Getting to Know Assistive Technology

Resources for no-, low-, mid-, and high-tech options

Expert Contributor: Kit Piltingsrud, Program Manager and Assistive Technology Professional, Living Well Disability Services


Assistive technology devices can either be created at home, purchased and used off the shelf, modified, and/or customized to meet individual goals and needs. From low-tech options such as toy or game modification to high-tech devices that include voice recognition or elopement monitors, assistive technology is empowering those with disabilities to live, work, and play in the most independent way possible.

What’s the difference between no-, low-, mid-, and high-tech?

No-Tech:  No-Tech solutions make use of procedures, services, and existing conditions in the environment and don’t involve the use of special devices or equipment. Examples include pencil grips, colored paper, extra time for testing, and the use of a scribe, reader, or interpreter.

Low-Tech: Low-Tech devices are simple devices that have few mechanical parts and don’t require a power source. They include adapted spoon handles, adapted pens, canes, non-tipping drink cups, magnifying glasses, eyeglasses, and Velcro fasteners.  At most, only limited training would be necessary to use these devices.

Mid-Tech: Mid-Tech devices are relatively complicated mechanical devices that may require a power source but don’t contain sophisticated electronic systems. These devices include manual wheelchairs, talking calculators, adapted computer keyboards and mice. The operation of mid-tech devices requires some training and technical knowledge.

High-Tech: High-Tech devices are often computer-based systems that incorporate sophisticated electronics. These devices are complicated to use and require extensive training, technical knowledge, and access to technical support.  Due to their sophisticated electronics, high-tech devices are often much more expensive than other technologies.  Examples include speech recognition software, eye gaze-controlled computers, closed caption televisions (CCTV), power wheelchairs, and environmental control units.

What types of Assistive Technology are out there?

There are several common categories in which assistive technology devices may be grouped, including (but not limited to):

Aids for Daily Living – Aids for use with daily tasks such as dressing, eating, cooking, bathing, etc

Environmental Controls – Electronic and non-electronic aids that help control items like lights, appliances, TV, air/heat

Mobility – Aids to assist individuals with limited to no mobility such as wheelchairs, automatic page turners, chair lifts, or hand controls

Seating and Positioning – Aids to assist with comfort and positioning including seat cushions, wheelchairs, adaptable work stations, vertical standers

Communication Aids – Verbal and non-verbal communication aids such as pointers, picture boards, type-to-talk or text-to-speech devices

Computer Access – Computer operation aids such as word prediction, keyguard, programmable keyboards, modified mice, screen readers, or voice recognition software

Blindness and Visual Impairment – Aids assisting those with vision loss or low-vision such as screen readers, video magnifiers, and braille watches

Deafness and Hearing Impairment – Assistive devices for all levels of hearing loss such as amplifiers, listening devices, or alert systems

Cognition and Learning Disabilities – Materials, devices, or programs that make an education curriculum accessible to students with disabilities such as raised line paper, talking calculators, scan and read programs, text-to-audio systems, and symbol based adaptive keyboards

Recreation and Leisure – Assistive technology providing opportunities for individuals to benefit from play, sports, and the arts, such as adaptive sporting equipment and games, or arm supports for drawing/painting

Vehicle Modification – Aids to help in vehicle operation such as modified hand controls, wheelchair lifts, power seats, and adjusted pedals

Finding the Right Device

When assessing possible AT solutions, providers will perform an initial evaluation and begin exploring options beginning with no-tech, low-tech, and mid-tech before recommending high-tech solutions. This will help achieve an ideal person/technology match and helps ensure the most cost-effective solution is being utilized.

Below are a few Minnesota resources that showcase and/or loan out assistive technology tools and devices to help individuals achieve a more independent lifestyle.

Courage Kenny Rehabilitation Institute on Pinterest

Courage Kenny Rehabilitation Institute has put together Pinterest Boards showcasing many assistive technology options.  From medication reminders to home assistants, and even DIY assistive technology devices including homemade styluses, playing card holders, or grips to make holding a pen or pencil easier, the Boards showcase numerous items and devices to help increase self-sufficiency for those living with disabilities.

