State Plan for AT

State Plan of Assistive Technology

0048 State Plan for AT Instrument and Instructions 2021-2023

State Grants for Assistive Technology Program

OMB: 0985-0048

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2024-06-28 - Revision of a currently approved collection

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State Grants for Assistive Technology Program
State Plan for Assistive Technology

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collection displays a valid OMB control number. The valid OMB control number for this information collection is 0985-0048. The
time required to complete this information collection is estimated to average 73 hours per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you
have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write
to: U.S. Department of Health and Human Services, Washington, D.C. 20201. If you have comments or concerns regarding
the status of your individual submission of this form, write directly to: Robert Groenendaal, Administration for Community
Living, 330 C Street, SW, Washington, DC 20201.

Instructions
Section 4 of the Assistive Technology Act of 1998, as amended (AT Act) establishes formula
grants to states to support comprehensive statewide programs (Statewide AT Programs) that
conduct activities that improve access to and acquisition of AT devices and services for
individuals with disabilities across the lifespan and across a wide array of disabilities, and their
family members, guardians, advocates, and authorized representatives.
Section 4(d)(1) of the AT Act requires that state formula grantees submit an application to the
Administration for Community Living (ACL) to receive a grant. ACL calls the application a
State Plan for Assistive Technology (State Plan for AT or State Plan). This document provides
the instructions for completing the State Plan that covers the activities of Statewide AT
Programs for Federal fiscal years 2021 (October 1, 2020 to September 30, 2021), 2022
(October 1, 2021 to September 30, 2022), and 2023 (October 1, 2022 to September 30, 2023).
The State Plan for AT must be developed, prepared, and submitted with the advice of the state’s
Advisory Council by the Lead Agency designated by the Governor to carry out the Statewide
AT Program. If an Implementing Entity carries out the Statewide AT Program rather than the
Lead Agency, the State Plan for AT can be jointly developed and prepared by the Lead Agency
and Implementing Entity with the advice of the state’s Advisory Council, though the State Plan
must be submitted by the Lead Agency. A Certifying Representative for the Lead Agency will
sign the plan electronically.
The State Plan describes how the state will conduct its Statewide AT Program during the three
year period covered by the plan. The plan is reviewed by ACL to ensure that it conforms to the
instructions in this document and the requirements of the AT Act. ACL may work with the
state to adjust the State Plan in order to make the plan approvable.
If ACL determines that the State Plan for AT is not approvable, ACL will attempt to resolve the
disputed issues after providing the appropriate technical assistance to the state. If no resolution
has been reached after reasonable efforts, ACL will provide an opportunity for a hearing in
accordance with 34 CFR Part 76.202 before the State Plan for AT is disapproved.
The State Plan for AT must be amended during the three-year period of the plan in the case of a
material change in state law, organization, policy or agency operations affecting the
information, assurances, or administration of the plan or any other significant change that ACL
determines would require an amendment. Certain sections of the State Plan must be updated
annually and those are noted in the instructions. Other sections must be changed or update as
needed to ensure the information contained in it accurately reflects the state’s activities. States
should note that the content of the State Plan directly correlates to requirements for reporting
annual data to ACL. The instructions contain frequent reminders that “. . . you are required to
provide annual progress report (APR) data for any activity claimed in this State Plan.” This is a
reference to the annual data submitted in the Annual Progress Report (APR) for State Assistive
Technology Programs. For State-level Activities (as explained below), the APR provides the
performance measure data referenced in Section H of the State Plan.

When ACL reviews a State Assistive Technology Program’s Annual Progress Report, it will
use the most recent version of the State Assistive Technology Program’s State Plan for AT as a
reference. Therefore, grantees must review their State Plan at least annually. Sections A and B
of the State Plan must be updated annually. Section A is basic demographic data that must be
kept current to ensure effective communications. Section B includes data elements that apply
to a new fiscal year in each State Plan and must be updated annually. All other Sections can be
updated as needed within the three year State Plan cycle.
Paper submissions of the State Plan for AT is neither required nor accepted. States will submit
plans using the National Assistive Technology Act Data System (NATADS),
https://www.state572data.net/). Only individuals with user identification (ID) and passwords
can enter data into NATADS. User IDs and passwords are issued by the NATADS
administrator.
The State Plan is completed by entering information into text boxes, making selections from
drop-down menus, and use of “check boxes.” The format cannot account for every variable in
how states conduct their programs. Therefore, a state should select its answers based on the
responses that are the most accurate and best describe how the Statewide AT Program operates,
even if the description is not exact. In almost all cases, there is an opportunity to clarify using
an open-ended text box. A state need not provide information related to activities it does not
conduct, but must respond to every item for activities it does conduct.
The instructions in this document reference the screens presented in the NATADS. The
NATADS does not contain extensive instructions, so states will need this document when
completing the State Plan online.
For assistance with completing a plan, contact Robert Groenendaal at (202) 795-7356 or
[email protected]. For technical support on use of the NATADS, contact
Vance Dhooge at [email protected].

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Table of Contents
A. Identification and Description of Lead Agency and Implementing Entity; and Change in
Lead Agency or Implementing Entity
Screen 1: Identification/Description of Lead Agency and Implementing Entity
Screen 2: Change in Lead Agency or Implementing Entity
B. Advisory Council, Budget Allocations and Actual Expenditures, and Identification of
Activities Conducted
Screen 3: Advisory Council
Screen 4: Actual Expenditures and Budgeted Allocations
Screen 5: Activities Conducted
C. State Financing Activities
Screen 6: Financial Loan Program
Screen 7: Other State Financing Activities Directly Provide AT
Screen 8: Other State Financing Activities Create AT Savings
D. Device Reutilization Activities
Screen 9: Device Exchange
Screen 10: Device Refurbish and Reassignment and/or Open-ended Loan
E. Device Short-term Loan Activity
Screen 11: Short-term Device Loan
F. Device Demonstration Activity
Screen 12: Device Demonstration
G. State Leadership Activities
Screen 13: Training
Screen 14: Technical Assistance
Screen 15: Public Awareness
Screen 16: Information and Assistance
H. Assurances and Measurable Goals
Screen 17: Assurances

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section A. Identification and Description of
Lead Agency and Implementing Entity;
Change in Lead Agency or Implementing
Entity
Section 4(d)(2) of the AT Act requires that the State Plan contain information identifying and
describing the Lead Agency and Implementing Entity (if applicable) designated by the state’s
governor. A state either has a Lead Agency alone or has both a Lead Agency and an
Implementing Entity. The Implementing Entity is a subcontractor separate from the Lead
Agency who is responsible for implementing the State AT Program activities. The Lead
Agency does not also name itself or a unit within the agency as the Implementing Entity.
If there is an Implementing Entity, section 4(d)(4)(B) requires that the State Plan include a
description of the mechanisms established to ensure coordination of activities and collaboration
between the Implementing Entity and the Lead Agency. If the governor chooses to re-designate
the Lead Agency or Implementing Entity, section 4(c)(1)(C) requires that good cause for this
change be shown in the State Plan, including why that previously designated agency or entity
no longer should serve. If the Lead Agency or Implementing Entity is changing, the
information provided in this State Plan should pertain to how the new agency or entity will
conduct the Statewide AT Program. The following items are intended to satisfy the
requirements just described.

