Advocating for Technology Supports

An Interview with Lauren Ireland

Recently, we were able to sit down for an interview with Lauren Ireland to discuss technology and how it plays a role in her daily life. Lauren lives in Minneapolis, MN and her home is licensed for supportive community-based services. At 30 years old,  Lauren has had access to and has used technology all her life, though it wasn’t until she moved into her current home nearly 10 years ago that she became aware of remote monitoring technology and the benefits it provided her and other individuals with disabilities.

As an advocate for technology supports, Lauren has been featured in a recent TRC video success story  Technology Delivering Independence and Staff Efficiency,” and will be a panel member at the upcoming session going behind the video at the ARRM Annual Conference, held June 6 and 7, 2018, to discuss her feelings towards the move to technology and answer questions from the audience.

TRC: When did you start using technology supports?
Lauren: I started the [remote support technology] a couple of years ago when I moved into this home, but I have been using technology pretty much all my life.

TRC: What types of technology do you use?
Lauren: In general, I’ve used Dragon NaturallySpeaking before where it types for you on a computer. It’s a speaking software. I loved it. I wish I could, you know, find other ways to use it. I want to get a job in the community, so hopefully soon I’ll be able to use more technology like that.

TRC: When did you start using the speaking software?
Lauren: My high school had it there, so I’ve been using it since school off and on. It takes a lot of training, so it’s hard. Maybe I’m not going to be able to use it. But it will always be helpful if it came up again. I’m hoping it is something I can use. It does take quite a bit of training to get it used to your voice and things like that.

TRC: What additional technology do you use?
Lauren: I use the pendant [for remote monitoring]. I have a dog at my house and went outside with her one day and I accidentally got her leash wrapped around my wheel of my wheelchair and so she almost died. But I had the pendant on me and rang it and the assistant came to help me. And without that I wouldn’t have been able to save her.

Hear Lauren tell her and Jinger Jo’s story in the 60 second video:

My dog is like a therapy dog for everyone. Thank goodness that I had that light to press, because otherwise I don’t think she’d be alive. We did a video for ARRM and presented the video to a lot of the people and they all wanted to see the dog, they asked where she was.

Whenever anyone asks me questions about this I bring this up. It really shows me that when I was first introduced to it, I was thinking, “There’s no staff in the house 24-7”, because they rotate between the different houses. There used to be staff there and they switched to this technology and we were all a little bit nervous about how it was going to work. But it actually works quite well.

I forgot to say there are sensors at the house as well. In front of the door, or above the door, so if someone has come in your room, it tracks if the staff is actually doing what they’re supposed to.

TRC: What types of activities or tasks does the technology help you with?
Lauren: Typing on the computer. I work in Bloomington, actually, so I use the computer there. But I use [remote monitoring] when I’m at home. At night, if I need something, you press a button and it goes to this place and they call the phone at my group home and the staff will come and help me with whatever I need.

TRC: Overall have these devices been helpful to you? Do you like how they work?
Lauren: Oh yes. The [remote monitoring] pendant definitely helps. It makes me feel like if I need something I can press it. So I’m more safe, you know? Every once in a while I get nervous about “Gosh, I hope I don’t fall,” but I know if anything were to happen, I have that light there to ring.

I usually get rolled over one time a night. I don’t use [the pendant] often, unless I need something. I get rolled over and I’m pretty much good. Even though I may not use it as much as other people, it’s there.

I like the sensors because even if I don’t realize if people are coming in my room, and I don’t know if so and so checked me last night, the staff know, hey, they did. Usually I don’t question stuff like that but I know they look into those things, so that’s important.

TRC: Do you feel like using the technology has allowed you to live more independently?
Lauren: Oh yes. Definitely. I mean I only wish it would work further out into the community, you know? If you’re going to be late or whatever and you could just press it and it would automatically call someone. I wish it would do that. But obviously it can’t. If there was ever a  chance that something like that would happen, I would totally jump for that, because I’m usually gone. I’m usually not at home. So if something could do that it would be really great. I would love that.

