missouri assistive technology annual report 2002 -...

Fitti

ng the pieces together . . .

Missouri Assistive TechnologyAnnual Report

2002 - 2003

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Reflections, 1993 - 2003We’ve Come A Long Wayby James Jordan, Retiring AT Council Member

In my decade on the Council, I have witnessed changes in assistive technology (AT)and its delivery in this state that rival the change from the horse to the automobile.

It is with nothing but pride that I look back on my time on the Council and feel blessedto have served with such a talented and forward thinking group of individuals. We have

definitely been a proactive Council that has left Missourians with disabilities in a betterposition, when it comes to assistive technology, than they were when I was selected as one of

the original Council members in 1993.Ten years ago, this Council focused primarily on introducing Missourians with disabilities to assistive technology. To

all corners of the state we went, explaining time and time again what AT is and how it could be beneficial in people’s lives.We followed this initiative with the creation of six demonstration sites around the state that provided individuals with thechance to see, try and learn about assistive devices. Yet, in some respects, our efforts seemed to be slightly hypocritical.Here we were introducing individuals to all of these wonderful adapted devices, but in far too many instances, they had nooption, due to limited funding, to purchase devices or try them for extended periods of time.

Thus, the Council began shifting its emphasis more toward increasing the number of avenues in which individuals couldobtain devices. This was a wonderfully effective move which has culminated in the development of the TelecommunicationsAccess Program for Telephone and Internet, the $how-Me Loans Program, the Kids Assistive Technology Program, theEquipment Technology Consortium, Swap ‘n Shop and the Assistive Technology Reimbursement Program, all of which are fur-ther profiled in this annual report. The theme of this report, “fitting the puzzle pieces together” reflects the developmentand expansion of the Council’s programs into a collage of service “pieces” which create more comprehensive access to ATacross the state.

My ten years of service to the Council have gone fast and have been most rewarding. While we still have some ATpieces missing and some that could better fit together, Missouri, I feel, has come far in assuring its citizens the best assis-tive technology access possible.

Missouri Assistive Technology(816) 373-5193 - Phone (816) 373-9315 - TTYpage 4

Voting ReformState legislation passed this session

that revises Missouri election law to con-form to the federal Help America Vote Act(HAVA). Both HAVA and state legislationinclude several sections related to improv-ing the ability of persons with disabilitiesto vote independently. The new state lawincludes a requirement for local electionauthorities to designate at least one votingsite (and up to four additional sites) as anelection day central polling place and thesesite(s) must conform to nationally acceptedarchitectural accessibility standards.Implementation of HAVA also includeddevelopment of a State Plan. MoAT staffwas active on the State Plan Committee indrafting sections relating to accessible vot-ing machines. Staff also drafted thestate’s grant application for HAVA Section261 funds to improve voting accessibilityfor persons with disabilities.

Information TechnologyAccessibility Standards

In January 2003, Missouri officiallyadopted information technology (IT) acces-sibility standards. As required by state lawthe standards were jointly adopted by theAssistive Technology Council and the Officeof Information Technology. The standardsare a modification of the federal Section508 IT access standards and cover theareas of web, operating systems and soft-ware, telecommunications, video and multi-media, desktop and portable computers, andinformation, documentation and support.Missouri appears to be the first state toundertake comprehensive IT accessibilitystandards development and adoption tospecifically address unique state needs andresources.

Assistive Technology SpecialEducation Funding

Over $56,000 was made availablefor vision-related devices to be added toMissouri’s short-term equipment loan pro-gram (ETC). The funding was made possiblethrough the combined efforts of MoAT,the Blind Task Force and Missouri’s Divisionof Special Education.

Additional funding, about $250,000is expected to be made available again nextyear from the Division of Special Educationto improve the ability of schools to provideassistive technology for school-aged chil-dren. More details on this year’s ATReimbursement Program and on ETC, bothadministered by MoAT, are provided in alater section of the annual report.

Policy Advocacy & Technical Assistance

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Disabled Parking LawsLegislation passed and was signed

into law, which makes disabled parking wind-shield placards renewable for two years.Under prior law the placards had to berenewed each year.