View Courage Kenny Assistive Technology on Pinterest

PACER Simon Technology Center Lending Library

The Simon Technology Center Lending Library houses more than 1700 assistive technology items and devices that are available for individuals and families to borrow and try out before making a purchase. This allows individuals to find the right fit for them without having to purchase each piece of equipment they may be interested in.

Learn more about the Lending Library and membership options

Minnesota STAR Program

The Minnesota STAR program is federally funded by the Department of Health and Human Services. The STAR program offers device demonstrations, exchanges, loans, re-utilization, and more.

Learn more about the Minnesota STAR program




Do the Numbers – Remote Monitoring vs. Sleep Staff

Remote monitoring vs. sleep staff. How do the numbers add up?

Expert Contributor: Sandy Henry, Technology Advocate and former community residential services provider

When deciding to implement a new support strategy it is important to run a cost analysis to fully plan out the business case for your organization. A sample cost analysis has been created below that can be used to help analyze anticipated costs and revenue when going from on-site sleep to alternative overnight supervision.  In very round numbers, it may be surprising to know:

  • All other things being equal converting 8 hours/day of sleep staff hours to remote monitoring increases revenue about $8,000 (per 4 person site), as calculated on the RMS Framework.
  • Savings from replacing on-site sleep staff is usually around $30,000 (plus expenses to recruit, train, and manage those employees).
  • Cost of the technology is the most variable but may be less than expected.  In our sample the equipment and technology vendor support/service ranges from $5,000 to $16,400 per year per house, depending on whether using passive or active remote supervision.
  • Cost of a local staff on duty to respond to needs at the house can be in the $40,000 range, but when shared by 3 or even 2 houses the cost goes to $14,500 – $22,000 per house per year.

In short, even with the new costs for services and technology, the increased revenue plus cost savings create funds that can be used to support other aspects of the home’s costs/services.  For a more detailed look, let’s walk through our sample.


Remote Monitoring Rates VS. On-Site Sleep Staff Rates

In our sample, we are comparing revenue from on-site shared sleep staff (V1) to the revenue of overnight shared remote monitoring (V2). Because remote monitoring hours in the DWRS rate framework are calculated at the same hourly rate as on-site awake staff in the RMS Framework (yes, you read that right!), there is generally a revenue increase of over $8,000. Let’s repeat that if it did not completely sink in. The hourly amount calculated for remote supervision hours = hourly awake staff calculated rate, $13.53 for 2018, compared to the rate for sleep staff of $8.35. Still don’t believe it? Download the DWRS worksheet from DHS, fill in your numbers, and see for yourself.

Our Sample Revenue Calculation:


As a baseline, we are calculating the cost of paying one household’s sleep staff for one year using $9.50/hr as the base pay and adding in 25% for taxes and benefits (use your true staffing cost for a more accurate analysis).  When converting to remote monitoring overnight, these “costs” become savings because they’re an expense no longer incurred.  Other related costs could be added to this sample, such as recruiting, training, and managing those staff that are no longer needed, but for this example we’re keeping it simple.

Passive Monitoring Costs

Building on our scenario, below are the costs associated with “passive” remote monitoring (i.e. using motion sensors and other devices but not cameras/video with a live remote caregiver actively monitoring the site). We have obtained quotes from 2 vendors and averaged their estimates. Your costs may vary based on your circumstances, but these numbers are a best effort for a reasonable sample.

The initial capital outlay on equipment will be the largest initial investment, but remember purchased equipment will be depreciable. We used a 3 year depreciation schedule. Equipment rental vs. purchase is available with most remote monitoring agencies. Rental rates are higher than monthly depreciation and interest, as shown here, but often include repairs and replacement.  In addition to the equipment purchase, there will be a support fee, generally including access to the software, initial and ongoing programing, training, and 24-hour response/support.

When using remote monitoring, local response staff is still required in case staff intervention is needed. In our scenario, we are assuming one shared staff for three houses. We’ve also included the numbers for shared staff for only 2 houses for comparison.

