Assistive Devices

Find the federal definition of assistive devices, resources related to managing the cost, prioritization of devices for distribution, and other helpful information for the administration of devices within OIB programs.

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Federal Definition of Assistive Devices and Services

An Assistive Technology Device is:

Any item, piece of equipment, or product system whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities
May include canes, slates, insulin gauges, video magnifiers, computers, adaptive software, magnifiers, adaptive cooking items, adaptive recreational items, handwriting guides, braille devices, and large button telephones, etc.

Assistive Technology Services may include:

the evaluation of assistive technology needs of an individual
services related to acquisition of technology, loan programs
maintenance and repair of assistive technology
training or technical assistance for the individual or professionals related to the use of assistive technology, programs to expand the availability of assistive technology
low vision services related to the use of optical aids and devices
other services related to the selection acquisition, or use of an assistive technology device.

This is defined in Section 3(4) of the Assistive Technology Act of 2004 (Pub. L. 108-364)

https://www.govinfo.gov/content/pkg/STATUTE-118/pdf/STATUTE-118-Pg1707.pdf

Managing the Cost of Assistive Devices
Best Practices

Agencies will have guidelines regarding inventory control, supplies, and equipment management. Utilization, maintenance, and consumer or contractor ownership and responsibilities for devices will be clearly delineated. Consumers will be provided with information about how to get devices repaired and batteries replaced, as needed.

Agencies will use comparable benefits (e.g., third-party support, such as Lions Club, iCanConnect, etc.) to minimize equipment costs to the agency. Agency resources will be considered in evaluating policies for providing devices.

Other cost saving measures may include bulk purchases, implementing financial needs assessment for co-payments, using innovative ways to pool resources (donated items, VA, Tech Act, VR), developing parameters for device maintenance and replacement, implementing procedures for recycling/refurbishing devices, developing ongoing relationships with collaborating agencies, and securing administrative oversight/approval of expensive items (over $500 or preset amount).

Equipment purchases will be consistent with each consumer’s functional needs assessment, and those needs will be documented in the case file. Case documentation will include an explanation of instruction provided and how the device benefits the consumer. Devices will promote consumer health, safety, and independence.

Consumers will be informed about the assistive devices available in the marketplace, regardless of whether or not the program can provide those devices.

Acceptable Practices

Any agency that does not implement best practices will have a plan in place to move toward best practices that includes an expeditious timetable and benchmarks.

Unacceptable Practices

It is unacceptable to (a) provide equipment without consumer assessment, training, and case file documentation; (b) lack inventory control procedures; (c) have inefficient accountability or administrative oversight; or (d) have unclear or inadequate communication with consumers and other stakeholders concerning equipment. It is unacceptable to provide equipment to consumers without ensuring consumers have adequate resources and information to get those devices repaired, including battery replacement.

It is unacceptable to fail to inform consumers about assistive devices available, even when the OIB program cannot provide the device.

Clarifying Comments

Devices that promote consumer health and safety are a priority. Identifying and accessing other funding sources and encouraging consumer responsibility for purchases, regardless of cost, is a positive practice. State-approved vendors for bulk purchases can be an effective practice. Some OIB programs have been successful in getting additional funding from other sources for programmatic expenses, including assistive technology. When potential opportunities arise to expand funding, staff will pursue efforts to secure it.

Devices for nonessential tasks and some non-specialized devices, such as crockpots, will be the consumer’s responsibility; although, techniques to facilitate use and safety (e.g., raised dots) may be provided. It is inappropriate for states to assume long-term financial responsibilities or provide services such as internet access.

Qualified staff can make purchasing decisions based on consumer assessments for items of specified amounts, as determined by the agency. Purchase of expensive items will require additional oversight.

When agencies allocate funds per consumer for equipment or devices, consumers will be informed about spending caps and assisted in maximizing the impact of the funds allotted to them.

To assist with the conservation of expenses for less expensive items and to facilitate training time, staff may use demonstration kits to show consumers the details or functioning of devices and to give a basic demonstration of how to use the device. Ideally, this would be done when the person expresses interest in the device, rather than after it is received.

Prioritizing Assistive Devices
Best Practices

The OIB program has policies/procedures to define program limits, ownership and maintenance of equipment, and related guidelines to maximize resources and utilization. Consumer needs and safety will be primary factors in distribution of devices and equipment. Consumers will have the opportunity to try out devices or equipment before committing to purchase or receipt (consumer choice based upon assessment). Distribution of devices includes appropriate training in its use for the consumer. When medical equipment is provided, documentation of need will be included in the case file.

Consumers are increasingly requesting accessible applications (apps) for their smartphones. Consumers unaware of these apps will be informed about availability. Staff will be trained by a qualified professional about the availability, cost, features, and operation of apps of potential interest to consumers.

Acceptable Practices

Any agency that does not implement best practices will have a plan in place to move toward best practices that includes an expeditious timetable and benchmarks.

Unacceptable Practices

It is unacceptable to provide the same equipment or no equipment to all consumers without regard to their demonstrated needs, to fail to consider individual consumer needs or delineate ownership, or to fail to provide sufficient training for each piece of equipment.

Clarifying Comments

Although equipment distribution is based on assessed consumer needs, some equipment is essential to most consumers.

Training must be provided for all equipment.

Frequently distributed equipment includes:

White cane
Timepiece/calendar
Medication delivery/identification device
Communication device (high contrast markers or pens, bold-lined paper, phones, signature guides, etc.)
Low-vision device (glare shields, magnifiers, etc.)
Computer access device (high contrast keyboards, etc.)
Money identifier

Household items should be externally funded or the responsibility of consumers, unless those items are specifically designed for use by persons with visual impairments and are not readily available at local sources.

Device Due Diligence Checklist

Why use this checklist?

Reduce overall costs for assistive devices
Minimize device abandonment.
Empower consumers to make effective use of both available funding and comparable benefits.
Avoid inadvertently developing consumer dependency on OIB staff through comprehensive training and follow-up.
Increase accuracy of data collected for the 7-OB.

Before Authorizing the Purchase of a Device (Checklist)

Has instruction in adaptive daily living techniques been discussed and offered prior to suggesting the purchase of an assistive device?
Is the device a specialized piece of adaptive equipment or can the instructor recommend the consumer purchase for themself a commonly available tool?
Based on the results of a comprehensive assessment and documented consumer goals, what AT devices are needed to meet those goals?
Does the device address consumer needs and preferences (rather than instructor preferences)?
Was there a demonstration of more than one option of similar devices to allow for the consumer to compare hands-on?
Did the consumer gain enough hands-on experience with the device to confirm it met the identified need prior to authorization for purchase?

Considerations After Provision of a Device (Checklist)

Was all training documented, including how use of the device increased the consumer’s independence and achievement of documented goals?
Was care, maintenance, and troubleshooting part of instruction on the device?
Was there documented follow-up regarding the on-going usefulness of the device for meeting consumer needs?
Was ownership, responsibility for the device, and the nature of on-going support, warranties, or repair policies for the device communicated to the consumer? Was information provided on how to obtain a replacement device?
Was the consumer informed of how to obtain the device regardless of the program’s ability to purchase it for them? Were other sources of funding shared?