Assistive Technology Guidance

February 2019

Purpose

To provide staff with information on assistive technology (AT) and how it can be used throughout the DVR process to assist consumers toward achieving their employment goals.

Rationale

Assistive technology is sometimes called rehabilitation technology, but in recent years has been more frequently described as assistive technology, or AT.

AT promotes greater independence through modification of the environment, use of devices, and specialized training, helping consumers complete tasks that they may have had difficulty with or had been unable to complete previously.

AT services, accommodations, and devices are intended to assist with disability-related needs. If a consumer has a need at any time during the VR process for AT to participate in services or work toward achieving their IPE goal, AT services should be explored and provided as needed.

Assistive Technology Topics Covered:

Best Practice Suggestions

Assistive technology needs should be addressed as early in the process as possible to ensure the options are understood and inform the rest of the process. When referring a consumer for an assistive technology assessment, the purpose for the referral, the specific tasks to be addressed, and the employment or training goals should be provided.

Some assistive technology service providers may provide assessments and recommend specific equipment they are selling without regard to other types of equipment and brands that may better suit the needs of the consumer. This would be an example of a non-neutral provider. Seek out professionals familiar with many types, varieties, and brands of technology.

Neutral providers do not typically sell equipment or represent a specific company or brand of equipment. Some neutral providers do sell equipment, but they represent a variety of brands and are free to recommend devices that meet the consumer need. When at all possible, it is recommended that a neutral provider be selected.

Assessments should recommend technology based on the specific need of the consumer and the functionality of the item. The assessment results and recommendations should be reviewed together with the consumer, DVR staff, and service providers prior to purchase.

Consult with your local AsTec team member for additional information on services and accommodation needs of consumers.

Referrals

The need for and utilization of assistive technology must be considered throughout the DVR process. Assistive technology may be needed and appropriate during:

  • Eligibility determination assessments*
  • Vocational rehabilitation needs assessments (may be repeated based on needs)
  • Individualized Plan for Employment (IPE) development
  • IPE services
  • Annual ineligibility decision reviews
  • Annual extended employment reviews
  • Post-employment services

*During eligibility determination assessments, examples of using assistive technology as an accommodation include renting assistive technology items to allow a consumer to participate in assessments for determining eligibility or an evaluator providing accommodations during an assessment.

Specialized Areas

Several varieties of specialized assessments exist that may be used to provide a full picture of a consumer's needs. These assessments can be used in combination as needed.

  • Communication accommodation: The consumer requires a disability-related adaptation or device(s) to communicate i.e.; communication board, or computerized speech device
  • Computer-based accommodation: The consumer requires a disability-related adaptation or device(s) to use a computer, or the computer hardware/software itself is the accommodation
  • Existing business accommodation: The consumer requires a disability-related adaptation or device(s) to obtain, maintain or advance in employment within an existing business
  • Hearing accommodation: The consumer requires a disability-related adaptation or device(s) to accommodate a hearing loss that affects specific work tasks
  • Low vision accommodation: The consumer requires a disability-related adaptation or device(s) to accommodate a vision loss that affects specific work tasks
  • Mobile devices: The consumer requires a disability-related adaptation or mobile device(s) to accommodate a specific work task i.e.; phone, tablets or applications
  • Mobility accommodation: The consumer requires a disability-related adaptation or device(s) related to seating, ergonomics, or movement within the workplace
  • Vehicle modification: The consumer requires a disability-related adaptation or device(s) to a vehicle to reach the employment goal
  • Workplace accommodation: The consumer requires a disability-related adaptation or device(s) to the workplace environment/work tasks to effectively complete tasks in the workplace

Service Provider Types

Several types of providers of assistive technology devices and services exist today. These include medical equipment dealers, manufacturer representatives, private sales agents, and non-profit agencies. The provider that is selected by the consumer for an assessment may not be the same provider of the device(s) or the training. It is important to understand the role of an Assistive Technology provider in these three different scenarios.

  • Assessment: This type of provider would complete an assessment to determine what accommodation(s), device(s) or training is recommended specific to the consumer and their employment goal.
  • Device Purchase: This type of provider sells and may repair recommended device(s). These devices may include specialized and custom equipment or "off the shelf" devices to be used to provide an accommodation for the consumer.
  • Training: This type of provider completes recommended training for a consumer to reach specified levels of proficiency in use of a device(s) or application of an accommodation.