TRC: Are you looking at adding any additional devices or technology pieces?
Lauren: Yeah. My best friend has an [Amazon] Echo at her house and she uses it for her own use and she and I love that thing. She uses it mostly for fun, but I think you can turn things on or off or get information about the world or the weather, or you know, whatever. But, you know, I’ve always thought of getting one to help with things like turn off lights and stuff, so that’s always something I thought about.

TRC: What’s holding you back from getting one?
Lauren: More information [on what it does] and the money. The money is a big deal. I’m not sure what it costs. It varies so much on what you get, and I want to make sure I’m going to be able to utilize it the most I can.  I’m hoping I can get one though, sometime here.

TRC: How was life different before moving to this location and using technology?
Lauren: When I was living at home without the [remote monitoring] technology I was asking people (my parents) if I needed something. I really wish I had had that there honestly. It would have been much calmer and nicer to have that. But also I want to encourage families if they have a person with a disability to look into getting something like this. It makes it a lot easier to sleep at night.

TRC: How has using these technologies changed the way you live your life?
Lauren: Oh my God. Well, it makes me a lot more comfortable to like be outside and go around to different places to like buy books and stuff, to visit people, you know? As long as I remember to take it with me. It’s pretty easy; I can bring it and it will alert someone to “Hey, I need help here.”

TRC: Would you recommend using technology to others?
Lauren: Definitely yes. And I wish it was more in the houses – like I had no idea that it existed. I have had a disability all my life and had no idea there was anything available like [remote monitoring].


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 or learn more about how to start the conversation.

Regaining Confidence Through Remote Support

Expert contributor: Tamara Twite, CCRI

 

Going from having caregiver support 24 hours a day to just nine hours per week seems unimaginable, right? Who is making sure the individual is safe? Who is making sure they are getting to work on time or taking their medications?

A 159 hour per week drop in caregiver hours seems dramatic. That’s because it is—but in a good way. Ryan Sebelius was able to achieve greater independence while decreasing his need for in-person support through the use of remote support technology. Though not “traditionally” supported 24 hours a day as he was before the addition of technology, he is certainly not without support during the times a caregiver isn’t physically present in his home.

The Move to Remote Supports

Living on his own was always Ryan’s goal. He chose CCRI’s Supported Living Services program in 2006 to first develop critical skills for living more independently, such as stable medication management. At the time, he received 24 hour care and received help in managing his medications to make him less “hyper”, as he would say. Once his medication was on track, his next move was to CCRI’s Independent by Design program (IBD) where he uses remote monitoring in conjunction with direct caregiver hours to provide increased independence while matching his support needs.

Ryan is very independent and does an outstanding job at the day-to-day tasks of life. Reassurance that he is doing a good job is what he needs most. Technology provided that reassurance and helped create a smooth transition to independent living.

The Technology

Remote supports consist of sensors that are placed around a home that alert staff to a need. Alerts from sensors trigger a phone call to the assigned caregiver. In IBD, there is a caregiver in a nearby office 24 hours a day, 365 days a year, to help individuals when a need arises. Caregivers respond to technology alerts, maintain the tech, and help with any other issues that come up.

At Ryan’s apartment, a front door sensor details comings and goings, and, because Ryan loves to cook (he is very proud of his pumpkin sloppy joes), a stove sensor was placed in a drawer next to the stove which notifies staff and Ryan if the temperature exceeds a certain level. On a weekly basis, Ryan, now independently, sets up his medications. In the beginning, a sensor was placed on his medication cabinet which let staff know when he was accessing his medication (by tracking when the cabinet opens and closes). With the consistency of the technology reminders, Ryan gained the independent routine to take his medications without the need for reminders.

How it works for Ryan

“Since beginning in IBD Ryan has become more outgoing and will stretch himself by trying new things—he just seems to beam.” Said Eric Hilber, SLS Director. Using remote support technology, Ryan is able to live safely in his own home—independently.

Since implementing the technology, Ryan’s in-person caregiver hours have gone from 24 hours a day to just nine hours per week. He no longer needs the sensors on his medication dispenser, he fills his automatic medication manager independently, and reorders his medications as needed. With his newfound independence, he is able to relax more, sleep in when able, and enjoys quieter mornings which he appreciates.

Technology can fulfill the desire for independence, while still maintaining the safety of the individual by instilling confidence and the assurance needed to achieve life goals. Often times following a technology implementation, it is found that certain supports are able to be removed as individuals become more confident and routines are solidified. Technology is there when needed, provides reassurance, and is easily modified as needs change.