Screen 1: Identification & Description of Lead Agency and
Implementing Entity
Statewide AT Program (Information to be listed in national State AT Program Directory)
1. State Program Title
2. State AT Program URL (home page for State AT Program)
3. Mailing address
5. State
4. City
6. Zip code
7. Main email address (for general public to use to contact State AT Program)
8. Main phone number (for general public to use to contact State AT Program)
9. Separate TTY number (for general public to use to contact State AT Program)
Lead Agency
10. Agency name

11. Mailing address
13. State
12. City
14. Zip code
15. Lead Agency URL
Implementing Entity
16. Does your Lead Agency contract with an Implementing Entity to carry out the Statewide AT Program
on its behalf? Yes
No
If yes, complete Items 17–22.
17. Name of Implementing Entity
18. Mailing address
20. State
19. City
21. Zip code
22. Implementing Entity URL
Program director and other contacts
23. Program Director for State AT Program (last, first)
24. Title
25. Phone
26. E-mail
27. Primary Contact at the Lead Agency (last, first)
28. Title
29. Phone
30. E-mail
31. Primary Contact at Implementing Entity (last, first) – If applicable
32. Title
33. Phone
34. E-mail
Person Responsible for completing this form if other than State AT Program Director
34. Name (last, first)
35. Title
36. Phone
37. E-mail
Certifying Representative
38. Name (last, first)
39. Title
40. Phone
41. E-mail

Screen 2: Change in Lead Agency or Implementing Entity
1. Describe the mechanisms established to ensure coordination of activities and
collaboration between the Implementing Entity and the state. [Text box - required if 16 is
checked yes]

Instructions: According to section 4(c)(1)(B) of the AT Act of 1998, as amended, the
Implementing Entity must carry out its responsibilities through a subcontract or other
administrative agreement with the Lead Agency. The description should identify the
mechanism used and how the Lead Agency provides oversight and holds the Implementing
Entity accountable for appropriate implementation of the Statewide AT Program.

2. Is the Lead Agency named in this State Plan a new or different Lead Agency from the
one designated by the Governor in your previous State Plan? [Drop-down menu - required]

Instructions: The drop-down menu allows you to select “yes” or “no.” The “previous
state plan” was the plan under which the Statewide AT Program operated from October 1,
2015 until the submission of this State Plan. If a change in Lead Agency already has been
approved by ACL under the previous State Plan, the state can select “no.” If you select
“no,” and you use an Implementing Entity, move on to Question 46 about changing
Implementing Entities.
If you answered no to this question, and you do not use an Implementing Entity, you
may skip ahead to the next section. Otherwise, you must answer the following
questions.
3. Explain why the Lead Agency previously designated by the Governor should not serve
as the Lead Agency. [Text box-required if Question 2 above is yes]

Instructions: Describe all factors that led the state to consider changing from the previous
Lead Agency or Implementing Entity, such as concerns about performance, state policies
that require periodic competition for contracts, or restructuring of state government.
4. Explain why the Lead Agency newly designated by the Governor should serve as the
Lead Agency. [Text box-required if Question 2 above is yes]

Instructions: Describe how and why the new Lead Agency was chosen to implement the
Statewide AT Program and justify the appropriateness of the choice.
5. Is the Implementing Entity named in this State Plan a new or different Implementing
Entity from the one designated by the Governor in the previous State Plan? [Drop-down
menu-required if Screen1: Line16 is yes]

Instructions: The drop-down box above allows you to select “yes,” “no” or “not
applicable.” The “previous state plan” was the plan under which the Statewide AT
Program operated from October 1, 2015 until the submission of this State Plan. If a
change in Implementing Entity already has been approved by ACL under the previous
State Plan, the state can select “no.”
If you answered no to this question, you may skip ahead to the next section.
Otherwise, you must respond to Items 6 and 7 below.
6. Explain why the Implementing Entity previously designated by the Governor should not
serve as the Implementing Entity. [Text box-required if Question 5 above is yes]

Instructions: Follow the same instructions for Item 3 above.
7. Explain why the Implementing Entity newly designated by the Governor should serve
as the Implementing Entity. [Text box-required if Question 5 above is yes]

Instructions: Follow the same instructions for Item 4 above.

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section B: Advisory Council, Budget
Allocations and Actual Expenditures, and
Identification of Activities Conducted
Section 4(c)(2) of the AT Act requires the Statewide AT Program to establish a consumermajority advisory council that provides consumer-responsive, consumer-driven advice to the
state for planning of, implementation of, and evaluation of the activities carried out through the
grant, including setting measurable goals. Exceptions to these requirements are allowed under
section 4(c)(2)(E) if the requirements will affect existing state statutes, rules, or official policies
relating to advisory bodies or require changes to existing governing bodies of incorporated
agencies. The following items provide assurances related to and identify compliance with the
requirements of section 4(c)(2).

Screen 3: Advisory Council
1.

In accordance with section 4(c)(2) of the AT Act of 1998, as amended our state has a
consumer-majority advisory council that provides consumer-responsive, consumerdriven advice to the state for planning of, implementation of, and evaluation of the
activities carried out through the grant, including setting measurable goals. This
advisory council is geographically representative of the State and reflects the diversity
of the State with respect to race, ethnicity, and types of disabilities across the age
span, and users of types of services that an individual with a disability may receive.
[Drop-down yes/no menu]

Instructions: You must read and verify the statement by selecting “yes” or “no” from the
drop-down menu (though N/A is available on the dropdown list, it cannot be selected). This
statement assures that the advisory council is representative of the state in terms of
geography and diversity and meets the purposes and performs the functions required under
the AT Act. The official submission of the State Plan in the NATADS attests to this
statement and the following statements being true as of the date of submission of the State
Plan for AT.
2. The advisory council includes a representative of the designated State agency, as
defined in section 7 of the Rehabilitation Act of 1973 (29 U.S.C. 705). [Drop-down
yes/no/NA menu]
3. The advisory council includes a representative of the State agency for individuals who
are blind (within the meaning of section 101 of that Act (29 U.S.C. 721)). [Drop-down
yes/no/NA menu]

4. The advisory council includes a representative of a State center for independent living
described in part C of title VII of the Rehabilitation Act of 1973 (29 U.S.C. 796f et
seq.). [Drop-down yes/no/NA menu]
5. The advisory council includes a representative of the State workforce development
board established under section 101 of the Workforce Innovation and Opportunity
Act). [Drop-down yes/no/NA menu]
6. The advisory council includes a representative of the State educational agency, as
defined in section 9101 of the Elementary and Secondary Education Act of 1965 as
reauthorized. [Drop-down yes/no/NA menu]

Instructions: For items 2-6 above, verify that the advisory council has each of the members
listed by selecting “yes” or “no” or “not applicable” from the drop-down menus. In order to
select “yes,” you must have an official representative of the applicable agency on record as
named and appointed to the council at the time of submitting this plan. In order to select
“not applicable,” you must either not have a separate agency for individuals who are blind
or not be required to have a member because existing statutes, rules or policies related to
advisory bodies or governing bodies of Statewide AT Programs would be affected.
7. The advisory council includes other representatives (list below). [Text box]

Instructions: Many advisory councils include agency or other organization representatives
beyond those required under the AT Act. In the text box, identify those members and the
entities they represent here, though you need not provide personal names. Do not list
consumer representatives here.
8. The advisory council includes a majority of individuals with disabilities that use
assistive technology or their family members or guardians:
A. Enter the number of individuals with disabilities that use AT or their family
members or guardians on the advisory council
B. Enter the total number of individuals on the advisory council
C. Percentage

A/B

Error message if ratio is less than 51% with note that item 9 must provide explanation of why
advisory council does not include a consumer majority.
Instructions: Section 4(c)(2)(B)(ii) of the AT Act requires that a majority, not less than 51
percent, of the members of the advisory council be individuals with disabilities that use
assistive technology or their family members or guardians. Enter the number of these
individuals that are current members of your council. In order to include an individual, he
or she must be on record as named and appointed to the council at the time of submitting
this plan. This total cannot include agency representatives from the previous lists.
9. If the Statewide AT Program does not have the composition and representation
required under section 4(c)(2)(B), explain here. [Text box]

Instructions: Provide the reasons that the Statewide AT Program does not have
representatives of the required agencies or does not have a consumer-majority on the
advisory council and where the Statewide AT Program is in the process of filling vacant

positions and otherwise taking actions to become in compliance. If the composition of the
advisory council is different from the requirements of 4(c)(2)(B) because existing statutes,
rules or policies related to advisory bodies or governing bodies of Statewide AT Programs
would be affected, explain here. Statewide AT Programs do not need to explain if “not
applicable” is selected because the state does not have a separate agency for individuals
who are blind.