Another bill also passed, but did notbecome law, which would have increased thepenalty for fraudulently using a disabledparking plate or placard. This bill wouldhave also expanded the types of medicalpractitioners who could certify disablingconditions in order for persons to obtain adisabled plate/placard. The bill also wouldhave increased the penalty for practition-ers who fraudulently issued a certificatefor a plate/placard. This bill was vetoed bythe Governor for issues having to do withprovisions not related to disabled parking.

Health Insurance Coverage forHearing Aids

A bi-partisan effort was again madein the legislature to require health insurersto cover hearing aids for children. FormerMoAT Chair Tom Bastean testified beforethe House Health Care Policy Committee ona bill to provide coverage. This legislationwas a MoAT Council priority this year.Many children with hearing impairments gowithout hearing aids because theirinsurance does not cover them, resulting inproblems with language development andeducational achievement. While the twobills that were introduced did not pass,legislation is expected to be introducedagain next session.

Tax Credit for Home AccessModifications

Missourians who need to make theirhomes accessible for themselves or for afamily member often find it unaffordableto do so. Passage of legislation to provide atax credit for individuals to help offset theexpenses of home access modifications wasa MoAT Council priority in the 2003session. The bill that was introduced wouldhave provided a tax credit for many typesof home access improvements. The state’stough budget year thwarted efforts to passthe bill, however legislation to help ease theexpense of making homes accessible islikely to be introduced again in futuresessions.


Power Up Attendee Comments

“The opening speaker was excellent. I havenever enjoyed a conference speaker more!”

“Conference Notebook is an outstandingreference!”

“The highlight was the involvement ofpeople with disabilities as presenters &participants . . . practical info presentedby people who use it!”

“Great conference (as usual). Keep up thegood work!” Power Up Highlights

MoAT again sponsored Power Up, astatewide AT conference and expo attend-ed by almost 500 participants. Keynotespeakers Michael Aronin & Kyle Glozierstarted and finished the conference & expowith exhilaration, inspiration, and highimpact! A special theatrical performanceby The DisAbility Project at the Mondayevening reception had attendees raving!Recipients of the AT awards were JulieItuarte, Blindness Skills Specialist inSpringfield, and Alisha Criswell, ElaineHoutman, & Cheryl Snorgrass ofThe CapperCenter of Kansas City.

With 42 exhibitors and 38 sessions,attendees had a plethora of choices and awealth of experience to learn from.Vendors from across the country demon-strated new technology, and the computerlearning lab offered attendees hands-onexperience. Visit our website for informa-tion on the Power Up 2004 Conference &Expo and come join us!

Other TrainingIn addition to Power Up, MoAT staff

conducted 22 other training events onassistive technology, reaching 1,361Missourians.

Training and Individual Assistance

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Individual AssistancePersons with disabilities and service

providers contact Missouri AssistiveTechnology (MoAT) seeking assistance inobtaining assistive technology, securingdevice funding, accessing MoAT programs,and gaining disability policy knowledge.During this fiscal year, MoAT staff han-dled 16,752 inquiries and requests forassistance by telephone and e-mail.

The People PieceCrossroads Hospice in Kansas City servesindividuals who are gravely ill. In the fallof 2002, MoAT staff received a call from aCrossroads employee who was new to assis-tive technology, but who knew enough toknow that assistive technology might beuseful in helping individuals maintain thebest quality of life possible. Toward thatend, MoAT staff has been periodicallyassisting Crossroads staff with determiningappropriate forms of assistive technologyto use and have been loaning devices toCrossroads through the ETC program.


The People PieceOf the 980 assistive devices

offered through ETC, perhaps none hasmore impact on the lives of individuals thanthe portable ramps. A family in Columbiathat rented a house last year well illus-trates the affect the ramps produce. Whilewaiting for a permanent ramp to be built ontheir home, the family coordinated withShow-Me Tech and Services forIndependent Living to borrow a portableramp via ETC. The loan of the portableramp made things much easier for the fami-ly member with a disability as well as themembers of his family. While they werewaiting for a permanent ramp to be con-structed, the temporary ramp enabled theyoung man to attend doctor’s appointments,complete his physical therapy routine, par-ticipate in community activities, and livewith the knowledge that, in case of anemergency, he would be able to get out ofhis house in a quick and safe manner.