 


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 or learn more about how to start the conversation.

From Legislative Sessions to Conference Sessions

Upcoming Conference sessions on technology at the ARRM Annual Conference

Utilizing technology to not only provide opportunities for greater independence, but to also assist with the declining workforce is not necessarily a new topic, but it is one that has made it to the top of many individuals lists due to recently passed legislation in Minnesota.

Why is the topic of technology conversations so important? How is technology impacting the lives of individuals served? How is technology assisting with the declining workforce? These questions will all be answered in upcoming sessions at the 2018 ARRM Annual Conference.

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ARRM Annual Conference: “When the Stakes Are High, Go All In!”

June 6 – 7, 2018 | Mystic Lake Casino | Prior Lake, MN

Learn how you can go “all in” for yourself, your family members, or the people you help support by checking out the following technology sessions at the 2018 ARRM Annual Conference. During these sessions, you will get an in-depth look at the stories behind the videos of recently published Technology Resource Center (TRC) video success stories. Learn how these individuals and organizations approached the conversation and planning process, how they managed change, and hear from staff and individuals on their feelings pre- and post-implementation.

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The Story Behind “Technology Delivering Independence and Staff Efficiency”

The most recently published ARRM Technology Resource Center (TRC) success story video “Technology Delivering Independence and Staff Efficiency,” showcased Dungarvin Minnesota personnel and individuals supported by the use of technology and how their transition to alternative overnight supervision impacted their lives, work, and the organization.

During this session, attendees will hear from the individuals featured in the TRC video about the initial goals related to services for individuals with complex medical needs, the impact on staffing, how they assessed success and/or need for changes, unexpected things they learned over time, and how it increased independence—from beginning conversations through today.  The session will conclude with an opportunity for audience questions to the panel.

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The Story Behind “Making a Plan to Use Technology”

Hear from a panel of individuals featured in the TRC video story “Making a Plan to Use Technology” about what their transition to technology supports looked like from beginning conversations through measuring outcomes.

The session will go over the initial goals related to services for Angie and others in CCRI’s Independent by Design program (IBD), the different technology they used, how they assessed success and/or the need for changes, unexpected things they learned over time, and what changes they made and why. The panel will be available to answer questions at the conclusion of the session.

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The Story Behind “Remote Support – It Starts with a Conversation”

Learn more about transitioning to remote support technology from a panel of Home and Community Options personnel and team members featured in the TRC video “Remote Support – It Starts with a Conversation”.

Panel members will share what technology supports they tried, how they measured success, unexpected things they learned, and what changes they made and why. There will be an opportunity for audience questions and discussion at the end of the session.

 

Learn more about the 2018 ARRM Annual Conference and Sessions

Remote Supports : 10 common questions every family should ask

Remote support technology comes in many forms. From medication dispensers that remind individuals to take their medication (and alert staff if access hasn’t occurred) to more high-tech options such as remote monitoring where external staff monitor a series of sensors and/or video  to alert internal staff to a need, options exist to help increase an individual’s privacy and independence while maintaining their needed level of care.

The first step in learning more about the remote supports that may work for you/your family member is knowing which initial questions to ask. We’ve captured the top 10 questions many family members and self-advocates have about using remote technology supports and received general answers from providers, vendors, and case managers. Keep these questions in mind when working with your team as you explore available options.

Without a physical body in the residence, how will the safety of the person be ensured?

Providers will work with the individual’s team to assess existing safety concerns, develop an appropriate monitoring and response plan, and then install the correct remote support technology to meet safety requirements as well as independence goals. The safety needs of each individual will be unique, and this planning process serves to outline the necessary staff coverage. It is important to remember that modifications may always be made to the plan to provide the best support possible for the individual receiving care.

Who determines what alerts and technology will be used? Who can change it?

The individual served and their team determines what monitoring technology will be needed to assure the individual’s needs and safety concerns are being met. Additional safeguards, such as specific alerts or tracking activity, may be set up to cover any “what if” scenarios the team may have, even if there isn’t a foreseen vulnerability or risk. At any time, the individual and team may make modifications to the technology in use. In fact, changes are common to either better account for things not originally considered or to decrease the level of alerts which the team may not find as necessary/useful as originally thought.