Screen 4: Actual Expenditures and Budgeted Allocations
1. Actual Expenditures Carryover Year Close-out (annual update required-table reset)

In the following table provide the actual expenditure data for the closed-out carryover
fiscal year AT grant award (liquidated the previous December 31). Please note, this data is
for a specific year AT Act grant award amount, NOT any specific 12 month period of time
as funds from a grant award can be obligated over a 24 month period. (For a State Plan
submitted in the spring of 2018, the most recent closed-out carryover year grant award will
be the FY16 grant award that began 10/1/2015 with the first year ending on 9/30/2016 and
the second carryover year ending on 9/30/2017 with 3 month liquidation period ending
12/31/2017).
Actual Expenditures for
Closed-out Carryover Year Award
A. All State Level Activities
B. All State Leadership Activities
C. Transition Training & Technical
Assistance
D. Total Expenditures
E. Total Award
F. Lapsed Amount

Percentage
Final Expenditures
$
$
$
$
$
$ [E-D] calculate

A/E calculate
B/E calculate –less
than 40/30% required
C/B calculate at least 5% required
D/E calculate
100%
F/E calculate

Note: The final expenditure amount on line D must equal the amount drawn down in the ACL
Payment Management System.

Instructions: Section 4(e)(3)(A) of the AT Act requires States to use not more than 40% of
an annual award to carry out state leadership activities if the state does not use flexibility.
If a state does claim flexibility in their approved State Plan, Section 4(e)(6)(B)(ii) of the
AT Act requires the State to use not more than 30% of an annual award to carry out state
leadership activities. (See next paragraph for definition of flexibility). In both cases,
Section 4(e)(3)(A) of the AT Act requires all States to use at least 5% of the state
leadership funds for transition training or technical assistance activities.
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. If the
state has claimed flexibility for a state level activity in a given fiscal year, the state does
not report data for that activity during that fiscal year and the grant award for that fiscal
year would be subject to a maximum 30% of total expenditures for state leadership
activities.

States must have a mechanism in place to accurately track all AT Act expenditures by
grant award FY and by the state level and state leadership categories. Most direct
expenditures like salaries and benefits, contractual expenses, etc. will be clearly
attributable to a state level or state leadership activity. For example, expenditures for
purchasing equipment for a device loan program will be state level expenses while staff
salaries and travel expenses to deliver training will be state leadership. A helpful way of
determining state level or state leadership will be to identify where the data reported in the
annual progress report for an expenditure activity will be reported. Since most all
activities should have associated data reported, if the data is state level (state financing,
reuse, device loan or device demonstration) then the activity and associated expenditure is
state level. Most staff salaries and benefits can be assigned in total or in portions to state
level or state leadership depending on staff job responsibilities and any time and effort logs
they are required to keep for federal reporting purposes.
For very generic administrative and operational expenditures, like paper or similar general
office supplies, an arbitrary ratio allocation can be used such as a 50/50 split. These very
generic expenditures should not be a large portion of the total fiscal year AT Act expenses
especially if an indirect rate is used to cover overhead costs. The same arbitrary ratio
allocation can be applied to any indirect costs claimed.
2. Actual YTD Expenditures and Budgeted Allocations for Immediate Preceding
Year Award (annual update required-table reset)

In the following table provide year-to-date (YTD) obligated and liquidated expenditure
data for the immediate preceding fiscal year AT grant award along with planned budget
allocations for the unobligated remainder of that award. Please note, this data is for a
specific year AT Act grant award amount, NOT any specific 12 month period of time as
funds from a grant award can be obligated over a 24 month period. (For a State Plan
submitted in the spring of 2018, the immediate preceding fiscal year award will be the
FY17 grant award that began 10/1/2016 with the first year ending 9/30/2017 and the
second carryover year ending 9/30/18).
Actual & Planned
Immediate Preceding
Year Award
Expenditures
All State Level
Activities
All State Leadership
Activities
Transition Training &
Technical Assistance
Total

YTD Obligated
not Liquidated
Expenditures

YTD
Liquidated
Expenditures

Planned not
yet Obligated
Expenditures

Screen 5: Activities Conducted
1. State Level Activities Conducted and Program Structure

Total

Must equal
total award

Using the table below, identify all types of state level activities that will be conducted by
the Statewide AT Program, who is conducting the activity, from where it is conducted and
if a fee is charged. Please remember that annual progress report data is required for any
activity identified as conducted in this State Plan.
Instructions: Check “yes” or “no” to indicate each of the activities conducted in the table
below.
AT Act State Level
Activities
State FinancingFinancial Loan
State Financing-Other
that Directly Provides
AT
State Financing-Other
that Creates Savings
for AT
Reuse-Device
Exchange
Reuse-Device Open
Ended Loan or
Reassignment
Device short-term loan
Device demonstration

Activity
Conducted?

Who conducts?
State
Other
Both

Where conducted?
Central
Regional
Both

Fee
Charged

Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No
Yes/No

For each activity conducted, select the one option that best describes who conducts each
state level activity from the choices of:
 The Statewide AT Program (State AT)
 Other entities e.g. contractors (Others)
 Both the Statewide AT Program and other entities/contractors (Both)
Use the following guidance to select the choice that best or most closely describes who
conducts each activity.
Lead Agencies/Implementing Entities implement their activities in many ways. Some
implement their activities directly using their own staff and resources, others use
subcontractors, and others use combinations of both. Remember, the Implementing Entity
is considered the Statewide AT Program, not an “other entity.” Indicate how your
program conducts this activity using the following rules:
Select “yes” for “The Statewide AT Program” and do not select “Other entities” if this
activity is carried out exclusively by employees of the Lead Agency/Implementing Entity
working directly with consumers using Lead Agency/Implementing Entity facilities and
resources. Regional sites that are staffed by employees of the Lead Agency/Implementing
Entity are considered part of the Statewide AT Program.
Select “yes” for BOTH “The Statewide AT Program” and “Other entities” if the Lead
Agency/Implementing Entity carries out the activity using its employees and facilities to

work directly with consumers and ALSO uses some subcontracts or other agreements with
external organizations whose own employees, facilities, and resources are used to work
directly with consumers.
Select ONLY “Other entities” if the Lead Agency/Implementing Entity does not work
directly with consumers using Lead Agency/Implementing Entity facilities and resources
and instead uses external organizations only.
For each activity conducted, select the one option that best describes from where each
activity is conducted from the choices of:
 One central location (Central)
 Regional sites (Regional)
 A combination of a central location and regional sites (Combination)
Use the following guidance to select the choice that best or most closely describe the
location from which each activity is conducted.
One central location – Select this if the Statewide AT Program conducts this activity from
a single site that houses all employees and resources engaged in the activity. It may be the
case that employees or resources travel from this site to other places, but they are based at
a single site, and the other places are not established/permanent sites. Sites that simply
serve as referral sources or provide minimal assistance to a central location are not
considered regional sites. Remember that this is tied to the activity itself, so two different
activities could take place at two different central locations. Also, if in previous items it
was indicated that subcontractors are used, it does not automatically mean that regional
sites are used. For example, your Statewide AT Program may have a building on a
university campus that houses the staff and devices for a device loan program. The
university campus is the central location for that program. The Statewide AT Program
also may contract with a CBO in another part of the state to operate an AFP as your state
financing activity. If the employees and resources for operating the AFP are housed at the
CBO, the CBO is considered the central location for state financing and not a regional site.
Regional sites – Select this only if the activity is conducted from at least two sites that
operate relatively independently without any of them being considered the main site or
headquarters (if one of them is considered the headquarters, choose a combination of
central location and regional sites instead). Regional sites can be directly managed by the
Lead Agency/Implementing Entity or can be subcontractors. For example, the Lead
Agency may employ three part-time staff people at three different one-stop centers in the
state. Those one-stop centers have their own small inventory of devices purchased by the
Lead Agency and the part-time staff uses those devices to provide device demonstrations
on a regular basis. These could be considered regional sites. Sites that simply serve as
referral sources or provide minimal assistance to a central location are not considered
regional sites. For example, if all of the devices for the Statewide AT Program loan
program are located at a central site along with those responsible for operating the
program, but independent living centers provide referrals and the Statewide AT Program
sends devices to those centers for pick-up by consumers, the independent living centers are
not considered regional sites.