The Program PieceIn this, its fourth full year of oper-

ation, the ETC Program yet again loanedmore equipment than in the prior year.Loans made in FY’03 totaled 1,265, anincrease of 11% from FY’02. An additional130 pieces of equipment were added to theinventory, bringing the total to 980, whichhelps the program maintain an up-to-dateselection of devices and provide devices in atimely manner. This year also saw 33 newschool districts and agencies joining theprogram, bringing the total to 384. Strongconsumer satisfaction continues to be ahallmark of the ETC program with 98% ofborrowers giving the program and its levelof service strong marks.

Equipment Technology Consortium (ETC)

Furthermore, family members no longer hadto lift this family member and carry him inand out, ending the potential danger of afall to both him and his family.

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One of the primary ideas behindthe development of the ETC Program wasto provide consumers, school districts andagencies around the state with anopportunity to borrow multiple items inorder to compare them in differentenvironments (e.g., in school, at home, andin the community). It is strongly believedthat by so doing, prudent use of dollars, inparticular public dollars, will occur; thatthere will be appropriate matches ofdevices to consumers based on evidence,not speculation; and that the assistivetechnologies purchased will be used by theconsumer for many years.

ETC staff perform periodic follow-up with borrowers from around the state.Of particular focus in our follow-upsurveying is the outcome achieved throughborrowing. In other words, was anappropriate device found for the child oradult and if so, how many other deviceswere tried before the correct match wasfound? A southwestern Missouri schooldistrict with a high number of current andpotential assistive technology usersborrowed 74 devices over the course of thepast year. At year-end, the school districtreports that after conducting device trialsusing the equipment, they confidentlypurchased 29 devices ranging fromcomputer access to portable wordprocessors and from augmentativecommunication to Braille learning aids.

ETC Program Piece continued…

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The People PieceLike many first-graders, Mikey

thinks computers are cool; and his KansasCity area school believes they are integralto effective learning. Mikey’s ability to usecomputers like his fellow students, though,was hindered by his disability and hisschool’s inability to pay for the assistivetechnology he needs to access the comput-er. Through the Assistive TechnologyReimbursement Program, Mikey’s school wasable to acquire an Intellikeys adapted key-board, a range of software tools to enhancethe capabilities of the Intellikeys, and aswitch that enables Mikey to operate theIntellikeys.

The Program PieceThe Assistive Technology

Reimbursement Program is MoAT’s newestprogram. Funded by the Department ofElementary & Secondary Education,Division of Special Education, the ATReimbursement Program helps school dis-tricts offset the cost of purchasing assis-tive technology for students with assistivetechnology needs written into theirIndividualized Education Program (IEP).

Assistive Technology Reimbursement Program


This year, the program received226 applications from 60 different schooldistricts throughout Missouri.

MoAT was able to fund 88 applica-tions divided among 42 different schooldistricts. The program aims to fund thoseforms of assistive technology that costbetween $1,000 and $5,000, items such asbraille embossers, augmentative communica-tion aids, computer access systems and per-sonal FM systems.

The program was well received byschool districts that applied, with severalciting the fact that it was refreshing tosee new sources of funding in a time whenbudgets are being reduced and programseliminated. More importantly, however, isthat it opens new opportunities to getassistive technology into the hands of stu-dents with disabilities, as in this instance:“We have our purchased Jordy (a form ofelectronic enlarging) in the classroom andHannah is so very happy to be using it.”


Every day, millions of Missourians use the telephone and internet to make purchases, search for jobs, apply for publicservices and to communicate with far-away family. The Telecommunications Access Program (TAP) provides adaptive telephoneand computer equipment needed for basic access to telephone and internet telecommunication for Missourians with hearing,vision, mobility and other disabilities.

