103D CONGRESS 1st Session REPORT SENATE 103-119 TECHNOLOGY-RELATED ASSISTANCE ACT AMENDMENTS OF 1993 AUGUST 3 (legislative day, JUNE 30), 1993.-Ordered to be printed Mr. KENNEDY, from the Committee on Labor and Human REPORT together with ADDITIONAL VIEWS [To accompany S. 1283] The Committee on Labor and Human Resources, to which was referred the bill (S. 1283) the Technology-Related Assistance Act Amendments of 1993, having considered the same, reports favorably thereon without amendment and recommends that the bill do pass. On July 30, 1993, the Committee on Labor and Human Resources, by a unanimous voice vote, ordered favorably reported S. 1283, the Technology-Related Assistance Act Amendments of 1993. The bill is sponsored by Senator Tom Harkin, chair of the Subcommittee on Disability Policy, and cosponsored by Senators Durenberger, Kennedy, Jeffords, Metzenbaum, Simon, Wellstone, Wofford, Dole, Pell and Hatch. As approved by the Committee on Labor and Human Resources, S. 1283 reauthorizes the Technology-Related Assistance for Individuals with Disabilities Act of 1988. The purposes of this legislation are: (1) To ensure the Federal support necessary to allow the States to successfully complete the systemic change process begun under the Technology-Related Assistance for Individuals with Disabilities Act of 1988. (2) To require that the State projects include systemic change and advocacy activities and clarify that these activities are to be the focus of the projects. (3) To promote systemic change through individual advocacy by ensuring that individuals with disabilities have access to protection and advocacy services to secure their rights to assistive technology devices and assistive technology services. (4) To emphasize the importance of consumer involvement in all aspects of the program. (5) To increase the accountability of the program in the development and implementation of consumer-responsive comprehensive statewide programs of technology-related assist ance. (6) To authorize the necessary technical assistance on a national level to the State projects and to individuals with disabilities and other interested parties. (7) To provide the basis for improved information systems and data collection on assistive technology through the development of a national classification system and to enhance the skills and competencies of individuals involved in providing assistive technology, consumers, and others. II. BACKGROUND AND NEED FOR LEGISLATION LEGISLATIVE HISTORY The Technology-Related Assistance Act Amendments of 1993 revise and extend the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (hereinafter referred to as the Technology Act). The Technology Act includes two titles. Title I establishes a competitive grant program designed to assist each participating State to develop and implement a consumer-responsive comprehensive statewide program of technology-related assistance for individuals with disabilities. Title II authorizes a variety of discretionary activities and studies. The Technology Act is administered by the National Institute on Disability and Rehabilitation Research in the Office of Special Education and Rehabilitative Services in the Department of Education. Assistive technology is a critical tool necessary for many individuals with disabilities to gain and maintain employment, to secure public services, to utilize transportation, and to access public accommodations and communication systems. The full impact of the Americans with Disabilities Act on access issues related to assistive technology has yet to be fully realized, but the ADA will play a sig nificant role in the increased recognition of the assistive technology needs of individuals with disabilities. While the ADA bars discrimination and opens the doors of opportunity, many persons with disabilities need services and supports to take advantage of the ADA. These services and supports in many cases include assistive technology devices and assistive technology services. In 1989, Technology Act grants averaging $515,000 were awarded to nine States. In fiscal year 1993, NIDRR made grants to 42 States ranging from $500,000 to $730,000. HEARING AND TESTIMONY The Subcommittee on Disability Policy held a hearing on Tuesday, June 29, 1993, to consider the reauthorization of the Technology Act. The first panel consisted of Dr. William Smith, Acting Assistant Secretary, Office of Special Education and Rehabilitative Services, accompanied by Carol Cichowski, Director of the Division of Special Education, Rehabilitation and Research Analysis; Office of Management and Budget/CFO and Betty Jo Berland, Planning and Evaluation Officer, National Institute on Disability and Rehabilitation Research. The second panel was made up of two consumers of assistive technology, Rachel Esparza, from Mendota Heights, MN, accompanied by her mother, Anne Esparza, and Casey Hayse from Iowa City, Iowa. The third panel was made up of John A. Gannon, Acting Chair, National Council on Disability, accompanied by Edward P. Burke, Chief Governmental Liaison, James Hardy, Project Director, Iowa Program of Assistive Technology, on behalf of the State project directors and Jenifer Simpson, Policy Associate, Governmental Activities, United Cerebral Palsy Associations, Inc., on behalf of the Consortium for Citizens with Disabilities accompanied by her son, Joshua Chartienitz. ISSUES RAISED Based upon testimony by witnesses at the June 29, 1993, hearing, additional written testimony submitted for the record, and discussions with all interested parties, several common themes emerged regarding the changes needed. CONTINUATION OF THE PROGRAM Witnesses at the Subcommittee hearing testified regarding the importance of assistive technology and the need for a continuation of the efforts to effect systems change in the manner in which individuals with disabilities access assistive technology. John Gannon, Acting Chair of the National Council on Disability, testified that "In our [Study on the Financing of Assistive Technology Devices and Services for Individuals with Disabilities], we found that assistive