A combination of central location and regional sites – Select this only if you have a site
that is considered the main site or headquarters that houses the majority of employees and
resources and regional sites that also have their own employees and resources. For
example, if the majority of the devices for your loan program are located in a central
inventory along with those responsible for operating the loan program, but independent
living centers under subcontract house their own, smaller inventories and have staff
assigned to do loans, you would have both a central location and regional sites.
For each activity you conduct, identify if a fee is charged. Many programs support their
activities by charging some kind of fee. Fees can be a set amount for participation in the
activity, a prescribed amount charged for each service, set amount charged for services
provided within a set time period like an annual fee, or fees can be variable based on a
number of factors such as a participant/recipient’s ability to pay, the type of
participant/recipient (individual with a disability, professional, or organization) or by the
complexity of the devices/services provided. If any type of fee is charged check “yes” and
in the description of that activity in later sections describe the fee structure used in the
simplest terms possible.
2. Comparability and Flexibility

For any of the four State Level Activities that are not conducted, the Statewide AT
Program must claim comparability or flexibility in the table below. The table below
automatically identifies those activities the state is conducting in the previous table and
requires a selection of flexibility or comparability for those the Statewide AT Program is
not conducting.
Comparability & Flexibility
Financial Loan
Other State Financing that
Directly Provides AT
Other State Financing that
Creates Savings for AT
Device Exchange
Device Reassignment or
Open Ended Loan
Device short-term loan
Device demonstration

Yes/No

State Level
Activities

Not Performed Claiming -

State Financing

Comparability/Flexibility
(required if all 3 are No)

Reuse

Comparability/Flexibility
(required if both are No)

Short-term Loan
Demonstration

Comparability/Flexibility
Comparability/Flexibility

Flexibility - 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. If the state claims flexibility in a given fiscal year, do not report data for that
activity during that fiscal year and the grant award for that fiscal year will be subject to a
maximum 30% of total expenditures for state leadership activities.
Comparability - Section 4 (e)(1)(B) of the AT Act provides that a state shall not be
required to carry out a required state-level activity if the amount of financial support
provided from the state or other nonfederal resources or entities for that activity is
14

comparable or greater than the amount that the state would have expended for the activity.
When a Statewide AT Program claims comparability; the state will not report data for any
state-level activities for which the state claimed comparability.
For any activity for which the Statewide AT Program is claiming comparability, describe
the comparable activity and comparable financial support. In the text box, explain in the
simplest terms possible what the comparable activity is, who conducts the activity, who
supports the activity, and what makes it comparable both in terms of resources supporting
the activity and how the activity is related to the purposes of the AT Act.

Multiple Activity Item Instructions
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. For the
purposes of the following portions of the State Plan, there is no distinction between a Lead
Agency or Implementing Entity in terms of implementation. If an Implementing Entity is used,
the State Plan reports on how that entity is implementing the Act.
Section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities.
Sections C-G of this State Plan contains items intended to meet these requirements for each AT
Act authorized activity. While Sections do request unique information about specific activities,
each begins with the same request for information regarding collaboration. Use the instructions
below as a reference for this question throughout the State Plan, as the instructions will not be
repeated in each section.
If this activity is conducted through a formal written agreement, by providing financial
support to other entities or by receiving financial support from other entities please
identify that coordination and collaboration in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Instructions: Identify all types of formal/written agreements and financial support provided and
received for this activity by selecting “yes” as appropriate for each type of entity identified. Do
not confuse these options with the use of an Implementing Entity (for purpose of these
questions, the Implementing Entity is the Statewide AT Program).
Have written agreement with this entity - Select this column “yes” if the Statewide AT
Program has a formal agreement of some sort with an entity to conduct all or part of a
state level or state leadership activity. If an entity is providing the State AT Program
with data for activities they are conducting and that data is reported in the Annual

Progress Report, the Statewide AT Program should have an agreement with that entity
and should report it in this column. The Statewide AT Program should also have a
written agreement with a funding source for an activity and similarly would have such
agreement with an entity to whom the Statewide AT Program is providing funding for
an activity. Both of these would be reported in this column and one of the two other
columns asking about direct financial support. It is possible to have a formal agreement
with an entity to support conducting an activity without associated direct financial
support provided (e.g. The Statewide AT Program provides a device demonstration
provider with all the AT devices for their inventory instead of direct dollars). In-kind
support with a written agreement will be reported in this category. It is likely that if one
of the financial support columns is checked “yes” that this column would also be
checked “yes”. However, this column could be checked “yes” without the associated
direct financial support (only in-kind or non-monetary). If no formal, written agreement
is in place this column should NOT be checked.
Provide financial support to this entity- Select this category “yes” if the Statewide AT
Program provides dollars directly to an entity to conduct all or part of a state level or
state leadership activity. This entity will be providing the State AT Program with data
to submit for the activity in the Annual Progress Report. In-kind support is NOT
included here.
Receive financial support from this entity- Select this category “yes” if the Statewide
AT Program receives dollars directly from an entity to conduct all or part of a state level
or state leadership activity. Details of this financial support will be reported in the
Leveraged Funding section of the Annual Progress Report. In-kind support is NOT
included here.
Select all organization types that apply for each column.
Banks/financial institution – Self-explanatory, typically only used with financial loan
programs.
Independent Living Center – Entity identified in the state as a recognized Independent
Living Centers funded with federal and/or state independent living funding.
Easter Seals – Entity recognized as an affiliate of the Easter Seals organization.
Disability/AT Organizations – Any entity that primarily serves individuals with
disabilities or provides AT services that is not more definitively identified in another
category.
Federal Entities/Agencies – Any public federal entity (usually reported as an agency
providing funding) such as Department of Education, Rehabilitation Services
Administration or Administration on Community Living, National Institute on
Disability, Independent Living, and Rehabilitation Research, etc.

State Entities/Agencies – Any public state entity such as Vocational Rehabilitation, State
Medicaid Agencies, Special Education, State Colleges and Universities, etc.
Local/Community Entities – Any public local or community entities, such as local
school districts, city government, county election offices, etc.
Private Entities – Private entities of any type, non-profits, foundations, etc. at any level,
national, state, or local.
Other – This category should only be used when the entity cannot reasonably be
categorized in any of the previous categories provided. (Should be used rarely and a
description must be provided.)

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section C: State Financing Activities
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 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.”
For the purposes of this State Plan, state financing activities include financial loan programs,
programs that directly provide AT such as home modification programs, telecommunications
distribution programs, and last resort funds, and programs that create savings for AT acquisition
such as cooperative buying programs and AT leasing programs. Each of these activities is
defined in the corresponding section of this State Plan.
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are intended to meet these requirements for State

Financing Activities. Respond only to the items that correspond with the State Financing
Activities selected in Section B of this Plan.