Active Monitoring Costs

The rationale for the active remote monitoring costs is the exact same. The equipment costs increase because 2-way audio/video is needed for off-site active monitoring as well as an additional hourly monitoring fee. For these numbers, the higher estimate of $5/hour of active remote supervision has been used, and eight hours per night of monitoring is assumed.  The cost of shared local response staff remains the same as in passive monitoring above.

Sample Recap

When moving to remote monitoring supervision from sleep staff in an hour for hour exchange – your rates will increase slightly.

  • The revenue difference for Remote Monitoring vs. Sleep Staff is $8,336.60/yr
  • 8 hrs of on-site sleep staff costs approx. $34,675/yr
    • This amount is saved when using remote monitoring
  • 8 hrs of Passive Monitoring (sensor only) costs $19,340/yr  (including local responder staff shared by 3 houses)
    • This usage leads to an annual $23,671.60 in savings
  • 8 hrs or Active Remote Supervision costs $31,004/yr  (including shared local responder staff for 3 houses)
    • This usage leads to an annual $12,007.60 in savings

The main sample is comparing outcomes when sharing responder staff with 3 houses. If we share responder staff with just 2 houses, the savings are as follows:

  • Passive Monitoring  =  $16,371.60 Savings
  • Active Monitoring =  $4,707.60 Savings

The hourly rate for on-site sleep staff in the RMS Framework is currently (2018) below minimum wage. This leads to certain loss for your organization. By Implementing remote monitoring, organizations not only increase security and accountability (not to mention quality of life improvements for person served), but also based on above scenario, savings may be rolled back into awake staff wages, expanded services, or used to recoup other costs. Implementing remote monitoring will help increase and maintain a talented and dedicated workforce and strengthen service offerings.


Learn about additional funding options.

Assistive Technology Assessment and Flow Chart

Kit Piltingsrud, Program Manager and Assistive Technology Professional, Living Well Disability Services

The DHS Olmstead Plan outlines several key goals that must be accomplished to ensure people with disabilities are living, learning, working, and enjoying life in the most integrated setting possible. One strategy outlined within the plan to achieve person-centered planning goals is to incorporate assistive technology assessments into person-centered planning processes. Learn more about the Olmstead Plan

With new assistive technology devices becoming available all the time, and as needs of individuals change, staff should assess assistive technology needs annually to ensure individuals are given the opportunity to perform as independently as possible.

To help us facilitate this objective, we created the following flow chart and assessment form to guide staff through the assessment process, and to determine the best course of action moving forward.

The documents referenced below are approved by Living Well Disability Services to be copied and modified for use by other organizations and individuals.

A flow chart to investigate how and when to use assistive technology

Visit the Technology Resource Center to learn more


Measuring for Success

A provider’s guide to technology program measurement and valuation

Sandy Henry, Technology Advocate and former community residential services provider

With newly implemented technology support strategies, it is important to measure the success, not only for persons-served and staff, but the financial success as well. To get a full look at the impact technology supports have had on an organization, providers should consider several key factors when assessing the financial output and associated benefits of the plan in place to determine cost effectiveness.

Calculating Costs

Providers should identify and calculate:

  • Any changes in revenue or income
    • Including rate changes and/or new revenue related to technology use
  • All direct cost reductions
    • Reduced employee wages, reduced overtime, avoided cost of recruiting and training new employees, if turnover reduced or staff hours reduced, etc.
  • Indirect costs or savings
    • Management and administration time saved due to reduced turnover and/or reduce staff hours and total number of employees
    • Management and administration time saved with access to better, more timely information that informs managers on activities and needs, and/or reduced time spent on investigations
  • Provider out of pocket cost
    • Cost to rent, purchase, and install equipment, tech vendor support costs, etc.
    • Costs associated with maintaining equipment such as batteries or staff time


The calculation of these numbers gives a surface look at cost effectiveness.

It is important to consider the financial impact the addition of technology supports has had on occupancy.  Items such as enabling a provider to continue to serve individuals they otherwise would not be able to, the ability to accept someone with needs not previously able to be served by the organization, and new individuals attracted by the technology enhanced services should also be weighed during calculations.

