I'm currently researching this subject, and came across a couple of recent reports on why PWD have difficulty obtaining the tech they need:
According to a 2017 report by the National Academies of Sciences sponsored by the Social Security Administration
http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=24740 "There is often a mismatch between products covered by Medicare and those that would best meet the needs of the users. The report goes on to state that the provision of assistive devices often depends more on reimbursement policy than on patient need. In some cases, the products and devices deemed medically necessary, and thus covered by Medicare and other insurers, are not those that would best meet the needs of users in terms of enhancing their participation in life roles."
When learning about an individual's assistive technology needs, the first question should be whether that person has easy access to a phone or equivalent communication device. In February 2019, the FCC released a report on the accessibility of smart phones and non-smart phones for people with disabilities.
http://www.wirelessrerc.gatech.edu/wireless-rerc-publishes-mobile-phone-accessibility-review While smartphones offered through traditional wireless plans are including an increasing number of accessibility features, phones provided to low-income people through the Federally-subsidized Lifeline program offer far fewer accessibility options. Since PWD are more likely to be low-income, they are likely to be a significant percentage of those relying on the Lifeline program. According to the study, only 17% of the Lifeline phones provide access to Wireless Emergency Alert Notifications, and only 26% of the Lifeline phone include text-to-speech, an accessibility tool which allows visually impaired people to hear what appears on the phone's screen. In addition, accessibility features for people who are deaf or hard of hearing are even more scarce: 58% of Lifeline phones lack the video calling features necessary for ASL users, and most phones lack hearing aid compatibility.
Accessibility to communications technology is covered under the 21st Century Communications and Video Accessibility Act of 2010 (CVAA).
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