Screen 6: Financial Loan 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.
1. If you conduct this activity through a formal written agreement, by providing financial
support to other entities or by receiving financial support from other entities please
identify that coordination and collaboration in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity






Revolving loans
Loan guarantees
Interest buy-downs
Combined loan guarantee and interest buy-down

Instructions: Identify all types of loans the Statewide AT Program offers, regardless of
whether any loans of that type are currently outstanding. The types of loan products are
defined as follows:
Revolving loan: A loan that uses Statewide AT Program funds for loans. The AT
program directly provides the funds that are to be loaned out and retains full control over
to whom and at what terms the funds are loaned. As loans are repaid, the money is lent out
again to other AT consumers — that is, the same money “revolves” out to other borrowers
as earlier borrowers return it to the program.
Loan guarantee or insurance program: The grantee uses its funds to guarantee all or a
portion of loans for AT. A guaranteed loan is a loan in which the Statewide AT Program
guarantees that the loan to a consumer is secure and will be repaid, thus increasing the
lender’s willingness to loan funds.
Interest buy-down loan: A loan in which AT program funds are used to buy down the
interest rate of a loan. The AT program uses funds to reduce the interest rate that lending
20

institutions offer to consumers for loans to purchase AT. The AT program pays the lending
institution for a portion of the interest on the loan, resulting in lower interest payments for
the consumer over the long term.
3. The lowest interest amount for loans as established by the policies of the activity (leave
blank if NA). [Percentage field in XX.XX% form]
4. The highest interest amount for loans as established by the policies of the activity
(leave blank if NA). [Percentage field in XX.XX% form]
5. The lowest loan amount provided as established by the policies of the activity (leave
blank if N/A). [Number field - dollar amount]

Instructions: The response to this item must be based on the Statewide AT Program’s
established, written policies. This is not the lowest loan actually provided in a given
year, but the lowest loan amount that would be provided as reflected in the written
policies. Leave it blank if the written policies do not specify a lowest loan amount.
6. The highest loan amount provided as established by the policies of the activity (leave
blank if N/A). [Number field - dollar amount]

Instructions: The response to this item must be based on the Statewide AT Program
established, written policies. This is not the highest loan amount actually provided in a
given year, but the highest loan amount provided as reflected in the written policies.
Leave it blank if the written policies do not specify a highest loan amount.
7. Describe the activity. [Text box]

Instructions: Explain in the simplest terms possible how this activity is conducted; a
person unfamiliar with the program should be able to read this explanation and understand
what the Statewide AT Program is “doing”. This explanation should make it clear how
this activity is related to the purposes of the AT Act. It also should describe who the
activity is intended to serve, specifically if only particular populations of individuals are
served by the activity or if there are qualifications for participation in the activity. The
role of the Statewide AT Program in carrying out the activity should be explained clearly
and any fees charged should be described.
8. The online page for this specific activity can be found at: [Text box]

Instructions: Enter the URL for the financial loan program (not the general home page
URL) or enter N/A if information about the activity is not available online.

Screen 7: Other State Financing Activities Directly Provide AT
1. If other state financing activities that directly provide AT are conducted through a
formal written agreement, by providing financial support to other entities or by
receiving financial support from other entities please identify that coordination and
collaboration in the table below.

Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Check if
Conducted

Telecommunications Equipment Distribution Program (EDP)-State
Deaf/Blind Telecommunications EDP-Federal
Last Resort Fund
Home Modification Program
Other (text box to describe)

Instructions: Identify all types of other state financing programs that directly provide AT.
The types of programs are defined as follows:
Telecommunications Equipment Distribution Program (State): This is a 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). States 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. States 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.
Last Resort Fund: 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 particular types of AT (such as home
modification) or they may be for any group or type of AT. States 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. States 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.
Other: Specify and describe in the text box provided.
3. Describe the activity or activities. [Text box]

Instructions: Explain in the simplest terms possible how this activity is conducted; a person
unfamiliar with the program should be able to read this explanation and understand what the
Statewide AT Program is “doing”. This explanation should make it clear how this activity
is related to the purposes of the AT Act. It also should describe who the activity is intended
to serve, specifically if only particular populations of individuals are served by the activity
or if there are qualifications for participation in the activity. The role of the Statewide AT
Program in carrying out the activity should be explained clearly and any fees charged
should be described. If there is more than one distinct program within this activity area,
number and describe each succinctly. The example provided below is for a Last Resort
Fund, but a similar concept should be applied here.
Example: Our State AT Program implements both the State Telecommunication Equipment
Distribution Program and the federally funded NDBEDP (iCanConnect). The State
program provides a full range of adaptive telephone equipment to all state residents who
are unable to use a traditional telephone due to disability. The NDBEDP provides a full
range of adaptive equipment needed by individuals who are deaf/blind for communication.
All funding used to purchase adaptive equipment is provided by state and federal sources
outside the AT Act. AT Act funds are used to support the administration of both programs.
There are no fees associated with this program but there are financial eligibility criteria for
both programs.
4. The online page (or pages) for this specific activity can be found at: [Text box]

Instructions: Enter the specific URL for each of the state financing programs that directly
provide AT (not the general home page URL) or enter N/A if information about these
activities is not available online.

Screen 8: Other State Financing Activities Create AT Savings
1. If other state financing activities that create AT savings are conducted through a formal
written agreement, by providing financial support to other entities and/or by receiving
financial support from other entities please identify that coordination and collaboration
in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Banks/financial institution

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Independent Living Center
Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. The following activities are conducted
Activities

Check if
Conducted

Cooperative Buying Program
AT Lease Program
AT Fabrication Program
Other (text box to describe)

Instructions: Identify all types of other state financing programs that create AT savings
conducted by the state. The types of programs are defined as follows:
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.
AT Fabrication Program: These programs fabricate AT systems for recipients from
readily available materials providing functional AT products at a significant savings.
Other: Specify and describe in the text box provided.
3. Describe the activity. [Text box]

Instructions: Explain in the simplest terms possible how this activity is conducted; a
person unfamiliar with the program should be able to read this explanation and
understand what the Statewide AT Program is “doing”. This explanation should make it
clear how this activity is related to the purposes of the AT Act. It also should describe
who the activity is intended to serve, specifically if only particular populations of
individuals are served by the activity or if there are qualifications for participation in the
activity. The role of the Statewide AT Program in carrying out the activity should be
explained clearly and any fees charged should be described. If there is more than one
distinct program within this activity area, number and describe each succinctly.
4. The online page (or pages) for this specific activity can be found at: [Text box]

Instructions: Enter the URL for each of the state financing programs that create AT
savings (not the general home page URL) or enter N/A if information about these activities
is not available online.

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section D: Device Reutilization Activities
The AT Act describes the State-level activity of device reutilization as follows:
“DEVICE REUTILIZATION PROGRAMS. —The State shall directly, or in collaboration with
public or private entities, carry out assistive technology device reutilization 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.”
For the purposes of this State Plan, device reutilization activities are categorized as either
device exchange activities, device refurbish and reassign activities or open-ended loan
activities. Device exchange activities are those in which the Statewide AT Program facilitates
the transfer of a device from a consumer who does not need the device to a consumer who
could use the device without the organization taking possession of the device at any time.
Devices are listed in a “want ad” or other type of 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 repair,
sanitization or refurbishing of used devices. In some cases, a Statewide 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 Statewide AT Program.
Section 4(d)(5) of the AT Act requires the State Plan include a description of how the Statewide
AT Program will implement State-level and State Leadership activities. Further, section 4(d)(4)
requires that the State Plan describe how various public and private entities will be involved in
the implementation of those activities, including a description of the nature and extent of
resources that will be committed by public and private collaborators. Section 4(d)(7) requires
that the State Plan include a description of the State-level and State Leadership Activities the
state will support with state funds. Section 4(e)(3)(B)(iii) requires that states coordinate and
collaborate their State-level and State Leadership activities among public and private entities.

Screen 9: Device Exchange
1. If device exchange activities are conducted through a formal written agreement, by
providing financial support to other entities and/or by receiving financial support from
other entities please identify that coordination and collaboration in the table below.

Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Banks/financial institution
Independent Living Center
Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. Select the option that best describes what happens when a device is exchanged. [Check
one]




The transaction is direct consumer-to-consumer
The Statewide AT Program is involved in the transaction

The transaction is direct consumer-to-consumer - The exchange is set up so that the person
who wants the device directly contacts the person who has the device and the two of them
work out the details of the exchange without the involvement of the Statewide AT
Program. Occasionally, an individual may not want to post contact information on the
exchange and requests that the Statewide AT Program be the contact. In these cases, the
Statewide AT Program’s only responsibility is providing the contact information to those
who ask.
The Statewide AT Program is involved in the transaction - A consumer who wants a
device must go through the Statewide AT Program to connect with the person who has the
device. The role of the Statewide AT Program may vary once this connection has been
made, but the Statewide AT Program undertakes some level of control over the exchanges
made through its program.
3. Describe the activity. [Text box]

Instructions: Explain in the simplest terms possible how this activity is conducted; a
person unfamiliar with the program should be able to read this explanation and
understand what the Statewide AT Program is “doing”. This explanation should make it
clear how this activity is related to the purposes of the AT Act. It also should describe
who the activity is intended to serve, specifically if only particular populations of
individuals are served by the activity or if there are qualifications for participation in the
activity. The role of the Statewide AT Program in carrying out the activity should be
explained clearly and any fees charged should be described. If there is more than one
distinct program within this activity area, number and describe each succinctly.
4. The online page for this specific activity can be found at: [Text box]

Instructions: Enter the URL for the device exchange program (not the general home page
URL) or enter N/A if information about these activities is not available online.

Screen 10: Device Refurbish and Reassignment and/or Openended Loan
1. If device refurbish and reassignment and/or open ended loan activities are conducted
through a formal written agreement, by providing financial support to other entities
and/or by receiving financial support from other entities please identify that
coordination and collaboration in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Banks/financial institution
Independent Living Center
Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. Select the option(s) that describe how a reutilized device is provided to a recipient.
[Check as many as apply]



Device ownership is transferred to the recipient
Device is loaned for as long as the recipient needs it with no ownership transfer.

Device ownership is transferred to the recipient – After the device is reassigned it is not
tracked or in any way controlled by the State AT Program or its supportive agencies.
Device is on open-ended loan - A recipient has possession of the device as long as they
need it but the State AT Program or its partner agencies retain ownership of the device.
3. Describe the activity. [Text box]

and adaptive daily living devices set aside for this program within our large reuse
program. When the ALS organization identifies an individual in need, they contact
and inform the State AT Program of the types of devices that could assist him or her.
We arrange to provide the devices, and support for their use, to the individual. We
track all devices as they come in and out of the program, and contact the individual
with the device on a regular basis to determine if he or she still is benefiting from it.
When the device no longer can be used by the individual, we collect it and take care
of any necessary sanitization and maintenance of the item in preparation for another
open-ended loan. No fees are charged for these open-ended loans.
4. The online page (or pages) for this specific activity can be found at: [Text box]

Instructions: Enter the URL(s) for the device refurbishment and reassignment or openended loan program(s) (not the general home page URL) or enter N/A if information about
these activities is not available online.

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section E: Device Short-term Loan Activity
The AT Act indicates that Statewide AT Programs are to “directly or in collaboration with
public or private entities, carry out device loan programs that provide short-term loans of
assistive technology devices to individuals, employers, public agencies, or others seeking to
meet the needs of targeted individuals and entities, including others seeking to comply with
IDEA, ADA and Section 504.” The purpose of a device loan may be -- (1) to assist in decision
making, (2) to serve as a loaner while the consumer is waiting for device repair or funding, (3)
to provide an accommodation on a short-term basis for a time limited event or situation or (4) to
conduct training, self-education or other professional development activity.
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are items intended to meet these requirements for device
loan activities.

Screen 11: Short-term Device Loan
1. If short-term device loan activities are conducted through a formal written agreement,
by providing financial support to other entities and/or by receiving financial support
from other entities please identify that coordination and collaboration in the table
below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

2. Select the option that describes how the majority of devices loaned are delivered to and
returned from a borrower. [Check one]




The majority of devices are shipped via mail or other delivery service.
The majority of devices are delivered or picked up in-person.

Statewide AT Programs use one of two methods for getting devices to borrowers using
their short-term loan program. Choose the option that is used for the majority of the
device loans issued.
3. Describe the activity. [Text box]

Instructions: Explain in the simplest terms possible how this activity is conducted; a
person unfamiliar with the program should be able to read this explanation and understand
what the Statewide AT Program is “doing”. Describe the process for obtaining devices for
the inventory, the procedures used by borrowers to request devices, how the program
tracks and ensures devices are returned and ready to be loaned out again, etc. If any
portion of the program is for a particular agency or entity, identify that agency or entity
and the purpose and population served. Describe any supports provided to the borrower to
ensure a successful loan. The role of the Statewide AT Program in carrying out the
activity should be explained clearly and any fees charged should be described. If there is
more than one distinct program within this activity area, number and describe each
succinctly. See example below.
The short-term loan program is operated by the State AT Program and is available to
any agencies, entity or school districts in the state. Equipment is available for loan that
meets the needs of adults and children of all ages with all types of disabilities. Entities
must have an approved short-term loan program agreement on file with the program
assuring acceptance of specific responsibilities to be able to borrow devices. The program
includes a wide range of equipment including switches and mounts, computer access
devices, environmental controls, hearing devices, home modifications, vision devices and
augmentative communication devices and the entire inventory is viewable online. Each
loan period is up to six weeks and an entity can borrow up to six devices. With each tablet
loan, up to 10 applications can be borrowed.
Items are shipped and returned by commercial delivery service except for a few
exceptionally heavy devices that must be delivered and picked up in person. All loans are
tracked in a database with routine follow-up to ensure timely return of devices. All
devices are sanitized and checked for functionality before being loaned out again. All
device loans include manufacturer’s instructions and/or a “cheat sheet” developed by the
program with basic instructions about set-up and use to support the borrower(s). The
device loan program inventory is updated as resources will allow and priority is given to
purchasing devices to reduce waiting lists and provide current high demand items. No
fees are charged to borrow devices.

4. The online page for this specific activity can be found at: [Text box]

Instructions: Enter the URL for the device short-term loan program (not the general home
page URL) or enter N/A if information about this activity is not available online.

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section F: Device Demonstration Activity
The AT Act describes device demonstrations as activities to “directly, or in collaboration with
public and private entities, such as one-stop partners, as defined in section 101 of the
Workforce Investment Act of 1998 (29 U.S.C. 2801), demonstrate a variety of assistive
technology devices and assistive technology services (including assisting individuals in making
informed choices regarding, and providing experiences with, the devices and services), using
personnel who are familiar with such devices and services and their applications.” Section
4(e)(2)(D)
Device demonstrations compare the features and benefits of AT devices to enable informed
decision-making. In a device demonstration, guided experience with the device(s) is provided
to the participant with the assistance of someone who has technical expertise related to the
device(s). This expert may be in the same location as the participant or may assist the
participant through Internet or distance learning mechanism that provides real-time, effective
communication to deliver the necessary device exploration.
A demonstration is characterized by its interactive nature whereby the participant can interact
with the device and an expert to increase their knowledge and understanding about the details
and functions of a device; the participant drives the demonstration and has the ability to interact
and have their individual questions about the device addressed. If the demonstration is
conducted via the internet or distance learning mechanism it must be a real-time, interactive
demonstration that provides one-on-one assistance to the participant. A web-based
demonstration that is archived or is a static presentation without interaction is considered an
awareness activity, not a demonstration.
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are items intended to meet these requirements for device
demonstration activities.

Screen 12: Device Demonstration
1. If device demonstration activities are conducted through a formal written agreement,
by providing financial support to other entities and/or by receiving financial support
from other entities please identify that coordination and collaboration in the table
below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Instructions: Enter the URL for the device demonstration program (not the general home
page URL) or enter N/A if information about this activity is not available online.