In 2000-2001 MoAT assumed operation of TAP for Telephone and initiated TAP for Internet. As projected, afterseveral years of steady program growth, TAP for Telephone experienced a “leveling off” of applicants while TAP for Internet,as a new program, saw a 47% increase in the number of devices provided.

A critical component of TAP is the delivery of consumer support to assist individuals with disabilities select the mostappropriate adaptive equipment and to assist with installation and use of the equipment provided. While adaptive equipmentcosts were relatively unchanged from last year, there was a significant increase in consumer support costs caused by theincreasing number of complex computer based adaptive equipment provided by TAP for Internet. Administration costscontinue to be very low at 6%.

Telecommunications Access Program (TAP)


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TAP Equipment Distributed by Senatorial District


The People PieceA rural Center for Independent Living contacted TAP for Telephone regarding a consumer

who needed equipment. The consumer had no speech and was low vision. She had good manual dex-terity. TAP for Telephone advised that this individual would be a good candidate for Hearing CarryOver services through Relay Missouri. TAP for Telephone would be able to provide the Q90 TTYwith External Speakers and a Large Visual Display. The Q90 is specifically set up for Hearing CarryOver (HCO). Because the consumer was unable to read the text she would be typing to the opera-tor, a Large Visual Display was attached to the Q90, which would allow her to read text she was typ-ing and she can now successfully use the telephone.

Equipment provided by TAP for Telephone can overcome years of inability to use the telephone. Forty-four percent of TAPfor Telephone consumers indicate they were unable to use the telephone for 6 or more years before receiving adaptive equipment.

TAP for Telephone


The Program PieceThis year, 7,637 adaptive telephone devices were

provided by TAP for Telephone. A network of agenciesacross the state provides consumer support and receivesongoing training and demonstration equipment from MoAT.This network ensures correct equipment selection throughtrial use of demonstration devices. Follow-up data fromprogram beneficiaries indicates that 62% relied on theadaptive telephone to make an emergency call and 56%indicated the adaptive telephone allowed them to remainliving in their own home.


The People PieceAs is true of many of the “seniors”

who apply to TAP-I, PENNY has maculardegeneration, which is causing her to loseher vision but not her motivation to keepdoing all of the activities she loves like tat-ting, reading and talking to her many rela-tives, and friends via e-mail.

This lively lady uses adaptive tech-nology to perform many daily activities.Included among the technology she useseveryday is her computer magnificationsoftware, ZoomText, which allows her touse the Internet and e-mail to keep intouch with her 3 children, 13 grandchildrenand 14 great grandchildren, and numerousfriends.

To quote Penny, “Thank you and allof those who work with the visuallychallenged and without the Zoom I would bejust an old 78 year old woman with a verydark and lonely day. It is a wonderfulprogram for those who like to keep in touchwith the world around, Thanks.”

When you walk into ROGER’Sapartment the first thing you notice arethe books that are everywhere. Roger is anavid reader who is particularly fond of theStephen King and Daniel Kuntz genre. It iseasy to get into a lively conversation withRoger about any of the books in hisapartment, as he has read them all. It justmakes sense that he would like to write hisown book.

Being able to write has become areality, because of the adaptive computerequipment Roger received through TAP-I.He now uses his adaptive hardware andsoftware to access the computer on a dailybasis. Because of the difference theadaptive equipment provided through TAP-Ihas made, Roger can now take advantage ofsocial interaction offered via the internetsuch as chat rooms; look toward thepossibility of attending college andbecoming an author; and, increase hisindependence through internet basedbusinesses such as ordering his grocerieson-line.

TAP for Internet


The Program PieceConsumers who received adaptive com-

puter equipment through TAP for Internetreport 55% are using the Internet and e-mail toconduct business and 37% are using it to accessgovernment services online.

Missouri continues to be the only statein the nation whose telecommunication equipmentdistribution program includes the adaptivedevices needed for Internet access.

TAP for Internet provided 1,008 adap-tive computer devices representing 124 differ-ent devices. The devices provided fall into fourvery broad categories including alternative key-boards and pointing devices, software adapta-tions, speech and braille output and enlargementsoftware.