technology devices and services can play a major role in increasing independence and empowering individuals with disabilities in a cost-effective manner." The study reported the following statistics: Almost 75 percent of children were able to remain in a regular classroom, and 45 percent were able to reduce school-related services. Sixty-two percent of working-age persons were able to reduce dependency on their family members, and 58 percent were able to reduce dependence on paid assistance. Eighty percent of older persons were able to reduce their dependence on others and half were able to avoid entering a nursing home. Ninety-two percent of employed persons reported that assistive technology helped them to work faster or better, 83 percent indicated that they earned more money, and 67 percent reported that assistive technology has helped them to obtain employment in the first place. With the aid of an augmentative communication device, Rachel Esparza, from Mendota Heights, Minnesota, testified to the importance of assistive technology in her life: I use lots of technology every day. At school I use a computer with a special keyboard. I do all my work on it. At home I use a computer to do my homework and to play games with my friends. *** I have special switches that turn on lights and that help me cook with my Mom. I go places in a van with a lift on it. Without my van, I couldn't go to T-ball or my swimming and horseback riding lessons. Dr. William Smith, Acting Assistant Secretary, Office of Special Education and Rehabilitative Services, testified that every State has made at least one application for a grant under the Act indicating that there is a recognition of the "major benefits to be obtained through improving the provision of assistive technology." He stated that the Administration supports the reauthorization of the Act in order "to give all States sufficient opportunity to establish statewide systems as envisioned by the Act.' Dr. Smith reported that the evaluation of the program conducted by the Research Triangle Institute of North Carolina (RTI) found that "the States had not yet succeeded fully in establishing comprehensive, consumer-responsive, statewide systems. . . [h]owever the report indicated there had been enough progress to suggest that, with additional time and Federal support, the States would be able to make significant improvements." James Hardy, Project Director, Iowa Program of Assistive Technology, on behalf of the State project directors, explained in his testimony that the systems change envisioned by the Act is too broad and extensive to be completed in five years. He testified that: Systems change is a complex process which will result in permanent changes only through an extended period of vigilance, advocacy, and education. It would be most unfortunate if the systems change initiatives of these grants were abandoned before it is certain they will be continued through implementation by State and national programs. According to Jenifer Simpson, testifying on behalf of the Consortium for Citizens with Disabilities, "There is so much to be done: still a paucity of expertise among advocates, attorneys, persons with disabilities, family members, and professionals across disciplines who can effectively weave their way through the complex web of Federal regulations regarding eligibility and technology funding." FOCUS ON SYSTEMIC CHANGE AND ADVOCACY ACTIVITIES Clarifying that the activities under the Act should focus on systemic change and advocacy was a recurrent theme of those making recommendations for changes in the Act. In her testimony before the Subcommittee, Jenifer Simpson noted that the focus of the recommendations made by the Consortium for Citizens with Disabilities was on systems change. She testified that: During the next few years, the Tech Act offers an opportunity to turn individual funding decisions to precedent setting policy change. As the [Research Triangle Institute] study suggests, the future of the Tech Projects lies in the success of the States in achieving lasting systems change. Dr. Hardy noted in his testimony that "[t]he term 'systems change' was not used in the Act of 1988. Nevertheless, the purposes that are articulated therein clearly call for the State grant programs to work for a comprehensive systemic change in all of the funding and service systems for persons with disabilities." Dr. Smith testified that the RTI study found that States were successful in increasing awareness of assistive technology and its potential, but that the lack of access to funding continues to be a significant obstacle to the widespread use of assistive technology. In addition, the study found a lack of uniformity among the State projects in regard to focusing project activities on the systems change activities that hold the most promise for facilitating the implementation of the comprehensive statewide system. Edward Burke, testifying on behalf of the National Council on Disability, stated that "without a focus on access and financing, all the other activities will cast State efforts adrift in a sea of process, with no guarantee that the result of this process will actually benefit real people in real communities." In addition, Mr. Burke noted that "experience dictates that advocacy is one of the most potent forces for consumer-responsive systems change." Casey Hayse described the efforts of the Iowa project in bringing about systems change: We recognized that our systems change strategy had to be multifaceted and comprehensive. It had to include work on the State level to facilitate cooperation among agencies, by sharing information and standardizing policies and procedures. On a local and regional level, community service agencies not only need to learn about assistive technology services, but also must cooperate with each other to ensure that those services and resources are optimal. SUPPORT FOR INDIVIDUAL ADVOCACY Many commentators expressed the view that one of the missing components in the efforts to bring about systemic change was support for individual advocacy. The commentators identified two dif |