National Council on Independent Living
Best Practices for Consumer Involvement in Assistive Technology Programs
Assistive Technology Survey - 2002

Background Information:

ASSIST! to Independence is a community based non-profit agency that was established by and for people with disabilities and chronic health conditions to help fill some of the gaps in service delivery. The agency serves as a consumer driven community action program to facilitate general awareness of disability related issues, community access, education, information sharing, assistive technology access, advocacy, and independent living that is relevant and culturally appropriate for American Indians. This is done through a comprehensive collaborative network which provides support and resources that promote the active participation of each individual in their self-care management. Program staff work to provide the tools necessary for individuals to make informed choices and decisions; to maintain a maximum level of independent living; to achieve equality of opportunity, inclusion and integration in the community and society; and for economic and social self-sufficiency. ASSIST! currently serves as the umbrella organization for five major programs:

The Center for Independent Living
The Regional Resource Center for Assistive Technology
The Special Needs Toy Lending Library
The Functional Assessment Clinic
The Sensory Integration Program

We are located in the western part of the Navajo Reservation in Tuba City, Arizona. Our program provides services primarily to Navajo, Hopi, and Southern Paiute Reservations, however, anyone needing information or assistance in the northern part of the state is welcome to request services or information. The mission of ASSIST! to Independence is to provide culturally relevant services to a cross disability American Indian consumer population. Each of our programs emphasize a common goal of enhancing quality of life and community access through maximizing independence and improving functional skills. These services are provided in an environment that promotes active consumer and family participation in self-determination and equal opportunities.

Best Practices Model:

In 1997, ASSIST! to Independence received a $150,000 grant from the Navajo Nation, and a grant of approximately $40,000 from the Arizona Technology Access Program, for the development of an assistive technology demonstration and loan center. At that time we were sharing a small trailer space with the Tuba City Family Wellness Center, which housed several other non-profit agencies. In 1998, we received a 3 year grant totaling $450,000 from the Navajo Nation to develop a Center for Independent Living, and a 5 year award from the Arizona Technology Access Program for the expansion of the A.T. Demonstration Center into a Regional Resource Center for Assistive Technology. The A.T. award was for $45,000 for three years, with a decrease of $10,000 each year for the last two years. A new facility was purchased, which houses both the CIL and the A.T. Resource Center. Since this was a brand new facility, we were able to design it pretty much to our specifications, so it is completely accessible (automatic door opener, all doors are 36" wide, accessible bathroom). In order to accommodate people with multiple chemical sensitivities, we installed commercial tile throughout the facility so there is no carpet. We also have a fully accessible kitchen for skills training, with cabinets designed specifically for wheelchair access.

Having the Regional Resource Center for Assistive Technology in the same facility as the Center for Independent Living has proven to be an invaluable asset. It has helped tremendously with education of consumers and providers in the world of possibilities that is available to them, and the impact assistive technology can have in improving or maintaining function and independence. Since we are a Native owned and operated program located on the Reservation, many of our CIL referrals come from the Indian Health Service medical facilities, physicians, public health nurses, community health representatives, social services, etc. Typically, we will go out and do a home visit, and usually during the course of the visit it is determined that the individual would benefit from some type of assistive technology or environmental intervention. We will then make a referral to the A.T. Center, and the CIL staff will provide follow-up services. For example, CIL staff were working with an individual who is a C-4/5 quadriplegic, to get adequate accessible housing and benefits which would pay for attendant care. She was staying in bed all day, because she had a standard, hospital type wheelchair. Once in the chair she was not able to self-propel at all so she would be stuck in one place all day. CIL staff made a referral to the AT Center for a power wheelchair assessment through Functional Clinic, and both programs are advocating for the purchase of the chair through the Tribal case manager. Another example involves an individual with Cerebral Palsy who uses a manual wheelchair and was getting ready to graduate from high school. He was concerned that he would not be able to move fast enough up the ramp to the stage to receive his diploma, and did not want to be pushed. The IL services coordinator was able to provide the student and the school with the loan of a power wheelchair from the AT Center, which would allow the student to be independent in his mobility, and receive his diploma unassisted. The wonderful thing about the close connection and collaborative effort of these two programs, is that assistive technology is infused into all aspects of the Independent Living Center services and activities. Having them housed together dramatically improves the service delivery time for the consumer. This is extremely important for us, given the huge geographic area and remoteness of most of the individuals we serve, the majority of which do not have a phone or transportation.

The Tech Act project in Arizona, when awarding funds for the Regional Resource Centers, showed great foresight and innovation in funding a project on the Reservation. Our program is the only Assistive Technology Center and Center for Independent Living Center that is Native owned and operated, and located on Tribal Lands. This has allowed services to be inclusive of historically under served and under represented populations - American Indians - who face greater barriers to services than other minorities. Because of our close collaborative efforts with Indian Health Service, we are able to serve a large cross-disability population across the life span. Both the Navajo Nation and the Hopi Tribe have excellent early intervention programs, so we usually don’t receive referrals for very young individuals until they have aged out of this program. Demographic information for contacts from January of 1999 to March of 2002 reveal the following:

In order to ensure that multi-cultural, rural, low-income, under represented populations are represented and have a voice, the Tech Act project recruits individual consumers from across the state to serve on their Advisory Board. Our Executive Director for the CIL served on the Advisory Board for approximately four years, representing the American Indian population in Arizona (AZ has 23 federally recognized Tribes). The Tech Act Project also involved the CILS across the state by training two individuals from each CIL as credit counselors for the Arizona Loans for Assistive Technology Program.

Having the state Tech Act funded A.T. Resource Center has also given us easy access to assistive technology expertise that would otherwise have been difficult to find here on the Reservation. The program manager for A.T. Center, who is the Director of Rehab Technology Services, has part of her time devoted to and paid for by the CIL. She is a RESNA certified Assistive Technology Practitioner and a certified Environmental Access Contractor. She is able to go with us on home visits to provide assistance and expertise when an environmental intervention or home modification is recommended. Having this service readily available has also allowed us to dramatically improve the chances that an individual who qualifies for these type of services will receive them in a timely manner. The state funded program which pays for these types of modifications, requires a professional evaluation and recommendation before the project is approved. They also require that the work be performed by a state licensed contractor. In Reservation areas, it is almost impossible to find either one of these services. We have been successful in advocating on the Navajo Nation for a policy with the state program that would allow an individual who does not have a state license to perform the work with a signed waiver from the President.

ASSIST! is also a member of the Navajo Nation Assistive Technology Consortium (Navajo-ABLE), which supports the coordinated operation and expansion of assistive technology loan banks and services for Navajo families and children. This year the Consortium sponsored the first assistive technology conference ever held on the Reservation, REZ-TECH 2002, which was attended by over 150 people. ASSIST! is one of four A.T. Resources funded by the state Tech Act Project across the state, and we participate in quarterly meetings with the other three resource meetings, as well as the Advisory Board meetings.

We feel we have been successful because of the partnerships we have cultivated with other providers, and creativity in cost sharing on many projects. Our Board of Directors represent communities across the Navajo Nation and Hopi Reservation. Each one is an individual with a disability, or a parent of a child with a disability, and is an assistive technology user. This gives us a unique perspective into providing appropriate services that are culturally relevant and useful to our community members. We actually had someone call and complain because we only provide services to people with disabilities!

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