How does remote support technology increase independence?

Remote support technology allows a person to function throughout their day without staff having to be constantly present providing direction or reminders. For example, increased independence may be found by staff only entering the residence when the individual needs them vs having a staff member check in every thirty minutes to see if there is a need. In lieu of a staff member administering medication, a medication dispenser may be used to alert an individual to take their medication and signal staff when the day’s medication container has been opened (or has yet to be opened). Many individuals enjoy, and thrive, with the increased privacy and independence the technology offers them.

What happens if there is a power outage?

Prior to implementing the technology, providers walk team members through their response plans for emergency situations. Most remote support technology has a battery back-up, both for the systems installed at the home and at the remote site. In the event the system goes out completely, additional back-up plans would be put into action.These redundancies ensure individuals are not without assistance if needed, regardless of power supply.

What happens if there is a problem with the equipment?

During implementation, this would be a conversation to discuss with the team and provider. Many, if not all monitoring agencies will have a process available to notify of any issues with the functioning of the system or loss of contact. Back-up plans would be put in place to address what will happen when these instances take place. Also Identified and discussed in that plan would include items such as what to do when the system is down and the process and responsible parties for replacing components.

When should changes be made to the plan using technology?

The plan for using monitoring technology will be continuously evaluated to assess its effectiveness in supporting the person’s needs. Monitoring technology should change when the individual’s needs or goals change.

What about staff training regarding the use of technology?

The vendor will assure that staff, and all individuals involved, are educated on the equipment installed in the residence and how it works. The provider will be responsible for ongoing training on changes in alerts as the individuals needs change and address performance issues if staff aren’t meeting the needs of the individual as indicated by the data provided.

What happens when I/my family member needs assistance, but there is not staff in the home/apartment?

If an individual is in need of assistance when staff is not present in the residence, staff may be alerted in one of two ways. If a sensor has been tripped, staff will be notified according to the response plan. If staff isn’t present, but an individual needs/wants assistance outside of what their sensors are programmed for, they may “call” staff using the method chosen in their technology plan, such as by pushing a button, using a voice activated phone, or initiating a video call. Each alert has a “calling tree” that can include several phone numbers. The phone numbers and the order in which the system calls the numbers is able to be changed at any time.

I am curious about the use of the sensors and the data that is collected. Am I able to receive the data as well?

Yes. At any time, members of the team are able to request a data summary from their provider for the sensors in the residence.

What is the response time of the office staff?

As a part of the alternative adult foster care licensing process, your caregiver must develop and provide you with policies, procedures, and response protocols.  You must give your consent before use of technology is implemented. The statute requires that a caregiver respond within 10 minutes unless certain other provisions are met and approved by the Department of Human Services, Division of Licensing.  The alternative adult foster care license allows for a longer response if you consent to it, if the caregiver assures that certain conditions are met including the provision where the remote care provider can maintain interactive communications with you to assure you are safe and your needs are met.

If you live in your own home or another licensed or non-licensed home, you should ask your caregiver for the same procedures and protocols to ensure you are comfortable with the level of risk present with whatever response time is decided upon.


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 or learn more about how to start the conversation.

Creating a strong base

Scott Wiyninger, SUCCESS Computer Consulting, Inc.

Investing in technology infrastructure for data security and independence

About seven years ago, The Phoenix Residence made the decision to invest heavily in new technology when they transitioned from paper records to electronic processing for items like medication, payroll, and scheduling.

Their new technology investments not only freed up resources to assist in handling some workforce issues that are common in the disability services industry, but also had the added benefit of allowing their residents to utilize assistive technology devices powered through Wi-Fi to increase independence.

Securing the data

In moving from paper to electronic medical records, The Phoenix Residence knew certain precautions would need to be put in place to protect individuals’ privacy. “Certainly, our exposure has increased, because we’re now doing so much of our work through an electronic mechanism,” noted Alan Berner, VP of Community Services.  