General Qualifications of Providers

Service providers must have sound knowledge of anatomy, physiology, disabling conditions, and disease processes relevant to the technical aspects of the equipment they provide. To gain and maintain this knowledge, service providers will regularly engage in self-guided study or attend courses, seminars, trade shows, and other continuing education activities.

Sound knowledge can be defined as having a combination of the educational, professional, or personal experience necessary to provide comprehensive information and services to the consumer. This may be in the form of formal education, professional certification, or in-depth training by a product manufacturer. Providers may have a credential called an Assistive Technology Professional (ATP) certificate, which is considered the hallmark of a trained professional in the provision of assistive technology services.

General Responsibilities of Assistive Technology

  • Gather comprehensive background information about the individual’s disability, functional limits, needs, and goals related to assistive technology
  • Explain the range of options that could meet the consumer's needs, including free technologies, options from no-tech to high-tech, and commercially-available to custom-fabricated technologies
  • Be transparent: share complete scope of products, services, and manufacturer relationships
  • Remain objective when providing comparisons of assistive technology options
  • Use appropriate tools and measurements to assure proper fit and function of the equipment
  • Provide equipment delivery, fitting, and adjustment
  • Provide complete instruction on proper use
  • Provide maintenance and repair information, including who can provide and who will pay for maintenance and repair services
  • Provide information about when the consumer may be eligible for an equipment update from a funding source, where applicable

Purchasing

AT services are exempt from comparable benefits; however, DVR's purchasing policies still apply (e.g., required price comparisons). See the DVR Rate of Payment Determination Chart for more information on required documentation and rate determination procedures for DVR services.

DVR staff should take the time to ensure that assistive technology items are identified and coded properly. Whether a specific item or service is considered assistive technology depends upon the purpose of the item. This identification is important because AT services are exempt from comparable benefits. However, if an outside funding resource is readily available to the consumer, DVR may ask the consumer to use this resource if it will not cause undue delay in the service. In some cases, cost sharing may be appropriate and arranged with the consumer, a local resource, or the employer.

When another entity is responsible for providing an AT service or device(s) under other laws (e.g., WIOA or ADA), DVR should provide resources and expertise in the coordination of these services. This type of situation may occur when a consumer is still in high school or when a consumer is working.

The purpose of the service needs to be determined on an individual basis. In one case, a specific item may be considered assistive technology, while in another case, the exact same item may not. Similarly, entire services may be considered assistive technology in one case, while in others, only part of the service is considered assistive technology.

For example, consider the case of a modified computer with adaptive software. The software may be considered assistive technology, while the computer itself is considered work-related equipment, which may be the responsibility of the employing business to provide.

For individuals who own an existing business, DVR does not purchase, provide maintenance, repair, or replace equipment customary for the size and scope of a business. These are considered standard expenses and the cost of doing business. The business owner/consumer should plan for these expenses to maintain their business. If an item cannot be adapted or modified and a new piece of equipment is recommended for purchase with the adaption or modification, DVR will only be responsible for the cost of adaption or modification and the business owner/consumer will be responsible for the new equipment cost. The business owner/consumer may trade in current equipment to help cover those costs.

DVR may participate financially in the purchase of assistive technology services and equipment identified as necessary for the consumer to perform the essential functions of a job. DVR cannot participate in the purchase of services or equipment identified for business use only.

See the DVR Fee Schedule to learn more about DVR's spending limits for specific goods and services and the exception process.

Reports

Assessment reports should include the information required in available technical specifications or other published guidelines. In general, they should answer questions related to the disability and the work-related task(s) that require modification. The report should explain the reasons and need for each accommodation. Solutions should be provided that include a variety of approaches and consider the work or training environment.

Training reports should include specific training targets, approaches to be used, progress, and anticipated timeframes for completion. These reports should provide DVR and the consumer with information about expectations and responsibilities for both the trainer and the DVR consumer.

Training

In some cases, AT training is recommended for a consumer to learn how to use a specific device(s) or to learn alternative accommodation strategies as part of implementing assistive technology.

This type of training should be time-limited, include learning targets, and outline a level of proficiency in the use of the accommodation. It may be necessary for the VRC to monitor training approaches to determine if progress is being made, if the training should continue, or if an alternative process should be identified or outlined.

Sometimes acquiring the skills necessary to use accommodations can be challenging for consumers. Before authorizing this training, the expected timeframes and ongoing time commitments necessary to reach proficiency should be discussed. Best practice is to include these timelines and progress measures in the consumer's IPE.