Calculating time saved of management by having the ability to check on information remotely is also an important factor to consider along with the other benefits realized in the areas that follow.  

Additional Benefits Realized

Workforce – aside from direct reduction of on-site staff hours

  • When individuals served are able to do more things for themselves independently without staff assistance, staff time can be focused on other priority needs and tasks. For example, staff may be alerted if/when someone needs intervention versus continually checking to see if needed.  Even if staff continues on-site, when individuals use technology to change the TV channel, take medications, get up on time in the morning, etc., staff may have more time for administrative and documentation tasks, and relationships between staff and individuals usually improve.
  • Technology offers the potential to document actual occurrences, verifying when staff have done their job or completed tasks, even if something bad were to occur. This may reduce stress and pressure on staff and managers.
  • Managers’ ability to more quickly identify when tasks aren’t being done or to identify when procedures are not followed enables managers to address and correct issues before something bad happens, and to pinpoint training and needed improvement.

Reduction & Investigation of Errors, Omission, Suspected Maltreatment

  • Data from some technology can provide early information about delayed or missed cares and activity of staff, allowing managers to intervene sooner – before there is a pattern of errors and/or a negative outcome or harm.
  • Technology may be used to provide reminders and prompts to busy staff on scheduled cares, such as medications or repositioning, before a care is actually missed.
  • When there is a report of maltreatment, data gathered by technology (e.g., staff movement, individuals served movement/actions, etc.) can help identify whether expected actions by staff were followed or not. This may be used to supplement staff documentation and reporting.

Organizational Growth Opportunity

The ability to add technology that helps staff know where to be and when to be there can enable a provider to serve some individuals they otherwise couldn’t or would have been reluctant to.  Behaviors like elopement, going into other’s rooms, and fall risks are easier to support with technology that keeps staff informed of activity without having to be constantly physically present.  This assists with occupancy by preventing demission when a person’s needs increase and by increasing the number and types of individuals considered for admission.

The use of technology can open opportunity for new types of services and greater flexibility in a provider’s ability to successfully meet individuals’ needs.  Supporting people in their own apartments is a growing area of service that may be added by a provider with little capital investment.  Enabling lower need individuals to move into more independent services opens group settings to admit individuals with higher needs.

The use of technology in support plans is not new, but it is changing the landscape of  the care industry.

There are many benefits realized by providers through the implementation of technology,  and weighing the benefits/costs of these supports into existing offerings has the potential to allow providers to continue providing care in the future as staffing shortages increase.

Learn more about Measurement or to learn the entire process of how to implement technology into care plans, visit the ARRM Technology Resource Center.

A New Way of Doing Business

Increasing independence while maximizing staff resources

Utilizing technology supports in care plans is not a new phenomenon – but is an option that is becoming more mainstream as the independence benefits for persons-served and staffing constraints for organizations are realized.

The Story

Eight years ago, Dungarvin began implementing alternative overnight supervision when they realized the workforce was becoming more and more limited.  As people served were expressing a stronger desire to be more independent, Dungarvin staff thought through scenarios on how to navigate both the independence desire and how they would provide services in the future. Technology was their answer.

The Outcome

Through the implementation of alternative overnight supervision, Dungarvin was able to reduce on-site full-time overnight staff for eleven homes while maintaining the same level of care and supervision. What once took 15 staff to accomplish is now able to be covered by four.  This allowed for previous overnight sleep staff to be more actively engaged in helping people at other times of the day.

How did they do it? Prior to implementation, Dungarvin staff spent several months documenting the needs that arose at night so they could get a better understanding of scenarios that would come up as well as needs of residents during the night shifts. Residents now have silent call buttons that they press when they need assistance instead of loud buzzers that their housemates might hear, which helps increase privacy. The call buttons alert awake float staff that they want or need assistance. Sensors placed throughout homes also help to notify staff if there may be a problem, as well as track care activity throughout the evening.