For facilities that process electronic medical records, certain measures need to be accounted for to ensure only the proper people have access to this sensitive data. How is this done? For The Phoenix Residence, they beefed up their data security infrastructure to ensure the proper level of security. They worked with our team to deploy firewalls throughout their 19 Minneapolis care facilities that were further reinforced by an additional layer of security services that stop malicious software (Malware) from gaining access to their system.

Adding access

As with most organizations, a stable and strong Wi-Fi network was very important to The Phoenix Residence as their staff utilize mobile devices for documenting care needs and medications. To help with this, additional Wi-Fi access points were installed to ensure a strong signal. These additional access points also allowed The Phoenix Residence to provide more extensive wireless coverage for the people they support—opening the door for greater independence through technology use.

“With the wireless access points, though we added them for business operations, there was a side benefit of being able to provide more extensive wireless coverage for the people we support where there wasn’t before – there’s a huge space for growth in this. For example, one person uses Alexa (Amazon’s digital assistant) for quality of life purposes. She controls her lights with it and even has it read her stories. Without being able to use that device, she could not do those things independently. We’ve been discussing integrating more of these devices in other areas of the residence so that when she’s not in her room, she can still have those functions, and some of the other people in the home would be able to utilize them as well,” said Alan.

Read the full case study prepared by SUCCESS Computer Software for full technology details.

SUCCESS provides managed network support, cloud services, project services, security solutions, CIO services, HIPAA consulting and Microsoft Office 365 migrations. We work with business leaders to ensure technology delivers the best value and is utilized in the most effective way for the success of their business today and in the future.

As a full-service provider of managed IT services, we are a part of your team, using technology as a tool to solve your business challenges, and integrating with your business as if we were a full-time employee. It is our purpose to revitalize the promise of technology — to empower businesses with the best and most appropriate technical infrastructure that enables them to succeed. 

 

Has your organization gone through a similar transition? If so, how has technology changed your daily processes or access to additional technology assistance for residents? Let us know about your tech experiences

ARRM Technology Initiative – Progress Report

The ARRM Technology Initiative began in 2016 with the intention of seriously moving the needle on the adoption of supportive technologies for people with disabilities. This effort had the dual purpose of promoting greater independence and better managing increasingly limited human and financial resources. In 2017, we made great strides to further our objective by launching the ARRM Technology Resource Center.

The ARRM TRC was created to serve as a one-stop resource where providers, families, people with disabilities, and case managers could come together to find new and curated tools and information that answer key questions and concerns. During this initial year launch, we’ve published several success stories, formal case studies, educational resources and articles, as well as a structured process to help people get from starting a conversation to measuring results. We’ve found great engagement in the community and are excited about our results so far.

Both to ensure this work had a defined purpose, and as part of ARRM’s commitment to being a leader in the progress of community-based services for people with disabilities, measurable goals were outlined for the initiative. More concretely, we sought to year-over-year increase in technology usage by ARRM members & year-over-year reduction of on-site staff time in key direct areas, such as overnight sleep staff (or said another way – to increase the service billing to DHS of remote monitoring and assistive technologies).

We’ve outlined our key findings on the adoption of technology as reported through DHS:

What surprised us…

 

In addition to 54% of corporate foster care recipients receiving sleep staff hours and that the minimum number of DSP FTEs in 2016 is over 2000;

  • While remote monitoring shared and individuals hours in corporate foster care increased by 69,316 from 2015 to 2016, the number of sleep hours increased by 272,608
  • The percent of people in corporate foster care with remote monitoring hours decreased slightly (1.91% to 1.84%), while the percent with sleep hours stayed the same at 54%.

— Sandy Henry, Technology Advocate and former community residential services provider

 

I think for me the most interesting thing is the lack of change from 2015 to 2016 (Remote Monitoring (RM) in DWRS. It is possible that the growth from 15-16 was still in its infancy and 2017 showed more substantial growth, however, I would have still expected the number of people using RM to go up (and technically the number went down. Three more people total were using RM, however the % of total recipients went down in addition to total hours).

— Dan Millan, Remote Monitoring Systems Analyst- Home and Community Options

 

The number of RM Family hours from 2015 to 2016 was reduced by more than 50% while Corporate hours went up YoY by nearly 30%.

