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Presenter(s)
Jason Hilkey, ATP
Assistive Technology Consultant
PATHways Therapy & Assistive Technology
P.O. BOX 325
Torrance, CA 90507
310-320-7865
Email: jason@pwtat.com
OVERVIEW
PATHways provides Assistive Technology (AT) services and Occupational Therapy (OT) services to children and families in the South Bay (southwest area) of Los Angeles, California. PATHways is a partnership business made up of an Occupational Therapist and an Assistive Technology Consultant and has existed since March 2003. Services are provided in the individual's home, school or work. Assistive Technology services provided by PATHways include evaluations, consultations and training for children and adults with difficulties performing daily tasks and/or accessing the school curriculum due to physical impairment or learning disability. Staff training and consultation are also provided for educational or professional staff.
Funding for services are provided through contracts with 15 school districts, California Regional Centers or private individuals. Over 110 clients received AT services through PATHways since August 2003.
DEVELOPMENT
The model of service delivery for PATHways Therapy & Assistive Technology was developed with the following priorities:
• provide high quality services to a community in need of services
• focus on a specific geographic area for service delivery
• enable flexibility with scheduling
When establishing the AT portion of PATHways, a needs assessment was performed. The community has the existing resources:
• an AT center in the local Department of Developmental Services (DDS) Regional Center providing consultations
• a non-profit, family centered AT center about 13 miles away
• a Speech-Language Pathologist (SLP) traveling to the area two 1/2 days each week providing Augmentative and Alternative Communication (AAC) and AT services in the schools and homes
• an established AT center operating through a hospital about 17 miles away providing AAC and AT services
The community appeared to need AT services provided on a regular basis within the school districts. The school districts have had difficulty training and retaining qualified AT services providers as employees. Some of the school districts have hired PATHways to provide AT consulting services within the school district on a bi-weekly basis. Other school districts have used PATHways services on an individual referral basis. Historically, the consulting model of services has serviced more students than the referral model and has enabled school districts to prioritize the services. However, the consulting model requires involvement of school district personnel to coordinate and schedule services. This coordination of services also reduces the overhead resources required by PATHways for each client enabling PATHways to serve students more efficiently and save the school money.
SERVICE PROVISION / MARKETING
AT and OT services through PATHways are accessed independent of each other.
The AT services provided by PATHways differ from traditional therapy service models in the high volume and turnover rate of clients. Unlike the therapy services, the AT services are provided in fewer appointments and therefore have a larger number of clients receiving services. This turn over rate requires establishing a constant flow of clients from several referral sources and receiving funding from the few available sources. To increase the ease of funding and referrals with schools, PATHways established itself as a Non-Public Agency (NPA) with the California Department of Education and negotiated Master Contracts and consulting contracts with local schools and Special Education Local Planning Areas (SELPA's). PATHways has also become vendored with the DDS Regional Center. To maintain a consistent flow of referrals, PATHways has taken the following actions:
• presented on basic AT devices to local support groups and parent groups
• provided in-service trainings to special education teams in schools, centers and a postsecondary transitional group
• met with local professional groups serving individuals with disabilities
• met with directors of key educational organizations (SELPA, special education departments, DDS Regional Centers)
• provided service information to local parent advocacy organizations
• consistently handed out business cards
• developed relationships with local AT vendors
Since word of mouth is so effective, each satisfied client is considered a potential referral source so high quality customer service is a priority.
Additionally, the quality of assessment or training report is considered a priority because these reports are "the products" produced by PATHways.
BUSINESS EXPERIENCE
When the partners established PATHways, little was known about running a business. We knew how to provide the services, but knew little about accounting, marketing, taxes, insurance, business law and many other business-related issues. One of our more costly mistakes was not involving an accountant early enough in the tax year when establishing the partnership. Books that have assisted us through the process are "Working for Yourself" by Stephen Fishman from Nolo, "Tax Savvy for Small Business"
by Frederick W. Daily from Nolo and "Hiring Independent Contractors" by Stephen Fishman also from Nolo. The digital forms in these books have been valuable and a time saver.
QUALITY OF SERVICE
PATHways attempts to maintain high quality service by ensuring services are provided by well trained AT consultants. PATHways has pursued AT independent contractors that have completed, at the minimum, a certificate course from a reputable organization and are pursuing an Assistive Technology Practitioner (ATP) credential from Rehabilitation Engineering & Assistive Technology Society of North America (RESNA). PATHways strives to stay current with technology through email listserv's including Quality Indicators of Assistive Technology (QIAT) and RESNA, attending and presenting at conferences, writing journal articles, subscribing to publications such as Closing the Gap, participating in software beta test groups and subscribing to online newsletters such as the Council for Exceptional Children (CEC) SmartBrief and ConnSENSE Letter.
EQUIPMENT
On-site assessments require proper equipment and thoughtful software selection to reduce the quantity of technology needed but provide the maximum evaluation options. Information about the client prior to the appointment has been necessary to determine the equipment to bring. PATHways uses laptops with multiple ports and a variety of adapters. A variety of keyboards and mice can be brought to assessments along with a case of switches and mounts. Typical assessment tools brought to site for the assessment include: an IntelliKeys, trackball, standard mouse, BigKeys keyboard, AlphaSmart with removable keyguard, Franklin electronic dictionaries, JellyBean switch, switch interface, Write:OutLoud, Co:Writer, WYNN, Kurzweil 3000, Inspiration, ATLAS from Laureate, Teach Me To Talk, Clicker, Dragon NaturallySpeaking, USB microphone, Thinkin' Things, MathPad, Early Learning Suite, JumpStart Typing, Marblesoft Single Switch Games and IntelliTools Classroom Suite. Additional equipment and!
software is available based on the needs for the evaluation.
When purchasing the equipment and software, PATHways frequently contacts the vendors and inquires if a discount is available for an AT consultant to purchase the technology. Some vendors have established programs; others were willing to discuss arrangements. One vendor provided software in exchange for occasional "stories from the field" for their newsletters. PATHways has not become a reseller of products to remain objective in assessments.
FUTURE
After providing AT services for a year, PATHways recognizes unmet needs in the community for AT services.
• SLPs providing AAC services are desperately needed.
+ PATHways is exploring the use of video conferencing with SLPs in adjacent areas through the use of high quality, consumer-level web cameras across the Internet
The Los Angeles area appears to have few AT service providers given the population and diversity of the area. AT centers in Los Angeles (LA) and adjacent Orange County (OC) have closed or work hard to be profitable. PATHways participates in the AT Consortium of Southern California, a group of AT services providers in the LA/OC area. PATHways hopes to develop a strong coalition of AT service providers in the Southern California region.
REFERENCES
Closing The Gap, www.closingthegap.com.
ConnSENSE Letter, www.connsensebulletin.com.
Council for Exceptional Children (CEC) SmartBrief, www.smartbrief.com/cec, www.cec.sped.org.
Daily, F. (2003). Tax savvy for small business. 7th ed. : Nolo.
Fishman, S. (2002). Working for yourself. 4th ed. : Nolo.
Fishman, S. (2003). Hiring independent contractors: the employers' legal guide. 4th ed. : Nolo.
Quality Indicators for Assistive Technology, www.qiat.org.
Rehabilitation Engineering & Assistive Technology Society of North America, www.resna.org.
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