Not only did investing in the technology help Dungarvin maintain their staffing needs, but gave residents, like Jamie Jensen and Lauren Ireland, the independence and privacy they appreciate. “It’s 100 percent worth it” was Jamie Jensen’s reply when asked his opinion on the transition to technology supports.

Watch the video to see how the staff at Dungarvin managed the funding process to implement remote monitoring and the impact it had on residents like Jamie and Lauren.

Download the Case Study One-Pager or Explore funding options for technology supports

Alternate Overnight Supervision – what it is and how to get it

Anna MacIntyre and Deb Amman
Minnesota Department of Human Services

What it is

Legislation, introduced in 2009, made it possible to use monitoring technology in Adult Foster Care (AFC) and Community Residential (CRS) settings in place of on-site overnight staff during normal (overnight) sleep hours.

A proven way to increase both independence and privacy of the person served, this newer monitoring practice is called Alternate Overnight Supervision and can be utilized following a formal assessment of the individual and once informed consent has been given by the person served. Along with obtaining an AOST (Alternate Overnight Supervision Technology) License, defined policies and procedures must be in place.

The person served should:

  • Be reasonably independent and have the ability to request assistance or direction.  
  • Be able to have their needs met within a reasonable timeframe for health and safety by using the least intrusive technology option.

How to get it

Once the technology has been found to match the needs of the individual, the AOST License can be applied for. DHS Licensing provides an AOST Licensing Checklist which identifies all licensing requirements.

Following the submission, barring any open investigations relating to supervision, the Licensing Consultant will review the file within 60 days. If any deficiencies are found within the application, the applicant will have 45 days to correct.

Read the full article on what AOST is (and isn’t) and further explanation on how to obtain and maintain AOST Licensing >

Anna MacIntyre is the policy lead for the Minnesota Department of Human Services, Disability Services Division. She can be reached at anna.macintyre (at)

Deb Amman is a licensing consultant  with the Minnesota Department of Human Services, Office of Inspector General Licensing Division. She can be reached deborah.g.amman (at)

A Case for Provider Investment

Alan Berner, Vice President of Community Services – The Phoenix Residence, Inc.


While the state of Minnesota boasts one of the richest, most comprehensive funding structures for technology, there continue to be areas in which funding is not available. Lack of formal funding should not deter providers from considering to invest their own dollars in certain solutions which make sense to help improve an organization’s ability to encourage independence of the people we support as well as helping an organization become more effective.

The Phoenix Residence, Inc. has invested heavily in back-end solutions aimed at helping us complete our work in the most efficient manner possible. This has helped us continue to grow in our ability to support people with their technology. It has also led to solutions which have great benefits for the people we support as well as our organization.

The first solution I’d like to highlight is our support of a highly mobile individual who has a history of falling and is living in an ICF/DD home where we provide support. We had several instances where bruising or other injuries occurred and were unable to be explained by staff as they hadn’t witnessed any causal events. As a result, the relationship between our staff and family members, who expected answers, grew strained; so at the request of the family members, we installed a camera system in the common areas of the home. For a cost of less than $2,000, staff have not only been able to identify more fall instances, but they are also better able to evaluate care needs such as whether a neuro evaluation is needed, and demonstrate to family members the proper supervision as detailed in the care plan is being provided. Those benefits alone were worth the investment. Financially—installing cameras has saved time in resources that would have gone into investigating issues and providing unnecessary supports.  As an organization, we continue to only implement this type of solution at the request and consent of the people living in the homes, as we feel it is their place to say whether they would want cameras in their home.

Another solution in which we invested is an assistive voice activated remote for an individual who spends considerable time in his room watching TV and movies. Like many of us, he wants to change channels frequently, but he needs help in order to do so. He would frequently call out to the staff members on site to come and change his channel causing them to either alter what they were doing or he would have to wait for a task to be completed before they could come and support him. By adding the device, he was able to change the channels on his own. With the investment we made in this device, it is not only improving his independence, but freeing up our staff to focus on alternative tasks for significant periods of time. The device itself, along with the training to make it useful, cost nearly $5,000.  While the investment in the remote was significant, even if it saved 15 minutes of our staff time a day, it would result in a savings of nearly $2,000 a year.  Over the five years he effectively was able to use this remote, we easily recouped our investment.