Follow-Up

Devices become the property of the consumer upon purchase. Discussion and planning should take place to address anticipated needs for follow-up, maintenance, repair, equipment upgrades, replacements, and how consumable supplies should be obtained, if needed.

DVR Responsibilities

DVR can be a great resource to educate employers on assistive technology, accommodations, and disabilities. DVR staff are encouraged to coordinate services and provide technical assistance to employers on modifications and architectural accessibility as a means of obtaining, maintaining, or advancing employment for people with disabilities. It is helpful to provide resources and services related to budgeting, saving, or financial literacy to consumers receiving AT services or equipment.

In some circumstances, under the Americans with Disabilities Act, it is the employer's responsibility to provide reasonable accommodations.

Once services under VR end and the case is closed, responsibility for the AT equipment provided and any additional needs falls to the employer as applicable by the Americans with Disabilities Act (ADA).

Any questions or concerns related to an employer’s obligation can be directed to the Department of Justice (DOJ) or Equal Employment Opportunity Commission (EEOC). DVR staff should discuss with consumers the availability of post-employment services as well as their ability to reapply for services as needed. AT services can be provided under post-employment.

Service Provider Responsibilities

  • Provide clear information about their ability to provide long-term service and support for equipment at both the service provider and manufacturer levels
  • Maintain knowledgeable and qualified staff to provide services and training
  • Maintain an inventory of replacement parts to provide timely service or repair, if applicable
  • Provide a loaner device, if available, or assist with locating a loaner device if repairs are needed
  • Provide a written estimate of cost and time required for repair work, if applicable
  • Provide clear information about the equipment warranties and response times for services
  • Maintain adequate levels of professional and product liability insurance, if appropriate

Definitions

Accommodation: A change or adjustment to a job (including reassignment of duties), workspace (i.e., an ergonomic chair or workstation) or use of an item necessary to perform a job (i.e., steps on a tractor). An accommodation is further defined as a disability related item or service required by the worker not typically required by others doing the same job and necessary due to a limitation caused by the disability.

Assistive Technology: Technology designed to be utilized in an assistive technology device or assistive technology service.

Assistive Technology Device: 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.

Assistive Technology Service: Any service that directly assists an individual with a disability in the selection, acquisition, or use of an assistive technology device.

High-tech: Solutions that involve a significant amount of customization, technology, or engineering. Examples include a sip and puff-controlled wheelchair or a computer with voice recognition software.

Low-tech: A device or item used in an innovative manner to provide solutions to a problem. Examples include use of a sponge roller on a pen to create a larger grip or an existing bookcase to create a raised workspace.

Rehabilitation Engineering: Use of engineering sciences to design, develop, adapt, test, evaluate, apply, or distribute technology solutions to individuals with disability.

Rehabilitation Technology: The systematic application of technologies, engineering methodologies, or scientific principles to meet the needs of, and address the barriers confronted by, individuals with disabilities in areas that include education, rehabilitation, employment, transportation, independent living, and recreation. The term includes rehabilitation engineering, assistive technology devices, and assistive technology services.

View listing of additional resources (top of page)

  • If the Service Provider has a flat rate for the AT Assessment, send the suggested AT Assessment DVR Referral and Purchase Order (PO) to the Service Provider.
  • If a flat rate is not available, VR staff should consult with the Service Provider via email or phone to discuss the rate of payment for the service. Once the rate of payment is determined, VR staff can send the suggested DVR AT referral form and PO to the Service Provider.

  • Service Provider has referral and PO (including travel if needed) and starts AT Assessment
  • Service Provider completes AT Assessment Report within 60-days of referral/authorization of service
  • DVR Counselor, Consumer, Service Provider, and other parties as appropriate, review recommendations
  • Once report is reviewed and services agreed upon, the IPE can be updated to include necessary and appropriate equipment/devices and training

No AT Training Recommended

  • Work with Service Providers to implement equipment and devices
  • Ensure equipment and devices are meeting consumer needs

AT Training Recommended

  • AT Provider should have provided an AT Training Proposal with the AT Assessment Report
  • Discuss/review proposal with consumer and Service Provider and authorize for training
  • Training Proposal is implemented, and monthly training reports (AT Training Competency Report) on consumer’s progress are completed by provider
  • Ensure progress is being made before authorizing additional training hours
  • Ensure equipment/devices are meeting a