— Tim Janssen, Operations Director – Sengistix, LLC

What does this mean for our industry

The number of people using RM align with my expectations that it is not widely utilized in MN. There is a big opportunity to further review who may benefit from RM supports, especially given the number of asleep hours being utilized.

— Tim Janssen, Operations Director – Sengistix, LLC

 

This only emphasizes the fact that we know we have technology that can help support people, and we have people that would benefit from technology support yet there is some barrier preventing the people from gaining access to the technology.

— Dan Millan, Remote Monitoring Systems Analyst- Home and Community Options

 

These numbers tell me that from 2016 we have a lot of education to do and opportunities to free up a substantial number of DSP hours currently consumed in sleep time.

— Sandy Henry, Technology Advocate and former community residential services provider

What’s next?

We are proud and excited by the results achieved so far, but we’ve only just begun. There is much work to be done to close the knowledge gaps and remove barriers to technology implementation. From the outset, the ARRM Technology Initiative was created to foster a community of individuals and organizations in order to increase independence for individuals with disabilities, extend caregivers reach, and improve tools to deliver better person-centered support.

 

There are several ways to get involved:

Many thanks to all the organizations and individuals that have been apart of this journey—to those that have been there since the beginning and the others that have joined along the way. We look forward to forming new partnerships and reaching our goals together in the year to come.

 

Thanks,

ARRM Technology Initiative

A Trip to PACER’s Simon Technology Center

Tablets and keyboards and toys, oh my!

 

For people looking for assistive technology resources to help them, or those they care for, live more independently, Pacer Simon Technology Center (STC)  is one great place to start.

The STC houses 2,000+ pieces of low to high tech items for people of all ages and disabilities and provides individuals, families, and organizations service options including free technology consultations, hands-on training, and in-services or workshops. This allows individuals to experiment with devices/resources to get a feel for which options might be best for them, and families and professionals the option to see what might benefit those they care for.

Devices can be expensive, trying out several to see what works is not always feasible—that’s where the STC and their staff members come in.

How it works

Consultations

To set up a consultation, free to those living in Minnesota, a consultation application is filled out and a meeting date is set. There is a $50 refundable deposit that will be held and returned to individuals at their appointment to discourage no-shows.

For the consultation, individuals are paired with a staff member whose knowledge and background best matches their needs. The individual’s new guide will walk them through options they believe could benefit them/their family member based on responses in the application and give a demonstration on each. Individuals are then given the opportunity to try the items themselves.

Lending Library

If you are interested in becoming a member of the STC Lending Library, you can decide which devices/resources make the most sense to borrow. Members may check-out items for 30 days, including apps that may be sent directly to individual devices. This “trial period” allows individuals and organizations time to utilize the resource in all aspects of a person’s daily life (school, work, or home) and have time to make an informed decision before making a purchase.

Trainings and Workshops

For organizations looking to expand their knowledge on current available technology, the STC offers free workshops and for fee customized in-service trainings to help navigate options and explore solutions.

The Resources

There are a number of awesome “gadgets” located in the STC such as modified keyboards, tablets, and text-to-speech technology. One piece of technology opens up a world of options for assistive technology devices—a 3D printer. The printer can print items like pencil grips, playing card holders, raised book pages, braille cards, customized wheelchair joysticks, and even prosthetic hands! With the right instructions, this machine can be used to create an unimaginable array of assistive devices.

A backroom in the STC housed several “toy” cars—some propped up like you might find in an auto shop. And, just like at an auto shop, these special vehicles were being fixed-up and modified for their owners.

There was a bright pink off-roading giant and a green jeep just waiting to be customized. Parents are able to purchase vehicles for their children and bring them in to the STC to have them modified by a staff member to fit their needs—for free. Modifications may include creating higher seat backs, adjusting seats, moving the controls from foot pedals to buttons that hands can reach, etc. And, because children will be children, all cars are equipped with a “kill” switch that parents can use if their child gets a little too adventurous.

With the customization help of the staff at STC, a child with Spina Bifida is now able to cruise around her yard independently—go when she wants to go and stop when she wants to stop.  This is just one example of how easy it is to customize readily available technology to increase independence for people with disabilities (young and old).

Check out the PACER’s Simon Technology Center website to learn more about the Pacer STC and their array of services.

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:

Cost/Savings

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