These two solutions were focused on creating better outcomes for specific individuals and funding was not available due to the ICF/DD homes where they live.  Our investment in both locations not only created the better outcomes we were hoping for, but also allowed us the significant savings in our staffing resources that outweighed the resources we dedicated to getting the technologies implemented.  


•  •  •

Visit the Resource Library to review additional tools that may be used to help find and evaluate funding options.

Funding 101 – Disability Waiver Rate System

Download Funding 101 – PDF Handout

Key Points

    • There are numerous funding streams that providers and service recipients can use to support
      technology use.
    • Minnesota has one of the strongest models for funding the use of technology.
    • Providers, technology suppliers, and individuals should work together to determine the right mixture
      of services and funding supports.
    • Remote support for residential services under the Disability Waiver Rate System is recognized as a
      form of supervision on the 6790 and rolled into the service provider daily rate.
    • 24-hour emergency assistance, paid to a service provider, and environmental accessibility adaptations,
      paid to the technology vendor, are available for people living in their own home.
    • Funding for technology is also available under the CDCS waiver and some items through State Plan


*Monitoring technology: 3 supervision/support options. 1) Awake on-site staff 2) Sleep on-site staff 3) Remote monitoring supervision


Download Funding 101 – PDF Handout, or visit the Technology Resource Center and learn more about Funding.

Putting a Plan Together for Independent Living

The Story

Though experiencing health issues that would ultimately require her to need more intensive care, including possible round-the-clock assistance, Angie wanted to maintain her independence and continue to live on her own without being reliant on a staff person constantly in her home.

Following conversations about her needs and wishes, a support and response plan was created with her team that not only made her feel supported, but maintained her desired level of independence as well.

The Outcome

Angie moved into her own apartment supported by CCRI’s Independent by Design program which helped to identify, implement, and monitor technology solutions to meet her medical and quality of life needs. Along with hourly staff services to assist with household tasks, technology supports provide monitoring and assistance for needs such as waking up on time and medication management.

Putting a plan together that considered Angie’s needs and desired living situation resulted in an overall improvement in her independence and reduced her reliance on assistance. She is healthier and continues to remain very active in the community—just the way she likes it.

Watch the video to learn how Angie and her team began the planning process:

Begin Planning or visit the ARRM Technology Resource Center to learn about more success stories and case studies showing how technology is changing the lives of those living with disabilities.

Required Technology Discussions

New legislation requires technology supports be discussed at all 45-day planning meetings.

New legislation goes into effect on August 1, 2017, requiring technology supports be discussed as part of all 45-day planning meetings for people with disabilities. These meetings establish the needs of the individual receiving services, their personal goals, and the supportive services necessary to meet these objectives.

It starts with a conversation

Technology supports are becoming a core option for more and more people. These supports are increasing independence while reducing the overall reliance on in-person staff time. Due to the variety of technologies and systems available—from remote monitoring to assistive devices— some form of technology support can be a part of almost anyone’s care plan. It all starts with a conversation between the person receiving services, their family, their provider, and their case manager to determine what options might be a good fit based on their person-centered plans.

Because this type of support marks a change in the look and feel of supportive services, questions and reluctance to even begin the conversation keep hundreds from having real discussions about technology as an option. That’s why Minnesota Statute 245D was revised this session to require teams to include a discussion about technology in all 45-day planning meetings. While the statute does not require that technology be used, the required discussion will open the opportunity for teams or team members who might have questions about initiating the use of technology.

A new source of information

As a key player in developing and passing the legislation, ARRM committed to ensuring resources are available to support conversations—including key information about technology supports and examples of successful implementations. ARRM’s new Technology Resource Center will house an ever-growing body of the latest information and tools related to utilizing technology to support people living more independent lives.

Get Started

Download ARRM’s one-page summary of what’s required under the new legislation and check out the rest of the Technology Resource Center for guidance as conversations begin.