People with vision disabilities continueto be among the most prolific users of the pro-gram with 50% of the equipment provided beingspeech and braille output and enlargement soft-ware. Consumers with reading, decoding and/orcomprehension disabilities represent 27% of theapplicants. People with physical disabilities rep-resent the minority with 18% representation.Given the proportionately larger number of peo-ple with physical disabilities, this percentage isexpected to increase dramatically.

Because of the wide range of adaptivecomputer equipment provided through TAP-I,consumer support is a critical factor both forthe selection and installation and use of theequipment. Over 400 consumer support sessionswere provided this year.


The People PieceJohn is 44 years old and lives in Boone County. He is legally blind, but has some

partial vision. He wanted to buy a Magni-Cam electronic print enlarger and a scanner so hecould read all of his day-to-day print materials at home. He especially wanted the devicesto be able to help his children with their schoolwork. He was able to get a discount on theMagni-Cam, but still needed $520 to purchase it and the scanner. It was just more thanwas affordable on his monthly disability payments. John applied for and received a $how-Me Loan, and now enjoys using his new equipment while making monthly loan payments ofonly $30.

Cinthia and Charles live in their home in Columbia. Their house was builtin 1931, and Cinthia, who uses a wheelchair, was frustrated with the home’sinaccessible kitchen. There was very little usable counter space; cabinets wereup too high for her to reach; she wasn’t able to open the windows; and applianceswere situated so they were difficult or impossible to use. Cinthia wanted to havethe ability to cook, do dishes, and other kitchen chores without having to rely onsomeone else for help all the time. A $how-Me Loan was approved withaffordable monthly payments that allowed the couple to make accessimprovements so Cinthia can be much more independent in her home.

$how Me Loans


The Program Piece$how-Me Loans is Missouri’s new

low-interest loan program that helps per-sons with disabilities to purchase assistivetechnology. Borrowers have been able toimprove independence for themselves orfamily members through the loan programwith interest rates averaging 3.1%. Theprogram can provide loans for any type ofassistive technology device or equipment, orfor making access improvements to homesor vehicles. During 2002-03, $how-MeLoans received 31 applications which werereviewed by a consumer majority loan com-mittee. The average time needed to

process & review applications was 23 days.The program approved $61,816 in loans for18 Missouri families. Eight borrowers pur-chased hearing aids, 3 purchased wheel-chair lifts for vehicles, 2 bought wheelchairramps, 2 purchased computers, and othersobtained home access modifications, anassistive listening system, a customizedwheelchair and an electronic print enlargingdevice. The average amount loaned was$3,434 with a range of $520 to $9,859.Terms of re-payment ranged from 18 to 60months with an average of 37 months.

Even though half of the borrowershad an annual income of less than $15,000there were no defaults on loans. During theyear, borrowers repaid a total of $20,462in principal and interest.


The People PieceA central Missouri school district

initially borrowed several different typesof CCTVs from the ETC program todetermine the most appropriate device.The CCTV was so much easier to use thana hand-held magnifier. They feel fortu-nate to have found exactly what theyneeded on the Swap ‘n Shop, and saved athousand dollars too!

An individual from southernMissouri had previously found andpurchased an accessible van off of theSwap n’ Shop program a few years ago,and was looking through the listings onceagain. They found a parachute harness.

They were able to attach this to a hoyerlift and now can use this for weight bearingexercises as well as a way to get out of thesitting position at times. The consumerstates that this was the first time theyhad ever seen this but it does the jobbetter than anything else they have foundand they saved $150!

The Program PieceIn fact, Missouri Assistive

Technology helped citizens save $370,748through the Swap N’ Shop program, anequipment exchange program that allowspeople with disabilities to obtain devicesfrom individuals in the state who no longeruse them. The Swap n’ Shop programreceived 124 new equipment listings while

89 new consumers wereable to place an ad.All types ofassistivetechnologies werelisted includingaccessible vehicles,porch and stair lifts,all types of mobilityaids such as canes,and wheelchairsallowing otherconsumers fromaround the state topurchase usedassistive technologyat a reduced price.

