purchase the devices that are leased to consumers. The leasing arrangement can include a lease-to-buy provision. More information is provided in the administrative guidance on leasing activities and related data reporting (word) document.
AT Fabrication Program: These programs fabricate AT systems for recipients from readily available materials providing functional AT products at a significant savings. More information is provided in the AT “Maker Efforts and Reporting” (word) document.
Characteristics of State Financing Programs
The structure of financial loan programs vary from program to program. Some programs are direct lenders while others have arrangements with banking partners for interest buy-downs, loan guarantees, or related arrangements. Responsibilities for various loan program functions also vary by state such as loan review, loan approval processes, and servicing of loans.
Other State Financing activities such as programs that provide for acquisition of or payment for devices and those that create savings for AT devices vary widely according to the types of consumers or types of AT for which the program is designed.
Performance Measures and Required Data Collection Elements
State financing activities are covered by the Acquisition Performance Measure. To report data for this measure, AT Act Programs must collect follow-up information from consumers regarding the primary purpose for which AT was needed, why they chose to use the program, and customer satisfaction. Data elements include the number, type, dollar amount provided, and scope of assistive technology provided. Data is also collected on customer satisfaction for State financing activities.
Using Data for Program Improvement
As a state plan is developed, the type(s) of state financing activities is one area to consider. Review the definitions, required data collection elements, and performance measures for state financing found in the current OMB-approved instructions.
Financial Loan Numbers and Overall Dollar Amount over Time
Is your total number or dollar amount of approved financial loans changing from recent years? You can also compare your state’s overall number of loans or total dollar amount of loans (e.g., increase or decrease) with the national trend data.
Ask: How can we explain the increase/decrease? e.g., what accounts for a significant change in the number of applications submitted or rejected? Was there a change in criteria for approval, loan terms or interest rates? Did we take on new partners or change our outreach strategy? Does our program account for a reasonable proportion of the national total dollar amount, and if not, do we understand why?
Decide: Do we want to increase the overall numbers of financial loans? The existing fund balance from which to make loans and administer the program is one important area to consider when making this decision, along with the perception of met and unmet needs for the state/territory. For our type of financial loan program, are loan payments, interest and other income sources adequate to sustain the program?
Financial Loan and Device Type
While nationally the dollar value of loans issued by financial loan programs overwhelmingly is for modified vehicles and vehicle modifications (72%), the dollar value and the number of loans by device type can vary significantly from program to program. You can generate a report that compares this activity by year (e.g., FFY 2020, 2021, 2022), exploring both the % and dollar amount by device category. You can also compare your program’s activity to national data.
Ask: Does the distribution of financial loans by device type and dollar amount loaned make sense in light of our loan program structure? Is our data substantially different from the national data and why? Can we explain changes over time, and differences among the device categories? What are the implications for making changes in our loan terms (e.g., minimum and maximum loan dollar amount) for certain device categories?
Decide: Do we need to look at changing the parameters of our program, e.g., the allowable age or mileage when financing a used adapted vehicle or the total amount that can be borrowed for secured loans like home modifications, to increase loans for a specific device type? Do we need to increase our outreach to one or more groups or to a specific type of AT vendor or service provider (audiologists, vehicle modification dealers, disability-specific organizations, state agencies, SLPs, OTs, PTs, etc.) so that our program is used to provide access to a broader range of devices and services?
Financial Loan Satisfaction
Are financial loan participants satisfied? You will want to be sure you are asking about satisfaction with your service, not the degree to which participants are satisfied with the acquired device(s) or service(s). Be sure you are obtaining satisfaction data from as many financial loan recipients as possible.
Ask: If satisfaction has increased dramatically (e.g., from 60% “highly satisfied” to 90% “highly satisfied”) what factors account for that trend? Or conversely, has there been a decline in satisfaction? Are we asking the satisfaction questions the “right way”? Is satisfaction data for our program in alignment with national trends?
Decide: Do we need to get more information from participants about their satisfaction with our services? For example, if our satisfaction ratings are significantly better than the national percentages, what might explain that and are there things we are doing that can be replicated by other programs? How can we discover why some consumers are only “somewhat satisfied” and learn what it would take for them to become “highly satisfied”?
Other Activities that Directly Provide AT and/or Create AT Savings
The development of a new State Plan is a good opportunity to examine your performance of “Other State Financing” activities and explore opportunities to add new ones in this category. If you currently operate an “Other” type of state financing activity (e.g., administering a last resort fund or running a telecommunications equipment distribution activity), review the required data collection elements and performance measures for state financing at http://www.catada.info/materials at the link for “State Grant for AT Annual Progress Report”. The categorization of devices should be reviewed in accordance with the classification decision rules and instructions for the APR, especially if you are administering a telecommunications equipment distribution program.
Other State Financing Numbers over Time
For the particular “Other” state financing activity or activities that you operate, did the number of devices provided change over time either by total number provided or by device type? Has the total dollar amount of devices provided changed over time either by total dollar amount or by device type? You can generate a report that compares this activity by year (e.g., FFY 2020, 2021, and 2022).
Ask: How can we explain the increase/decrease? e.g., did the number of applications that the program received change from previous years?
Decide: Do we want to increase the number or dollar amount of devices and services provided through the program?
Ask: Do we need to increase our outreach to one or more groups or to a specific type of AT vendors or service providers to (audiologists, vehicle modification dealers, disability-specific organizations, state agencies, SLPs, OTs, PTs, etc.)?
Other State Financing and Device Type
For some “Other” state financing programs, the type of devices provided may be limited by eligibility for the program and the type or purpose of the equipment the program is authorized to provide. Comparisons with national data are not as helpful with other State-Level activities since the types of “Other State Financing” activities vary considerably from program to program.
Ask: Are consumers able to acquire a range of assistive devices through our “Other” state financing program?
Decide: Do we need to look at changing the parameters of our program?
Other State Financing Satisfaction
Are Other State Financing participants satisfied? You will want to be sure you are asking about satisfaction with your service, not the degree to which participants are satisfied with the acquired device(s) or service(s).
Ask: If satisfaction has increased dramatically (e.g., from 60% “highly satisfied” to 90% “highly satisfied”) what factors account for that trend? Or conversely, have we seen a decline in satisfaction? Are we asking the satisfaction questions the “right way”? Is satisfaction data for our program in alignment with national trends?
Decide: Do we need to get more information from participants about their satisfaction with our services? Can we discover why some consumers are only “somewhat satisfied” and learn what it would take for them to become “highly satisfied”?