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section G: State Leadership Activities
Training Activities
The AT Act describes training as follows:
“(i) TRAINING AND TECHNICAL ASSISTANCE. —
(I) IN GENERAL. —The State shall directly, or provide support to public or private entities
with demonstrated expertise in collaborating with public or private agencies that serve
individuals with disabilities, to develop and disseminate training materials, conduct training,
and provide technical assistance, for individuals from local settings statewide, including
representatives of State and local educational agencies, other State and local agencies, early
intervention programs, adult service programs, hospitals and other health care facilities,
institutions of higher education, and businesses.
(II) AUTHORIZED ACTIVITIES. —In carrying out activities under sub clause (I), the State
shall carry out activities that enhance the knowledge, skills, and competencies of individuals
from local settings described in sub clause (I), which may include—
(aa) general awareness training on the benefits of assistive technology and the Federal, State,
and private funding sources available to assist targeted individuals and entities in acquiring
assistive technology;
(bb) skills-development training in assessing the need for assistive technology devices and
assistive technology services;
(cc) training to ensure the appropriate application and use of assistive technology devices,
assistive technology services, and accessible technology for e-government functions;
(dd) training in the importance of multiple approaches to assessment and implementation
necessary to meet the individualized needs of individuals with disabilities; and
(ee) technical training on integrating assistive technology into the development and
implementation of service plans, including any education, health, discharge, Olmstead,
employment, or other plan required under Federal or State law.”
Training activities are instructional events, usually planned in advance for a specific purpose or
audience, and are designed to increase participants’ knowledge, skills, and competencies
regarding AT. Such events can be delivered to large or small groups, in-person, or via
telecommunications or other distance education mechanisms. In general, participants in training
can be individually identified and could complete an evaluation of the training. Examples of
training include classes, workshops, and presentations that have a goal of increasing skills,
knowledge, and competency, as opposed to training intended only to increase general
awareness of AT. Training activities have more depth and breadth than public awareness
activities and are focused on skill building and competency development.
35

Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are items intended to meet these requirements for training
activities.

Screen 13: Training
1. If training activities are conducted through a formal written agreement, by providing
financial support to other entities and/or by receiving financial support from other
entities please identify that coordination and collaboration in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Banks/financial institution
Independent Living Center
Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. Provide a short description of at least one and no more than three planned training
activities. One of the activities described must be planned Information and
Communication Technology (ICT) accessibility training that will provide the required
ICT Training performance measures. If the Statewide AT Program is meeting the
transition requirements of the AT Act through training, please describe that planned
activity. If the Statewide AT Program sponsors or co-sponsors a statewide conference
please include that event as one you describe. [Three text boxes]
Planned ICT Accessibility Training (required)

Planned Transition Training or Other Training Activity (optional)

Planned Statewide Conference or Other Training Activity (optional)
3.

The online page for this specific activity can be found at: [Text box]

Instructions: Enter the URL for training activities (not the general home page URL) or
enter N/A if information about this activity is not available online.

Technical Assistance Activities
The AT Act describes training as follows:
“(i) TRAINING AND TECHNICAL ASSISTANCE. —
(I) IN GENERAL. —The State shall directly, or provide support to public or private entities
with demonstrated expertise in collaborating with public or private agencies that serve
individuals with disabilities, to develop and disseminate training materials, conduct training,
and provide technical assistance, for individuals from local settings statewide, including
representatives of State and local educational agencies, other State and local agencies, early
intervention programs, adult service programs, hospitals and other health care facilities,
institutions of higher education, and businesses.
(II) AUTHORIZED ACTIVITIES. —In carrying out activities under sub clause (I), the State
shall carry out activities that enhance the knowledge, skills, and competencies of individuals
from local settings described in sub clause (I), which may include—
(aa) general awareness training on the benefits of assistive technology and the Federal, State,
and private funding sources available to assist targeted individuals and entities in acquiring
assistive technology;
(bb) skills-development training in assessing the need for assistive technology devices and
assistive technology services;
(cc) training to ensure the appropriate application and use of assistive technology devices,
assistive technology services, and accessible technology for e-government functions;
(dd) training in the importance of multiple approaches to assessment and implementation
necessary to meet the individualized needs of individuals with disabilities; and
(ee) technical training on integrating assistive technology into the development and
implementation of service plans, including any education, health, discharge, Olmstead,
employment, or other plan required under Federal or State law.”
Technical Assistance (TA) is direct problem-solving services provided by Statewide AT
Program staff to assist programs and agencies in improving their services, management,
policies and/or outcomes. TA may be provided in person, by electronic media such as
telephone, video or e-mail and by other means. The following are examples of technical
assistance: needs assessment, program planning or development, curriculum or materials
development, administrative or management consultation, program evaluation and site reviews
of external organizations, and policy development.
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and

extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are items intended to meet these requirements for
technical assistance activities.

Screen 14: Technical Assistance
1. If technical assistance activities are conducted through a formal written agreement, by
providing financial support to other entities and/or by receiving financial support from
other entities please identify that coordination and collaboration in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Banks/financial institution
Independent Living Center
Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. Provide a short description of at least one and no more than two planned technical
assistance activities. If the Statewide AT Program is meeting the transition
requirements of the AT Act through technical assistance, please describe that planned
activity. [Two text boxes]
Planned Transition Technical Assistance or Other Technical Assistance Activity
(required)

Planned Other Technical Assistance Activity (optional)

Public Awareness Activities
The AT Act says the following about Public Awareness:
“The State shall conduct public-awareness activities designed to provide information to targeted
individuals and entities relating to the availability, benefits, appropriateness, and costs of
assistive technology devices and assistive technology services, including—
(aa) the development of procedures for providing direct communication between providers of
assistive technology and targeted individuals and entities, which may include partnerships with

entities in the statewide and local workforce investment systems established under the
Workforce Innovation and Opportunities Act (29 U.S.C. 3101 et seq.), State vocational
rehabilitation centers, public and private employers, or elementary and secondary public
schools;
(bb) the development and dissemination, to targeted individuals and entities, of information
about State efforts related to assistive technology; and
(cc) the distribution of materials to appropriate public and private agencies that provide social,
medical, educational, employment, and transportation services to individuals with disabilities.”
Public awareness activities are designed to reach large numbers of people, including activities
such as public service announcements, radio talk shows and news reports, newspaper stories
and columns, newsletters, brochures, and public forums.
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are items intended to meet these requirements for public
awareness activities.

Screen 15: Public Awareness
1. If public awareness activities are conducted through a formal written agreement, by
providing financial support to other entities and/or by receiving financial support from
other entities please identify that coordination and collaboration in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Banks/financial institution
Independent Living Center
Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. Provide a short description of at least one and no more than two planned major public
awareness activities. If the Statewide AT Program conducts a major ongoing public
awareness activity such as an annual AT awareness day with a Governor’s
Proclamation, please include that activity. [Two text boxes]
Major Annual Planned or Other Public Awareness Activity (required)

Planned Other Public Awareness Activity (optional)

Information and Assistance Activities
The AT Act says the following about information and referral activities, which for the purpose
of this State Plan are called information and assistance activities:
“(aa) IN GENERAL. — The State shall directly, or in collaboration with public or private (such
as nonprofit) entities, provide for the continuation and enhancement of a statewide information
and referral system designed to meet the needs of targeted individuals and entities.
(bb) CONTENT. — The system shall deliver information on assistive technology devices,
assistive technology services (with specific data regarding provider availability within the
State), and the availability of resources, including funding through public and private sources,
to obtain assistive technology devices and assistive technology services. The system shall also
deliver information on the benefits of assistive technology devices and assistive technology
services with respect to enhancing the capacity of individuals with disabilities of all ages to
perform activities of daily living.”
Section 4(d)(5) of the AT Act requires that the State Plan include a description of how the
Statewide AT Program will implement its State-level and State Leadership activities. Further,
section 4(d)(4) requires that the State Plan describe how various public and private entities will
be involved in the implementation of those activities, including a description of the nature and
extent of resources that will be committed by public and private collaborators. Section 4(d)(7)
also requires that the State Plan include a description of the State-level and State Leadership
Activities the state will support with state funds. Section 4(e)(3)(B)(iii) requires that states
coordinate and collaborate their State-level and State Leadership activities among public and
private entities. The following items are items intended to meet these requirements for
information and assistance activities.