Swap ‘n Shop


The People PieceA mother in St. Louis was worried

about having to carry 12-year old Marty andhis wheelchair up and down stairs in front

of their home. Carrying Marty, who hascerebral palsy, was dangerous for both himand his mother. Since the house had a highporch and there was limited yard space, itwas clear that a wheelchair lift would be abetter solution for the family than a ramp.

But Marty’s mom, a single mother of five,could not afford a lift costing several thou-sand dollars. The KAT program was able toprovide most of the needed funding. Noweven Marty’s brothers and sisters can oper-ate the lift and don’t have to wait for helpevery time Marty wants to go outside orcome in.

The Program PieceFor three years, families of children

with disabilities have obtained assistive

technology through the KAT program.Program funds have come from theDepartment of Health and Senior Services- Bureau of Special Health Care Needs.While fewer KAT funds were available thanin previous years, the program was still ableto help 18 Missouri children. MoAT wasable to utilize $24,438 in KAT funds toleverage another $29,378 in other fundingto provide a total of $53,814 in devices andequipment.

Kids Assistive Technology Program (KAT)


Missouri’s 2003 legislative year took many twists and turns including two special sessions. Persons with disabilities and otherdisability advocates needed up-to-date information on the status of disability-related legislation and budget issues. MoAT’s MissouriDisability Legislative Listserv helped them meet this need. More than 330 individuals and organizations subscribed to the Listserv at nocost, and provided the legislative information to hundreds of other Missourians with disabilities.

“I have appreciated the complete and up-to-date info. I have forwarded a lot of the emails to my son’s caseworkers.”— Parent of a child with a disability

“There is not much more I can ask from you...You did an awesome job of informing many of us on the legislative actions and bills... Keepup the good work”

— School special education administrator

“MoAT’s listserv is considered one of the best resources for up to date Missouri legislative issues. It is clear and concise—all that isneeded.”

— Director of a center for independent living

“The information provided is concise while offering all the important highlights. It is perfect for someone like myself that does not havea lot of time to review tons of information on the various issues. Anytime I have needed additional information I have been able tocontact MoAT staff and get the information I needed.”

— Director of a community non-profit organization

“I think you do an excellent job of tracking legislative issues...I don’t have the time (or the know how) to keep on top of all of thedifferent issues being considered each session, so your reports are invaluable for keeping me up to date and informed. I subscribe toanother list that does not seem to track anywhere near the number of legislative issues you track. Keep up the good work, we certainlyappreciate it!”

— Assistant director of a center for independent living

Missouri Disability Legislative Listserv


Council members during 2002 – 2003:Consumer Representatives

Teddi Brace, ChairpersonRita Lynch, Chairperson ElectShari LaRoussa, Past ChairKaren Collier Chris CraigMarnie GustafsonNeil HarmsScott HigdonDick HostyJim JordanDeana O’BrienRhonda Triller

Legislative RepresentativesSenator Kenneth JacobRepresentative - vacant

Agency RepresentativesJim Brinkman – Rehab. Serv. for the BlindAurita Prince Caldwell – Health & Sr. ServicesJim Casey - InsuranceMelodie Friedebach - Special EducationDolores Hampton – DD Planning Council Ed Kniest - Medical ServicesNancy Nickolaus – Mental HealthElaine Reiter - AARPVacant – Vocational Rehabilitation

The Mission of the Missouri Assistive TechnologyAdvisory Council is to increase access to assistive technology

for Missourians with disabilities.


In keeping with statutory requirements, the Missouri Assistive Technology Council is pleased toprovide this report on the Council’s services and programs. Every attempt has been made to providetimely and comprehensive information in a cost effective manner by using existing staff resources.

Alternate formats are available upon request and an accessible electronic version is available atwww.dolir.mo.gov/matp/.

Photography by Bob LaRoussa and Tom Olin

Missouri Assistive Technology4731 S. Cochise, Suite 114

Independence, Missouri 64055(816) 373-5193 - Voice (816) 373-9315 - TTY

(816) 373-9314 - [email protected] - Email www.dolir.mo.gov/matp/ - Website

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