job market” (AFB, 2001, unpaged). In yet another arena, the National Council on Disability has observed that it means little to recommend that the role of assistive technologies be considered more fully in the development of individual education plans (under the Individuals with Disabilities Education Act) if no member of the team developing such plans “is familiar with the range of [technologies] available to address desired goals (NCD, 2000b, unpaged).

Some consumers find information through state programs that have been funded under the Assistive Technology Act to aid consumers in learning about and acquiring technologies. For example, in a report on state activities funded under the Assistive Technology Act, RESNA (2003) found that the 34 states that provided data reported that they supported or operated 109 assistive technology demonstration centers. States also reported providing information to consumers through the Internet, e-mail, regular telephone and text telephone, and regular mail.

Particularly for the more expensive assistive technologies, a lack of financial resources can be a significant barrier to the acquisition of an effective, recommended technology. According to the University of Michigan survey of people with disabilities, the percentage of respondents for whom assistive technologies were paid for through public or private insurance (38 percent) was about equal to those for whom their equipment was paid for personally or through family members (37 percent) (Carlson and Ehrlich, 2005). Six percent received their equipment at no cost to themselves. People with low incomes were far more likely than people with higher incomes to report unmet needs for technology.

About 23 percent of the survey respondents sought help from an agency in selecting or purchasing equipment, and about 19 percent reported receiving help from an agency (Carlson and Ehrlich, 2005). Most people believed that they did not need agency help, but some said that they did not know an agency to contact. This again suggests the need for a more intensive public awareness effort.

As discussed further in Chapter 9, Medicare and private insurance coverage of assistive technologies is limited and often complex. Medicaid programs, for those who qualify, tend to cover a wider range of assistive technologies. This coverage is sometimes provided under waiver programs that do not extend to all parts of a state or to all categories of Medicaid recipients. The rules are often complex for consumers, family members, and even professionals.

One option for improving access to assistive technologies is through innovative practices in leasing or rental arrangements. One example is a leas-