Screen 16: Information & Assistance
1. If information and assistance activities are conducted through a formal written
agreement, by providing financial support to other entities and/or by receiving
financial support from other entities please identify that coordination and collaboration
in the table below.
Collaborating organizations
conducting this activity

Have written
agreement
with this entity

Banks/financial institution
Independent Living Center

Provide
financial
support to this
entity

Receive
financial
support from
this entity

Easter Seals
Disability/AT Organizations
Federal Entities/Agencies
State Entities/Agencies
Local/Community Entities
Private Entities
Other (text box to describe)
2. Describe the activity. [Text box]

Instructions: This should include a description of how a consumer in need of information
and assistance can contact the Statewide AT Program and how the program would provide
assistance to him or her. Explain in the simplest terms possible how this activity is
conducted; a person unfamiliar with the program should be able to read this explanation and
understand what the Statewide AT Program is “doing.”
Example: Our Statewide AT Program has four regional sites. Each site has a half-time
person devoted to answering information and assistance calls and e-mails and this person
receives extensive and ongoing training. A consumer can contact any of the four sites
(usually he or she is directed to the one closest to where he or she lives) and either speak to
the staff or leave a message via voicemail. E-mail inquiries are handled similarly, except
that they all go to a general account and then are forwarded to the appropriate staff
member. Our policy is to respond to all inquiries within one business day. When
contacting a consumer, the staff has a routine of questions to ask to ensure that we have all
of the information necessary to connect the consumer with appropriate resources. The
expertise of the staff about AT-related resources in the state is backed up by several threering binders full of topical information for quick reference. If staff is not able to respond to
a request for assistance alone, the request is brought to the weekly staff meeting to problemsolve.

Assistive Technology State Grant
Program
State Plan for FY 2021-2023
Section H: Assurances & Measurable Goals
Section 4(d) of the AT Act prescribes the duties of the Lead Agency receiving a grant under
section 4 of the AT Act and requires the State to provide a number of assurances in its
application for funds. 34 CFR part 76 also requires that any State Plan include certain
assurances. The Statewide AT Program certifying representative will attest to these assurances
and other requirements below and by submitting the State Plan, will affirm that to the best of
his or her knowledge and belief all information provided in the State Plan is true and correct
and the State Plan fully discloses all known weaknesses concerning the accuracy, reliability,
and completeness of the information.

Screen 17: Assurances
1.

As the Certifying Representative of the Lead Agency for the State of [state name], I
hereby assure the following:

The Lead Agency prepared and submitted this State Plan on behalf of the State of
[state name].

The Lead Agency submitting this plan is the State agency that is eligible to submit
this plan and if an Implementing Entity is identified it is designated to implement
the required AT Act activities.

The State agency has authority under State law to perform the functions of the
State under this program.

The State legally may carry out each provision of this plan.

All provisions of this plan are consistent with State law.

A State officer, specified by title in this certification, has authority under State law
to receive, hold, and disburse Federal funds made available under the plan.

The State officer who submits this plan, specified by title in this certification, has
authority to submit this plan.

The agency that submits this plan has adopted or otherwise formally approved this
plan.

10.

The plan is the basis for State operation and administration of the program.

11.

The Lead Agency will maintain and evaluate the program under this State Plan.

12.

The State will annually collect data related to the required activities implemented
by the State under this section in order to prepare the progress reports required
under subsection 4(f) of the Act.

13.

The Lead Agency will submit the annual progress report on behalf of the State.

14.

The State will prepare reports to the Secretary in such form and containing such
information as the Secretary may require to carry out the Secretary's functions
under this Act and keep such records and allow access to such records as the
Secretary may require to ensure the correctness and verification of information
provided to the Secretary.

15.

The Lead Agency will control and administer the funds received through the grant.

16.

The Lead Agency will make programmatic and resource allocation decisions
necessary to implement the State Plan.

17.

Funds received through the grant will be expended in accordance with Section 4 of
the Act, and will be used to supplement, and not supplant, funds available from
other sources for technology-related assistance, including the provision of assistive
technology devices and assistive technology services.

18.

The Lead Agency will ensure conformance with all applicable Federal and State
accounting requirements.

19.

The State will adopt such fiscal control and accounting procedures as may be
necessary to ensure proper disbursement of and accounting for the funds received
through the grant.

20.

Funds made available through a grant to a State under this Act will not be used for
direct payment for an assistive technology device for an individual with a disability.

21.

A public agency or an individual with a disability holds title to any property
purchased with funds received under the grant and administers that property.

22.

The physical facility of the Lead Agency and Implementing Entity, if any, meets the
requirements of the Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et
seq.) regarding accessibility for individuals with disabilities. Section 4(d)(6)(E)

23.

Activities carried out in the State that are authorized under this Act, and supported
by Federal funds received under this Act, will comply with the standards
established by the Architectural and Transportation Barriers Compliance Board
under section 508 of the Rehabilitation Act of 1973 (20 U.S.C. 794d). Section
4(d)(6)(G)

24.

The Lead Agency will coordinate the activities of the State Plan among public and
private entities, including coordinating efforts related to entering into interagency
agreements.

25.

The Lead Agency will coordinate efforts related to the active, timely, and
meaningful participation by individuals with disabilities and their family members,
guardians, advocates, or authorized representatives, and other appropriate
individuals, with respect to activities carried out through the grant.

General Description of Measurable Goals:
Section 4(d)(3) of the AT Act requires that the State include information on the measurable
goals, and a timeline for meeting those goals, that the State, with the advice of the Advisory
Council required in section 4(c)(2), has set for addressing the assistive technology needs of
individuals with disabilities in the State related to education, employment, community living,
and telecommunications and information technology).


Section 4(d)(3)(A)(i) of the AT Act states that education goals include goals involving the
provision of assistive technology to individuals who receive services under the Individuals
with Disabilities Education Improvement Act (20 U.S.C. 1400 et seq.). This includes
infants and toddlers receiving early intervention services under Part C.



Education also includes the provision of assistive technology to individuals who receive
services under section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 720 et seq.) and
individuals in institutions of higher education and vocational education, including
community colleges.



Section 4(d)(3)(A)(ii) of the AT Act states that employment goals include goals involving
the State vocational rehabilitation program carried out under title I of the Rehabilitation Act
of 1973 (29 U.S.C. 720 et seq.).

ACL has established three types of measurable goals for Section 4 grantees:


Access to AT Goals relate to the activities of device loan for a decision-making purpose and
device demonstration. The State will show that it has improved access to AT by reaching or
exceeding the ACL set target percentage of individuals and entities who accessed device
demonstration programs or device loan programs and made a decision about an AT device
or service as a result of the assistance they received. The Access Goal performance measure
data is found in the Annual Progress Report (APR) for State Assistive Technology
Programs.



Acquisition of AT Goals relate to the activities of state financing, device reutilization, and
device loan for purposes other than decision-making. The State will show that it has
improved acquisition by reaching or exceeding the ACL set target percentage of individuals
and entities who obtained devices or services from State financing activities or reutilization
programs who would not have obtained that AT device or service. The Acquisition Goal
performance measure data is found in the APR for State Assistive Technology Programs.



Information and Communication (ICT) Accessibility Goal is focused on obtaining an
outcome/result from information and communication technology accessibility training
including improvement of policies procedures or practices in the areas of website and
software development and procurement. The State will show that is has improved ICT
training results by reaching or exceeding the ACL set target percentage of participants
reporting a targeted outcome. The ICT Training performance measure data is found in the
APR for State Assistive Technology Programs.
44

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File Modified	2021-05-24
File Created	2021-05-24